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Hydro-Pneumothorax of Long-Standing Which Came Under Ing from A

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1652 Dr. BUSHBY read some short notes on five cases of the internal to the external. A few strards of silkworm git Pneumothorax which had come under his notice during the were left in one corner of the wound, the rest being drawa bst twelve months. The first case was one of tuberculous into perfect apposition and the whole covered with sulpho- disease of the lung in which the pneumothorax was recovered cyanide gauze and wool. At the end of twenty-four hours from without effusion of fluid. The second was a case of the wound was dressed and at no time did the temperature hydro-pneumothorax of long-standing which came under rise above 1011 F. The limb was placed in plaster-of.PaIis> notice a few weeks before death. The third was a case of at the end of four weeks and a week later the patient was pneumothorax ariirg in a strong, healtby man without evi- discharged. The plaster was removed in nine weeks from dence or history of tuberculous disease. The condition in the date of the operation ard he was now able to go about this case was completely recovered from without effusion of without support and with a limb practically no shorter than fluid. The fourth case originated in a left-sided pneumonia its fellow, for on very careful measurement one-eighth of an passing into gangrene WhICh broke down into the pleural inch could scarcely be detected. Mr. Butcher was of opinion cavity. At the necropsy the husk of a grain of wheat was that the result was far preferable to any that could have found in the gangrenous patch. In this case the patient been attained by the ordinary method of excision, where the himself bad ascribed his illness to the inhalation of dust patient would have had a couple of inches shortening and from grain. The fifth cafe was in a man whose left lung would have been obliged to wear a special boot. It is not was almost destroyed by tuberculous disease. Death resulted often that one is called upon to operate on a perfectly from the rupture of a vessel in a small cavity in the apex of healthy joint in order to procure fixation, but for diseased the right lung which was otherwise not diseased. joints the matter is different, for there are then removed not Mr. SHEARS showed a man, aged thirty-five years, suffer- only cartilage and synovial membrane but almost invariably ing from a Traumatic Implantation Cyst of the Iris. certain portions of diseased bore. Dr. W. FLOYD read notes (1) of a case of Death after Parturition from Ursemic Convulsions ; and (2) Post-partum Peritonitis arrd Septicasmia in which the Anti-streptococcic. BIRKENHEAD MEDICAL SOCIETY. Serum had been used. Mr. WILKINSON read notes (1) of a case of Bicornate Uterus; and (2) a case of Rigid Os where the vertex of the Subl1u)’Jation the - I)path Opel)’ation for of Xnee-júint. fl)’om fcetus was bound down by adhesions to the lower zone of the Ul)’ae1nio Convulsions following Partur7,tian -A1.ti.f;Þrepto. uterus. coccie Sel)’111n in Post partrcnz Peritonitis arid Septicamla - In tte discussions which ensued on the various cases Bi,eornate Os with Ute’f1Is.-.H.igid Co22iplicatto,)bg.-Exki- Fhown: the PRESIDENT, Dr. F. JoHiSTON, Mr. WILKINSON, bition of Cases and Specimens. Dr. GIBSON, Dr. BRIEN, and Dr. W. FLOYD took part. A MEETING of this society was held on Dec. 10th, Dr. STANSFiELD exhibited (1) a case of Hemiannaesthesia Dr. R. S. MARSDEN, President, being in the chair. affectirg: the right side of the body ; and (2) a man suffeiirg Mr. A. H. BUTCHER showed a man and read the following from a Tumour of the Ethmoid Bone most probably of a. notes of an operation he had performed in order to fix themrcom3tcus nature. knee-joint in a case of Subluxation. He said that there were i Dr. W. FLOYD showed an Acepbalic Foetus. ’ certain cafes not very frequent which come before surgeons Dr. STAKSMBLD showed a large Meningocele. for alleviation and which were not referred to in the ordinary Dr. CARDEN PEARSON showed (1) a pair of Contracted works on surgery and this was his excuse for making a few Kidneys ; and (2) a Perforated Ulcer of the Colon. remarks on the cause and result of an operation he bad per- formed at the man’s express desire so that he might be able to his follow employment with greater confidence and safety. ROYAL ACADEMY OF MEDICINE IN The case was one of constantly recurring sublvxatien due to Extreme laxity of the joint structures, so much so that the man IRELAND. could subluxate his joint at will.’The result of this laxity was so that the of his as a instability, followirg employment SECTION OF SURGERY. dock labourer was attended with considerab’e risk, for when any extra strain was put upon the joint it gave way and the Suppurative Middle-ear Disease. man would fall. He was under treatment at the Borough A MEETING of this section was held on Nov. 12th, Sir- Hcspital and various methods were tried in the hope of WILLIAM THOMSON, the President, being in the chair. cauiDg some contraction of the surrounding structures of Mr. ROBERT H. WOODS read a paper on a case of Suppu- the joint ; knee-caps, caustics, &c., were used, but without rativeI Middle-ear Disease complicated by lateral sinus success. An operation was performed in the hope ofthrombosis, extra-dural cerebellar abscess, and temporo.- anchoring the patella in position, but this a1:;o failed ; thesphenoidal abscess. The patient, a man, aged twenty-seven patient then migrated elsewhere where exchion was sug-years, was admitted to the Hardwicke Hospital suffering gested, but to this he would not agree on account of thefrom symptoms of typhoid fever. He had had chronic inevitable shoitening. The man returned to him (Mr.otorrhcea for seven years, the discharge ceasing seven days Butcher) in the hope that he might be able to give him a before admission. Lateral sinus thrcmbosis was diagnosed stiff knee, as he declared that a stiff knee would beand an operation performed. The mastoid antrum was more useful to him than the knee in its then lax con- opened and cleared out and the bony meatus extended bach dition. This Mr. Butcher agreed to do and operated to the groove from the lateral sinus, in which a septic in the following manner. A slightly incurved incision thrombus was found. An extra-dural abscess on the pos- was made across the front cf the joint from the back terior aspect of the temporal bone was evacuated. Two days portion of the internal to the back portion of the ex- later, symptoms of brain abscess persisting, a second opera- ternal condyle of the femur, dividing all the structures tion was undertaken with the result that a temporo- down to the bone and cutting through the ligamentum sphenoidal abscess was tapped and four drachms of pus were patel]a3, which was turned up, the joint was forcibly nexed, removed. The patient made an uninterrupted recovery. the lateral ligaments were divided together with the crucial The PRESIDENT congratulated Mr. Woods on the result ligaments, which were quite healthy, and the joint was which had attended his operation. Such cases, so far, hsd brought well into view. With a sharp gouge the semilunar not always been so satisfactory. cartilages were removed and the condyles of the femur were Mr. M’ARDLE said that he had seen Mr. Wocds me the thoroughly denuded of all the articular cartilage, taking care mallet and gouge and he himself preferred the gouge. There to remove the portions well back and also the patellar portion was a great difficulty in guiding the electric bmr. in front; then the tibia was treated in the same manner with Mr. FITZGIBBON said that the question as to the use of the the exception that the tuberosities were slightly gouged out gouge or the use of a burr or the use of a trephine must so as to make a cup-shaped surface into which to place the depend to a great extent on what is found after the- convex femur. The cartilage surface of the patella was incision. next removed and the ligamentum patellae sutured. The Several other members having spoken Mr. WOODS said, in. femur was now placed into the hollowed out tibia and the reply, that in these cases there was the greatest difficulty in- whole limb placed on a McIntyre splint. The bones were now getting through the bone because there was a sclerosing secured in position by two ivory pegs about four inches long, osteitis set up which eburnated the mastoid process and one b3ing driven through the external condyle of the femur made it exceedingly difficult to get through and it was in into the internal tuberosity of the tibia and the other from these cases that the burr was so useful. It was not at al) 1653 probable that concussion of the brain could be caused byanatomical lectures. In 1748 John Hunter, then twenty jalows of the mallet on a chisel. years of age, joined his brother in London. His early life is brought before the reader in this exquisite passage: his he was at such as the SECTION OF PATHOLOGY. ’’ Throughout boyhood good games village afforded to boys and observant of nature, but deficient Exhibition of Specimens. in self-control, idle, and ignorant, a great disgrace for a A MEETING of this section was held on Dac.
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