Reports of Societies
1888
BMJ (Clinical Research Edition)
TuB BRITiSH MEDICAL JOURNAL 795 how much more so would it be in a(lults? Mtr. Erichsen shows the mortality to be one in three or thereabouts. If this immense mortality is comparedl to lateral lithotomy on large stones which I can show to be one in twelve, the (lifference is startling. I will now proceed to quote from Erichsen's SYurgery, 8th edlition, which I believe is the latest, vol. ii, page 988: ..." of a gross total of 467 cases of the suprapubic operation in both sexes, thlere had been
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... 5 deaths, or a mortality of 1 in 3.44; the mortality being about one in three in males." The mortality is said by Iumphry, who collectedI 104 cases with thirty-one deaths, to b due chliefly to peritonitis and uirinary infiltration. So much for the supIrapuhic operation for the present. GREAT NORTHERN CENTRAL hIOSIPITAL. CASE OF IAIDLY FATAL CIIOREA: DEATH IN 130 novnui. (Under the care of Dr. CooK and Dr. CLIFFORD BEALE.) A. C., aged 9, was brought as an out-patient on October 27th, 1887, suffering from chorea. The mother stated that on October 25th the clhild had had some difficulty in putting on her stockings ow1ng to slight loss of control over her right arm and leg. TIle mouth and eyes had been noticed to twitch next morning, and since then the irregular movements had become general, though most marked on the right side. The child hadl not taken food well, had slept badly, and been slightly delirious during the night, occasionally screaming and complaining of pain in the left hypochondrium. She had been very thirsty. The evacuations had been normal, and never passed unconsciously. She had been a fairly healthy child, and had passed through an attack of scarlet lever two years previously witlhout any known sequele. She had not been frightened, nor lnad she heen in company with other choreic children, nor had any worms been seen. When first brought under observation, on the 27th, the child was obviously very ill, with flushed face, lot skin, and a terrified expression of countenance. The choreic movements were violent, and according to the mother were hourly becoming more so. The pulse was very rapid, varying between 160 and 170, but the respirations were only slightly increased. She was at once sent into the ward, where, after careful examination, a short systolic murmur could be made out at the apex, wvhich was in the normal position. Only a few scattered crepitations could be detected in the lungs, the breathing being quite regular. The child kept constantly smacking her lip8 and frequently protruding the tongue, but there was no difculty in deglutition. October 28th. She slept very little anid was very restless, being sometimes delirious and occasionally screaming. During the day the movements became so violent as to render restraint niecessary to prevent injury. The bowels were freely open; the urine was passed involuntarily, but a little, collected, was found to be free from albumen; the tongue was clean and moist, but the lips dry and cracked; the temperature was slightly raised, but never exceeded 1010. The heart's action continued at the same rate or faster, and the pulse at tlle wrist became almost imperceptible. On the following day some difficulty w%as experienced in swallowi and the girl became very noisy, frequently screaming and uttering inarticulate sounds; the respiration became irregular and jerky, and she died rather suddenly the same evening, the whole course of the illness having run between the morning of the 25th and the evening of October 30th. At thepo.st-nortem examination both lungs were found to be much congested at the bases, and the left pleura was adherent.
doi:10.1136/bmj.1.1424.795
fatcat:zzoqczgqsfcrtatfgurw7zir7y