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An Abdominal Section

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

Considerable suffering was experienced for Dr. M. B. Ward has furnished a detailed re- the first twenty-four hours, owing to the nauport of an operation for the removal of the

sea from ether. At no time was there any uterine appendages, a synopsis of which is as bloating, or soreness of the bowels. follows :

In a letter written to a sister six weeks after Mrs. W—, aged 40, married, has had three the operation, Mrs. W— said: “I never felt children, oldest now 18, and the youngest 8 the wound at all. Excepting the few moments years; had three miscarriages, the first four during which the stitches were being removed, years ago, and was caused by an accidental I have never. at any time, felt any pain from blow against the abdomen. From this sick- the wound. From any trouble that the wound ness she did not recover for a number of has given me, I would never have known it weeks, One year afterward she had a second

was there." miscarriage, which was quite as serious as the

Only four months have elapsed, yet the pafirst.

tient is now able to endure many hardships, About September, 1889, she again suffered and gaining every day. Her flesh is hard, from what was diagnosticated a miscarriage, skin clear, and in short she is the picture of from which she did not regain her health ex-health. cept to be able to be up a part of the time, This case is reported to indicate what may, and occasionally to ride out in her carriage, as a rule, be promised in cases demanding aband then to suffer greatly for a few days as dominal section when the operation is done the reward for her pleasure. To stand erect, before the last spark of vitality has ebbed out. or walk without the use of a cane, seemed al- The KANSAS MEDICAL JOURNAL is pleased most impossible.

to record the above case, as it, and others preAbout March 1, Dr. J. C. McClintock was viously reported show that we have in our called in consultation. Examination revealed own community, surgeons who are prepared a firmly adherent uterus, enlarged and tender by training and experience to perform the tubes; the patient suffering intensely from most difficult operations with credit to themvery careful bimanual manipulation.

selves, and profit to the patients. We advised the removal of the appendages, as the only relief from her sufferings and American Rhinological Association. means to restore her health. The patient was

OMAHA, NEBRASKA, Aug. 9, 1890. so much reduced in strength that her husband had to carry her up stairs. Consent was given

DEAR Doctor:—The American Rhinologfor the operation, and it was done March 13. ical Association will hold its Eighth Annual Dr. Ward was assisted by Drs. J. C. McClin- Session at Louisville, Ky., October 6, 7 and 8. tock, J. W. Donaldson, W. H. Righter and D.

All leading subjects relating to nasal and F. Rodgers.

naso-pharyngeal diseases will be opened for The patient would not relax under the an- tion. The medical profession is cordially in

discussion by a leading fellow of the associaesthetic, which made it quite difficult to oper- vited to attend. ate through a two-inch incision---so perfectly

The secretary, Dr. R. S. Knode, Omaha, rigid were the recti muscles. Adhesions were

Nebraska, will furnish any information to numerous and dense. Considerable delay was caused by a bleeding point, where the bleeding physicians desiring to become members. was persistent, before the vessel could be

For Pruritus ani: found and ligated. ligated. The retention of the

R. Benz. oxid. zinc. Ung. drainage tube was prolonged to 36 hours,

Campho-phenique, āā 3 ss. owing to the oozing.

M. Sig. Apply as often as necessary. No untoward symptoms occurred to inter- The itching frequently disappears as if by rupt the progress of her recovery. The tem magic.-Medical Progress.

of the eye.

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

Fracture of Base of Skull. 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.

tissues I found a compound dislocation back

ward and downward of right nasal bone. Air In the malarial fevers, when the irritable

passed in and out at base of nose during the stomach will neither tolerate food or medicine,

respiratory acts. think of your hypodermic syringe and that

He had been unconscious about one hour the neutral hydrochlorate of quiniæ will dis- after the receipt of the injury but seemed solve in twice its weight of water, and is the perfectly rational when I arrived. best preparation of quiniæ for hypodermic use.

The lids of both eyes were swollen, the right You can give ten grains of quiniæ at a dose if

so much so, that it was difficult to get a view, your case demands it. This is the ideal meth

Profuse subconjunctival hemorod of producing cinchonism. Then the children, how difficult to give the bitter drug. guinolent Auid drained from the right nostri

rhage had occurred. Considerable sero-sanRub it into the skin, inject into the rectum. for three days. This I regarded as the arachSave the stomach, minister to the nutrition of

noid fluid stained with blood. the system.

Hemorrhage which had been profuse conIt is said that women have not had equal tinued with more or less severity for three advantage in the medical profession with men, days, during which time the patient frequentand that obstetrics and gynecology should be ly vomited blood. The stomach showed so given to them exclusively. But from the his- much irritability that it was necessary to tory of the past, when they were in full pos- nourish the patient by enema during the session of the field, they let the science first week. dwindle into empyricism and superstition, and I replaced the dislocated bone as best I could it reverted back to men. The advantages of closed the flesh wounds and told the friends women, like that of men, being greater now, that in my opinion, the base of the skull was and with renewed inclination on their part to fractured and might prove fatal. occupy the field again, they may elevate it The fourth day after the injury, meningitis into a higher state of perfection through the accompanied by severe pain in the rear of the increased advantages of a higher civilization. eye developed. This continued with more or

less intensity during the remaining five weeks The chairmen of the various sections ap- the patient lived. pointed at the late meeting of the State Med- Delirium, 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 sequent course of the illness. There was alWichita. You are bound to succeed, gentle- most entire unconsciousness for ten days men, go ahead.

preceding death. THE words American Ambulance” are

Since it was my first case in that neighborpainted on each of the hospital wagons used hood my diagnosis had been negatived in the in Paris.--Chicago Med. Times.

minds of the friends and neighbors by two competing practitioners, I solicited and se

Roreign Body in the Throat. cured 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 After a little while she said she had swalthree-fourths of an inch into the brain sub-| lowed it and it ceased to hurt her. She was stance. Evidence of basilar meningitis was very nervous and did not sleep for two days found and sero purulent fluid to the amount of and nights. Her throat then became sore and six or eight ounces (estimated) was found in was filled with phlegm. the ventricles which accounts for the pressure June 14' a physician was called, who probed symptoms.

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 The doctor then told the mother that the nasal bone and distributed to the lower ante-jack-stone had probably been swallowed, and rior portion of the vertical plate of the ethmoid had caused swelling by scratching the mucous with which it articulates posteriorly, causing membrane as it went down. it to rotate on a transverse axis corresponding Two days after, the soreness still continued, to the base of the crista galli. A probe could and pain in the arms of a pricking, shooting be readily passed from within outward through character was complained of, and from this the ethmoid bone and right nostril.

time on for about two weeks, whenever the A force sufficient to produce a fracture of child attempted to drink the fluid came out this kind at the base of the skull might be ap- of the mouth and nose. After this the child plied to various other parts of the skull with- was quite well for about two weeks, except out serious harm.

that no solid food was swallowed, nor had any This idea is borne out by the anatomical been swallowed since the accident occurred. structure of the ethmoid and the relation

The soreness of the throat becoming annoyof its vertical plate to the nasal bones. ing, the voice hoarse, and the general condi

Subconjunctival hemorrhage, followed by tion failing, the physician was again called, brain symptoms after the application of any and administered iron, probably the tincture considerable force to the face should always of the chloride, as the child was supposed to arouse strong suspicion of fracture of the have had enough cast iron. anterior fossa of the skull.

At this time an examination with the throat L. REYNOLDS, M. D., mirror was promised, but as the physician HORTON, KAS., July 14, 1890.

failed to obtain one the child was brought to

Dr. Brock August 5, her condition then being Use none of the oatmeal preparations that, as follows: 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 lulls 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 time.-N. Y. Med. Times.



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 esophagus just be

REMARKS. low the level of the hyoid bone.

Primary malignant disease of the kidney is August 7. Chloroform was administered, and 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 esophagus; 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 Walks and Moxon are of the opinion that the patient and attendants, inasmuch as many the lymphatic glands outside the kidney are of these cases call for surgical operations in a primarily attacked, then the hilus. region abounding in large blood vessels and The latter is probably the correct view. nerves, and the operation is both difficult and The erroneous idea that malignant tumor fordangerous.

mation is a disease of advanced life only, leads After removal of the foreign body the pa- a great many physicians to exclude it from the tient made a slow recovery; the swelling con- category of infantile diseases. tinuing several days.


There was a rapid growth of some parts of Sarcoma of Kidney-Death Autopsy. the abdomen, as shown by tape measurement,

notwithstanding shrinkage and progressive A son of Mr. P., age 3% 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 The heart becomes embarrassed, the lungs and liver normal: emaciation, enlargement compressed, so that dyspnoea is a prominent of the abdominal veins, large tumor over the symptom during the latter stages of the illness. region of the spleen and stomach, with slight Usually only one kidney is effected. The bulging over the upper part of the left lumbar right has the preference. Hæmaturia is not region, posteriorly.

found so constantly in malignant renal growths The tumor was smooth and dull on percus-as has been generally supposed. It occurs in sion. Aspiration yielded negative results, about forty to fifty per cent. of all cases, and

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 Soc:vessels, there will be enlargement of the superficial abdominal veins, and anasarca and the American practitioners have been using

ety. Since the publication of these articles 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

Sulpho-icthyolate of ammonium is a slightly present constantly or only occasionally.

volatile, dark red-brown liquid of a syrupy

consistency and a pungent or burning odor Icthyol and Its Uses.

and taste. The odor, although strong and pe

culiar 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 Schmidt found it to be composed of: among us local physicians; perhaps because Carbon,

55.05 per cent. our attention has been diverted from it by the Hydrogen,

6.06 per cent. other almost innumerable and important new Sulphur,

15-27 per cent. remedies recently brought forward for notice Ammonium,

7.73 per cent. and trial.


15.85 per cent. Near Seefeld in the Tyrol, is found a peculiar bituminous rock containing fossilized fish

99.99 per cent. 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 distil- decomposition of the substance ;' and accordlation product, icthyol, treated with sulphuric ing to Unna, “the sulphurous constituents of acid and then neutralized with sodium or am- Icythol represent its essential and active prinmonium, produces the sulpho-icthyolate of so- ciple.” It is described by the same authority dium or ammonium. These icthyolates are as being "powerfully antiphlogistic causing the preparations used in medicine, preference anæmia and rapid subsidence of swelling in all being given by nearly all practitioners, to the tissue," this effect being attributed to its acammonium compound.

tion on the blood vessels whereby their calibre Icthyol, or its compounds, was first prepared is lessened. Physiological studies, however, by Schrötter, a chemist of Hamburg, and used have not given a very satisfactory explanation by Unna in the treatment of skin diseases, in of this effect, nor indeed of its general action. 1882. It rapidly grew in favor among the Used as an internal medicament, Baumen Germans and since that time has received and Schotten found it to be innocuous when marked attention and been used with great sat- given to dogs in less than two drachm doses ; isfaction by them.

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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