30

LONDON HOSPITAL.

SCIRRHUS OF THE TIAMMA. EXTIRP3TI0B ,- -DEATH. I

March 26, 1832.-Sarah Palmer, mtat. 47, married, mother of eight children, the Iyoungest sixteen months old, was admittedinto this hospital on the 22nd instant, underthe care of Mr. Scott, labouring under Iscirrhus of the left mamma. She states thatthe disease first commenced about eightmonths since, but without her being ableto assign any particular cause for its for-mation. On examination the nipple wasfound retracted and puckered, the diseased

part hard and lobulated, with the upperportion presenting a dark livid appearance.The operation of extirpation was this day

performed in the following manner. Theextent ot the morbid attection oemg care-fully distinguished, an incision was com-menced on the brachial side, and carrieddownwards till the knife made a pointdirectly opposite on the sternal side, de-scribing in its course a segment of a circle.A similar incision was then made in thesame direction on the superior side of the i,

nipple, and carried onwards to the pointwhere the first incision terminated. The

gland was then dissected away from thesubjacent muscles, great care being takenthat no morbid or indurated part should re-main. The time of the operation was pro-longed in consequence of there being threeindurated elands in the axilla, which werecarefully removed. After the parts wereremoved, it was found necessary to tie

upwards of ten vessels. The edges of thewound were then brought together by onesuture, and retained by straps of adhesiveplaster, and the whole was kept ira situ bya compress and roller. After the operationshe had tinct. opii Ill. xx.

27. Has passed a tranquil night, pulse78, soft; tongue clean, bowels not open.01. 7’icini ss statim sumend. Mist. effer-vescens omnis 6tis hor.

28. Pulse 84, fuller ; tongue clean ;bowels open three times ; skin dry. Slepttolerably well last night. To continuethe effervescinn mixture. Eight p. m.

complains of severe pain in the left side;thirst, with difficulty of breathing ; coun-’tenance anxious ; pulse 94, small ; to have30 leeches to the side.

29. Passed a restless night ; pain in theside and difficulty of breathing very muchincreased; and at eight a. m. died.

FATAL CUT THK

March 26. At seven this morning, a manwas admitted who had made a most deter.mined attempt to commit suicide by cutting

his throat, the incision being just abovei the thyroid cartilage, separating the cornum’ from the os hyoides, cutting into the pha-rynx, and dividing a few of the fibres ofthe sterno-cleido-mastoidei muscles. Thedresser succeeded in injecting some barleywater into his stomach by passing the gumelastic tube of the stomach-pump throughthe wound down the oesophagus into thestomach ; but on attempting this afternoonagain to pass it, so much irritation was

caused by the instrument that the eyperi-ment was immediately desisted from, and

an enema of barley-water, with tinct. opii,111 xxx, was ordered instead. -

27. Passed a very restless night. Thewhole of his time appears to be passed inprayer. Respiration difficult, with mucousrattle ; intense thirst ; is evidently sinking.The enema has been repeated three times.Eight p. m. is rapidly sinking ; pulse 97,small; respiration extremely difficult; in-tense thirst ; skin hot and dry.

28. Passed a very restless night. At halfpast six he died.

ABUSE IN THE LIBRARY REGULATIONS.

To the Editor of THE LANCET.

SIR,—Knowing you to be the ever stre-nuous supporter of our rights, and the ex-positor of our wrongs, I have to call yourattention to a piece of illiberality practisedon the lecturing pupils of the London Hos-pital by the two principal surgeons of thatinstitution. The illiberality complained ofis exhibited in the following regulation :-

" That no pupil be allowed to subscribe tothe library unless he enter to the hospitalpractice." About a year ago the law was

put aside, but since the opening of the newroom.* it has again been brought into force,acting as a trap to induce pupils to enter

sooner than their arrangements would haveotherwise led them to do.

Publicity will no doubt effect the objectI have in view, and therefore forbearingfrom further remarks,

I have the honour to beYour obedient Servant,

A LECTURE PUPIL.

ST. BARTHOLOMEW’S HOSPITAL.

REMOVAL OF AN OSSEOUS GROWTH FROM

1HE UPPER JAW-BOXE.

MARY RosE, setat. 50, admitted March22nd, is a woman of strong constitution and

* They were in debt 301. at that time.