Replied. Surgery.-Exhibition Specimens

Replied. Surgery.-Exhibition Specimens

1140 the new -Mr. PARKINSON, Dr. CAMPBELL, WIGAN photography. MEDICAL SOCIETY. and Dr. GOYDER spoke on the subject and Dr. FARRAR Some Recent Advanees in of replied. Surgery.-Exhibition Specimens. AN ordinary meeting of this society was held on April 14th GLASGOW MEDICO-CHIRURGICAL SOCIETY. in the board-room of the Royal Albert Edward Infirmary, Mr. C. R. GRAHAM, President, being in the chair. The PRESIDENT read an exhaustive address on Some Exhibition of Cases and Specimens, Recent Advances in Surgery, reviewing the operations and A MEETING of this society was held on April 17th, treatment of middle-ear and intracranial disease, laminec- Dr. NEWMAN being in the chair. tomy in injuries to the spine, cholecystotomy, resection of Dr. R. M. BUCHANAN showed specimens from a case of the’intestines, operations for appendicitis, &c., and concluded Cancer of the Pylorus. The special feature of the case with some remarks on the new and photography Roentgen’s was provided by the secondary distribution of the malignant rays. An interesting discussion then followed. elements. This had occurred widely in the lymphatic glands The following cases and specimens were shown :— in various parts of the body and some of the glands were Dr. MILROY : Patient suffering from Elephantiasis of Both observed to have undergone caseous changes-an unusual Legs. Specimens of (1) Encephaloid Cancer of the Gall- circumstance in malignant growths. The peritoneum, peri- bladder and Spigelian Lobe of the Liver; and (2) Fracture cardium, and right pleura were dotted over with a large of the Body of the Third Cervical Vertebra with Hoemor- number of minute secondary malignant formations, though rhage into the Cord caused by Indirect Violence in a Young no symptoms during life had suggested the involvement of Man ; death in twenty-four hours. these serous membranes. Mr. BERRY : (1) Ununited Fracture (transverse) Wired Dr. WALKER DowNiE related eight consecutive cases in with an excellent result; (2) Compound Fracture of the which he had opened the larynx (crico-thyrotomy) for the Elbow-joint ; and (3) Triple Osteotomy (both femora and purpose of removing Intra-laryngeal Tumours and showed one tibia) in a child aged three years. several of the patients. The series included only one death, Mr. COWAN : Compound Depressed Fracture of the Skull that of an adult who was the subject of a chronic lung in which he had trephined in three places. The patient affection and who died from septic pneumonia. The most of the other cases were:-1. An adult from whom was nearly well. noteworthy Mr. HUGH E. JONES: (1) Coloboma Iridis; (2) Choroiditis the left vocal cord was excised three and a half years ago on of Senilis ; and (3) Ophthalmic Demonstration of several ca-ses. account malignant disease and who had now a somewhat Mr. MACDONALD : (1) Hydatid of Liver ; and (2) Uric rough but distinct voice ; in phonating the right cord would be seen to cross the middle line and rise to meet the Acid Calculus from a Boy aged two years which weighed up 134 grains. I left ventricular band, which acted, therefore, as a substitute Mr. WM. MITCHELL RoocCROFT: Mulberry Calculus for the vocal cord. The disease had not recurred. 2. A five on whom it was to removed from a Boy aged ten years which weighed 220 boy aged years necessary perform grains. Tracheotomy for Attacks of Dyspnoea, one of which reduced The PRESIDENT: Fifty-two Biliary Calculi removed by the patient to a state of coma. The laryngoscope failed to Cholecystotomy. detect any new growths, but on peiformance of crico- thyrotomy a small mucous polypus was seen to spring by a long pedicle from the tracheal wall about the level of the second and the of the was BRADFORD MEDICO-CHIRURGICAL ring, length pedicle such as to allow the tumour to irritate the laryngeal SOCIETY. mucous membrane and so lead to spasm of the glottis. The removal of the polypus was followed by cessation of the 3. A child two Exhibition Cases and complete symptoms. of Specimens. years of age on whom Crico-thyrotomy had been per- A MEETING of this society was held on April 14th, Dr formed six times for recurring papillomata. Dr. Downie ADOLPH BRONNER, President, being in the chair. expressed his conviction that growths within the larynx are Dr. S. LODGE gave a demonstration of Alicro-specimens much more satisfactorily dealt with by crico-thyrotomy than illustrating Pathological Conditions of the Nose, Throat, by an endo-laryngeal operation. He regards the operation as Mouth, and Orbit.-Dr. GOYDEE and Dr. HiME discussed an eminently safe one and has had no trouble with subse- the specimens. quent malposition of the cartilages leading to aphonia. In Dr. H. BRONKER showed a patient who had recently order to secure accurate readjustment he is in the habit of suffered from Tetanus and whom he bad treated with injec- making the incision in the thyroid cartilage, not in the tions of antitoxin. Recovery was complete. The patient middle line in its whole length, but commencing obliquely was a woman who was admitted into the Bradford Infirmary in one ala he reaches the middle line, continues downwards, suffering from trismus. There were no stiffness of the and then completes the division obliquely in the other ala. ’muscles of the neck and no dysphagia. The knee-jerks Then when the divided parts are replaced they dovetail into were present. The pulse was 92, the respiration 24, one another and so accuracy of apposition is secured. For and the temperature 1000° F. Fifteen grains of antitoxin malignant growths Dr. Downie considers an endo-laryngeal were injected and 20 grains of chloral hydrate and of operation quite unsuitable. Such growths are almost invari- bromide of potassium were given by the mouth. The ably larger and more widely extended than appears in examina- patient had a spasmodic attack twenty-four hours after tion by the laryngoscope, and they cannot be properly attacked admission. At inteivals 40 grains (followed by doses of unless by an operation which renders complete access to 20 grains and 15 grains) of antitoxin were injected and them possible. The patient who had now been free from there were further spasms of the neck and jaw noted. On any sign of recurrence for three and a half years after ex- the tenth day (after admission) pain in the back and legs tirpation of the vocal cord for epithelioma illustrated the was complained of; around the left knee-jint there was a advantage of operating thoroughly and in an early stage of roseolar rash, and the left wrist and shoulder were swollen the disease.-Dr. NEWMAN agreed generally with Dr. and tender. There was a sore throat and the temperature Downie’s views R ith regard to the crico-thyrotomy as cem- was 104°. The after progress of the case was one of pand with an endo-laryngeal operation. He quoted a case in gradual improvement. Two abscesses in the back required which he had extirpated both vocal cords for malignant to be incised and drained. The mode of action and the disease six years ago and in which there had been no recur- method of administration of the antitoxin were described.- rence. His experience bad led him to the conviction that The case was discussed by Dr. GOYDER, Dr. FARRAR, Mr. early operation in malignant disease offered a very good GABRIEL, Mr. HORROCKS, Dr. HIME, and Dr. CAMPBELL, chance of complete cure, whilst when the disease had and Dr. H. BRONNER replied. advanced to such a point that complete extirpation of the Dr. J. HAMILTON CRAWFORD showed a man suffering larynx was necessary it was almost as well to refuse to from Idiopathic Muscular Atrophy. operate ; one of his cases, however, had survived the opera- Dr. FARRAR showed a Skiagraph of the Hand which tion fur eighteen months. disclosed a piece of Steel near the second Phalanx of the Dr. J. H. TEACHER showed two patients illustrating the Little Finger, and described the apparatus necessary for value of Skin Grafting in Promoting the Healing of Extensive 1141 Wounds. In one the wound had been caused by the excision of a large part of the skin c. f the thigh on account of numerous small sarcomatous growths and the other was due to an Reviews and Notices of Books. accident. In each case it had been found that whilst epithelial grafts give rapidly a covering layer to the granula- National Vol. XLVI. Pocock- tions this covering is thin and nothing like so permanently Dictionary of Biography. Edited SIDNEY LEE. London: valuable as that provided by whole-skin grafts. Photographs Puckering. by Smith, and Co. 1896. Price 15s. representing the various stages of the healing process were Elder, exhibited. THIS volume contains upwards of 450 articles, the most Dr. NEWMAN showed from a case of specimens Malignant noteworthy of which are probably those on Alexander Pope Disease of the (Esophagus which had terminated fatally Joseph Priestley. Mr. Leslie to whom we are in consequence of the ulcerative process extending into and Stephen, the aorta. The stricture had been recognised during’ indebted for the biography of Pope, says of him that "he life, the growth not only producing dysphagia, but also had qualities which would have enabled him to give an paralysis of the left vocal cord. Gastrostomy was success- adequate embodiment in verse of the spirit of any generation fully performed and for fourteen days progress was quite into which he had been born. He might have rivalled satisfactory. Then blood began to pass from the in opening Chaucer in one century and Wordsworth in another." The the stomach and in the end death occurred suddenly from a was a remarkable of the association of severe haemorrhage.

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