Clinical report [on cases in the Edinburgh Surgical Hospital] for the winter session 1834-35.

  • Syme, James, 1799-1870.
Date:
1835]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical report [on cases in the Edinburgh Surgical Hospital] for the winter session 1834-35. Source: Wellcome Collection.

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    ficulty after repeated purgatives and injections. In the evening and during the night, he had very frequent black vomiting. Pulse 150. On the 10th, the vomiting was succeeded by a nearly incessant and violent hiccup. A blister was applied to the epigastrium. On the 11th the hiccup still continued, and the state of the limb remained the same. Twenty leeches were applied to the groin. On the 12th, the pain and tension were diminished, and by the 15th were nearly gone. In addition to the treatment which has been stated, it may be mentioned that mild laxatives were occasionally administered, and evacuations procured regularly by injections. The patient during the at¬ tack presented a very sunk appearance, and subsequently be¬ came much emaciated. For several weeks he could not assume the erect posture without feeling great pain throughout the af¬ fected limb. On the 3d of April he put on his clothes for the first time; and on the 12th it was found that the arm had ac¬ quired considerable firmness. On the 28th he went home, a distance of twenty miles, the arm being quite rigid, perfectly straight, and not perceptibly shortened. There was still a very slight discharge of matter, but this I understand has since nearly ceased. There being only three recorded instances of this operation proving successful in ununited fractures of the humerus since the case of Mr White in 1760, I feel happy in adding another. The cases requiring it must be extremely rare, but when they do occur, it will be satisfactory to know that the cure may be thus accomplished even under circumstances rather unfavour¬ able. But this case is perhaps still more interesting from the strik¬ ing example it affords of an attack similar in all respects to the phlegmatia dolens* of puerperal females occurring in a male. Other cases of the same kind are recorded, but none that I know of so well marked. There can be no doubt, after the researches of Dr Davis and other modern pathologists, that this very cu¬ rious affection depends on inflammation of the great venous trunks; and it is not difficult to conceive why this should be apt to happen after the process of parturition. But what led to it in the present case cannot be so readily explained. Poisonous effects of Mercury externally applied.—Recovery.— James Maxwell, aged 35, had been in the Hospital for some time on account of an extreme tight stricture of the urethra, from which, * An odd error has crept into pathological nomenclature through the use by Dr Davis and others of the title phlegmasia dolens, instead of phlegmatia dolens. Phleg- matia is a genus of the order Intumescentiac, of the class Cachexiae, of the system of Sauvages, while Phlegmasia is the second order of Dr Cullen’s class Pyrexiae.