Pub Date : 1852-10-27DOI: 10.1136/BMJ.S1-16.22.557
W. A. Cox
ordinary lesions of meningitis. The suppression of urine might, perhaps, be accounted for, by a granular state of the kidneys; and the hypogastric tumour was a piliferous ovarian cyst, containing atheromatous matter, with hair, and a fragment of bone, resembling a portion of the maxilla bone, from which arose five teeth. If the patient had not been moribund, we have no doubt that those who attended the case would have required the conviction of its being ovarian, by examining it carefully; as it was, they provided against the retention of urine. The urine, had it passed, would have indicated the granular state of the kidneys.
{"title":"On Syphilis and Gonorrhœa","authors":"W. A. Cox","doi":"10.1136/BMJ.S1-16.22.557","DOIUrl":"https://doi.org/10.1136/BMJ.S1-16.22.557","url":null,"abstract":"ordinary lesions of meningitis. The suppression of urine might, perhaps, be accounted for, by a granular state of the kidneys; and the hypogastric tumour was a piliferous ovarian cyst, containing atheromatous matter, with hair, and a fragment of bone, resembling a portion of the maxilla bone, from which arose five teeth. If the patient had not been moribund, we have no doubt that those who attended the case would have required the conviction of its being ovarian, by examining it carefully; as it was, they provided against the retention of urine. The urine, had it passed, would have indicated the granular state of the kidneys.","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79623807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-27DOI: 10.1136/BMJ.S1-16.22.566
J. Mitchell
{"title":"The Acid Treatment of Diarrhœa","authors":"J. Mitchell","doi":"10.1136/BMJ.S1-16.22.566","DOIUrl":"https://doi.org/10.1136/BMJ.S1-16.22.566","url":null,"abstract":"","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83849902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/bmj.s1-16.21.525
Thomas Nunneley
I think I am right in drawing the following proportional relation between local symptoms and fever, in gastritis and in rheumatism of the stomach. In gastritis, the acuteness of the attack, the pain of the stomach, and dryness of the tongue, are in proportion to the degree of fever. In rheumatism of the stomach, the pain may be very intense, with moderate or little fever, and a moist tongue. Now this is of some value, though not without exceptions. No doubt, it is of the first importance to know real inflammation, be it primary or arising from acute rheumatism of that organ. In about twenty-four hours this becomes clear; under that time, if in high fever you find the child vomiting, with tense epigastrium, a lively expression of pain in the countenance, and continuous painful moaning, instantaneous increase of those symptoms, by a painful outcry of the child, as soon as you press with your finger upon the epigastrium; if all these are present some hours, and cease not under suitable warm poultices, it would be a fault to wait longer with energetic antiphlogistic means, and expose the child to the possibility of danger by delaying until the fever, and along with it the gastric affection, might show its real nature. Rheumatisn of the liver, having its seat in the serous envelope of this organ, causes painful moaning under the respiratory movements of the chest and diaphragm, bilious vomiting and similar diarrhoea, and is easily discoverable by carefully touching over the liver. I believe most of those cases, which it the first years of any hospital practice I have called " hepatitis," were but rheumatic affections of this organ, only a few of which had the inflammatory character. Both rheumatalgia and rheumatic inflammation of the intestines are rather common in children, even of the tender age. Rheumatism in these parts, connected with fever, can scarcely be overlooked; besides a continuous uneasiness, and painful expression of counte,nance with moaning, from time to time the pain increases so far as to cause vehement painful crying, with the usual drawing up and moving of the legs, then usually comes a sudden diarrhoea of thin serosity, a little yellowish in nurselings, above that age not unfrequently greenish. After these tumultuous evacuations the child becomes more quiet, but appears still uneasy, the belly is puffed up and tender on pressure. If the affection be inflammatory all these signs are more strongly expressed, and the expression of pain itself almost unremittingly strong. In peritoneal rheumatism the more puffed state of the belly, with exquisite tenderness all over its surface, will soon discover the seat of pain. Serous diarrhoea and most of the before-mentioned symptoms will be present. I believe in fact, that the abdominal peritoneum may merely be affected in this way, without involving the intestines. As to the question,-Whetber the seat of rheumatism be in the serous or muscular, or both envelopes of the alimentary canal? I bel
{"title":"Introductory Lecture","authors":"Thomas Nunneley","doi":"10.1136/bmj.s1-16.21.525","DOIUrl":"https://doi.org/10.1136/bmj.s1-16.21.525","url":null,"abstract":"I think I am right in drawing the following proportional relation between local symptoms and fever, in gastritis and in rheumatism of the stomach. In gastritis, the acuteness of the attack, the pain of the stomach, and dryness of the tongue, are in proportion to the degree of fever. In rheumatism of the stomach, the pain may be very intense, with moderate or little fever, and a moist tongue. Now this is of some value, though not without exceptions. No doubt, it is of the first importance to know real inflammation, be it primary or arising from acute rheumatism of that organ. In about twenty-four hours this becomes clear; under that time, if in high fever you find the child vomiting, with tense epigastrium, a lively expression of pain in the countenance, and continuous painful moaning, instantaneous increase of those symptoms, by a painful outcry of the child, as soon as you press with your finger upon the epigastrium; if all these are present some hours, and cease not under suitable warm poultices, it would be a fault to wait longer with energetic antiphlogistic means, and expose the child to the possibility of danger by delaying until the fever, and along with it the gastric affection, might show its real nature. Rheumatisn of the liver, having its seat in the serous envelope of this organ, causes painful moaning under the respiratory movements of the chest and diaphragm, bilious vomiting and similar diarrhoea, and is easily discoverable by carefully touching over the liver. I believe most of those cases, which it the first years of any hospital practice I have called \" hepatitis,\" were but rheumatic affections of this organ, only a few of which had the inflammatory character. Both rheumatalgia and rheumatic inflammation of the intestines are rather common in children, even of the tender age. Rheumatism in these parts, connected with fever, can scarcely be overlooked; besides a continuous uneasiness, and painful expression of counte,nance with moaning, from time to time the pain increases so far as to cause vehement painful crying, with the usual drawing up and moving of the legs, then usually comes a sudden diarrhoea of thin serosity, a little yellowish in nurselings, above that age not unfrequently greenish. After these tumultuous evacuations the child becomes more quiet, but appears still uneasy, the belly is puffed up and tender on pressure. If the affection be inflammatory all these signs are more strongly expressed, and the expression of pain itself almost unremittingly strong. In peritoneal rheumatism the more puffed state of the belly, with exquisite tenderness all over its surface, will soon discover the seat of pain. Serous diarrhoea and most of the before-mentioned symptoms will be present. I believe in fact, that the abdominal peritoneum may merely be affected in this way, without involving the intestines. As to the question,-Whetber the seat of rheumatism be in the serous or muscular, or both envelopes of the alimentary canal? I bel","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83684196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/BMJ.S1-16.21.537
W. A. Cox
{"title":"Letter from W. A. Cox, Esq., on the Case—“Bourne v. Cox”","authors":"W. A. Cox","doi":"10.1136/BMJ.S1-16.21.537","DOIUrl":"https://doi.org/10.1136/BMJ.S1-16.21.537","url":null,"abstract":"","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90542256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/bmj.s1-16.21.532
bistoury. In a second cas, that of Hisgate, a fusible calculus crumbled to atoms within the grasp of the forceps, and was partially removed with the scoop and warm water injections. In the third case, that of Leonard Garner, a brittle oxalate calculus, weighing one ounce and a half, broke up into thirteen fragments, one of which was only detected and removed with the forceps from the bladder after placing the patient in bed. Result.-The ten first operated upon recovered, the remaining three died. First, Jary,. aged 35, on the fourth day, from secondary hnemorrhage; second, Kemp, aged 67, a very unfavourable subject, case of triple calculus, on the twenty-ninth day, from exhaustion; and the third, Gosling, aged six years and a half, in thirtysix hours, diarrhoea and stupor supervening. The instruction derived irom witnessing and assisting at numerous lithotomy operations, including two in which no stone was found, conducted with the gorget, beaked knife, or common scalpel, led in each case to the employment of the cutting gorget, as the safest and best instrument in not over experienced or dextrous hands, to insure limited incision of the prostate and neck of the bladder, a point of the first and very highest importance. The blunt gorget or finger served as a dilator of the wound, and in each instance, where an elastic tube was not left in the bladder, the finger was gently passed a few hours after the operation to lessen the danger of urine becoming effused into the pelvic cellular tissue. Since the practice of lithotrity and the more frequent use of the catheter-forceps,* operations for lithotomy appear to have become comparatively more rare in this district. The five cases just reported, commencing with that of Stanfield, include the whole number lately performed at the Lynn Hospital.
{"title":"Proceedings of Societies","authors":"","doi":"10.1136/bmj.s1-16.21.532","DOIUrl":"https://doi.org/10.1136/bmj.s1-16.21.532","url":null,"abstract":"bistoury. In a second cas, that of Hisgate, a fusible calculus crumbled to atoms within the grasp of the forceps, and was partially removed with the scoop and warm water injections. In the third case, that of Leonard Garner, a brittle oxalate calculus, weighing one ounce and a half, broke up into thirteen fragments, one of which was only detected and removed with the forceps from the bladder after placing the patient in bed. Result.-The ten first operated upon recovered, the remaining three died. First, Jary,. aged 35, on the fourth day, from secondary hnemorrhage; second, Kemp, aged 67, a very unfavourable subject, case of triple calculus, on the twenty-ninth day, from exhaustion; and the third, Gosling, aged six years and a half, in thirtysix hours, diarrhoea and stupor supervening. The instruction derived irom witnessing and assisting at numerous lithotomy operations, including two in which no stone was found, conducted with the gorget, beaked knife, or common scalpel, led in each case to the employment of the cutting gorget, as the safest and best instrument in not over experienced or dextrous hands, to insure limited incision of the prostate and neck of the bladder, a point of the first and very highest importance. The blunt gorget or finger served as a dilator of the wound, and in each instance, where an elastic tube was not left in the bladder, the finger was gently passed a few hours after the operation to lessen the danger of urine becoming effused into the pelvic cellular tissue. Since the practice of lithotrity and the more frequent use of the catheter-forceps,* operations for lithotomy appear to have become comparatively more rare in this district. The five cases just reported, commencing with that of Stanfield, include the whole number lately performed at the Lynn Hospital.","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83804212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/bmj.s1-16.21.538
half-a-guinea, under the circumstances of the case, was more than I was justified in charging him. This brought his bill to £21. 5s.; and by the advice of Mr. Slack, a most respectable attorney, I arrested him for this amount. I had reason to know that he was a young man of property; but he pleaded poverty, and I consented to take £15, and give him his discharge. He then retums to Bath, trumps up a story, which, on the trial was proved to be false, that I had sent him in a bill for £2. 6s.; and his friends commence an action in the County Court for malicious arrest, laying the damages at £50. Not content to await the trial, the public-houses all over the city are made use of to circulate the grossest calumnies, and thus a strong feeling is excited against me. Confident in the justice of my own case, although I heard six medical men were to be brought forward by the plaintiff, yet, as I flattered myself that I stood pretty well with the profession, being conscious that I had never done a dishonourable action towards any one of them, I relied on their honour and integrity, and did not provide myself with a single medical testimony on my behalf. I was generously offered support (not by those who gave evidence in my favour on the trial, but by a gentleman of as high respectability and as long standing as any in the profession in this city), but I refused to allow another to share in the prejudice that had been raised. The trial came on, and then to my utter astonishment I found the medical witnesses deposing to the impossibility of the existence of such a complication of diseases as that for which I had made out a bill, and which I subsequently swore had existed in this case. Fortunately for me there were two gentlemen in court, Messrs. Bush and John Barrett, who had the manliness and generosity to stand forward when they saw an attempt made to crush a professional brother, and voluntarily gave evidence on their own experience that they had seen similar cases. I here beg publicly to thank them; and I tell them that I appreciate their conduct the. more highly because it arose from the spontaneous and unsolicited impulse of generous, manly, ancI independent feeling. But can I wonder at the verdict that was returned after the medical evidence for the plaintiff, that evidence being, as the Judge charged the Jury, " that they all agreed that they did not believe that the diseases which were specified on the face of the bill, ever could coexist in the samepatient. (See Bath and Cheltenham Gazette, September 8th, 1852.) Observe, the adverse medical evidence denied the possibility of the coexistence of gonorrhcsa and syphilis. With such evidence as this before them, the Jury could come to no other conclusion than that the bill was a concoction, and the whole transaction a fraud. My only wonder is, that with such extraordinary medical evidence against me, the Jury were bold enough to cut down the damages from £50 to £15. With regard to the bill, portions of w
{"title":"Foreign Department","authors":"","doi":"10.1136/bmj.s1-16.21.538","DOIUrl":"https://doi.org/10.1136/bmj.s1-16.21.538","url":null,"abstract":"half-a-guinea, under the circumstances of the case, was more than I was justified in charging him. This brought his bill to £21. 5s.; and by the advice of Mr. Slack, a most respectable attorney, I arrested him for this amount. I had reason to know that he was a young man of property; but he pleaded poverty, and I consented to take £15, and give him his discharge. He then retums to Bath, trumps up a story, which, on the trial was proved to be false, that I had sent him in a bill for £2. 6s.; and his friends commence an action in the County Court for malicious arrest, laying the damages at £50. Not content to await the trial, the public-houses all over the city are made use of to circulate the grossest calumnies, and thus a strong feeling is excited against me. Confident in the justice of my own case, although I heard six medical men were to be brought forward by the plaintiff, yet, as I flattered myself that I stood pretty well with the profession, being conscious that I had never done a dishonourable action towards any one of them, I relied on their honour and integrity, and did not provide myself with a single medical testimony on my behalf. I was generously offered support (not by those who gave evidence in my favour on the trial, but by a gentleman of as high respectability and as long standing as any in the profession in this city), but I refused to allow another to share in the prejudice that had been raised. The trial came on, and then to my utter astonishment I found the medical witnesses deposing to the impossibility of the existence of such a complication of diseases as that for which I had made out a bill, and which I subsequently swore had existed in this case. Fortunately for me there were two gentlemen in court, Messrs. Bush and John Barrett, who had the manliness and generosity to stand forward when they saw an attempt made to crush a professional brother, and voluntarily gave evidence on their own experience that they had seen similar cases. I here beg publicly to thank them; and I tell them that I appreciate their conduct the. more highly because it arose from the spontaneous and unsolicited impulse of generous, manly, ancI independent feeling. But can I wonder at the verdict that was returned after the medical evidence for the plaintiff, that evidence being, as the Judge charged the Jury, \" that they all agreed that they did not believe that the diseases which were specified on the face of the bill, ever could coexist in the samepatient. (See Bath and Cheltenham Gazette, September 8th, 1852.) Observe, the adverse medical evidence denied the possibility of the coexistence of gonorrhcsa and syphilis. With such evidence as this before them, the Jury could come to no other conclusion than that the bill was a concoction, and the whole transaction a fraud. My only wonder is, that with such extraordinary medical evidence against me, the Jury were bold enough to cut down the damages from £50 to £15. With regard to the bill, portions of w","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82432073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/bmj.s1-16.21.534
{"title":"On Benevolent and Provident Societies","authors":"","doi":"10.1136/bmj.s1-16.21.534","DOIUrl":"https://doi.org/10.1136/bmj.s1-16.21.534","url":null,"abstract":"","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82500992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/bmj.s1-16.21.542
{"title":"Provincial Medical & Surgical Journal","authors":"","doi":"10.1136/bmj.s1-16.21.542","DOIUrl":"https://doi.org/10.1136/bmj.s1-16.21.542","url":null,"abstract":"","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76665330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-10-13DOI: 10.1136/bmj.s1-16.21.530-a
ON the 24th of May, 1851, I was requested to visit Sarah G., aged 26, unmarried, servant. History.-That she was confined (being primipara) in London without assistance; the child still-born. That, after the labour, sloughing took place, and she was compelled to seek advice at one of the metropolitan hospitals, in which she remained three months, and at the expiration of that period was dismissed as incurable. Since then she has continued to suffer from the constant involuntary escape of urine and feces, which passed through the vagina, and so distressing was her state on this, my first visit, that she was unable to move beyond her bed, or bed-chair, frbm the intense paia and uneasiness produced by the irritating and offensive discharges4 On examination I found the external genitals immensely swollen, excoriated, and smelling most disgustingly. On introducing a speculum, I discovered that fistulous communications existed between the rectum and vagina, and urethra and vagina. Treatment.-I carefully cauterised the margins of the fistulous apertures with nitrate of silver, and adapted a vulcanised India-rubber apparatus to collect the urine, and prevent excoriation, and at the same time filled the vagina with lint, smeared with an ointment composed of iodide of lead, glycerine, and cod-liver oil. Pills of the iodide of iron and hyoseyamus were nightly administered. The fistulEe gradually closed, and in three or four months she returned the apparatus, as she deemed herself nearly well. After the lapse of ten months she again applied to me, having walked a distance of three miles. She complained of excessive irritability of the bladder, severe pain during micturition, agonising suffering after the discharge of urine from the bearingdown of the rectum, uterus, and bladder. Suspecting that stone in the bladder existed, I immediately examined, and found the orifice of the urethra very patulous, and the mucous membrane everted and excoriated. On sounding I discovered a large calculus. Dr. J. Bunny, at my request, then visited her, and most kindly assisted me in the further treatment of the case. Hoping that I might be enabled to remove the calculus by dilatation of the urethra, I introduced compressed sponged tents, and continued the process by Weiss's dilator. The patient complained so bitterly of the pain, and there being comparatively but little progress made, owing to the contracted state of the passages from cicatrices, and the size of the stone, determined me to have recourse at once to crushing, ana for that purpose I employed Professor Ferguson's lithotrite. By giving a smart blow on the side of the pelvis with the open hand, in the manner recommended by Sir B. Brodie and Mr. Skey, the calculus was soon seized, and broken, and on washing out the bladder a quantity of mucus and detritus escaped. The operation was repeated several times, a greater period being occupied in the treatment owing to the reappearance of the catamenia, which had been suppre
{"title":"Hospital Reports","authors":"","doi":"10.1136/bmj.s1-16.21.530-a","DOIUrl":"https://doi.org/10.1136/bmj.s1-16.21.530-a","url":null,"abstract":"ON the 24th of May, 1851, I was requested to visit Sarah G., aged 26, unmarried, servant. History.-That she was confined (being primipara) in London without assistance; the child still-born. That, after the labour, sloughing took place, and she was compelled to seek advice at one of the metropolitan hospitals, in which she remained three months, and at the expiration of that period was dismissed as incurable. Since then she has continued to suffer from the constant involuntary escape of urine and feces, which passed through the vagina, and so distressing was her state on this, my first visit, that she was unable to move beyond her bed, or bed-chair, frbm the intense paia and uneasiness produced by the irritating and offensive discharges4 On examination I found the external genitals immensely swollen, excoriated, and smelling most disgustingly. On introducing a speculum, I discovered that fistulous communications existed between the rectum and vagina, and urethra and vagina. Treatment.-I carefully cauterised the margins of the fistulous apertures with nitrate of silver, and adapted a vulcanised India-rubber apparatus to collect the urine, and prevent excoriation, and at the same time filled the vagina with lint, smeared with an ointment composed of iodide of lead, glycerine, and cod-liver oil. Pills of the iodide of iron and hyoseyamus were nightly administered. The fistulEe gradually closed, and in three or four months she returned the apparatus, as she deemed herself nearly well. After the lapse of ten months she again applied to me, having walked a distance of three miles. She complained of excessive irritability of the bladder, severe pain during micturition, agonising suffering after the discharge of urine from the bearingdown of the rectum, uterus, and bladder. Suspecting that stone in the bladder existed, I immediately examined, and found the orifice of the urethra very patulous, and the mucous membrane everted and excoriated. On sounding I discovered a large calculus. Dr. J. Bunny, at my request, then visited her, and most kindly assisted me in the further treatment of the case. Hoping that I might be enabled to remove the calculus by dilatation of the urethra, I introduced compressed sponged tents, and continued the process by Weiss's dilator. The patient complained so bitterly of the pain, and there being comparatively but little progress made, owing to the contracted state of the passages from cicatrices, and the size of the stone, determined me to have recourse at once to crushing, ana for that purpose I employed Professor Ferguson's lithotrite. By giving a smart blow on the side of the pelvis with the open hand, in the manner recommended by Sir B. Brodie and Mr. Skey, the calculus was soon seized, and broken, and on washing out the bladder a quantity of mucus and detritus escaped. The operation was repeated several times, a greater period being occupied in the treatment owing to the reappearance of the catamenia, which had been suppre","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79075460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1852-09-29DOI: 10.1136/BMJ.S1-16.20.508
S. Merei
{"title":"Dr. Merei on Typhus Fever","authors":"S. Merei","doi":"10.1136/BMJ.S1-16.20.508","DOIUrl":"https://doi.org/10.1136/BMJ.S1-16.20.508","url":null,"abstract":"","PeriodicalId":20791,"journal":{"name":"Provincial Medical and Surgical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1852-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75460297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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