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TRANSACTIONS OF THE ILLINOIS STATE MEDICAL SOCIETY FOR THE
YEAR 1857. Chicago: Chas. Scott & Co. From the Committee of Publication.
We have received a copy of the above, but have not time to examine it attentively. It is a pamphlet of 128 pages and in mechanical execution excellent. The sittings of the society occupied three days of two sessions each, and judging from the minutes, were industriously and profitably spent. The contents are made
of: 1. Minutes of the Seventh Annual Meeting, 2. Annual Address of the President,
9 3. Report of Committee on Practical Medicine,
28 4. Report of Committee on Druggs and Medicines, 10 5. Report on the Medical Properties of the Asclepias Tuberosa,
9 6. Report on Congestive Intermittents,
8 7. Report on the Changes which take place in the Blood in the Continued Forms of Fever,
14 8. Stomatitis Materna,
19 9. Case of Severe Mechanical Lesion of the Knee Joint, 3 10. List of Members,
4 We truly envy our Illinois brethren their interesting and harmonious meeting and the eclat of their transactions. The majority of the members of the Michigan State Medical Society voted themselves too poor to publish their transactions in pamphlet form, although they could elect a man as President of the Society, who in its early struggles toward permanent growth contemptuously derided it, and spat upon its deliberations with sovereign disdain.
We wish the Illinois State Medical Society a long continuance of harmonious action and an annual exbibit of their deliberations.
KI We have received the first number of a new medical journal published in San Francisco, California, and called The Pacific Medical and Surgical Journal, edited and published by John B. Trask, M. D., and David Wooster, M. D. This is the second medical journal started in the golden land, and although its predecessor died from inanition, we can see no reason why it should not succeed. It is a monthly journal of forty-eight pages and well filled with interesting and instructive matter. Our best wishes attend it. W. B.
With this number of the Peninsular closes my editorial career for the present. In all my relations with its readers, (and they have been those that would engender ill feeling, if any,) I can
with but a few solitary exceptions, have been of the most pleasant character. Though necessitated often to remind them of unpaid subscriptions in order to furnish them their intellectual pabulum, the response has always been hearty, and with due acknowledgement of neglect.
The books of the Journal yet show an indebtedness of over $1,000, much of which we yet hope to receive. We are owing our printer, (who must be paid,) and therefore, even in our last public capacity of an editor, must needs remind and request of those who have not yet paid, that their remittances are anxiously awaited. In the February number of the Peninsular we sent a statement of the standing of all in arrears.
Since that time we have received some $80. We need the balance in order to the just settlement of our indebtedness, and trust that this, our last appeal, will be fully appreciated.
K Cincinnati Lancet & Observer will please send us the February number, as we have not received it. The article by Dr. Chas. Tripler, U. S. A., in the March number is worth the subscription for
let alone the other valuable matter. The March number is such an improvement over the January one, that we take back all we said about typography, and recommend it as a model journal.
IT In the Southern Journal of Medical and Physical Sciences for December, and which has just come to hand, we learn that its publication is to be suspended, and that a new journal under the name of The East Tennessee Medical Times will take its placeour friend Richard 0. Curry, M. D., at the helm. We wish it a better prosperity than has attended its predecessor. Please send us individually a specimen number.
I Will friend Bowling of the Nashville Medical Journal please send us the January and February numbers, as we have not received them?
I Will the American Medical Monthly please send us the February number for 1857, in order to complete the volume for binding, and oblige?
KI Will the N. O. Medical News and Hospital Gazette send us number eight for 1857 ?
South CAROLINA MEDICAL ASSOCIATION.-We have only time, before going to press, to return our thanks to some unknown friend for a copy of the excellent annual address of the President of this Association, Dr. R. W. Gibbes, which was delivered on the 3d February, 1858. The address is worthy of the author; that is praise sufficient for those who know him.
The delay in the issue of the March number of the Peninsular Journal affords us time to barely notice the following
DISSOLUTION. On Thursday evening, March 4th, 1858, the Detroit Medical Society, organized in May 1853. It has existed four years and ten months. It had its day. Requiescat in pace.
Two CASES OF EXSECTION FOR CARIES. By C. E. Isaacs, M.D., Consulting Surgeon to King's County and Blackwell's Island Hospitals.
CASE 1.- Caries of the lower third of the fibula—Exsection of that portion of the bone-recovery.-M–, a girl eighteen years of age, of scrofulous constitution, an inmate of King's County Hospital, came under
my notice on the 15th of August, 1857. She had suffered almost constant pain for several months, in the lower and outer part of the right leg. On examination, I found this much discolored and swollen, and presenting several pouting, fistulous orifices, from which was discharged a serous, curdy and offensive pus. On passing a probe into these sinuses, I could easily detect diseased bone at various points, corresponding to the course of the fibula. The pain in the part gradually ceased until the patient, at first reluctant, at length consented to an operation for the removal of the diseased bone. On the 22d of August, assisted by Dr. Turner, Resident Physician of the hospital, and Drs. Ghent and Farley (the patient having been placed under the influence of ether), I made an incision directly over, and parallel with, the longitudinal axis of the fibula, commencing just above the junction of the lower with the middle third of the bone, and completely down to its surface. The muscles and other soft parts were separated from around the bone, and this was then sawn through by a small straight saw, which was passed underneath it, and made to cut from below upwards. The bone was thus divided at the junction of the lower with the middle third of the fibula. The external malleolus was much enlarged from ossific masses and spiculæ, which projected from its outer surface. The interosseous ligaments, and those connecting the malleolus to the astragalus and os calcis, were then divided, and the lower third of the fibula completely removed. By this procedure, the ankle joint was necessarily opened to a large extent, and the lateral, smooth, polished surface of the astragalus, which articulates with the external malleolus, was exposed. The portion of the fibula removed was entirely carious, with the exception of the articulating surface of the lower part of the fibula, and which is naturally opposed to that of the astragalus. This was in a normal condition. The hemorrhage was inconsiderable. The wound was filled with pledgets of very soft lint and a compress, and a few turns of a roller applied. A well padded splint was applied on the inside of the leg and foot, in order to prevent the strong tendency of the foot to turn inwards.
No unpleasant symptoms occurred after the operation. It is now more than five months since it was performed. The pain has entirely disappeared, and the patient can now walk almost as well as ever, and the motions of the ankle joint, both forward, backward, and laterally, are nearly perfect.
From the large opening necessarily made into the ankle joint, by the removal of the external malleolus, I expected that at least some
I anchylosis would certainly follow this operation. I was therefore much surprised and gratified that this result did not take place.
CASE 2.- Case of Caries and Exsection of the three first metatarsal bones—Recovery.-J. C., æt. nineteen years, of good constitution, a resident of Shark River, New Jersey, was brought to my
office on the 28th of September, 1857, on account of an injury of his foot, which he had received one year previously. He informed me that at that time a horse had stepped upon his foot, in consequence of which it became severely inflamed, and that since that time he had had more or less pain in it almost constantly, and had been unable to walk, or indeed even to put his foot upon
the ground. Hed had kept the leg constantly flexed upon the thigh, and almost always nearly at an acute angle. As a consequence, the tendons had become contracted, and I could not succeed in straightening the limb by any reasonable amount of force. The anterior half of the foot was of a dark red color, much enlarged, with numerous fistulous openings over the metatarsal bones, and which, when examined with the probe, were all found to lead to carious bone.
The amount of disease in these parts seemed to be so considerable, that my first impression was in favor of amputation, by Lisfranc's operation, but after more minute examination, I concluded that it would be more judicious to endeavor to save the foot, by ex-secting only the bones which were actually diseased. Accordingly, the next day (29th), assisted by Drs. Cullen, Enos, and Drake, the patient having been placed under the influence of chloroform, I made an incision on the inner side of the foot, over and along nearly the whole length of the first metatarsal bone, completely down to its surface; another transverse incision was then made, commencing from the centre of the first, and extending about an inch through the integuments towards the outer side of the foot. The knife was now kept
close to the first metatarsal bone, so as to dissect the soft parts completely from around the greater portion of it.
This bone, which was found to be carious, was divided by Liston's forceps, and the posterior part separated by the scalpel from the first cuneiform bone, and removed. The remainder was then taken away, with the exception of about one inch of the anterior extremety, upon which the first phalanx of the great toe is articulated. This portion, being apparently healthy, was preserved. The second and third metatarsal bones, being also much diseased, were entirely removed by cutting through them with Liston's forceps, and then disarticulating their extremities from the second and third cuneiform bones, and from the first phalanges of the second and third toes. A number of irregularly formed masses of ossific matter, which had been thrown out in the vicinity of the diseased bones, was also taken away.
The hemorrhage, which was principally from the minuter vessels, amounted, perhaps, to ten or twelve ounces. Only the external plantar, and one or two small arteries, required the ligature. The wound, which was very deep, was filled with soft pledgets of lint, covered by a compress and a few turns of a roller.
Not the slightest unfavorable symptom occurred during the whole course of treatment. After the wound had commenced to suppurate I enjoined upon the patient the necessity of making frequent extension of the leg upon the thigh, and of keeping the limb, for a considerable time every day, as nearly as possible approaching the extended position, with the view of overcoming the contraction of the parts about the knee joint. The patient came to see me on this day (December 12th), about two and a half months from the time of operation, having walked nearly half a mile. I found the wound perfectly healed. A cicatrix, about an inch and a quarter in depth, occupies the former situation of the bones which have been removed. The patient states that he is free from pain, but that there is some swelling about the foot and ankle joint whenever he walks much, but that this is daily diminishing, and the power and motions of the limb are constantly improving. He can now extend the leg upon the thigh nearly to a straight position without any difficulty, the contracted state of the parts, about the knee-joints, having almost entirely disappeared.
P. S.—This day (January 27th, 1858) I received a letter from the patient, in which he says: “I am happy to inform you that my foot
" is getting along very well. The swelling has gone out of my leg, and I now walk around with a cane, and hope I will soon walk without any." He otherwise expresses himself as exceedingly well satisfied with the result of the operation.—N. Y. Jour. of Med.
A COUNTERBLAST FOR PUFFING.
eschew Of the advertising pack. He's generally a Jew,
Invariably a quack. 63_VOL. V. NO. IX.