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skin is uninvolved. There is no pain nor ten- | Femur, with Effusion into the Knee joint.-derness, no fluctuation nor pulsation, nor is Elizabeth B, æt. 15, was admitted on October there any impulse on coughing. There is no 4th. Ten days ago the patient, who lives with dimpling nor retraction of the nipple. The her aunt, was stooping to pick up something glands in the axilla are not affected. Two from beneath the bed, when she suddenly felt days after admission (January 11th) the patient a sharp pain in the knee. She is stated never was under the influence of ether, and Mr. to have been ill before. Her temperature, on Bloxam made an oblique incision, under anti- admission, 102.2 Fahr., and the kneeseptic precautions, about three inches long, joint was hot and a trifle swollen. Ice-bags along the axillary border of the left mammary were applied. 5th-Morning temperature 103° gland. From this wound a mass of tissue was Fahr., evening temperature 101° Fahr. Paremoved, about the size of a pigeon's egg. tient passed a bad night, and has no appetite. On section, this was found to consist of dense Tongue furred, and bowels confined. She was fibrous tissue scattered about, in which were a ordered to take infus. sennæ comp. Ziss. 7thnumber of cysts, containing a dark-brown | The knee is about the same. Her temperature viscid fluid, which was not at all offensive. The in the afternoon was 103.2° Fahr. 8th-Pawound was then closed by means of horse hair tient passed a restless night, temperature 103.3° sutures, and a drainage-tube inserted. Tem- Fahr. The joint is more swollen and someperature some hours after the operation 99.2° what easier. 11th-Patient passed a better Fahr., pulse 78.. The wound was dressed on night, temperature 101.2° Fahr. She comthe 14th, when it looked healthy, with very plains of pain in the right groin. The tongue little discharge. Temperature 101° Fahr. is cleaner. The swelling seemis somewhat less. Patient feels comfortable, and there is no pain. 17th--Patient's condition remains about the 23d—Sutures were removed to day; everything same. She has required sleeping draughts on is proceeding satisfactorily. Patient left cured two or three occasions. The swelling of the on the 25th.
knee is less, but the lower part of the thigh is Inflamed Inguinal Glands, consequent on very tender to the touch. The temperature Irritation from External Hemorrhoids.-has returned to normal. 25th— There is a good Ellen N—, cook, was admitted on December deal of thickening around the lower part of IIth, complaining of swelling and pain in the thigh, but not much pain. The synovitis right inguinal region. She says she has been of knee has practically disappeared. Poultices suffering from piles for two years, and has now and fomentations were constantly applied. No some inflamed, external piles. Three or four fluctuation could be detected. No further days ago she had to lift a heavy pan off the elevation of temperature took place, and the fire and the glands began to swell two or three thickening gradually diminished. Patient was hours later. The next day the enlarged glands discharged, as an in-patient, on November 14th. became painful and hot, and continued to in- Case of Paraplegia of doubtful Origin.crease in size, until her admission to the Alice D-, æt. 20, domestic, was admitted on hospital.
October 9th. She is suffering from loss of She had an ulcerated throat three months power in both legs, below the knee; she can ago, and this has recurred since. Patient is both flex and extend the knee, but is unable to anæmic looking, but says her general health is walk. Patient complains of pain over the ingood, and menstruation is regular.
ternal malleoli of both legs, also just above the She was kept in bed, and her bowels opened patellæ—this is worse in damp weather, and is by means of laxatives. The swelling at once increased by pressure. The right leg is slightly began to decrease, and the pain disappeared. Alexed on the thigh. She says she has pain Her temperature was never above normal. She occasionally of a shooting character in the left cured on the 19th. The case is peculiar, epigastric region, usually in the morning after because the patient notices that when the piles taking food. Patient is very stout, and this become inflamed she has lumps in her groin, seems more marked about the legs. Both generally on the right side near the body of the hands are weak and tremulous, the left being pubes, but they had never been as large nor as the worse. The catamenia is regular, and pain fúl as on the present occasion.
there is nothing abnormal in the heart or lungs. Case of Acute Periostitis of Lower End of Patient says she enjoyed the best of health until she was sixteen years of age, when she | Elizabeth H—, æt. 25, married, was admitted gradually began to feel weak, and apt to fall April 19th. Patient has one child, three years down, and she had to give up her situation in old, and three weeks ago she was prematurely consequence. The following week she had confined of another at seven months. Patient some sort of fit, on recovering from which she is a pale, cachectic-looking woman. At the found herself unable to use either leg, from the edges, and under surface of the tongue she has hip downwards. Both arms, as high as the several shallow, sloughy-looking ulcers. The shoulders, were likewise affected, the muscles tongue itself is enlarged, red, and the epithewere relaxed, with the exception of the flexors lium is absent in patches. The right side of of the left forearm, so that the fingers of the the tongue, towards the centre, is elevated and left arm were pressing into the palm. She was indurated. Several glands in the neck, and then an in patient at the Lambeth Infirmary, groin, and around the elbows are enlarged. and the battery was used at intervals. For- Patient says the ulceration commenced some merly she had the same pain about the six months ago as a round nodule, situshoulders, elbows, and wrists as she now has in ated on the tip of the tongue, after a time this the legs. For some time after the “fit” she opened in the centre and then spread. No was unable to retain her urine, which dribbled active treatment was adopted at this time on away, and this continued for some months, account of her being pregnant. A lotion of but she gradually, improved, and in six months seven grains of bi-cyanide of mercury to half she had recovered the power. There was also an ounce of water was ordered to be applied to general anesthesia of both the arms and legs the ulcerated surface every morning. Patient when first affected, but under the use of the bat- complains that this gives her great pain, so it was tery the sensation first returned, followed later ordered to be used every other morning, and she on by the power of movement in the arms and was put on a mixture containing 15-grain doses in the legs as far as the knees. Eighteen months of iodide of potassium with Ziij of tincture of after her first attack she was able to sit up and bark, to be taken three times a day, together use her arms a little. Strength gradually be- with 5 grains of quinine, in a powder, to be came restored to the arms, but even now they taken every day at noon. May 8th—The paare far from the normal standard. Her father tient has decided signs of phthisis, and the condied of heart disease, and her mother of dropsy clusion was arrived at that the ulceration was and bronchitis. Brothers and sisters are tubercular. The above treatment was, therehealthy, with the exception of one brother who fore, abandoned. Temperature last night is consumptive. Patient was ordered to walk 102.6° Fahr., this morning 99° Fahr. The a little,'with assistance, every day. She com- glands of the neck are smaller and the tongue plains of great fatigue after walking a few steps. is less swollen. Glycerine of borax was substiGalvanism was prescribed, one pole being ap- tuted for the bi-cyanide of mercury, as an applied to the lumbar region. 20th—Patient is plication for the tongue. 23d— The condition now able to walk across the ward, leaning on of the tongue remains about the same. The one person's arm only. November roth-Pa- patient's temperature oscillates a good deal, , tient can now stand up and do a step or two and she has had a sharp attack of diarrhoea. quite alone. 27th-Yesterday patient fell She was put on cod-liver oil and syrup of the while taking a little promenade, and after- iodide of iron. She sweats profusely at night, wards complained of great pain in the left leg, and the tuberculosis seems to be making strides. which gave way and caused the accident. She There is not much expectoration. 26th-The seems to have lost all power in the legs once diarrhoea still continues, and patient was more, and can neither stand nor walk. The ordered the mistura, acid. sulph. dil. Her same treatment was continued. December 7th temperature varies from 98° Fahr. in the -Patient has begun to pick up again and can morning to 103.6° Fahr. at night. June 2d now walk a little. 20th-The improvement has .
The ulceration is no worse.
Patient was continued and she can walk a little with the ordered the brandy and egg mixture twice a help of a nurse. Patient was discharged, on day, with Kepler's extract of malt and codJanuary 4th, very much improved in health, liver oil twice a day. 5th—The diarrhea has and able to walk with the help of sticks. now ceased, but the patient complains of a
Case of Tubercular Ulceration of Tongue.- good deal of pain in her tongue and of sore
Dr. Walker also directs a gargle of honey, salt
, and vinegar to be used three or four times
CARDIAC DILATATION. Professor Da Costa often prescribesB. Tinct. digitalis
3ss. Tinct. ignatia .
zss. Tinct, cinchonæ comp.
Zv. M. Sig.-One teaspoonful three times daily.
3j. Aqua rosa
zvj. M. Sig.–Two teaspoonfuls in water three times a day.
f3j. Spts, ætheri nitrosi
q. s. ad. fzij. M. Sig.-One tablespoonful every two hours.
Dr. T. J. Draper (Weekly Medical Review) recommendsR. Tinct. nucis vomicæ
mxxx. Tinct. iodi .
mxxx. Tinct. hyoscyami
3j. Ext. buchu, A.
3j. Sat, sol. sodii sulphatis zij. M. Sig.–Teaspoonful every two hours.
M. Ft. Ung.
Sig.—Apply night and morning.
R. Atropia sulph..
gr. Quinia sulph.
3j. Acidi hydrochlorici dilut. 3ij. Syr, yerba santa
Ziiss. M. Sig.-One teaspoonful in water every four hours.
MALARIAL JAUNDICE. Professor Bartholow recommendsR. Acidi arseniosi
gr. j. Ferri sulphatis
Dr. W. C. Wile (New England Medical Monthly) frequently prescribes-R. Hydrastin
3j. Liq. morphia sulphatis
3ij. Mucil. acacia.
ziv. M. Sig.–Use as an injection four times daily after urinating.
3iij. . Potassii bicarb.
ziiiss. M. Sig.–Dessertspoonful in water every three hours.
3jv. M. Sig.- Dessertspoonful every two hours.
gr. iij. gr. xx.
R. Tinct. ignatia
13ij. M. Sig.-One teaspoonful in water before meals,
fzij. M. Sig.-One teaspoonful in water after meals.
fziij. M. Sig.-One teaspoonful in water four times a day.
HÆMOPTYSIS. Professor Bartholow frequently prescribes R. Tinct. digitalis
3ij. Vini ipecac
zss. Ext. ergota
f3ij. M. Sig.-One teaspoonful every hour.
Dr. W. F. Corlett (Cleveland Medicaļ Tinct. hydrastis
Gazette) says, as this annoying affection is Aqua lauro-cerasi .
merely a local neurosis, internal medication M. Sig.–One teaspoonful in water every four avails but little except in severe cases where hours. EPILEPSY.
the paroxysms of itching occur several times
during the day, when hydrobromic acid may Professor Bartholow frequently prescribes— be used with marked benefit. It is by local R. Sodii bromidi.
measures, however, that we are effectually able Potassii bromidi
to control it. Liq. potassii arsenitis
At the outset of a paroxysm apply caustic Tinct. colombo
ziij. Syr. zingiberi q. s. ad. zvj.
potash in strength varying from x to xxx grains M. Sig.- Dessertspoonful after meals and at too the ounce of water, to which a drachm of bedtime.
glycerine may be added, after which the followWARTS.
ing ointment should be employed :-
3ss. Dr. D. C. Platt (New England Medical
3ss. Monthly) recommends
Misce. M. Sig.–Apply once a day.
In mild cases, by omitting the caustic potash,
the following lotion will be sufficient:--
3j. Dr. J. A. Batte (Mississippi Valley Medical
3ij. Monthly) has obtained excellent results from
3ss. R. Creasoti.
R. Pulv. camphoræ . M. Sig.-One teaspoonful every four hours.
Ung. zinci oxidi benz. . 3ij.
M. Sig.--Apply externally.
Professor Pancoast recommends
R. Morphia sulphatis
3ss. Potassii bicarb.
3ij. Professor Da Costa often orders
ziij. R. Argenti nitratis
M. Sig.-Two teaspoonfuls, well diluted, every Ext. hyoscyami
gr. ij. three hours. M. Ft. pilulæ No. xii.
PLEURISY. Sig.-One pill three times a day.
R. Tinct. opii deod.
3ss. Tinct. bryonia alba
3ss. SUBACUTE RHEUMATISM,
Giss. Dr. A. J. Conger (New England Medical Syr. zingiberi
Ziss. Monthly) recommends
M. Sig.-One teaspoonful every hour. B. Potassii iodidi
3ss. Tinct. cimicifugæ .
Ziss. M. Sig.-One teaspoonful, well diluted, every M. Sig.-One teaspoonful in water every four
M. Ft. ungt.