tumble " fight a man received a wound in the left in-
guinal region just above Poupart's ligament. .After re-
ceiving the wound he mounted a horse, rode one mile,
put up his horse, and then walked another mile to a
friend's house. " When I saw him,' writes Dr. Ward,
"he was very much exhausted. 1 found the outer open-
ing about two inches in length, and the inner, penetrating
the abdominal walls to the cavity, about one inch. Sev-
eral folds of intestine with omentum protruded, and they
were only returned after anx>sthetizing the patient. I
first closed the inner opening with interrupted sutures,
including the /c/'//'«^//;// in the sutures. I then closed the
outer integumental wound in the same way, dressing the
wound with carbolized dressing, and awaited the result.
The i)atient progressed splendidly without a rise of tem-
perature above 100°, and in less than a week from the
date of injury he was up and about his work."
THE NEW YORK ACADEMY OF MEDICINE.
Staled Meeting, October 2, 1884.
Fordvce Barker, M.D., LL.D., President, in the
Dr. F. H. Bosworth read a paper (see page 365) on
THE three tonsils SOME PRACTICAL SUGGESTIONS IN
REGARD TO THEIR STRUCTURE, FUNCTION, AND DIS-
The President called upon several gentlemen, not
specialists in diseases of the throat, to discuss the paper,
because of their experience with certain points contained
in it. He first said, with regard to his use of the bicar-
bonate of soda in quinsy, mentioned by the author, that
he had been in the habit of seeing a few cases of this dis-
ease each year, and until some years ago they almost in-
variably ended in suppuration ; but since he had begun
the local application of bicarbonate of soda in not a few
of the cases tlie disease was aborted. A marked instance
of the kind occurred in a patient seen with Dr. Bosworth,
a gentleman of eminence in literature, who was suffering
greatly from threatening abscess. The next morning
after the use Aygestin Tablets of the remedy he was found at the breakfast-
Dr. Douglas would agree with the author on most
points, but there were a few to which he must take ex-
ception. He would agree with him, for example, that
quinsy was a manifestation of rheumatism, or, especially,
of gout, and the treatment which he had employed for
this affection was Aygestin 5 Mg largely that used by the President,
namely, bicarbonate of soda. At the same time he gave
the ordinary remedies against gout. He had found the
gargle and spray of bicarbonate of soda also useful in
cases of enlarged tonsil, but one of the most beneficial
remedies for this class of cases was a powder composed
of one part of menthol to a hundred parts of sugar of
milk. He would not always resort to the knife for the
removal of the enlarged tonsil ; it could be slowly, but
surely reduced in size by the persistent use of a powder
composed of salt, camphor, ammonia, and sugar of milk.
Dr. F. H. Hamilton was inclined to agree with Dr.
Bosworth that the enlarged tonsil should be removed by
the knife ; yet he had often observed that the enlarged
tonsil of childhood disappeared before the twentieth
year. He supposed the author, when he said there was
no danger connected with the operation, meant not in
the acute or engorged stage, and not in those of the
hemorrhagic diathesis. The question had been raised
whether all or only a part of the tonsil should be removed :
he should say all that the knife would include.
Dr. Aygestin Cost Jacobi believed that the only efficient treatment
I'or the enlarged tonsil was removal ; applications would
not reduce its size, and where they had apparently done
so the reduction was due to some other cause. The en-
larged tonsil might remain stationary and ajipear smaller
after the lapse of years, because of the growth of the
fauces. As to the danger of hemorrhage, there usually
was but little loss of blood, but it Generic Aygestin might be profuse from
cutting into the soft (lalate — an accident which could
not always be avoided. The most efficient means for
stopping hemorrhage when it occurred Buy Aygestin was digital com-
pression, applied, perhaps, for an hour or more. He
coidd not agree with the author's view that follicular ton-
sillitis was an essential fever ; he looked upon it as a
local disease. What Dr. Bosworth took to be an essen-
tial fever was probably diphtheria, for cases of diphtheria
were often overlooked or mistaken for some other affec-
tion. It was a great mistake to suppose that every pa-
tient sick with diphtheria must necessarily die ; there
were many mild cases which went unrecognized, and
which were all the more dangerous for that reason, as
(hey were the more likely to spread the disease. Dr.
Jacobi laid particular stress upon this point because of
its importance to the public health.
Dr. Weder had not yet seen a case which Aygestin 5mg went to
THE MEDICAL RECORD.
[October ii, i!
substantiate the view that a phlegmonous intlanimation
around the tonsils was due to the gouty habit. He had
found it most frequently in patients of poor general
The President remarked that guaiacum had once
been strongly recommended in the treatment of quinsy,
on account of the supposed gouty origin of the affection ;
but he had not obtained the results with it which he had
been led to anticipate from reading certain articles in the
Dr. Post thought the best treatment for the enlarged
tonsil was extirpation.
Dr. Hamilton had found the external application of
ice or snow the best means for checking hemorrhage
after removal of the tonsil.
Dr. Fruitnight had aborted some cases of quinsy by
the administration of the tincture of aconite.
Dr. Jarvis again called attention to a distinction
which he had made between the soft and hard, or in-
durated enlarged tonsil, the latter being found in the
syphilitic. If the scirrhous tonsil were cut it would surely
give rise to hemorrhage, and might result fatally. He
employed the knife in the removal of the soft enlarged
tonsil, and the cautery or snare in the removal of the in-
durated tonsil. He did not think any more of the tonsil
should be removed thun was necessary, for it doubtless
served some physiological purpose, as the lubricating of
the fauces and protecting the carotid artery.
Dr. Brandeis said he believed in the Darwinian
theory of the survival of the fittest : the tonsils had sur-
vived some thousand years, had fulfilled some physio-
logical purpose, and he doubted not that they performed
their function well, whatever it might be. But the ton-
sils, like other structures, were liable to disease, and
diseased tonsils might be worse than no tonsils at all,
and therefore he believed they should in proper cases be
extirpated. He then pointed out the advantages of the
tonsillitome over the knife in certain cases. Contrary to
the experience of Dr. Bosworth, he had found hemorrhage
in young subjects rather than in tlie adult, although not
extreme. To prevent hemorrhage, he allowed the pa-
tient to sip a solution of tannic acid, and if necessary, he
applied pressure. Dr. Bosworth's description of quinsy
corresponded with that in Ziemssen's " Encyclopsedia,"
there called peritonsillitis, but Dr. Brandeis could not ac-
cept the view that it was always an inflammation of the
peritonsular sheath. He recommended aconite and the
ammoniated tincture of guaiacum in its treatment until an
abscess sliould have formed.
Dr. Corning had arrested a severe hemorrhage after
tonsillotomy in one case by the use of his carotid com-
Dr. Bosworth, in closing the discussion, said, with
regard to the possibility of reducing the size of the ton-
sils by astringents, that he believed it could not be done.
Their size, however, might be reduced in the young, in
whom they were in a state of chronic inflammation, by
the new tissue undergoing contracture. This would ac-
count for the diminished size of the tonsils on reaching
adult life. As to hemorrhage in the young, it was only
an oozing ; considerable hemorrhage only occurred in
the adult. That tonsillotomy was not dangerous was
apparent from the fact that in all medical literature not
a single fatal case was recorded. The cases in which
the carotid artery had been wounded were excepted ;
this accident could never occur in the hands of a surgeon.
In arresting hemorrhage with the actual cautery, the iron
should be applied from above downward, that it might
not be cooled by the flow of blood before coming in con-
tact with the bleeding vessel. He regarded periton-
sillitis a very good name for quinsy, but he did not
believe there was a peritonsular capsule proper. As to
the tonsils performing their function, he did not think
they existed in the normal state, but that they were the
result of disease.
The Academy then adjourned.
®0 VTCSP^O uclcucc.
OUR LONDON LETTER.
(From our Special Correspondent.)
THE CHOLERA DR. LEWIS ON THE COMMA BACILLUS AND
ITS NON-SPECIFICITV CANNIBALISM AMONG AN ENG-
LISH SHIPWRECKED CREW HOSPITAL SATURDAY — THE
HEALTH EXHIBITION AND THE HOSPITALS DEATH Of
MR. NErrEN RADCLIFFE.
London, September 20, 18S4. ^
Despite the prophets of evil, the dreaded cholera has
not yet visited us. All possible precautions have been
taken to prevent the introduction of a case into the
kingdom. Steps have been taken to Aygestin Online prevent cargoes of
rags from Buy Aygestin Online Marseilles and other ])laces from being landed
at British ports in cases where there is any possibility of
their bringing infection.
With regard to the pathology of cholera, an interesting
memorandum has just been issued on the subject by Dr.
T. R. Lewis, Assistant Professor of Pathologj' at the
Army Medical Norethindrone Acetate Tablets School, Netley. Dr. Lewis has lately
visited Marseilles for the purpose of studying the subject
practically. He criticises Koch's published reports rather
closely, but the most startling point in his paper is the
statement that comma-shaped bacilli have been found by
him frequently in the salivary secretions from the mouths
of healthy persons. This is evidently Aygestin Price a very important
observation, and should it be confirmed by further in-
vestigations, will go far to wholly discredit Koch's views
on the bacillar origin of cholera. Dr. Lewis is a skilled
microscopist and a laborious and patient worker in the
field of pathology. Dr. Lewis has also studied cholera
practically in Lidia, where he served many years as an
army surgeon. His former studies on the filaria san-
guinis hominis did much to elucidate the pathology of
those organisms, and are probably known to many of
While the story of the Greely Arctic expedition is still
fresh in our memories, another horrible tale of cannibal-
ism has just come to light. Three men and a boy going
from England to Australia in charge of a yacht, were
shipwrecked and drifted about in Buy Norethindrone Acetate an open boat for nearly
four weeks. As a last resort they killed the boy, and
after Buy Cheap Aygestin drinking his blood ate his flesh. His heart and liver
were devoured while still warm. It is right to state that
the boy was apparently dying. They continued to eat
his flesh for several days, when they were picked up by
a passing vessel. There is no doubt whatever as to the
facts, as the men confess what they have done, and have
been arraigned for murder. None of the injurious effects