HOTEL-DIEU.
1
542 10. Eruption is evidently getting better; bowels twice open; tongue clean. ’" 11. The itching is undiminished to-day. To have a warm bath, and repeat medicine. 18. Relieved by the bath; the itohiug is less; the legs to be sponged with warm water. To take one-sixtla of a grain of the ox,ynzuriate of merCU1’y in two ounces of a decocttOn of elm bark, three times a day. 1b. The pruriency of the eruption is still great. To use a weak ointment composed of si7nple cerate and red precipitate. 16. The ointment has considerably di- minished the irritation. 19. The eruption is dying off; bowels open ; appetite good. He sleeps well, and there is no irritation whatever. 20. Convalescing. The eruption has dis- I appeared from the legs, but has made its < appearance at the bend of the left elbow ; 1 to be treated with the ointment again. ( 27. The eruption has entirely gone. 1 29. He is dismissed quite well. J This was a good case of the licben of old g age ; its cure was entirely ascribable to the E stimulation of the red precipitate. c HOTEL-DIEU. FRACTURE OF THE OS SACRUM AND THE HORIZONTAL BRANCH OF THE OS PUBIS. M., of a strong constitution, received a vio- lent contusion from some bricks falling from the height of about 20 feet on his loins; he was taken up insensible and caried to the H6te!-Dieu in the following state ; his fea. tures were altered, the countenance pale, extremities cold and covered with sweat, and the pulse small and quick ; he was quite senseless, but slightly recovered soon after his admission, and complained of violent pain in the abdomen, particularly in the re- gion of the os sacrum and at the loins ; there was much tenderness of the hypogastrium, which also exhibited distinct fluctuation. The extreme pain which was caused by any attempt at a close examination, rendered it impossible to form any certain diagnosis, but from the great mobility of the pelvis it was suspected that it was fractured ; there was no sign of any lesion of the spine, the patient could make water, and the lower extremities were not affected. About four hours after the accident some reaction seem- ed to take place, the temperature of the skin was increased, and he complained of fie,,id- ach ; he was bled, but two ounces of blood had scarcely been emitted when he was seized with syncope, difficulty of breathing, all of which continued, and proved fatal within a few hours. On examination of the body, the skin and muscles at the loins and ; sacral region were found infiltrated with blood; the peritoneal cavity also contained . about a pint and a half ot’ blood, part of which was in the cavity of the small pelvis ; the horizontal branch of the as pubis, and i the sacro-iliac apophysis were fractured; th heart and larger vessels were empty; : the origin of the haemorrhage could not be d ise ,O"red. -La2tc. F1’anç. CASE OF GENERAL HYPERTROPHY, IN CON- SEQUENCE OF SUPPRESSED 1VIEDTSTRUA· z TION. The " Journal Hebdomadaire" contains the following interesting case, byM. de Claubry: N., of a robust constitution, had been in the enjoyment of good health up to her eighteenth year, when she, at the time of her menses, experienced a fright, in conse. quence of which the menstrual discharge was suddenly suppressed. From this pe. riod up to her twenty-ninth year, she has suffered from the effects of increasing tend. ency of the blood towards the head, but in all other respects felt quite well. The state of amenorrhcea, in which she continued dur. ing this time, has, however, caused a very remarkable change in the nutritive process, which has increased to such a degree as to produce hypertrophy of most of the soft parts of her bodv. and in particular of the muscles and subcutaneous tela cellulosa. The osseous system does not seem to have partaken Qf this chauge ; the stature is not changed, and the skull is of natural dimen- sions ; but the skin, eyelids, lips, nose, cheeks, and all the soft parts of the face, have undergone such an extraordinary de. velopment, that, at first sight, they appear to belong to a colossal fiame ; and the coun- tenance is almost become similar to that of patients affected with the species of lepra Arabum, which is called leontiasis. The tongue is also so much larger than usual, as to cause impeded articulation, and a con- tinual flow of saliva. Ttie neck is remalk. ably thick and fat, particularly at its poste- rior part ; the breasts are so large as to touch the chin. The abdomen is not very prominent, but the muscles and skin of the back and loins are very much developed. The clitoris and external genitals are also unusually large; the extremities seem at first sight very shc-rt on account of their increased volume, which does not only re- suit from the large quantity of subcutaneous fat, but also from the morbid development of the muscles, as appears from their pro- minence under the skin. The heart evinces likewise all the signs of hypertrophy, both to the touch and the stethoscope, the brain also is in a morbid state, for the patient is almost in a state of idiotism ; the digestive orguns appear to be healthy.
Transcript of HOTEL-DIEU.
542
10. Eruption is evidently getting better;bowels twice open; tongue clean.
’"
11. The itching is undiminished to-day.To have a warm bath, and repeat medicine.
18. Relieved by the bath; the itohiug isless; the legs to be sponged with warmwater. To take one-sixtla of a grain of theox,ynzuriate of merCU1’y in two ounces of adecocttOn of elm bark, three times a day.
1b. The pruriency of the eruption is stillgreat. To use a weak ointment composedof si7nple cerate and red precipitate.
16. The ointment has considerably di-minished the irritation.
19. The eruption is dying off; bowels
open ; appetite good. He sleeps well, andthere is no irritation whatever.
20. Convalescing. The eruption has dis- Iappeared from the legs, but has made its <appearance at the bend of the left elbow ; 1to be treated with the ointment again. (
27. The eruption has entirely gone. 1
29. He is dismissed quite well. J
This was a good case of the licben of old g
age ; its cure was entirely ascribable to the Estimulation of the red precipitate.
c
HOTEL-DIEU.
FRACTURE OF THE OS SACRUM AND THE
HORIZONTAL BRANCH OF THE OS PUBIS.
M., of a strong constitution, received a vio-lent contusion from some bricks falling fromthe height of about 20 feet on his loins; hewas taken up insensible and caried to theH6te!-Dieu in the following state ; his fea.tures were altered, the countenance pale,extremities cold and covered with sweat, andthe pulse small and quick ; he was quitesenseless, but slightly recovered soon afterhis admission, and complained of violentpain in the abdomen, particularly in the re-gion of the os sacrum and at the loins ; therewas much tenderness of the hypogastrium,which also exhibited distinct fluctuation.The extreme pain which was caused by anyattempt at a close examination, rendered itimpossible to form any certain diagnosis,but from the great mobility of the pelvis itwas suspected that it was fractured ; therewas no sign of any lesion of the spine, thepatient could make water, and the lowerextremities were not affected. About fourhours after the accident some reaction seem-ed to take place, the temperature of the skinwas increased, and he complained of fie,,id-
ach ; he was bled, but two ounces of bloodhad scarcely been emitted when he was
seized with syncope, difficulty of breathing,all of which continued, and proved fatalwithin a few hours. On examination of the
body, the skin and muscles at the loins and
; sacral region were found infiltrated withblood; the peritoneal cavity also contained
. about a pint and a half ot’ blood, part ofwhich was in the cavity of the small pelvis ;
the horizontal branch of the as pubis, and
i the sacro-iliac apophysis were fractured;th heart and larger vessels were empty;: the origin of the haemorrhage could not bed ise ,O"red. -La2tc. F1’anç.
CASE OF GENERAL HYPERTROPHY, IN CON-
SEQUENCE OF SUPPRESSED 1VIEDTSTRUA·z TION.
The " Journal Hebdomadaire" contains the
following interesting case, byM. de Claubry:N., of a robust constitution, had been in
the enjoyment of good health up to her
eighteenth year, when she, at the time ofher menses, experienced a fright, in conse.quence of which the menstrual dischargewas suddenly suppressed. From this pe.riod up to her twenty-ninth year, she hassuffered from the effects of increasing tend.ency of the blood towards the head, but inall other respects felt quite well. The stateof amenorrhcea, in which she continued dur.ing this time, has, however, caused a veryremarkable change in the nutritive process,which has increased to such a degree as
to produce hypertrophy of most of the softparts of her bodv. and in particular of themuscles and subcutaneous tela cellulosa.The osseous system does not seem to havepartaken Qf this chauge ; the stature is not
changed, and the skull is of natural dimen-sions ; but the skin, eyelids, lips, nose,cheeks, and all the soft parts of the face,have undergone such an extraordinary de.velopment, that, at first sight, they appearto belong to a colossal fiame ; and the coun-tenance is almost become similar to that ofpatients affected with the species of lepraArabum, which is called leontiasis. The
tongue is also so much larger than usual, asto cause impeded articulation, and a con-tinual flow of saliva. Ttie neck is remalk.
ably thick and fat, particularly at its poste-rior part ; the breasts are so large as to
touch the chin. The abdomen is not veryprominent, but the muscles and skin of theback and loins are very much developed.The clitoris and external genitals are also
unusually large; the extremities seem at
first sight very shc-rt on account of theirincreased volume, which does not only re-suit from the large quantity of subcutaneousfat, but also from the morbid developmentof the muscles, as appears from their pro-minence under the skin. The heart evinceslikewise all the signs of hypertrophy, bothto the touch and the stethoscope, the brainalso is in a morbid state, for the patient isalmost in a state of idiotism ; the digestiveorguns appear to be healthy.
