Page images
PDF
EPUB

Medical Times.

June 28, 1884.

THE

MEDICAL TIMES

AND GAZETTE.

A

JOURNAL OF MEDICAL SCIENCE,

LITERATURE, CRITICISM, AND NEWS.

VOLUME I. FOR 1884.

LONDON:

PUBLISHED BY J. & A. CHURCHILL, 11, NEW BURLINGTON STREET;

AND SOLD BY ALL BOOKSELLERS.

MDCCCLXXXIV.

June 23, 1884.

LONDON:

HARRISON & SONS, PRINTERS IN ORDINARY TO HER MAJESTY,

ST. MARTIN'S LANE.

AND GAZETTE.

LONDON, SATURDAY, JANUARY 5, 1884.

No. 1749.

Contents.

PAGE

CLINICAL LECTURES, &c. By JONATHAN HUTCHINSON, F.R.S., Emeritus Professor of Surgery to the London Hospital.-On Injuries to the Elbow joint in Children..

By GEORGE JOHNSON, M.D., F.R.S., Professor of Clinical Medicine, Senior Physician to King's College Hospital. -On the Influence of the Auricles in the Production of Cardiac Sounds and Murmurs

Lecture III.-By J. MATTHEWS DUNCAN, M.D., F.R.S., Physician-Accoucheur and Lecturer on Midwifery at St. Bartholomew's Hospital.-Terminations of Peri- and Para-Metritis ....

By ALFRED SANGSTER, M.B. Cantab.,
M.R.C.P. Lond., Physician for Disease3
of the Skin, Charing Cross Hospital;
and J. MITCHELL BRUCE, M.D. Lond.,
F.R.C.P. Lond., Physician to Charing
Cross Hospital, and Assistant Physi-
cian to the Hospital for Consumption,
Brompton.-On a Rare Form of Itching
Vesicular Eruption (? Hydroa Bulleux
of Bazin).

REPORTS OF HOSPITAL
PRACTICE.

GUY'S HOSPITAL:

Jaundice from Impaction of Gall-stone in common Bile-duct - General Tuberculosis with Tubercular Pericarditis, and Meningitis-Death. Under the care of Dr. Frederick Taylor

1

[merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed][subsumed][ocr errors][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][subsumed]

3

The Epidemiological Society

15

Sanitation in Egypt

15

Dr. Drummond on Diseases of the Brain and Spinal Cord...

Sir Thomas Browne's Religio Medici...... 29

Sanitation in England

15

The Plethora of Consultants.............. 15

The Diagnosis and Treatment of Diseases of the Ear

Consultants' Fees

16

The Dissector's Manual

5

The Medical Directory.

16

The Alienist and Neurologist

The Health of the Navy.

17

The American Psychological Journal... 30
Elements of Practical Medicine

[blocks in formation]

ABSTRACTS AND EXTRACTS.

[merged small][merged small][subsumed][merged small][merged small][merged small][subsumed][merged small][merged small][subsumed][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][merged small][ocr errors][ocr errors][merged small][merged small][merged small][merged small][merged small][merged small][merged small]

CLINICAL LECTURE ON INJURIES TO THE almost all complicated cases, the complication usually

ELBOW JOINT IN CHILDREN.

By JONATHAN HUTCHINSON, F.R.S., Emeritus Professor of Surgery to the London Hospital.

occurs instead.

being a partial detachment of the lower epiphysis of the humerus. The ossification of the lower end of this bone occurs, as you know, at several separate points. These are, however, pretty much on a level; and whilst it is quite possible for any one portion to be detached alone, it is also quite possible for the whole epiphysis to be cleanly separated from the shaft by a transverse line of detachment, which permits the condyles and epicondyles to pass backwards together with the bones of the forearm. I need not stop to tell you how to distinguish such an injury from a true dislocation, although mistakes constantly occur; they are excusable only by the fact that the swelling is often very great, the child difficult to examine, and anæsthetics usually omitted. I am sure that you will bear me out that cases are very common in which, after the treatment of a case diagnosed as dislocation backwards at the elbow, the joint remains stiff, swollen, and with much apparent thickening of bones for many months afterwards. Other opinions are often sought in such cases, and the surgeon who reduced the dislocation is often discredited. Such cases are almost always examples of displacement of the epiphysis, complete or partial.

GENTLEMEN,-I have often asked your attention to the fact, that the elbow is almost the only joint which in children is liable to be dislocated from violence. Now and then we see a dislocation at the hip, even in very young subjects, but as regards the shoulder, the knee, the ankle, the wrist, and the finger joints, those of us who have had the largest experience could easily count up all that we have seen. They are exceedingly rare, the cause of their rarity being that, in each, separation of the adjacent epiphysis usually Of this latter accident at the shoulder, the ankle, and the wrist, we see plenty, and at the knee and hip a few; contrary, however, to what is known to obtain at all the other articulations, dislocations at the elbow in young persons, are reputed to be common, more common, I think, than they are in adults. This fact is probably to some extent explained by the circumstance, that in young children the coronoid process is low and imperfectly ossified. I have seen many examples of complete transverse It is, of course, in the adult the chief hindrance detachment of the whole lower epiphysis, and have to dislocation, but in children its cartilaginous had opportunities of demonstrating several to you. tip may easily be crushed down, or possibly detached Most of them have come to me late, on account of This explanation, however, does not cover the whole awkward union, but in a certain number I have had ground. To a large extent, I feel sure that the an opportunity of examining the state of things immepopular belief as to the frequency of clean disloca-diately after the accident. I show you here a phototions at the elbow in children is a mistake. They are graph of one which I examined, and had taken within VOL. III. 1884. No. 1749.

« PreviousContinue »