The Boston medical and surgical journal (1857) (14781795135)

Identifier: bostonmedicalsur5718mass (find matches)

Title: The Boston medical and surgical journal

Year: 1858 (1850s)

Authors: Massachusetts Medical Society New England Surgical Society

Subjects: Medicine Surgery

Publisher: Boston, Cupples, Upham & Co

Contributing Library: Yale University, Cushing/Whitney Medical Library

Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

Text Appearing Before Image:

n by the reporter. His con-dition was then as follows : The skin was shrivelled, cool and moist,and, upon the extremities, purple—the countenance was somewhatflushed and anxious—the tongue was cool, and thinly coated with adirty-yellow fur—the pulse from 120 to 130, and quite small—the ab-domen tympanitic—urine scanty. At long intervals the patient vomit-ed, with but little effort, a thin, stercoraceous fluid. There was nodejection, except as above mentioned, from the commencement of theattack. Stimulants were administered freely, and external warmthand frictions seemed to rally him temporarily ; so that, on the morn-ing of the 27th, he was decidedly improved. His skin was warm,and he had had some sleep. Efforts were made, by introducingOBeirnes tube its whole length into the intestine, and by passingthrough it large quantities of warm water, to penetrate the obstruc-tion, which it was evident existed ; but without avail. He sank,without pain, at 2 oclock, P.M., of the 28th.

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The autopsy was made by Dr. Ellis the same evening, and the smallintestine was discovered just caught within the inner ring, from whichit seemed to have almost escaped. It was found, however, to be firm-ly adherent, and perfectly strangulated. The whole canal, below the 64 Reports of Medical Societies. point of strangulation, was entirely empty, and contracted to the sizeshown in the drawing, while that above was, as is also shown, verymuch enlarged and discolored. The case is remarkable in two respects : First, from the fact thatthe hernia, after being apparently reduced should have remained reallystrangulated; and next, that the disease should have gone on to itsnecessarily fatal termination so very slowly and with so small anamount of active suffering. Dr. Clark remarked that he should not omit to state, as an exampleof the difficulty of verifying on a living patient a state of affairs whichmay reasonably be supposed to exist, that the patient was seen onthe 22d or 23d, by Dr. Hodg

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1857

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