Volume 1

The Hunterian oration, presidential addresses, and pathological and surgical writings.

  • Hawkins, Caesar Henry, 1798-1884.
Date:
1874
Catalogue details

Licence: Public Domain Mark

Credit: The Hunterian oration, presidential addresses, and pathological and surgical writings. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

    460/464 (page 448)
    commenced) became developed, indicating disease of the cervical vertebrae, and consequently there can scarcely be any doubt that these curious symptoms depended upon some real disease just commencing at that time, but which appeared to arise from irritation excited by the bone. And now two or three interesting questions arise. First, the bone being lodged, and abscess being liable to form between the oesophagus and spine, did the presence of the bone give rise to disease, and were the symptoms not only indicative of such disease of the vertebrae having commenced, but actually ^.the result of the lodgment of the bone? lam inclined to think not. No difficulty of swallowing remained after the bone passed down, as would have been the case if ulceration had taken place in the tube, or if abscess had formed. Neither did any pain remain in swallowing. A lady who was under my care with an abscess in this situation suffered such pain and incon- venience that she was almost entirely unable to swallow, or even to breathe freely. Neither of these remained in our patient after the bone had passed on. Again, it might be supposed that the disease, commencing in the spine, had given rise to the whole train of symptoms. AfEections of the cervical vertebrae, both acute and chronic, sometimes occasion derangement of the function of deglutition, and the bone might become fixed, in consequence of the impaired muscular power. It is a possible suggestion. A woman came under my care, believing that she had a piece of meat sticking in her oesophagus. On examination, I found a malignant stricture, which had probably existed for some time, and which had been indicated by no symptom until irritated by the passage of a morsel larger than usual. In this way it is possible that the disease might have commenced in the vertebrEe, and been aggravated and made more active by the lodgment of the bone. But, on the whole, it appears to me most probable that the lodgment of the bone and the disease of the spine were unconnected. You will do well to watch the case. Much will depend on the local effects of the disease,—much on the effect it may have on the system. It will be weeks or months before it can be cured, and will not improbably terminate fatally. [This patient continued under treatment till October, when he left the hospital, apparently cured.] [_Medical Oatette, vol. v., new series, p. 236. END OP VOL. I. Printed by W. J. V S. &0LB0TIRN, Princes Street, Coventry Street, London. W.