WESTMINSTER HOSPITAL.

62

dose of laudanum. No tetanic the night, but had one at seven A.M., and another about ten A.M., but of less severity than before, TRAUMATIC TETANUS. EDWARD HOGAN, labourer, xtat. 29, One, P.M. No recurrence of spasm ; admitted into St. Luke’s Ward under Mr. pulse 120, full; breathing hurried; coughs Vincent, on Saturday, 23th September. The much, with viscid expectoration. Comterminal phalanx of the index finger of the plains of thirst, but experiences extreme right hand was severely lacerated; the in- i difficulty in deglutition, and the fluids enter teguments divided along its outer side and the larynx, exciting great distress. The across the articulation ; the bone fractured, face is flushed, an’d the conjunctivaeinjected ; and its ligamentous connexions extensively the tongue clean, but dry ; skin warm and torn. The middle finger of the right hand moist ; less tenderness of abdomen ; but the He stated, that neck still feels stiff, and the lower jaw can was also slightly injured. the injury had occurred that day, and re- with difficulty be relaxed. The sternosulted from the fingers having been caught mastoid muscles are prominent and rigid; in a windlass, at which he was employed. he trembles much, and his countenance is His health, previous to the accident, was expressive of great anxiety. Croton oil and very good, and the several functions were injections to be repeated as before, and the same doses of laudanum to be resumed if regularly performed. Some difference of opinion, we under- the spasms should recur.

ST. BARTHOLOMEW’S HOSPITAL.

stand,

the

arose as to

amputating measure,

the

propriety

of

was not

proceeded

spasms

through

Another opisthotonic spasm taken place, which lasted three with, minutes, exhibiting the usual phenomena, Un-but with diminished violence ; mental fune..

at once

injured phalanx.

however,

the second

Two,

Thishas

1’.M.

just

and the common poultice was applied. der this treatment suppuration ensued, andtions completely undisturbed. When we returned, at four p.m., he had on Tuesday morning, 28th September, the’ wound abundantly, and lookedL just expired in a spasm, a few minutes after well. The bowels were at this time rather leaving the warm bath. the day he complained of torpid. During pain from a " gumboil," and difficulty of WESTMINSTER HOSPITAL. deglutition ; but this circumstance escaped particular notice till the evening, when it had become more severe ; the internal REMOVAL OF AN EXOSTOSIS OF THE NASAL BONES. fauces were relaxed, and rather tender to i JOHN CHACE, about 20 years of age, a the touch, and the back of his neck was stiff, ’, uneasy, and slightly swollen. The sister chimney-sweeper, admitted 1ith August, gave him an alum gargle, and rubbed his under Mr. Lynn, with fungous growths arisneck with the common liniment. ing from the palatal plates of the superior 29. Rested badly. At seven A.M., was maxillary bones, extending downwards into suddenly seized with a violent tetanic spasm, the mouth, and upwards so as to fill almost assuming the forms of trismus and opistho. entirely the inferior meatus nasi : an excretonos. After the spasm had continued some scence of the size of a marble occupied the time, the house-surgeon was called, who ! situation of the left lachrymal sac. An directed a drop of croton oil to be repeated exceedingly fcetid smell emanated from the every two hours, till the bowels should be mouth and nares. He was ordered by Mr. relaxed. From that time several spasms Lynn to have the parts washed with warm occurred, until Mr. Vincent’s visit at halt water, and the bowels well and regularly past twelve o’clock. The wound was then opened. The lad gave this story of his disfound dry and pale ; the countenance ease. A year ago, whilst at play,he received anxious ; breathing oppressed and hurried ; a scratch of a finger-nail in the septum of the neck and abdomen tender to the touch; the nose ; the inner parts of the nose swelled pulse quick and rather full. Croton oil had and became painful, and the passage of air not operated. Mr. Vincent ordered the through the nasal meatus was much impeded. patient a warm bath, two drops of croton oil Whilst in this state, he received a violent every second hour till dejections should be blow on the nose when in a crowd. The procuied, and drachm doses of laudanum painful consequences of this compelled him also, every second hour. The red precipi- to apply for relief to a parochial infirmarv, where and various remedies were retatp to be applied to the wound. SO. Eleven A.M. Seven drops of croton sorted to without effect, and the disease oil taken, and two common injections admi- gradually took its existing form. nistered at alternate periods. Four doses of Aug. 22. Mr. Lynn determined to remove laudanum used. Bowels scantily moved by the fungous excrescence from the roof of the the croton oil ; injections returned as soon mouth with a scalpel. The boy was for that as given. Has slumbered at intervals since purpose brought into the theatre, and the

discharged

many

63

judgment of the chirurgical officers required.

but the

being in the affirmative, Mr. Lynn having depressed the under jaw to the utmost, introduced the scalpel with the left hand into the mouth, and opposing the index of the right hand as a fulcrum on the This

pain

in the

ear

continued,

and

was

for some days even accompanied with so much febrile excitement as to require the use of the lancet. A large abscess formed at the left mastoid process, and being opened on the 20th of March, discharged a very other side of the tumour, cut towards its large quantity of purulent matter : the dismiddle as close to the parent bone as possi- charge from the ear had evidently been from ble. The knife was then changed to the the same source, for on examination,a comright hand, and the other half of the tumour munication was found to exist between the cut in like manner. Two of the superior abscess and the meatus externus. From incisor teeth were removed with the mass. this time the patient rapidly recovered, No haemorrhage occurred. Mr. Lynn post- the wound healed up, etc., and towards poned the excision of the other fungi until the middle of April he was discharged well. the effect of the present operation should be determined. On cutting into the tumour it HANDEY v. HENSON. was found to be cartilaginous in its circumCOSTS OF THE TRIAL. ference, but bony in its centre, being a specimen of true exostosis. An astringent lotion was applied; and the bowels were SIR,—After the apparently spirited manner in which some members of the profeskept open. Sep. 20. The patient has very much im- sion seemed at first to notice the signal vicproved since the operation ; his speech is tory obtained by them through the instrumore distinct; his appetite and spirits good; mentality of Mr. Handey, in the case of and he is well disposed to submit to the " Handey v. Henson," I did hope that some men of note would have come forward zemoval of the other fungi. and headed a subscription for the purpose of

HOPITAL BEAUJON. POLYPOUS TUMOUR IN THE UPPER PART OF THE PHARYNX.

ROBUST young man, 17 years of age, admitted on the 26th of February last, with the following symptoms ; the uvula was forcibly pushed forwards and downwards, and on lifting it up by a spatula, a round polypous tumour of the size of a walnut, of white colour, and apparently of great consistence, appeared behind it ; it was loose and pendulous ; its pedicle could not be traced, but it seemed to be fixed to the lower portion of the septum narium; the patient complained of difficulty of breathing°,and during sleep was heard to snore very much ; his voice was of a nasal kind, the passage of the air through the right nostril was much impeded, that through the left was entirely suspended. On the 27th, M. Blandin applied a ligature according to Desault’s method; the change which was observed in the colour of the tumour immediately after the operation, evidently showed that the pedicle was well comprised in the ligature. On the 4th of March (the ligature having been repeatedly tightened during the interval), the polypus was detached and thrown up with a small quantity of blood ; the difficulty of breathing, the nasal sound in the voice, etc., immediately disappeared, but the patient complained of much pain in the left ear, from which there was some purulent discharge. A small abscess was discovered to have formed at the posterior part of the pharynx; it was opened,

A

was

presenting that gentleman, as a sense of the obligation we owe him, with a piece of plate, but the feeling appears to have lived but for " nine days." Like many others I have been waiting for a leader, none appear. ing I have presumed, though but little known, to take the duty on myself. I know that Mr. Handey has lost, owing to the insolvency of the defendant, the whole of the debt and costs, and that the latter amounted to upwards of seventy pounds. This is a loss that I think the profession is called on to share, and herewith forward a sovereign to prove the sincerity of my feeling, trusting others may be induced to follow the example. Should the liherality of the profession get together a subscription beyond the amount of the costs, and I cannot doubt but it will do so, I should suggest that the surplus be laid out in a piece of plate to be presented to Mr. Handey. Your readiness to stickle for the rights of the general practitioner, renders, I trust, any apology unnecessary for troubling you to receive the subscriptions. I am Sir, &c. HENRY EDWARDS. Oakham, 30th August, 1830. YOUNG

BAT CLUB.

of some miserable young BATS took place on Tuesday last, at 3 P.M., at the London Hospital. Their movements, ’like themselves, were very feeble and irregular; we have an eye upon them ; it is a pity the poor little creatures have not sense enough

A

to

MEETING

know who

are

their best friends.