Report of clinical cases treated in the surgical wards of the Royal Infirmary under the care of Mr. Spence during the session 1862-63 / by Arthur G. Reid.

  • Reid, Arthur G.
Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Report of clinical cases treated in the surgical wards of the Royal Infirmary under the care of Mr. Spence during the session 1862-63 / by Arthur G. Reid. Source: Wellcome Collection.

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    and thighs. On examination^ the peringenm, scrotum^ penis, and lower part of the abdomen, were found swollen and the glans dis¬ coloured. A free ineision was made in the raphe of the peringeum ; the matter which escaped consisted of pus and urine. A grooved statf was immediately passed into the bladder, the stricture divided, and a gum-elastic catheter introduced. Free incisions were then made in the infiltrated textures, and charcoal poultices applied. Although stimulants were liberally given, in order to rally him, the prostration nevertheless deepened, and he died on the fourth day after admission. Hydatid Cyst. J. F., set. 55, a native of Yorkshire, was admitted August 23, suffering from retention of urine, to fits of which he had been liable for the previous eight months. On this occasion, several unsuc- cessful attempts had been made to relieve him before sending him to Mr Spence, who, on examination per rectum, detected a large fluctuating cyst in the recto-vesical fossa, and as the curvature of the urethra was thus increased, he selected a prostatic catheter, and introduced it without much difficulty. A large quantity of water was drawn off, but the cyst, which at first was thought to be a dilated portion of the bladder, underwent no diminution in size. This proved its independent origin, and as the man was in apparently good health, and had never suffered from inflammatory symptoms in the pelvis, and as there was an indistinct feeling of a tumour deep in the right hypochondrium, it was thought probable that this was an instance of a hydatid cyst in a very uncommon situation. The patient was kept under observation, and the water regularly drawn off. At the end of a fortnight, the cyst was tapped by a curved trochar introduced per rectum. A considerable quantity of clear fluid escaped, in which, both on ordinary visual, and in microscopic examination, numerous hydatids were detected. The discharge from the rectum continued for a few days and then ceased. The cyst refilled, but while the patient was making efforts at stool, it burst; the fluid was again submitted to the microscope, and was found to contain the shreds of broken down acephalocysts. For a short time discharge continued to be passed of a purulent character, but this gradually diminished, and ultimately disappeared, leaving only a degree of hardness in the position formerly occupied by the cyst. At the date of dismissal (10th October), the deep- seated swelling in the hypochondrium had become much more per¬ ceptible to the touch. It could then be defined as a small tumour, about the size of an orange. On his returning about a month afterwards, it had attained the size of a melon, and on his again presenting himself, at the end of two months, it filled nearly the whole of one-half of the abdomen. Remarks.—There will be found in this report the first fatal cases