on the 24tli March 1877 with partial hemiplegia of the left side. Trephine wound not perfectly healed. After a month her brother came to the dispensary and reported that she can walk well and the wound in the head lias almost healed.
pital
NO: II.?WOUND
ON THE
CHEST;
PROTRUSION
OP
LUNG: DEATH.
Boroo, a Mahomedan male, aged 35 years, was admitted on the 7tli May 1877, with a gaping oblique incised wound on the right side of the chest completely dividing the fourth rib, and penetrating into the thoracic cavity. A large portion of the lung protruded through the -wound; it was somewhat consolidated, cold, and adherent to the chest wall, and could not be
back. There was emphysema around the nipple and above the wound. The patient spat blood ; can speak and swallow. May 8lh, 4 P.M.?Temperature 102?F.; pulse 108 ; respiration 48. May 9th, 7 a.m.?Temperature 100?P. 4 P.M.. temperature 103?P.; pulse 108 ; respiration 48. May 10th.?Temperature 101?F.; pulse 108 ; respiration 42 ; cough troublesome; spits blood still. 4p.m.. temperature 103?; pulse 108 ; respiration 42. May 11 th.?Temperature 100?; respiration 30 ; pulse 102 ; feels pain in the chest during cough ; expectoration of blood diminished; crepitation in right infra mammary region; front of the clicst is resonant; wound suppurating. 4 p.m , pulse 108 ; respiration 4-2 ; temperature 10T F. May 12th.?Temperature 99?; pulse 90 ; respiration 35. 4 P.M., respiration 30; pulse 102 ; temperature 102?. May 13th.?Temperature 99'5?; pulse 90 ; respiration 36 ; wound extensively suppurating. 4 p.m., temperature 101?F.; pulse 108 ; respiration 42 ; bowels loose. May 14th.?Temperature 99?; tip of the protruded lung black and has a gangrenous smell. 4 p.m., temperature 103"F. May 16th.?G-urgling sound at the protruded lung during respiration, evidently from decomposition ; perspires at night.
put
\
NOTES OP TWO SURGICAL CASES. By Pooeno Chundee Singh, Assistant-Surgeon, Burrisaul. NO. I.?A CASE OP TREPHINING: RECOVERY.
Mohesliurry,
a Hindoo female, aged 19 years, liad received a contused wound on top of right temporal region, 3 inches long, and 11 inch wide, not exposing the bone but dividing all structures down to the pericranium. Behind and nearly parallel with this wound above and behind the ear, was a contused wound, 3 inches long, cutting the skin and causing much effusion of blood into the scalp. Behind the ear over the mastoid process was a small contused wound, size of a gram seed. There was also a small contused wound on the occipital region, i inch long, and 1 inch deep. No fracture of the cranial bones. She was struck with a ruler, and was admitted into the Hospital on the 10th October 1876, in a state of insensibility. Pupils normal; pulse slow and weak. The patient continued in this state for three days. October 16th ?Was delirious ; restless ; wounds on the head suppurating, the one on the top of temporal region exposing the bone. October 1*7 th to20t7i.?Talked irrationally. October 2\st.?Had fever with shivering. October 22nd to 26th.?Fever with shivering every day. October 315/?Was suddenly delirious ; part of the exposed bone in the wound was dead, having become dry and yellowish. Complained of much pain in the head. JNo puffy swelling; pulse extremely feeble. Trephining was performed without chloroform. !STo pus was found beneath the bone on the dura mater, but a very little in the cancellated tissue of the bone. After the operation the patient began to _
improve.
November 5th.?Left side of face paralysed. Speaks rationalSuffered from pain in the right shoulder and arm for Can get up and about a fortnight. Wounds granulating. walk a few steps. January 5th, 1877.?With the exception of trephine wound all others have healed. Has partial hemiplegia of the left ide ; always lies in bed; speaks rationally. Left the Hos-
ly.
May V7th.?Gets hiccup. May 18th.?Hiccup still continues; gangrene of the lung
4 p.m., respiration greatly hurried and difficult, died at night. Post-mortem Examination?The middle lobe of right lung protruded and was adherent in all directions to the adjacent The parts. A considerable portion of it was gangrenous. manubrium, to the extent of about one-half, was cut through, The cut was eight inches as also the cartilages of three ribs. in length. The thoracic cavity was nearly filled with blood. The man lived for 14 days, and the wound had been inflicted two days before admission.
extending. pulse low ;
1/ o
pital
NO: II.?WOUND
ON THE
CHEST;
PROTRUSION
OP
LUNG: DEATH.
Boroo, a Mahomedan male, aged 35 years, was admitted on the 7tli May 1877, with a gaping oblique incised wound on the right side of the chest completely dividing the fourth rib, and penetrating into the thoracic cavity. A large portion of the lung protruded through the -wound; it was somewhat consolidated, cold, and adherent to the chest wall, and could not be
back. There was emphysema around the nipple and above the wound. The patient spat blood ; can speak and swallow. May 8lh, 4 P.M.?Temperature 102?F.; pulse 108 ; respiration 48. May 9th, 7 a.m.?Temperature 100?P. 4 P.M.. temperature 103?P.; pulse 108 ; respiration 48. May 10th.?Temperature 101?F.; pulse 108 ; respiration 42 ; cough troublesome; spits blood still. 4p.m.. temperature 103?; pulse 108 ; respiration 42. May 11 th.?Temperature 100?; respiration 30 ; pulse 102 ; feels pain in the chest during cough ; expectoration of blood diminished; crepitation in right infra mammary region; front of the clicst is resonant; wound suppurating. 4 p.m , pulse 108 ; respiration 4-2 ; temperature 10T F. May 12th.?Temperature 99?; pulse 90 ; respiration 35. 4 P.M., respiration 30; pulse 102 ; temperature 102?. May 13th.?Temperature 99'5?; pulse 90 ; respiration 36 ; wound extensively suppurating. 4 p.m., temperature 101?F.; pulse 108 ; respiration 42 ; bowels loose. May 14th.?Temperature 99?; tip of the protruded lung black and has a gangrenous smell. 4 p.m., temperature 103"F. May 16th.?G-urgling sound at the protruded lung during respiration, evidently from decomposition ; perspires at night.
put
\
NOTES OP TWO SURGICAL CASES. By Pooeno Chundee Singh, Assistant-Surgeon, Burrisaul. NO. I.?A CASE OP TREPHINING: RECOVERY.
Mohesliurry,
a Hindoo female, aged 19 years, liad received a contused wound on top of right temporal region, 3 inches long, and 11 inch wide, not exposing the bone but dividing all structures down to the pericranium. Behind and nearly parallel with this wound above and behind the ear, was a contused wound, 3 inches long, cutting the skin and causing much effusion of blood into the scalp. Behind the ear over the mastoid process was a small contused wound, size of a gram seed. There was also a small contused wound on the occipital region, i inch long, and 1 inch deep. No fracture of the cranial bones. She was struck with a ruler, and was admitted into the Hospital on the 10th October 1876, in a state of insensibility. Pupils normal; pulse slow and weak. The patient continued in this state for three days. October 16th ?Was delirious ; restless ; wounds on the head suppurating, the one on the top of temporal region exposing the bone. October 1*7 th to20t7i.?Talked irrationally. October 2\st.?Had fever with shivering. October 22nd to 26th.?Fever with shivering every day. October 315/?Was suddenly delirious ; part of the exposed bone in the wound was dead, having become dry and yellowish. Complained of much pain in the head. JNo puffy swelling; pulse extremely feeble. Trephining was performed without chloroform. !STo pus was found beneath the bone on the dura mater, but a very little in the cancellated tissue of the bone. After the operation the patient began to _
improve.
November 5th.?Left side of face paralysed. Speaks rationalSuffered from pain in the right shoulder and arm for Can get up and about a fortnight. Wounds granulating. walk a few steps. January 5th, 1877.?With the exception of trephine wound all others have healed. Has partial hemiplegia of the left ide ; always lies in bed; speaks rationally. Left the Hos-
ly.
May V7th.?Gets hiccup. May 18th.?Hiccup still continues; gangrene of the lung
4 p.m., respiration greatly hurried and difficult, died at night. Post-mortem Examination?The middle lobe of right lung protruded and was adherent in all directions to the adjacent The parts. A considerable portion of it was gangrenous. manubrium, to the extent of about one-half, was cut through, The cut was eight inches as also the cartilages of three ribs. in length. The thoracic cavity was nearly filled with blood. The man lived for 14 days, and the wound had been inflicted two days before admission.
extending. pulse low ;
1/ o
