115

tiously, and I do not think that any

Bsurgeon v.ho is not connected withthe Hospital would swear that if wasproper treatment to suffer a tight ban-dare to remain on a man’s leg tor fouror five days and nights, while an in-thmmation was going on, without ex-amining the wound.

The Coroner said, the surgeons hadsworn that the treatment was proper,and the verdict ought not to be againstevidence.

After some further discussion, tileJury returned the following verdict :The deceased received a cut in the

knee by accident, and fron’the effectsof IMPROPER SURGICAL TREATMENT

AND NEGLECT HIS DEATH WAS FRO-

DUCED.

The Verdict being returned, a

Juror observed, that the cut was onlytwo inches long, and that he did notbelieve any artery was cut in theknee of the deceased, as h:td beenstated by Mr. PITMAN, the surgeon.Mr. BAILEY, the toaster of the de-

ceased, %,%as of the same opinion, andsaid that the wound should be ex-

amined by a person competent to

speak to the question.

We have taken the above accountfrom the Morning chronicle of Tues-day, and as the matter is still under-going an investigation by the Go-vernors of the Hospital, we shall de-ter our observations until next week.We will publish the report of the casefrom our correspondent, together witha description of the subsequent pro-ceedings of the Hospital Committee.We recommend Mr. JEFFREYS to

resign; and cannot suffer the presentopportunity to pass without offering toMr. BAILEY onr thanks for his lm-mane and spirited exertions in bring-ing this disgraceful transaction before

t he eye of the public.

HOSPITAL REPORTS.

GUY’S HOSPITAL.Case of Fungoid Disease of the Arm.Timothy Harridan, a middle-aged

man, was admitted into the Hospitalon January 19th, under the care ofMr. KEY, with disease of the arm, ofwhich he gave the following history.-About fourteen yeas since, he per-ceived a swelling at the middle of theleft fore-arm, for which he consultedMr. T. BLIZARD, and it was consideredby him to be aneurismal, for it appearsthat the brachial at tery was tied.The patient states that after this ope-ration the swelling disappeared; the

arm got quite well, and he resnmedhis usual employments. About two

years and a half ago, another swellingappeared at the same place as theformer, and with this he came intoGuy’s Hospital as a patient of Sir A.COOPER.

Sir A. considered the disease to befungoid, as it appears t’rom the ac-count of Mr. KEY, who also statesthat the tumour was dissected outclean fr’-)m the muscles (the flexor’carpi radialis and flexor digitorumsublimis). After this second opera-tion the patient got well, and was dis-missed from the Hospital in a shorttime.A few weeks previons to his present

admission, he perceived a small tu-mour projecting from the upper partof the cicatrix, and at the same timethe arm swelled and became paiufnl.It appears that Mr. KEY puncturedthis tumour (we do not know withwhat view) and a small quantity ofbloody fluid issued from it.

At the time of our present report(Juty 15th), the arm presents thefollowing appearances :-There is afungoid tumour about the size of a-

pigeon’s egg, situated in the middle ofthe fore-arm, about one-third of thewhy dowu ; the integuments immedi-atelv around the tumour are red andshining; the glands in the axilla areenlarged, and, a few weeks after hisadmission, they supl;urxted, but thematter was ot a healthy character,running down towards the tumour;below the outer condyle of the hume-

116

rns, an artery may be felt stronglypulsating, and there is also strong pul-sation in the situation of the brachialartery, at the bend of the elbow.Upon breaking off a portion of thetumour, the remaining part bleedsfreely; but although in this particu-lar, and also in its disposition to sliootup after beiog destroyed, it resemblesfungus hæmatodes, yet some of the- essential characters of that diseaseare not present ; the fungus does not

consist of that brain-like matter, norhas the discharge that peculiar of-fensive smell which malks the truefungoid disease.The principal treatment adopted

since the patient has been in the Hos-pital, has been by means of pressureand caustic to keep domn the morbidgrowth. We understand that Sir A.CoopEn has recommended the arteryat the bend of the elbow to be tied. *

Case of malignant Ulceration of the. Scrotum, commonly called Chimney-

sweepers’ Cancer.Daniel Nash, a chimney sweeper,

aged 28, was admitted into the Hos-pitat June 8, under the care of Mr. B.COOPER, with malignant ulceration of’the scrotum and left groin. He statedthat about three years since, he per-ceived a pimple at the lower part ofthe septum scroti, which soon becameenlarged and hard like a wart; this,in the space of a few months, ulcer-ated, but the sore did not spreadrapidly. It is now about the size ofa half-crown, and has the followingcharacter : its edges are hard, irregu-lar, and exceedingly tender; largeflabby granulations may be seen aris-ing from its internal surface ; the soreis not deep, and the discharge is of avery offensive nature ; there is very- extensive ulceration of the same cha-racter in the left groin ; the testiclesare diminished in size, and have a

pulpy feel, as if broken down and de-stroyed by the disease ; there is no

« It seems (says Dr. PARRY) as ifa peculiar modification of increasedmomentum of blood, accompanied,and perhaps determined that speciesof tumour called fungus hæmatodes."—(P. 151.)

perceptible hardness to be traced

along the spermatic cord of either side,but the right inguinal glands aremuch enlarged, and will probably goon to ulceration of the same mahg.nant and destructive character as onthe opposite side. * Mr. EARLE hasstated that the perspiration of thewhole body, in this disease, has a pe-culiar ammoniacal smell; this is not

apparent in the present case. Theconstitution is evidently suffering fromthe ravages of this disease; the pulseis small and quick; he complains ofexcruciating pain, which prevents himfrom obtaining rest. The constitu-tional and local treatment, since hisadmission; have been as follows:

l9tit. Blue pill, 3 grains.Extract of henbane, 5 grains, in a

pill; to be taken every night.Tincture of henbane, 20 drops.Decoction of sarsaparilla, 2 oz., to be

taken three times a day.An ointment made ith powdered

opium and lard to be applied to thesore.

23d. Omit the former medicines.Subcarbonate of iron, I scruple, to

, be taken three times a day.

’

Opium, 1 grain to be taken at bedtime, and the hemlock poultice tobe applied to the ulcers, (thispoultice occasioned an increaseof pain.)

30. Omit the powders.Sulphate of quinine, 2 grains, to be

made into a pill and taken threetimes a dav.

I Lint to be dipped in a watery soln-tion of opium, and over this a blackwash poultice to be applied. Ftomthese applications he has found muchrelief.

Aneurismal Varix.

At the suggestion of Sir A. COOPER,Mr. KEY lately attempted to cnre acase ofanenrismal varix, by means ofpressure upon the brachial artery.The patient had been bled about sixweeks previous to his admission, andthe tumour at the bend of the arm wasabout the size of an egg, it had the

pulsating jarry motion" and hissingnoise so peculiar to this species ot

* Vide Medico Chirurgical Trausac.tions, Vol. XII.

117

swelling, (the patient had apparentlybeen bled in the median basilic vein.)A brass ring ahont two inches in

breadth, in which was fixed a screwwith a pad attached to it, was pnt onthe upper arm, and the pad placed.over the brachial artery and screwedas tightly down as the patient’s feel-

ings would permit of, but the applica-tion of the instrument occasioned somuch swelling of the arm, and pain,that it was necessary to abandon itsnse; the principle in the applicationof this instrument is by means ofpressure to effect an obliteration ofthe artery. Sir A. CoopER has snc-

ceeded, in two or three instances, incuring the swelling by means of pres-sure thus applied on the brachialartery. ,

Continuation of the case of TraumaticTetanus, from p. 62, Vol. VIII.

Our last report of this case (Jnly 12)was t’avonrable; many of the symp-toms certainly had yielded to the ex-hibition of the laudanum ; the patientcontinued much the same (with littleor no change in the symptoms untilSaturday (16th), when he obstinatelyrefused to take any more medicine.Upon visiting him on Monday, he

was obviously worse ; there was notmuch general spasm, but all the mus-cles were very ugid ; the difficulty ofdeghttition was increased, and there,piration was exceedingly anxious.Pulse very quick, but not deficient instrength. A blister was applied alongthe conrse of the spine. but lie stillrefused to take any medicine. Welearn that the violence of the symp-toms increased mnch, and he diedon the following day. His friendswould not permit the body to be exa-mined.

The operations performed this weekwere two of a trivial nature—the se-

paration of adhesions which hadformed between the lips and gnms ofa child, in consequence of the inflam-mation occasioned by the exhibition ofmercury. This operation was per-formed by Mr. KEY ; the other was hyMr. MORGAN, in a case of fistnlonsopening in the urethra, jnst anteriorto the scrotnm, and the result of uri-cary abscess ; having passeil a sound

! into the bladder, with a double-edged

scalpel Mr. MORGAN cut out the in-

teguments immediately around theopening, and then, by means of sn-tures, brought the edges of the woundtogether.

The only accidents of importanceadmitted this week are—an incisedwound of the wrist, in which the ra-dial artery was wounded ; a severescald, aud an incised wound of thethroat, occasioned by an attempt to

commit suicide. ’.

ST. THOMAS’S HOSPITAL.

Case of Strangulated Scrotal Hernia.R. J. Savage, a stout muscular

man, aged 50, was admitted into theHospital under the care of Mr. TRA-VERS, on Tuesday afternoon (July 26).abont two o’clock, with strangulatedscrotal hernia of the right side ; hestated that he had been the subject ofliernia upwards of twelve years, dur-ing which period he had constantlyworn a truss, and that occasionallywhen he took off the truss, the herniawould come down, but he had neverexperienced any difficulty in return-ing it.It came down on Tuesday morning

about nine o’clock, when he was em.ployed in some very laborious exer-cise ; and finding he was uuable toreturn it, he came to the hospi-tal. We visited the patient aboutsix o’clock, and learned the follow-ing particulars : some time after his

admission, he was put into the warmbath and bled largely, which producedmuch faintness, and upon attemptingthe taxis, the tumour appeared to

yield to the pressure; the taxis wascontinued for a long time without suc-cess ; the patient was then put to bed,and a solution of tartar emetic givenin the dose of half a grain every tenminutes, until much nausea was pro-i duced, and, whilst in this state, thetaxis was again attempted by Mr.TRAVERS’ dresser. The tumour wasabout the size of a goose’s egg, andvery firm; it had become very tenderto the touch, and the integumentswere considerably discoloured ; therewas not much tenderness of the abdo-

men. Pulse 100, and somewhat sharp.