Analptical Records

1883 The Lancet  
Hospital the tumour had been incised as an ordinary strumous swelling. The limb was removed at the upper third of the thigh and a rapid recovery ensued. The second case was that of a girl, aged twelve, who had complained of p'lin in the right shoulder joint for two months, which was attributed to rheumatism. One month before admission to the hospital a tumour was noticed over the right scapula ; this rapidly increased until it was the size of a man's clenched fist and was accompanied by
more » ... on. The whole of the scapula was removed, but the patient died of shock seven hours after the operation. Both tumours were mixed forms of sarcomata, and of periosteal origin. Dr. WINDLE exhibited the following specimens :-1. A large deposit of carcinoma in a left kidney, secondary to scirrhous mamma of two and a half year's duration; the patient was a female aged sixty-two. This is the only secondary deposit. After removal of the breast very little urine was passed, and none at all the day preceding death. The fatal termination occurred six days after the operation 2. Renal calculi. Right kidney very small, containing several calculi, and the gland structure was very much destroyed. The left kidney was larger than normal, but otherwiseunaltered. 3. Right kidney containing one large branched calculus and one small round one. The substance of the gland was much destroyed. The left kidney was a mass of structureless fat containing a small calculus. Mr. PRIESTLEY SMITH read a paper on the Use of Eserine in Glaucoma, in which the action of the drug in the usual forms of the disease was discussed. It was shown that the opposite effects of eserine and atropine on glaucomatous tension are not due to any influence over secretion, but to changes in the mechanical relations of the iris. Whenever atropme or eserine produces any pronounced changes in the tension of the eye, they do it by altering the relations of the iris in such a way as to injure or promote the escape of the intra-ocular fluid. This assertion was supported by comparing clinical experience with the facts discoverable by dissection in the chief varieties of glaucoma. A series of drawings from specimens of glaucoma were exhibited. In forming an opinion as to the propriety of using eserine in any individual case, the question should be asked, Is there any obstruction in the eye which is capable of reduction by contraction of the pupil ? The author advocated caution in the use of the remedy; inasmuch as where it does no good it is apt to do harm, because it increases the flow of blood through the vessels of the iris, and indeed it has been known to induce haemorrhages. Also it should never be allowed to stand unduly in the way of operative treatment, for the cases in which eserine by itself suffices to cure are few in number. Mr. WEST read a paper on Chronic Joint Inflammations and their Treatment, which he illustrated by various cases that had been under his care. He reviewed the pathology of such inflammations as they occurred in the synovial membranes, ligaments, and bones, and the effects which were subsequently produced on the cartilages. He advocated immobilisation of the limb, or rest by the weight extension, together with the application of ice and freezing mixtures to the surface of acutely inflamed joints ; where considerable effusion exists aspiration and free antiseptic incision should be employed. Mr. West considered that Listerism had revolutionised the treatment of joint inflammations, and there should be no hesitation in laying open any inflamed articulation.
doi:10.1016/s0140-6736(02)37531-7 fatcat:3dfj5zsgojef7evfx4znlo5r4e