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TREATMENT OF INVERSION OF THE TOE-NAIL.
medium of butter, and a strong turpentine enema to be injected. In the evening, the right side of his body was completely paralysed, and there was no improvement whatever. For three days this state of things continued, the same treat-
being resorted to. I was now convinced that unless something further was quickly done he would sink, and that, ment
from the symptoms of the case, it was compression from extravasation. Bearing in mind Mr. Hilton’s opinions on these cases, on the 22nd I trephined over the site of the middle meningeal artery on the left side. On removing the bone, to my great pleasure I found a large clot of blood between the bone and dura mater. This I removed, and in two hours afterwards the man had recovered his consciousness, and could speak distinctly and rationally; the paralysis also entirely disappeared. He went on well for the next four days, and on our arrival at Malta I sent him to the hospital these, as it would be some time before he would be able to attend to his duties. At the expiration of a month the wound had nearly healed, and he had nothing whatever to complain of; I therefore ordered him on board to resume his duties. In a couple of weeks the wound had entirely healed, and he went on performing his duties till our arrival in England in July, when he was discharged, perfectly well. Remrks. -This case is very interesting, and shows the great value of Mr. Hilton’s opinions on injuries of the head. He doubtless struck his head on the right side when falling, and, from the form of the skull, the effects were felt on the opposite side, resulting in the rupture of the middle meningeal
A Mirror OF THE PRACTICE OF
MEDICINE AND
SURGERY
IN THE
HOSPITALS OF LONDON. Nulla est alia pro certo noscendi via, nisi quam plurimas et morborum et disseetionum historias, tam aliorum proprias, collectas habere et inter se comparare.-MORGaGNI. De Sed. et Caus. Morb. lib. 14. Prooemium.
CASES OF RESECTION OF JOINTS.
Excision of Knee-joint
...
Mr. FERGUSSON.
Knee-joint... " Knee-Joint KING’S COLLEGE ‘ Mr. PARTRIDGE. Knee-joint } Elbow-joint Mr. FERGUSSON. ) Wrist joiaat Mr. ERiCHSEN’. Knee-joint UNIVERSITY Knee-joint COLLEGE Elbow-joint... ( reason for of trethe French). My Mr. CUTLER. ( artery (the" contre-coup" Knee joint GEORGE’S phining on the opposite side to the bruise, was the paralysis ST.HOSPITAL Knee-Joint ... Mr. TATUM. on the right side; that being a point on which I have heard Hip-joint... Mr. C. HAWEINS. Mr. Hilton particularly dwelt, and which I believe is especially Mr. HOLT. " Knee-joint mentioned in his lectures. ! Knee-joint ... Loughborough, Leicestershire, August, 1856. ’WESTMINSTER J Elbow-joint HOSPITAL Elbow-joint ... " ) Elbow-joint ... Mr. HOLTHOUSE. Elbow-joi)2t ... TREATMENT OF INVERSION OF THE BAP.T-UOL031EW’S Mr. STANLEY. Knee-joint TOE-NAIL. HOSPITAL Elbow-joint... Mr. LAWRENCE. ( BY C. LOVEGROVE, ESQ., Brighton. Mr. BIRKETT. " Knee;joint Elbow-joint... SEEING in THE LANCET of the 9th instant a new mode of GUY’S HOSPITAL Elbow-joint... Mr. HILTON. ( treating " Inversion of the Nail of the Great Toe," and one ( Mr. MooRE. which I cannot say seems to be any great improvement on the MIDDLESEX Knee-joint Mr. SHAW. old and barbarous system of bygone days, induces me to subHip-joint ... HOSPITAL mit to the profession a mode of operating which I have tried " Hip-joint ( Mr. SOUTIT. successfully on one ortwo occasions. It is not an idea of my ST. THOMAS’S K2?ee-joint HOSPITAL own, but one I saw in some surgical work. ( Elbow-joint... Mr. SOLLY. CASE.-A young person, about twenty-six years of age, had ST. MARY’S " Elbow-joirit Mr. WALTON. been under a snrgeon of some renown in London for three or HOSPITAL four months, and in spite of all the means usually adopted in such cases, continued to get worse. She visited Brighton, and HERTS Excision of Elbow-joint ... Mr. SOLLY. consequently the case came under my notice ; I saw at once it WEST INFIRMARY " ( Elbow-joint ... was a fair opportunity of trying this new idea,. which is as follows :-The nail, which is usually very thick on the great toe, was scraped moderately thin with a piece of glass, and WE commence this week a series of cases of resection of the then the whole surface covered with a good coating of nitrate of silver, which was accomplished by rubbing the stick of knee, hip, elbow, and wrist joints, as enumerated in the table silver carefully over the whole of the nail, moistened with a above. Should we have omitted any recent cases, we shall be little water; after which a linseed meal poultice (hot) was happy to add them if kindly supplied. Excision of the kneeapplied, and the next morning nearly the whole of the nail joint will be the first that will occupy our attention, of which was separated from the flesh, and another milder application In former our table furnishes us with 14 cases. divided it entirely. The nail was then removed without the operation least pain, and the patient assured me she had not suffered at "Mirrors" many cases of this operation performed in the Lonall during the whole operation. In less than a fortnight after don hospitals have been placed on record. We may refer to the operation was completed, the patient wore her usual boots cases under Mr. Fergusson’s care at King’s College :-A young with comfort, and before leaving Brighton, a new nail was man, aged twenty-one, (THE LANCET, vol. ii. 1850, p. 183;) rapidly growing. a girl, aged twenty, (vol. ii. 1852, p. 518;) a female, aged August, 1856. twenty-eight, (vol. i. 1853, pp. 367, 425;) and a boy, ten CHOLERA.-This disease is raging fearfully at Moscow, years old, (vol. ii. 1854, p. 123.) A boy, aged seven, under which is said to be the true cause for the postponement of the Mr. Erichsen’s care, (vol. i. 1854, p. 302;) and a man, aged Czar’s coronation; and Lisbon letters speak of cholera as still thirty-four, under Mr. Birkett at Guy’s, (vol. ii. 1855, p. 78.) continuing its ravages in Lisbon and through the provinces. Others have been merely referred to, and as the last was very Peniche is now declared infected. The French screw liner, Prince Jerome, has lost several men from this disease and briefly given it will be presented more in detail. It is with no ordinary satisfaction we present this series of typhus fever. The intelligence from Madeira is very disastrous. Cholera broke out at sea amongst some Portuguese cases to our readers. It is seldom, indeed, we have had such troops that left Lisbon on the 20th of June, and whenthey an opportunity of collecting together so many examples of relanded at Funchal a fair was being held, the troops mixed sections of joints, occurring within a limited period of time. with the inhabitants, and cholera broke out amongst the latter. is It in this way that the propriety of such an operation only When the Avon left Madeira on the 3rd of August, there had been 5000 cases of cholera and 1500 deaths among the popu- as excision of the knee-joint can be fairly tested. Up to the lation of Funchal, which numbered only 28,000. present time it has been performed, we believe we are correct 250 17
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being resorted to. I was now convinced that unless something further was quickly done he would sink, and that, ment
from the symptoms of the case, it was compression from extravasation. Bearing in mind Mr. Hilton’s opinions on these cases, on the 22nd I trephined over the site of the middle meningeal artery on the left side. On removing the bone, to my great pleasure I found a large clot of blood between the bone and dura mater. This I removed, and in two hours afterwards the man had recovered his consciousness, and could speak distinctly and rationally; the paralysis also entirely disappeared. He went on well for the next four days, and on our arrival at Malta I sent him to the hospital these, as it would be some time before he would be able to attend to his duties. At the expiration of a month the wound had nearly healed, and he had nothing whatever to complain of; I therefore ordered him on board to resume his duties. In a couple of weeks the wound had entirely healed, and he went on performing his duties till our arrival in England in July, when he was discharged, perfectly well. Remrks. -This case is very interesting, and shows the great value of Mr. Hilton’s opinions on injuries of the head. He doubtless struck his head on the right side when falling, and, from the form of the skull, the effects were felt on the opposite side, resulting in the rupture of the middle meningeal
A Mirror OF THE PRACTICE OF
MEDICINE AND
SURGERY
IN THE
HOSPITALS OF LONDON. Nulla est alia pro certo noscendi via, nisi quam plurimas et morborum et disseetionum historias, tam aliorum proprias, collectas habere et inter se comparare.-MORGaGNI. De Sed. et Caus. Morb. lib. 14. Prooemium.
CASES OF RESECTION OF JOINTS.
Excision of Knee-joint
...
Mr. FERGUSSON.
Knee-joint... " Knee-Joint KING’S COLLEGE ‘ Mr. PARTRIDGE. Knee-joint } Elbow-joint Mr. FERGUSSON. ) Wrist joiaat Mr. ERiCHSEN’. Knee-joint UNIVERSITY Knee-joint COLLEGE Elbow-joint... ( reason for of trethe French). My Mr. CUTLER. ( artery (the" contre-coup" Knee joint GEORGE’S phining on the opposite side to the bruise, was the paralysis ST.HOSPITAL Knee-Joint ... Mr. TATUM. on the right side; that being a point on which I have heard Hip-joint... Mr. C. HAWEINS. Mr. Hilton particularly dwelt, and which I believe is especially Mr. HOLT. " Knee-joint mentioned in his lectures. ! Knee-joint ... Loughborough, Leicestershire, August, 1856. ’WESTMINSTER J Elbow-joint HOSPITAL Elbow-joint ... " ) Elbow-joint ... Mr. HOLTHOUSE. Elbow-joi)2t ... TREATMENT OF INVERSION OF THE BAP.T-UOL031EW’S Mr. STANLEY. Knee-joint TOE-NAIL. HOSPITAL Elbow-joint... Mr. LAWRENCE. ( BY C. LOVEGROVE, ESQ., Brighton. Mr. BIRKETT. " Knee;joint Elbow-joint... SEEING in THE LANCET of the 9th instant a new mode of GUY’S HOSPITAL Elbow-joint... Mr. HILTON. ( treating " Inversion of the Nail of the Great Toe," and one ( Mr. MooRE. which I cannot say seems to be any great improvement on the MIDDLESEX Knee-joint Mr. SHAW. old and barbarous system of bygone days, induces me to subHip-joint ... HOSPITAL mit to the profession a mode of operating which I have tried " Hip-joint ( Mr. SOUTIT. successfully on one ortwo occasions. It is not an idea of my ST. THOMAS’S K2?ee-joint HOSPITAL own, but one I saw in some surgical work. ( Elbow-joint... Mr. SOLLY. CASE.-A young person, about twenty-six years of age, had ST. MARY’S " Elbow-joirit Mr. WALTON. been under a snrgeon of some renown in London for three or HOSPITAL four months, and in spite of all the means usually adopted in such cases, continued to get worse. She visited Brighton, and HERTS Excision of Elbow-joint ... Mr. SOLLY. consequently the case came under my notice ; I saw at once it WEST INFIRMARY " ( Elbow-joint ... was a fair opportunity of trying this new idea,. which is as follows :-The nail, which is usually very thick on the great toe, was scraped moderately thin with a piece of glass, and WE commence this week a series of cases of resection of the then the whole surface covered with a good coating of nitrate of silver, which was accomplished by rubbing the stick of knee, hip, elbow, and wrist joints, as enumerated in the table silver carefully over the whole of the nail, moistened with a above. Should we have omitted any recent cases, we shall be little water; after which a linseed meal poultice (hot) was happy to add them if kindly supplied. Excision of the kneeapplied, and the next morning nearly the whole of the nail joint will be the first that will occupy our attention, of which was separated from the flesh, and another milder application In former our table furnishes us with 14 cases. divided it entirely. The nail was then removed without the operation least pain, and the patient assured me she had not suffered at "Mirrors" many cases of this operation performed in the Lonall during the whole operation. In less than a fortnight after don hospitals have been placed on record. We may refer to the operation was completed, the patient wore her usual boots cases under Mr. Fergusson’s care at King’s College :-A young with comfort, and before leaving Brighton, a new nail was man, aged twenty-one, (THE LANCET, vol. ii. 1850, p. 183;) rapidly growing. a girl, aged twenty, (vol. ii. 1852, p. 518;) a female, aged August, 1856. twenty-eight, (vol. i. 1853, pp. 367, 425;) and a boy, ten CHOLERA.-This disease is raging fearfully at Moscow, years old, (vol. ii. 1854, p. 123.) A boy, aged seven, under which is said to be the true cause for the postponement of the Mr. Erichsen’s care, (vol. i. 1854, p. 302;) and a man, aged Czar’s coronation; and Lisbon letters speak of cholera as still thirty-four, under Mr. Birkett at Guy’s, (vol. ii. 1855, p. 78.) continuing its ravages in Lisbon and through the provinces. Others have been merely referred to, and as the last was very Peniche is now declared infected. The French screw liner, Prince Jerome, has lost several men from this disease and briefly given it will be presented more in detail. It is with no ordinary satisfaction we present this series of typhus fever. The intelligence from Madeira is very disastrous. Cholera broke out at sea amongst some Portuguese cases to our readers. It is seldom, indeed, we have had such troops that left Lisbon on the 20th of June, and whenthey an opportunity of collecting together so many examples of relanded at Funchal a fair was being held, the troops mixed sections of joints, occurring within a limited period of time. with the inhabitants, and cholera broke out amongst the latter. is It in this way that the propriety of such an operation only When the Avon left Madeira on the 3rd of August, there had been 5000 cases of cholera and 1500 deaths among the popu- as excision of the knee-joint can be fairly tested. Up to the lation of Funchal, which numbered only 28,000. present time it has been performed, we believe we are correct 250 17
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