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Mrs. W- aged 40, married, has had three children, oldest now 18, and the youngest 8 years; had three miscarriages, the first four years ago, and was caused by an accidental blow against the abdomen. From this sickness she did not recover for a number of weeks. One year afterward she had a second miscarriage, which was quite as serious as the first.

About September, 1889, she again suffered from what was diagnosticated a miscarriage, from which she did not regain her health except to be able to be up a part of the time, and occasionally to ride out in her carriage, and then to suffer greatly for a few days as the reward for her pleasure. To stand erect, or walk without the use of a cane, seemed almost impossible.

About March 1, Dr. J. C. McClintock was called in consultation. Examination revealed a firmly adherent uterus, enlarged and tender tubes; the patient suffering intensely from very careful bimanual manipulation.

We advised the removal of the appendages, as the only relief from her sufferings and means to restore her health. The patient was so much reduced in strength that her husband had to carry her up stairs. Consent was given for the operation, and it was done March 13. Dr. Ward was assisted by Drs. J. C. McClintock, J. W. Donaldson, W. H. Righter and D. F. Rodgers.

perature the first night was 99, after that it was normal.

the first twenty-four hours, owing to the nauConsiderable suffering was experienced for sea from ether. At no time was there any bloating, or soreness of the bowels.

In a letter written to a sister six weeks after

the operation, Mrs. W— said: “I never felt the wound at all. Excepting the few moments during which the stitches were being removed, I have never, at any time, felt any pain from the wound. From any trouble that the wound has given me, I would never have known it

was there."

Only four months have elapsed, yet the patient is now able to endure many hardships, and gaining every day. Her flesh is hard, skin clear, and in short she is the picture of health.

This case is reported to indicate what may, as a rule, be promised in cases demanding abdominal section when the operation is done before the last spark of vitality has ebbed out.

The KANSAS MEDICAL JOURNAL is pleased to record the above case, as it, and others previously reported show that we have in our own community, surgeons who are prepared by training and experience to perform the most difficult operations with credit to themselves, and profit to the patients.

American Rhinological Association.

OMAHA, NEBRASKA, Aug. 9, 1890. DEAR DOCTOR:-The American Rhinological Association will hold its Eighth Annual Session at Louisville, Ky., October 6, 7 and 8.

All leading subjects relating to nasal and naso-pharyngeal diseases will be opened for tion. The medical profession is cordially indiscussion by a leading fellow of the associa

The secretary, Dr. R. S. Knode, Omaha,
Nebraska, will furnish any information to
physicians desiring to become members.
FOR Pruritus ani:

The patient would not relax under the anesthetic, which made it quite difficult to oper-vited to attend. ate through a two-inch incision-so perfectly rigid were the recti muscles. Adhesions were numerous and dense. Considerable delay was caused by a bleeding point, where the bleeding was persistent, before the vessel could be found and ligated. The retention of the drainage tube was prolonged to 36 hours, owing to the oozing.

No untoward symptoms occurred to interrupt the progress of her recovery. The tem

R. Benz. oxid. zinc. Ung.

Campho-phenique, āā 3 ss.
M. Sig. Apply as often as necessary.
The itching frequently disappears as if by
magic.-Medical Progress.

Fracture of Base of Skull.

THE dysenteric period of the year is here. MEDICAL MISCELLANY. Malaria and dysentery, so to speak, work together. Do not make the mistake of calling this combination typhoid fever (and we think this mistake is made very often.) Don't forget to begin the treatment by a saline cathartic The following case recently came under my and complete irrigation of the bowels, with care. F. R. a farmer boy, aged 13, was kicksalt water as hot as can be borne. By the ear-ed by a barefooted horse about noon, May 21, ly free irrigation and clearing out the intestinal last. I saw him about 4 p. m. the same day. tract, the dysentery may be arrested. This is Besides several lacerated wounds in the soft simple, scientific and sure.

IN the malarial fevers, when the irritable stomach will neither tolerate food or medicine, think of your hypodermic syringe and that the neutral hydrochlorate of quinia will dissolve in twice its weight of water, and is the best preparation of quiniæ for hypodermic use. You can give ten grains of quiniæ at a dose if your case demands it. This is the ideal method of producing cinchonism. Then the children, how difficult to give the bitter drug. Rub it into the skin, inject into the rectum. Save the stomach, minister to the nutrition of the system.

IT IS said that women have not had equal advantage in the medical profession with men, and that obstetrics and gynecology should be given to them exclusively. But from the history of the past, when they were in full possession of the field, they let the science dwindle into empyricism and superstition, and it reverted back to men. The advantages of women, like that of men, being greater now, and with renewed inclination on their part to occupy the field again, they may elevate it into a higher state of perfection through the increased advantages of a higher civilization.

tissues I found a compound dislocation backward and downward of right nasal bone. Air passed in and out at base of nose during the respiratory acts.

He had been unconscious about one hour

after the receipt of the injury but seemed perfectly rational when I arrived.

The lids of both eyes were swollen, the right so much so, that it was difficult to get a view, of the eye. Profuse subconjunctival hemorrhage had occurred. Considerable sero-sanguinolent fluid drained from the right nostri for three days. This I regarded as the arach

noid fluid stained with blood.

Hemorrhage which had been profuse continued with more or less severity for three days, during which time the patient frequently vomited blood. The stomach showed so much irritability that it was necessary to nourish the patient by enema during the first week.

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I replaced the dislocated bone as best I could closed the flesh wounds and told the friends that in my opinion, the base of the skull was fractured and might prove fatal.

The fourth day after the injury, meningitis accompanied by severe pain in the rear of the eye developed. This continued with more or less intensity during the remaining five weeks the patient lived.

THE chairmen of the various sections appointed at the late meeting of the State MedDelirium, divergent strabismus, accompanical Society are getting to work, and showing ied by partial paralysis not sharply defined a lively interest. Already a programme is and a pulse below fifty-five per minute was being arranged by some two or three of the the condition which existed during the latter sections for the '91 meeting. If this means part of the second week and most of the subanything it indicates a grand meeting at Wichita. You are bound to succeed, gentlemen, go ahead.

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sequent course of the illness. There was almost entire unconsciousness for ten days preceding death.

Since it was my first case in that neighborhood my diagnosis had been negatived in the minds of the friends and neighbors by two

Foreign Body in the Throat.

competing practitioners, I solicited and secured the privilege of holding an autopsy, which was made in the presence of three BY W. B. BIDWELL, M. D., LEAVENWORTH, KAS. regular physicians and as many laymen as wished to look on.

June 12, 1890, Mary A. L-, ten years The body was greatly emaciated, right eye old, residing in the country, was holding in considerably sunken and several scars marked her mouth one of the six-pronged iron jackthe points of former wounds in the soft stones that children play with, when it sliptissues of the face. The removal of the ped down into her throat. She complained upper half of the skull and dislodgment of of its strangling her, and her mother slapped the anterior cerebral tissue revealed a solution her on the back, and afterward the patient of continuity in the cribriform plate of the tried to vomit, but in vain. ethmoid and its vertical plate projecting about three-fourths of an inch into the brain substance. Evidence of basilar meningitis was found and sero purulent fluid to the amount of six or eight ounces (estimated) was found in the ventricles which accounts for the pressure symptoms.

After a little while she said she had swallowed it and it ceased to hurt her. She was very nervous and did not sleep for two days and nights. Her throat then became sore and was filled with phlegm.

June 14' a physician was called, who probed for the jack-stone with throat forceps, and The highest temperature I found at any once thought he touched it, but afterward time was 102 F. concluded he had touched the teeth.

The force had been applied to the right nasal bone and distributed to the lower anterior portion of the vertical plate of the ethmoid with which it articulates posteriorly, causing it to rotate on a transverse axis corresponding to the base of the crista galli. A probe could be readily passed from within outward through the ethmoid bone and right nostril.

A force sufficient to produce a fracture of this kind at the base of the skull might be applied to various other parts of the skull with

out serious harm.

This idea is borne out by the anatomical structure of the ethmoid and the relation of its vertical plate to the nasal bones.

Subconjunctival hemorrhage, followed by brain symptoms after the application of any considerable force to the face should always arouse strong suspicion of fracture of the anterior fossa of the skull.

L. REYNOLDS, M. D., HORTON, KAS., July 14, 1890.

The doctor then told the mother that the jack-stone had probably been swallowed, and had caused swelling by scratching the mucous membrane as it went down.

Two days after, the soreness still continued, and pain in the arms of a pricking, shooting character was complained of, and from this time on for about two weeks, whenever the child attempted to drink the fluid came out of the mouth and nose. After this the child was quite well for about two weeks, except that no solid food was swallowed, nor had any been swallowed since the accident occurred.

The soreness of the throat becoming annoying, the voice hoarse, and the general condition failing, the physician was again called, and administered iron, probably the tincture of the chloride, as the child was supposed to have had enough cast iron.

At this time an examination with the throat mirror was promised, but as the physician failed to obtain one the child was brought to Dr. Brock August 5, her condition then being. as follows:

USE none of the oatmeal preparations that, according to their advertisements, "can be She was somewhat emaciated, expression prepared in three to five minutes." They are anxious, respiration hoarse and whistling, mostly oats, with the hulls removed, and voice hoarse and often reduced to a whisper; chemically prepared. They are very unwhole- larynx swollen, a gland opposite the cricoid some. Cook oatmeal thoroughly and a long cartilage being enlarged to the size of a small

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The patient not submitting to a larnygo- supportive and palliative treatment was conscopic examination, was ordered to return for tinued until February 9, when death closed etherization, and possible operation the fol- the scene. lowing day.

Autopsy revealed sarcoma of the kidney

Before leaving the office the throat was ex-weighing four pounds. The tumor was adamined externally by Drs. Callahan, Van herent to the adjacent structures, as the spleen, Eman and Bidwell, and the foreign body could liver, stomach and intestines. be indistinctly felt in the oesophagus just below the level of the hyoid bone.

REMARKS.

Primary malignant disease of the kidney is August 7. Chloroform was administered, and rare. It is usually unilateral, and is found. Dr. Brock, with his forefinger pushed down more frequently during the first decade of the throat, removed the offending body, which life. It occurs with greater frequency before measured about five-eighths of an inch in each the fifth year. Gross says, "it may be confidirection. dently asserted that carcinoma is never The body had become imbedded in the tis- witnessed in early life, and at least two-thirds sues, forming a pus cavity, and furnishes a of all examples recorded as cancer should be classical illustration of the symptoms caused classed as sarcoma. We accept the doctrine by a foreign body in the oesophagus; strang- that cancer are cells which have gone astray ling, attempt to vomit, inability to swallow and develop under new conditions. Some solid food, temporary paralysis, pressure on authorities maintain that cancer begins the larynx leading to hoarseness, stridulous in the cortex, and afterwards spreads to the breathing and coughing. pyramids."

The termination was a fortunate one for the patient and attendants, inasmuch as many of these cases call for surgical operations in a region abounding in large blood vessels and nerves, and the operation is both difficult and dangerous.

After removal of the foreign body the patient made a slow recovery; the swelling continuing several days.

Sarcoma of Kidney Death Autopsy.

Walks and Moxon are of the opinion that the lymphatic glands outside the kidney are primarily attacked, then the hilus.

The latter is probably the correct view. The erroneous idea that malignant tumor formation is a disease of advanced life only, leads a great many physicians to exclude it from the category of infantile diseases.

CLINICAL HISTORY.

There was a rapid growth of some parts of the abdomen, as shown by tape measurement, notwithstanding shrinkage and progressive A son of Mr. P., age 31⁄2 years, about nine emaciation of other parts of the body. The or ten weeks ago showed signs of failing primary site of bulging is, therefore, of great health, weakness by loss of appetite, anæmia, importance, as tumor of the kidney will disfretfulness, etc., slight fullness appeared just place other organs upward towards the above the left lumbar region, posteriorly, thoracic viscera. This was demonstrated in which soon showed in front, about the region the case just cited. The tumor during life of the spleen and stomach. Bowels were was not located particularly in the renal reregular; appetite gradually declined. No gion, but attained its greatest prominence fever, no hæmaturia. About two weeks before, over the region of the spleen and stomach. death occurred, examination showed lungs and liver normal: emaciation, enlargement of the abdominal veins, large tumor over the region of the spleen and stomach, with slight bulging over the upper part of the left lumbar region, posteriorly.

The

The heart becomes embarrassed, the lungs compressed, so that dyspnoea is a prominent symptom during the latter stages of the illness. Usually only one kidney is effected. right has the preference. Hæmaturia is not found so constantly in malignant renal growths The tumor was smooth and dull on percus- as has been generally supposed. It occurs in Aspiration yielded negative results, about forty to fifty per cent. of all cases, and

sion.

when found with co-existing tumor of the a very practical article on the same subject, kidney is confirmatory. When the tumor is read by Dr. Edward Martin, of Philadelphia large, and presses on the internal abdominal before the Philadelphia County Medical Socivessels, there will be enlargement of the ety. Since the publication of these articles. superficial abdominal veins, and anasarca and the American practitioners have been using ascites are not infrequent. The tumor does Icthyol extensively, obtaining as satisfactory not follow the diaphragm. Fever is rarely results as their German brethren. present; cachexia is common; pain may be present constantly or only occasionally.

Icthyol and Its Uses.

Sulpho-icthyolate of ammonium is a slightly volatile, dark red-brown liquid of a syrupy consistency and a pungent or burning odor and taste. The odor, although strong and peculiar is not very disagreeable or altogether

BY E. E. LIGGETT, M. D., OF OSWEGO, KANSAS. unpleasant, and both the odor and taste "may

be satisfactorily disguised by the addition of a The purpose of this article is to call your few drops of alcohol in which equal parts of attention to Icthyol, a drug whose remedial cumarine and vanalline are dissolved." it is powers, exerted in so many and such varied entirely soluble in water; also in equal parts ailments, has made for it a distinguished of alcohol and ether, and combines readily place among other remedies. My observation with the fats and the petroleum products in leads me to believe, however, that its useful- any desired proportion. ness has not been sufficiently appreciated among us local physicians; perhaps because our attention has been diverted from it by the other almost innumerable and important new remedies recently brought forward for notice and trial.

pecu

Schmidt found it to be composed of:

Carbon,
Hydrogen,

Sulphur,

55.05 per cent.

6.06 per cent.

15-27 per cent.

Ammonium,

7.73 per cent.

Oxygen,

15.85 per cent.

99.99 per cent.

Near Seefeld in the Tyrol, is found liar bituminous rock containing fossilized fish and other marine animal matter. Upon distil- It will be observed that it is especially rich lation this rock yields a clear, yellow-brown in sulphur which "is so intimately associated oil called icthyol; so named from two Greek that it cannot be separated without complete words meaning, literally, fish oil. This distillation product, icthyol, treated with sulphuric acid and then neutralized with sodium or ammonium, produces the sulpho-icthyolate of sodium or ammonium. These icthyolates are the preparations used in medicine, preference being given by nearly all practitioners, to the ammonium compound.

Icthyol, or its compounds, was first prepared by Schrötter, a chemist of Hamburg, and used by Unna in the treatment of skin diseases, in 1882. It rapidly grew in favor among the Germans and since that time has received marked attention and been used with great satisfaction by them.

decomposition of the substance;" and according to Unna, "the sulphurous constituents of Icythol represent its essential and active principle." It is described by the same authority as being "powerfully antiphlogistic causing anæmia and rapid subsidence of swelling in all tissue," this effect being attributed to its action on the blood vessels whereby their calibre is lessened. Physiological studies, however, have not given a very satisfactory explanation of this effect, nor indeed of its general action.

Used as an internal medicament, Baumen and Schotten found it to be innocuous when given to dogs in less than two drachm doses; larger doses caused "copious intestinal evacuIn 1886, in the June and July numbers of ations which continued for several days." the Therapeutic Gazette, Joseph Schmidt, of "Professor Nussbaum took seventy-five grains Berlin, published an elaborate and exhaustive without ill effects or inconvenience;" the orarticle describing Icthyol and its uses. The dinary dose, however, is from one to five Medical News of February 11, 1888, published grains three or four times a day. It may be

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