Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner.
- Date:
- MDCCCXLIX [1849]
Licence: Public Domain Mark
Credit: Monthly retrospect of the medical sciences : January to December 1849 / edited by George E. Day, Alexander Fleming, W.T. Gairdner. Source: Wellcome Collection.
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![and all of the cases were successful. Al¬ though the bilateral operation of Dupuy- tren is occasionally performed, the lateral operation, with the gorget, is the method in common use. Supposing all of the patients to have been males in the preceding accounts when the contrary is not stated, and adding the whole of the males together, we have in 380 cases only seventeen deaths, or about one in twenty-two.—Medical Examiner, February 1849. 310. —Lithotomy—117 Calculi, weighing together four and a-half ounces, successfully removed. By Paul F. Eve, M.D.—The largest weighed 5'j- and 38 grs., the two next in size each 78 grs., and the smallest 1 gr. The calculi were four-sided, and were found, on analy.sis, to consist of phosphate of lime. The patient, forty-three years of age, received an injury of the back twenty-five years ago, after which he had difficulty in making water. For the two last years this difiSculty became so great, that, to discharge urine at all, he had to assume the horizontal position, and push up the bladder with his fingers introduced into the rectum. Much matter also came by the urethra. There was a swelling on the right side of the perineum ; and when he sat down on the edge of a chair, he felt a crepitating sensation as if a ball of snow was being crushed in the perineum. The swelling in the perineum was in¬ cised, a quantity of pus escaped, and fifty calculi were removed. They lay in a cavity which communicated through the bulbous part of the urethra with the blad¬ der, which lay two inches deeper. The lithotomy incisions were completed, and sixty-one stones removed from the cavity of the bladder. The operation occupied an hour. The patient made a good reco¬ very, and preserved his virile powers.— Amer. Jour, of the Med. Sciences, April 1849. [The author reckons this case of interest on account of the great number of the stones, and the occurrence pf ulceration by which they were in progress towards a spontaneous discharge by the perineum. Partial or complete cases of the latter oc¬ currence are related by Brodie and Lau- genbeck; and Mr S. Cooper refers to a case, recorded in 1822 in Germany, in which 398 calculi, varying from the size of a pea to that of an olive, were found in the bladder after death. By analysis they w'ere found to consist of phosphate of lime, phosphate of magnesia, and uric acid.] 311. —Re-union of Parts, after Total Separation by Incision. By Mr Denny, of Stoke Newington.—Although I am aware that there are several cases on re¬ cord of portions of the thumb and fingers having become re-united and re-organ¬ ised, after separation for a short period, still they are not so numerous, nor is the principle of grafting in the practice of surgery so well established, as to render it useless to add to their number, or to corroborate its practicability by reporting any successful case that may occur. A labouring man applied to me to dress the thumb and forefinger of the left hand, having, as he stated, met with an accident whilst cutting or chopping a handful of grass with a sickle. Upon examination, I found he had by a clean incision, cut out of the thumb a triangular-shaped piece, the incision extending from the end down the centre of the nail, nearly to the root, then outwards towards the forefinger. The piece thus disunited con¬ sisted of the portion of nail described, in¬ tegument, muscle (?), and a minute por¬ tion of bone. From the finger he had merely sliced off a piece of muscle and integument on the side next to the thumb. I sent him back the distance of two miles, to search amongst the grass for the dis¬ membered portions, which he succeeded in finding, and w'hich, upon his return, I carefully washed with warm water, and adjusted in exact apposition to the sur¬ faces from whence they were cut. I freely applied collodion, so as effectually to ex¬ clude the atmosphere, and prevent any further hemorrhage, and with narrow pieces of strapping held them firmly in the position in which I had placed them. The result has been the perfect re-union of both pieces, leaving little or no cica¬ trix. I should mention that the period that elapsed from the occurrence of the acci¬ dent to the replacing of the parts was four hours ; also that the pain, which was very acute, from the exposure of the cut surfaces to the atmosphere, ceased imme¬ diately that the parts were replaced, and the man experienced little or no pain af¬ terwards.—Dub. Med. Press, Sept. 26,1849. 312_Death from Impaction of Food in the Glottis—Deficiency of the Epiglottis. By Mr Gabb, of Hastings.—Mr J-, aged fifty, had often complained of his food “ going the wrong way.” He was in the habit of eating very greedily, and on this occasion hurriedly tried to swal¬ low a large piece of mutton chop. He began gulping, but in a few seconds seemed relieved; again he commenced doing so, when a neighbour came in, and, with the handle of a tablespoon, tried to](https://iiif.wellcomecollection.org/image/b29348390_0228.jp2/full/800%2C/0/default.jpg)
