Case of Spontaneous Keloid

Henry Tuck
1869 Boston Medical and Surgical Journal  
set. 51, born in Ireland, but has lived in Boston for tho last twenty years. Is of healthy parentage, and to his knowledge no member of his family has ever had cancer, tubercle or scrofula. Patient himself has always enjoyed good health, except that for some years past has suffered more or less from luumorrhoids. For this latter trouble 1 was called to see the patient, and while talking with him (ho having on a loose flannel shirt, unbuttoned in the neck), I noticed some red spots on his chest.
more » ... spots on his chest. A closer examination showed them to be patches of kcloid. Patient thinks that he never had anything of the kind till six months ago, when ho first noticed a small red spot on his chest, just over the middle of the sternum. Since then this has gradually enlarged, and several other smaller patches have appeared in its neighborhood. At the present time there are five patches, two of which are one inch and a half long and half an inch broad, and the other three rather smaller than this, scattered over the centre and upper right half of the chest. In tho immediate vicinity of these larger patches thero are perhaps a dozen other smaller ones, varying from the size of those just mentioned to that of a pea. The patches, especially the larger ones, have the perfectly characteristic appearance of keloid. They arc hard, red bands raised about two lines above the surface of the skin, crossed at intervals with strips of white, glistening, cicatricial-looking tissue. The long diameter of the paftehes runs across tho chest. They are not painful either on light or deep pressure, and only annoy the patient by excessive itching, especially in tho morning on rising. The patient has never had any cut, burn, or injury of any sort on his chest, and tho disease is entirely of spontaneous origin. Treatment.-All internal treatment is useless. Extirpation with tho knife gives only temporary relief, as tho diseaso always returns. As good a plan as any is, according to Hebra, to apply ung. hydrarg. over tho patches of the disease. This relieves the itching and prevents tho patient from Scratching himself, which, unless prevented, often leads to ulcération of the patches. Tun New Jersey Insane Asylum of Trenton has 519 inmates. One sixth are paying patients, and live sixths are supported by taxation. SCIATICA TREATED BY ACUPUNCTURE Mr. EniTon, -Believing that acupuncture has nearly fallen into oblivion, 1 cannot forbear recording an interesting case of sciatica in which I successfully tried this method. A gentleman alighted from his carriage with great difficulty and in extreme pain, and limped into my office. He had long been suffering from unilateral sciatica, which had proved rebellious to ordinary remedies. Having determined on the application of acupuncture, 1 selected twelve line steel needles, which I inserted in tho direction of the nerve along tho ischiotroohanterio fossa. After stretching the skin tense with my left hand, 1 seized a needle by its head, and, holding it at an angle of 45°, passed it through tho skin about half an inch, in a boring or rotatory manner. All the needles were successively applied and left in place half an hour, when they were extracted in the same rotatory manner, 1 now requested the patient to get up and walk, well knowing that when acupuncture is going to do good the benefit is generally immediate. To his astonishment, ho rose ctiid walked with case and without pain. The cure was radical.
doi:10.1056/nejm186901210792505 fatcat:jk5bsybdufanvlvz4ua5wf3mpa