Reviews and Notices of Books

1865 The Lancet  
was only a little chronic, painless thickening of the tibia. She was therefore discharged. CASE 4.-Giles R—, aged sixteen, plasterer, admitted March 20th. Eight days previous he fell down, striking his knee. This was followed by swelling, which had gradually extended up the thigh. On admission the right thigh was found very much swollen; skin red, tense, and exquisitely painful. There was considerable effusion into the knee-joint. The patient had a strumous look, and his expression was
more » ... ession was extremely anxious. Tongue furred ; pulse very quick and feeble. Ordered fish diet ; effervescing saline draught, an ounce and a half every six hours; warm lead lotion. March 24th.-There is less pain and swelling; he can now bear it to be touched. Still looks anxious, and is feverish; pulse 120, weak. To have four ounces of port-wine daily. 29th.-The pain is now very slight, except at night, when it is much more severe. The tension of the skin has all disappeared, and the swelling is now found to be deeper-seated and apparently connected with the bone. All anxiety of countenance has disappeared. Enjoys his food. April 5th.-He does not complain of pain ; the swelling is rather less ; he has constant night-sweats, and is losing flesh; has no cough. There is evidence of consolidation at the apex of the left lung. To haav cod-liver oil, three drachms ; tincture of iodine, ten minims; compound tincture of quinine, one drachm; in one ounce of milk, three times a day. He continued to improve under this treatment until June lith, the swelling gradually diminishing, when he was seized with pain in one spot on the inner side of the thigh, and the skin there became soft and boggy. Subsequently another place formed on the outer side of the thigh, but after a time disappeared. On July 14th the skin on the inner side of the thigh gave way, and discharged a quantity of thin sero-purulent matter. On August 6th the sinus was still discharging. There was found to be very considerable thickening of the lower end of the femur, hard and firm, and evidently connected with the bone. On introducing a probe into the sinus, however, no exposed bone could be felt. He was discharged at the request of his parents.
doi:10.1016/s0140-6736(02)58400-2 fatcat:bjfii5qjf5flbbwzpyh3xxyila