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Elsberg's Surgery of the Spinal Cord Vol. XXX, No. 6. NOVEMBER, 1916 Published Bi-Mpnthly by the MEDICAL MISSIONARY ASSOCIATION OF CHINA. Editor, K. M. Merrinj, M.D., St. J ohn?s University, Shanghai. Husinesa Manager, D f. R . 1 C , Beebe, 5 Qulnsan Qasdeasy, Shanghai. «**''*'' Sec'y and Treas., H. H. Morris, M.D., 4B Minghàng Road, / f*, Shanghai. r 1 1 -- TABLE OF CONTENTS. ORIGINAL : Page. Page. ^ s s a r V’ On the Evils of Chinese Foot-binding. The EducationaPStaadaFdofucationarStaadaFdof ’Ffe-Medi- i J. Preston Maxwell, M.D., F.R.C.S. 393 cal and Medical, of Mission Medical Schools. Edward M. Merrins.M.D. 421 Acute Complete Inversion of the Uterus. EDITORIAL: Chinese Medicine and Sur­ M. h. Hanington, M.B., M.D., C.M. 396 gery. C. M. M. A., Constitution and By­ laws. Medical Education in China.- Re­ Ovarian Tumours and Ovariotomy. M. port of First Meeting of ünion Committee Edith Bryson, M.B., Ch.B., and J. on Medical Terminology. National Health, H. Montgomery, M.B., Ch.B. ... 400 Essay Contest ... ... ... 432-441 Plastic Closure of Buccal Cavity Follow­ Medical Reports ... .............. ... 442 ing Gun-shot Injury. Carl A. Hed- Medical and Surgical Progress ... ... 448 blom, M.D. ............... 407 “ Needling ” Painful Spots, as Practised Japanese Medical Literature ... ... 460 by the Chinese. James Cantlie, M.A., Book Reviews ... ... 466 M.B., F.R.C.S........................... ... 410 Clinical Notes ........................................ 413 Correspondence ... f 73 Customs Medical Report: Health of News and Comment ... ...474 Chinkiang. By Hermann Balean, M.D.i B.Sc. (Lond.), F.R.C.S. ... 417 Nurses’ Association of China ... ... 476 V JUST READY Elsberg’s Surgery of the Spinal Cord There is no other book published like this by Dr* IJlsberg. It gives in clear, definite language the ¡diagnosis and treatment of all surgical diseases of the spinal .cord and its membranes, illustrating each operation with, original pictures. Berarase it goes so . thoroughly into symptomatology, diagnosis, and indications‘for operation, this work appeals as strongly to the general practitioner and neurologist as to the surgeon. The j. first part of the -vyorkiis devoted to anatomy and physiology of the spinal cord and to the k symptomatology of surgical spinal diseases. The second part takes up operations upon the spi^e, the cord, and nerve-roots. The third part is given over to surgical diseases of the cord arid, its membranes—their diagnosis ana treatment. Included also are chapters on hematomyelia and spinal gliosis, because in thesediseases much harm is dope to the fiber tracts by compression. There is also a chapter on X-rays'in fcpinalfUseases. Octavo of 400 pages, with 150 illustrations. By Ch ar les A. E lsberg, M.D., Professor of Clinical Surgery, New York University and Bellevue Hospital Medical School. Cloth, 21s. net. SAUNDERS, Publishers—See also Advertising Page iii. - We have a large stock of P IIiL S sind TABLETS for J N TERN A L Hypodermic & OPHTHALMIC application. SERUMS, TOXINS, VACCIN ES, SPECIALITIES. Special Quotations ior’ Large Quantities. SHANGHAI 3 7 , N anking Road, FIRST MEETING Ol- THE i’NION COMMITTER ON MEDICAL TERMI NOI,OGV. V ol. XXX. NOVEMBER, 1916. No. 6. ; [All copy must be iu the hands of the editors at least six weeks before date of publication to ensure appearance in the following number. The Editors assume no responsibility for the views expressed by t h e writers of articles published in the J o u r n a l , nor can they undertake to return the manuscripts sent to them. When Romanised terms or phrases in Chinese are used in.au article, it is reQuested that the translation and the eQuivalent Chinese characters be also given. A dozen complimentary reprints of his article will be furnished to each contributor, but any number of reprints may be had at reasonable rates if a written order for the same accompany the paper.] ON THE EVILS OF CHINESE FOOT -BINDING.* J. P reston M a x w e u ,, M.D., F.R.C.S., Yungchuu, Fukien. It seems strange that in the fifth year of the Republic of China one should have to report that iu many regions, such as South Fukien, the auti-footbinding movement has made but little progress. And it is still worse to have to report that the principal obstacle is the attitude of the women themselves. Again and again has the writer secured the consent of the male members of a family to the unbinding of a child’ s feet only to be thwarted by the older female members of the same family. It .is true that in the coast ports the movement has made considerable progress, but in inland cities such as Yungchun there is scarcely any progress to be noticed. Of the general evils following on this senseless and cruel practice much has been said and written, yet the subject is not exhausted and the purpose of this paper is to deal with some of the severer physical evils which may affect its victims. These may be divided into two classes:— (a) Due to septic infection and strangulation of the tissues. (¿) Due to weakening and displacement of bones and ligaments. («.) Due to septic infection and strangulation of the tissues. In greater or lesser degrees almost every bound-footed woman suffers from these conditions, and ulceration during the process of foot- binding is very common. The severer forms are the following :— 1. Acute ulceration of the skin on the dorsum of the foot. 2. Gangrene of the toes. 3. Gangrene of the foot and leg. 4. Pyaemia. 5. Granulomata of the instep or iu the fold of the toes. * A paper read at a meeting of the Fukien Branch, C. M. M. A., August, 1916. 394 The China Medical Journal. The first three forms may be taken together, as they are progres­ sive stages of the same process. Owing to septic infection of a rub, wound, or bite, on an area the circulation in which has been impaired, swelling takes place beneath the bandages, this leads to further obstruction of the circulation and intense pain. Should the complaint of pain be attended to at onee, only the skin on the dorsum of the foot will,, die ; a little later, this and some of the toes will be lost; but should no attention be given, the pain may diminish, and when the matter receives attention, usually on account of the smell, the whole foot and lower part of the leg may be beyond repair, and one gets the condition illustrated in the first photograph. The history of this case, which may be taken as a t57pical one, is as follows: A girl of 9 years of age was admitted into the Yungchun Hospital on February 20, 1916. Both feet had separated owing to gangrene, and the bones of both legs were sticking out at the end of the stumps. Eighteen mouths previously the feet had been bound (and it may be noted that this was late to bind, and that the worst cases of septic infection occur in these late cases), and three months after when they were undone after a very severe attack of pain, the dorsum of the foot was already black. The feet and lower part of the legs finally dropped o'ff after nine months’ serious illness. With a view to leaving as long a stump as possible, after disinfecting the stumps incisions were made down on to all four bones, and these were resected, the periosteum being destroyed as far as possible. She left hospital in May with the stumps uearl3r healed, and with sufficient length to permit of fitting artificial legs allowing the use of the knee joint. Shortly after she left another similar case came in, but the patient w7as a couple of years older, both feet were the seat of moist gangrene, the infection having extended above the ankle. She was already beginning to suffer from septic pneumonia, and it was clear that she was doomed. She was carried home and died next day. 4. Pyaemia. At the same time as the first cass, there was admitted to hospital another girl of much the same age, with what appeared to be a psoas abscess pointing in the thigh. She had been ill some four months, and complained also of pain in the back where there w7as evidently a deep lumbar abscess. There was no clear evidence of tubercular disease of the spine. The abscesses in the thigh and lumbar region were opened, and the girl kept as far as possible on her back. On the Evils of Chinese Foot-binding. 395 After a few days as the case was not progressing, she was again placed under chloroform, and the lumbar abscess opened up freely and explored. It ran up and down the spine on the edge of the erector spinae but no tubercular focus could be found. After this free opening she improved, but as soon as she was got 6n to her feet it was evident that there was something wrong with them, and she confessed that one of them hurt her. It was unbound after a great , deal of resistance on her part, and a suppurating sore was found over some of the deformed toes. Then the history came out, that this was the primary trouble, and evidently the thigh and lumbar abscesses were pysemic in nature. She went out strong and well, but not at all pleased that her feet had been unbound as she was afraid of being despiséd. 5. Granuloma of the instep or in the fold of the toes. In some of these bound feet a small ulcer develops into a granuloma which may be very difficult to heal, especially if it develops somewhat late in life, and occasionally these granulomata form the starting point for malignant disease.
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