- Email: [email protected]
NEWCASTLE-UPON-TYNE INFIRMARY.
The age of a third child, nineteen months; the lobes of
linen dipped in cold water, and pretty tightly strapped around the arm. A bandage is then applied to keep them in position, and the whole confined in two stout leather splints, which are bent at an obtuse angle, and quite encase the arm. This These few cases seem to indicate that there is no certain treatment has been made use of now for the last six weeks; correspondence between the ages of children and the size of the arm has steadily improved under it, and he is now able to the thymus gland. The author had just examined the bodies raise a light weight to his head. He has been taking a glass of twin children dying within six days of each other with of wine daily for the last six weeks, and his general health is good. symptoms of inflammation of the lungs; ages respectively, ten very Jan. 15th, 1856.-The arm is now in pretty much the same and eleven weeks. The thyroid and thymus glands in the ’ not having larger and elder child weighed three drachms; the thyroid and condition as when the last observations were made, could have thymus glands in the smaller and younger child weighed two made so much progress during the last month as been wished. The patient has taken cod-liver oil for the last six drachms and a half. months, with the best effects. When he came in he had every appearance of being a weak scrofulous boy, whereas now he is quite robust and healthy-looking; he can now flex the forearm upon the humerus to a slight extent; he carries articles of light weight about the ward with the arm with the greatest ease, and there is every prospect of its being a useful limb to NEWCASTLE-UPON-TYNE INFIRMARY. him in after life, which from his being an orphan is of vital imCASE OF EXCISION OF THE ELBOW-JOINT, PERFORMED BY MR. portance to him. The elbow is at present still dressed with the linen straps. HEATH, M. B., &c., Surgeon to the Infirmary. Feb. 6th.-Since the last report the elbow has been going on (Reported by J. T. MILBURN.) very favourably. The fistulous opening which communicated GEORGE R-, a boy aged eleven, was admitted on the with the ulna is quite healed up; and as Mr. Heath thinks a 10th of May, 1855, from the workhouse, where he was born change of air will do him good, he is to leave the hospital and has resided all his life. He is an orphan. He has had scrofulous disease of the right elbow-joint for upwards of a year, and he fell down a day or two ago and hurt his bad elbow, which caused it to swell and ulcerate a good deal. The elbow is at present much enlarged, there is a sore over the outer condyle, and ulceration over the inner one, extending an inch and a half above the joint, in which there is very little motion. About three inches below the joint there is a fistulous opening, Lettsomian Lecturers on the Physiological Constitution, Diseases, and Pructures of Bones. By JOHN BISHOP, F.R.S., Fellow through which a probe can be passed down to the ulna, which s carious. The surrounding integuments are much discoloured. and Member of the Council of the Royal College of Surgeons A probe can be passed quite into the joint, which seems to be of England. Svo, pp. ’0. London: Samuel Highley. totally disorganized. To have a little castor oil in the morning, A DEBT of gratitude is due to those eminent men who have and to have a bread poultice applied to the elbow. in former times founded courses of lectures in our Colleges and May llth.-To take plenty of milk. 14th.—Notwithstanding its being a very unfavourable case, Societies, which, unlike the elementary courses delivered to on account of the caries in the ulna below the joint, which students, are intended to convey to the more advanced memcould not be removed, Mr. Heath determined to make an bers of the profession the most recent and important discoveries attempt to save the limb by performing the operation for in one or other of the departments of science, or to advance the excision of the elbow-joint. 15th.-The boy having been put under the influence of original views of the author. By this means, indeed, the dischloroform, Mr. Heath made an incision from about two inches covery of the circulation of the blood was promulgated by above the elbow-joint to a little below it, and another incision Hunter in his prelections at the College of Physicians long before at right angles to the first, forming together the letter T. The the publication of his treatise, " De Motu Cordis;" and by the flaps being carefully dissected back and the joint opened, the ends of the humerus and ulna were found to be greatly ulcerated professorships of the College of Surgeons the profession is anand softened. The radius was unaffected. The articular sur- nually made acquainted with some of the most recent discofaces of the humerus and ulna, with the olecranon process of veries in surgery, comparative anatomy, and histology. the latter, were removed, a few sutures put in, and the lad For this reason we ivelcome the appearance of the Lettsomian sent to bed. and we shall now enter on a brief notice of those on Lectures, 16th.—The lad looks very well; no feverishness; bowels delivered last year before the Medical Society of LonSurgery, open. 19th.-The arm was opened out to-day, and looked as well don by Mr. Bishop. The lectures are three in number-the as could be expected. To be dressed with warm water, and a first comprising an examination of the physical properties of bandage cut into lengths of about nine inches each, so as to bones, their elasticity, strength, and flexibility in relation obviate the necessity of moving the arm when it is dressed. to their inorganic and organic constituents, rickets, mollities 25th.-Since the operation the lad has been doing very well, without any symptoms worthy of remark. There is a slight ossium, caries, and psoas abscess; the second comprises the discharge from the wounds, which are granulating. Ordered, organic changes, producing necrosis and the formation of new bismuth and carbonate of iron with sugar, of each a quarter of bone, the necessity for the removal of dead portions, exostosis, a grain, twice a day. soft tumours of bone, and the difficulty of their diagnosis; the June 4th.-Very little discharge, and swelling much dimi- third lecture is devoted to fractures and their reparation, fracnished. To continue water dressing, with a leather splint to be tures of difficult and of difficult diagnosis. Such being reunion of the surface elbow. Continue medicine. applied to the under 24th.-Doing extremely well. The arm to be put in a larger the subjects, it is our intention to touch lightly, as our brief and more bent leather splint. Continue the medicine. space will alone permit, on a few of the more interestingpoints Aug. 14th.—Doing well. He can raise his arm a little with- presented for our consideration. out help. About a month ago, he was ordered to take a tableThe author has long devoted great attention to the relation spoonful of cod-liver oil with syrup of iodide of iron, which which subsists between the physical properties of bones and their he has done; but as the syrup purges him, he is to omit it. Ordered, carbonate of iron with sugar, a quarter of a grain; chemical constituents, and he has proved by well-directed ex. periments that, while the elasticity and strength of bone desulphate of quina, two grains. Dec. 5th.-The wound of the long incision is now nearly pend on the inorganic, the flexibility and cohesion are conhealed, and the transverse one is healing gradually, and has a ferred by the organic constituents, and that an intimate very healthy appearance. The original sore over the internal relation exists between their physical properties and their condyle is about the size of a sixpence, and is quite healthy, normal composition. as is also the original sore on the forearm, which is much dimiIf the inorganic matter be deficient, as is very often the case nished in size, and the whole of them are secreting a small quantity of laudable pus. The sores are dressed with strips of in the first few years of life, the flexibility of the bone is inchest.
gland reduced in thickness to the size of two ordinary quills; cause of death, hooping-cough with pneumonia ; this child was very greatly emaciated.
Provincial Hospital Reports.
I shortly.
Reviews and Notices of Books.
318
linen dipped in cold water, and pretty tightly strapped around the arm. A bandage is then applied to keep them in position, and the whole confined in two stout leather splints, which are bent at an obtuse angle, and quite encase the arm. This These few cases seem to indicate that there is no certain treatment has been made use of now for the last six weeks; correspondence between the ages of children and the size of the arm has steadily improved under it, and he is now able to the thymus gland. The author had just examined the bodies raise a light weight to his head. He has been taking a glass of twin children dying within six days of each other with of wine daily for the last six weeks, and his general health is good. symptoms of inflammation of the lungs; ages respectively, ten very Jan. 15th, 1856.-The arm is now in pretty much the same and eleven weeks. The thyroid and thymus glands in the ’ not having larger and elder child weighed three drachms; the thyroid and condition as when the last observations were made, could have thymus glands in the smaller and younger child weighed two made so much progress during the last month as been wished. The patient has taken cod-liver oil for the last six drachms and a half. months, with the best effects. When he came in he had every appearance of being a weak scrofulous boy, whereas now he is quite robust and healthy-looking; he can now flex the forearm upon the humerus to a slight extent; he carries articles of light weight about the ward with the arm with the greatest ease, and there is every prospect of its being a useful limb to NEWCASTLE-UPON-TYNE INFIRMARY. him in after life, which from his being an orphan is of vital imCASE OF EXCISION OF THE ELBOW-JOINT, PERFORMED BY MR. portance to him. The elbow is at present still dressed with the linen straps. HEATH, M. B., &c., Surgeon to the Infirmary. Feb. 6th.-Since the last report the elbow has been going on (Reported by J. T. MILBURN.) very favourably. The fistulous opening which communicated GEORGE R-, a boy aged eleven, was admitted on the with the ulna is quite healed up; and as Mr. Heath thinks a 10th of May, 1855, from the workhouse, where he was born change of air will do him good, he is to leave the hospital and has resided all his life. He is an orphan. He has had scrofulous disease of the right elbow-joint for upwards of a year, and he fell down a day or two ago and hurt his bad elbow, which caused it to swell and ulcerate a good deal. The elbow is at present much enlarged, there is a sore over the outer condyle, and ulceration over the inner one, extending an inch and a half above the joint, in which there is very little motion. About three inches below the joint there is a fistulous opening, Lettsomian Lecturers on the Physiological Constitution, Diseases, and Pructures of Bones. By JOHN BISHOP, F.R.S., Fellow through which a probe can be passed down to the ulna, which s carious. The surrounding integuments are much discoloured. and Member of the Council of the Royal College of Surgeons A probe can be passed quite into the joint, which seems to be of England. Svo, pp. ’0. London: Samuel Highley. totally disorganized. To have a little castor oil in the morning, A DEBT of gratitude is due to those eminent men who have and to have a bread poultice applied to the elbow. in former times founded courses of lectures in our Colleges and May llth.-To take plenty of milk. 14th.—Notwithstanding its being a very unfavourable case, Societies, which, unlike the elementary courses delivered to on account of the caries in the ulna below the joint, which students, are intended to convey to the more advanced memcould not be removed, Mr. Heath determined to make an bers of the profession the most recent and important discoveries attempt to save the limb by performing the operation for in one or other of the departments of science, or to advance the excision of the elbow-joint. 15th.-The boy having been put under the influence of original views of the author. By this means, indeed, the dischloroform, Mr. Heath made an incision from about two inches covery of the circulation of the blood was promulgated by above the elbow-joint to a little below it, and another incision Hunter in his prelections at the College of Physicians long before at right angles to the first, forming together the letter T. The the publication of his treatise, " De Motu Cordis;" and by the flaps being carefully dissected back and the joint opened, the ends of the humerus and ulna were found to be greatly ulcerated professorships of the College of Surgeons the profession is anand softened. The radius was unaffected. The articular sur- nually made acquainted with some of the most recent discofaces of the humerus and ulna, with the olecranon process of veries in surgery, comparative anatomy, and histology. the latter, were removed, a few sutures put in, and the lad For this reason we ivelcome the appearance of the Lettsomian sent to bed. and we shall now enter on a brief notice of those on Lectures, 16th.—The lad looks very well; no feverishness; bowels delivered last year before the Medical Society of LonSurgery, open. 19th.-The arm was opened out to-day, and looked as well don by Mr. Bishop. The lectures are three in number-the as could be expected. To be dressed with warm water, and a first comprising an examination of the physical properties of bandage cut into lengths of about nine inches each, so as to bones, their elasticity, strength, and flexibility in relation obviate the necessity of moving the arm when it is dressed. to their inorganic and organic constituents, rickets, mollities 25th.-Since the operation the lad has been doing very well, without any symptoms worthy of remark. There is a slight ossium, caries, and psoas abscess; the second comprises the discharge from the wounds, which are granulating. Ordered, organic changes, producing necrosis and the formation of new bismuth and carbonate of iron with sugar, of each a quarter of bone, the necessity for the removal of dead portions, exostosis, a grain, twice a day. soft tumours of bone, and the difficulty of their diagnosis; the June 4th.-Very little discharge, and swelling much dimi- third lecture is devoted to fractures and their reparation, fracnished. To continue water dressing, with a leather splint to be tures of difficult and of difficult diagnosis. Such being reunion of the surface elbow. Continue medicine. applied to the under 24th.-Doing extremely well. The arm to be put in a larger the subjects, it is our intention to touch lightly, as our brief and more bent leather splint. Continue the medicine. space will alone permit, on a few of the more interestingpoints Aug. 14th.—Doing well. He can raise his arm a little with- presented for our consideration. out help. About a month ago, he was ordered to take a tableThe author has long devoted great attention to the relation spoonful of cod-liver oil with syrup of iodide of iron, which which subsists between the physical properties of bones and their he has done; but as the syrup purges him, he is to omit it. Ordered, carbonate of iron with sugar, a quarter of a grain; chemical constituents, and he has proved by well-directed ex. periments that, while the elasticity and strength of bone desulphate of quina, two grains. Dec. 5th.-The wound of the long incision is now nearly pend on the inorganic, the flexibility and cohesion are conhealed, and the transverse one is healing gradually, and has a ferred by the organic constituents, and that an intimate very healthy appearance. The original sore over the internal relation exists between their physical properties and their condyle is about the size of a sixpence, and is quite healthy, normal composition. as is also the original sore on the forearm, which is much dimiIf the inorganic matter be deficient, as is very often the case nished in size, and the whole of them are secreting a small quantity of laudable pus. The sores are dressed with strips of in the first few years of life, the flexibility of the bone is inchest.
gland reduced in thickness to the size of two ordinary quills; cause of death, hooping-cough with pneumonia ; this child was very greatly emaciated.
Provincial Hospital Reports.
I shortly.
Reviews and Notices of Books.
318