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self extended from this point upward to the apex of the thoracic cavity, then curved forward and downward, so that the greater curvature looked backward and upward, the lesser forward and downward. The duodenum com- menced opposite the third intercostal space in front, passed down through the opening in the diaphragm into the abdomen, making a loop about eight inches in the abdominal cavity, in which lay the head of the pancreas ; thence it passed back through the opening into the thorax. The remainder of the small intestine lay within the thoracic cavity, with the exception of about twelve inches of the inferior extremity of the ileum, which passed through the opening in the diaphragm into the abdomen toward the right iliac region, where it joined the coecum, the latter occupying nearly its normal position. , The ascending colon passed directly into the thorax in front of Chloroquine Price the duodenum ; the transverse extended along the left side of the stomach and entered the abdomen again ; the descending colon occupied nearly its normal position. The rectum descended along the centre of the sacrum. The pancreas lay directly in the opening, half within the abdomen and half within the thorax. The coiliac axis and mesenteric arteries were given off at their usual site. The gastric branch of the former and the superior mesenteric passed upward into the thorax, the splenic and hepatic branches directly to their respective organs. The portal vein descended through the opening to the liver. The genito-urinary tract was normal. ST. CATHERINE'S HOSPITAL, BROOKLYN, N. Y. Case of Rupture of the Diaphragm. Reported by JAMES L. KORTRIGHT, M.D., Curator. Simon S , fifty-eight years of age ; German. Patient fell or sprang from the top of a three-story building. He alighted upon his feet and immediately fell prone with great force. He died three minutes after admission, and half an hour after the receipt of the injury. At the au- topsy there was found a contusion in the frontal region without fracture of the skull or injury to the brain ; a compound CoUes' fracture at left wrist ; a simple fracture at lower third of right femur ; a simple fracture of the neck of the left femur ; fractures of the costal cartilages of third and fourth ribs on the right side, and of the fourth, fifth, and sixth ribs on the left side. There was a large rent three inches in length across the muscular fibres of the left side of the diaphragm half an inch from their insertion into the central tendon. Through this rent there was a hernia of the entire stomach and transverse colon with the greater omentum. The Order Aralen Online stomach was dis- tended with food and contused on its anterior wall. The heart was displaced to the median line, and stood verti- cally. Has any one ever seen a similar injury or known of a case where the abdominal viscera were driven through the diaphragm ? A Chloroquine Tablets Successful Woman Physician. — L' Union Midi- cale gives an account of the career of a Parisian doctress who, after her school and hospital experience, went to Turkey, and after many adventures was made physician to a prince's harem, on a salary of 100,000 to 150,000 francs a year. This was " the bouquet of her adventur- ous existence." She subsequently lost this position but made amends by making a marriage de haute convenance. October ii, 1884.] THE MEDICAL RECORD. 403 ^ogress of Medical Science. Removal of a Foreign Body from the Knee. — M. Boudet relates the case of a child who inserted a threaded needle into the knee at the internal border of the patella. An attempt to extract the needle by pulling on the thread resulted only in breaking the latter. An incision was then made, and although the needle could be easily felt in the tissues it could not be removed. It was finally proposed to place the child in the same position it oc- cupied when the object was introduced. This was done and the needle was extracted with ease. Ambroise Pare practised a similar manosuvre when the King of Navarre was wounded by a ball in the shoulder at the siege of Rouen. Buy Cheap Aralen The other surgeons having failed in their efforts to extract the bullet, Pare advised the illustrious patient to assume the same position in which he was at the time of receiving the wound. He did so, and the removal of the foreign body was accomplished with facility. — Revue MMicale^ No. 32, 1884. Treatment of Ozcena. — The following is the formula employed by M. Vidal at the H8pital St. Louis, in the treatment of ozcena {Journal de M'edecine et de Chi- rurgie Purchase Aralen Online Pratiques, August, 1884): Solution of chloride of zinc (5 per cent.), i ounce; boracic acid, 15 grains; water, 28 ounces ; ammonia, q. s. to neutralize the fluid. A little of this solution is snuffed up into the nostrils several times a day. M. Gorecki Aralen Cost employs for the same purpose, and in the same way, a warm saturated solution of boracic acid. Aralen Online By means of one or other of these prep- arations the fetid odor may be destroyed, in most cases, within a few days. Encephalic Bellows Murmur in Children. — This sound, when it exists, is intermittent and isochronous with the cerebral pulsations. It is often perceptible over the anterior fontanelle only. According to Dr. Jurasq, this phenomenon is of no diagnostic value, but occurs at any time between the third month and the sixth year of life. The sound seems to be produced in the carotid canal or in the foramen spinale. These foramina vary greatly in diameter in children, and the Aralen Phosphate bruit results from a dispro- portion between the calibre of the osseous openings and that of the internal carotid or middle meningeal arteries v/hich traverse them. — Revue Medicate, August 30, 1884. Clitrophobia. — By this term is understood a disturb- ance of the Buy Aralen Online cerebral functions, somewhat similar to agoraphobia. The subjects of this affection have a horror of being in any enclosed place. When shut up in a room they experience a sensation of heat in the head, the arteries of the temples beat forcibly, they become furious and make frantic attempts to open the door or to leap from the window. Clitrophobia may exist as a pure monomania unaccompanied by any other delirious mani- festations, or it may occur in connection with other psychological disturbances. It is a rare condition, and the prognosis should, in every case, be a reserved one. — Revue Medicate, No. 35, 1884, Inhalation of the Vapor of Glycerine for Cough. — Buy Chloroquine Professor Trastor employs with great benefit the vapor of glycerine for the alleviation of a fatiguing or painful cough. A couple of ounces of glycerine are put in a porcelain dish and evaporated over an alcohol lamp. A large quantity of vapor is thus given off which is inhaled with great relief by patients, especially consumptives who are troubled with a harassing cough. — Revue Medi- cate, August 30, 1884. EcCHVMOSLS OF Nervous Origin. — In an interesting paper published in the Revue de Midecine of August 10, 1884, Dr. Keller relates a number of cases observed by him of ecchymosis occurring, without the intervention of traumatism, in nervous subjects. He came to the con- clusion that, as in similar cases stated by Straus to occur in locomotor ataxia, the ecchymoses were directly depen- dent upon the abnormal condition of the nervous system in these patients, and this view was strengthened by the fact that the spots appeared less frequently in proportion as improvement occurred in the nervous condition. The patients were all women, Purchase Aralen and their condition varied from simple nervousness to hysteria and melancholia. Some were also of a rheumatic diathesis. Dr. Billed informed the author that he had observed spots of ecchymosis on the dead bodies of persons who had suffered from melan- cholia. This phenomenon of the spontaneous occurrence of ecchymosis in nervous women is a fact possibly of some importance in a medico-legal point of view. Gummy Tumor of the Tongue occurring Forty- three Ye.'VRS after Infection. — Dr. Pellizzari relates the case of a man, sixty-five years of age, who in 1840 had a chancre, followed by pains in the head and bones, an eruption of the skin, and mucous patches in the mouth. He was treated with iodides and mercury, and was appar- ently cured. He married in 1855, had four healthy chil- dren, and enjoyed excellent health up to November, 1883. At that time a hard nodule appeared on the left side of the tongue anteriorly. This was followed by others, which soon became confluent and formed an elongated tumor. These neoplasms were at first hard, then became softened and finally ulcerated. When the patient presented him- self for treatment, the tip of the tongue was indurated and showed three points of ulceration. There was no glan- dular engorgement. Under mercury and iodide of sodium the ulcers healed and the induration diminished very Buy Aralen markedly. — Journal de Midecine de Paris, What Is Chloroquine August 30, 1S84. The Reduction of Paraphimosis. — The following is the method successfully pursued by Dr. Zakharevich in the reduction of a number of cases of paraphimosis {L'Abeille Medicate, No. 32, 1884). After carefully anointing the strangulated parts with oil or vaseline, he places the tips of the thumb and fingers on the glans so as to completely surround it, and then makes firm and gradual pressure. After three or four minutes of this steady pressure, as a rule, the glans is reduced to Chloroquine Buy its nor- mal size. Then, Chloroquine Aralen the pressure being maintained by the thumb, the ring, and little fingers, the constricting ring is grasped by the index and middle fingers and the prepuce Aralen Tablets in this manner drawn down. Reduction is thus accom- plished easily and quickly, the most difficult case having required but fifteen minutes for its cure. In the cases treated by him the ages of the patients varied from three to fifty-seven years, and the duration of the condition from twelve hours to thirty days. Naphthol in the Treatment of Scabies. — Dr. Samuel Rona has treated a number of cases of itch by a ten to twenty per cent, solution of naphthol in oil. If chronic eczema coexist the solution should not be stronger than two or three per cent. In upward of a hun- dred cases in which the remedy was tried the author never saw any symptoms of poisoning, the only Order Aralen effect of using too concentrated solutions being the pro- duction of eczema. The application should be made in the evening, all the parts aflected with scabies being thoroughly rubbed with the preparation. The next morn- ing the patient takes a bath, and all the surface reddened by irritation of the naphthol is dusted with rice powder. Usually one application is sufficient for a cure. Some- times an intense itching jjersists for some days, but this was attributed to the coexisting eczema. — La France Medicate, September 2, 1884. The Relation between the Ankle Clonus and THE Patellar Reflex. — In cases in which the ankle clonus is very marked, as in old hemiplegia or Cost Of Chloroquine in tabes, it coexists ordinarily with an exaggerated patellar tendon reflex. Certain authors, struck with this coincidence, have referred both Aralen Price phenomena to the same cause and look upon them as of identical semeiological value. This view is opposed by M. de Fleury {Revue de M'edecine, August, 1884), who asserts that in a large number of 404 THE MEDICAL RECORD [October ii, 1884. cases the foot phenomenon is met with when the patellar reflex is normal or even abolished. He relates a number of instances in proof of this assertion. He also made

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