450
BULLET WOUNDS.
As usual there were several cases admitted from the outlying districts, the most severe was one from Yaumati with a bullet wound that entered the neck just above and to the left of the sternum, it fractured the clavicle and skirting the upper two or three intercostal spaces emerged in the back at the posterior fold of the axilla. Fortunately the large blood vessels escaped injury and after the removal of several pieces of the clavicle the wound healed up.
The other two presented no particular features of interest: one was a bullet wound of the forearm admitted from Hung-Hom; the bullet had passed through the arm and was lying under the skin; it was extracted without any difficulty; in the second case, the ballet had passed through the thigh just above the patella, fortunately escaping the joint.
COMPOUND FRACTURE OF THE SKULL.
This case shows the extraordinary vitality some of the Chinese possess:-
The patient, a Chinaman, was admitted from the Tung Wah Hospital on the 26th April where he had been for two weeks, with a compound fracture extending through the right parietal and occipital bone;
the wound was very dirty and covered with the usual Chinese pitch; the cause of the injury was a fall of some 30 feet from the third storey of a house On the 29th as there was severe hemorrhage which could not be stopped the man was anesthetised and the wound explored, on elevating some depressed bone a quantity of brain matter extruded and as it was impossible to seize any bleeding vessel the huge hole in the cranium was plugged with carbolic oiled lint, no less than 8 inches of lint half an inch wide being used; two days afterwards this was removed and the wound syringed with 1 in 2,000 corrosive solution; there was no return of the haemorrhage; with the exception of slight left facial paralysis, he recovered completely. The temperature, which rose to 105° the day after the operation, remained high for three or four days, by the 4th May it had fallen to 100° and was norinal on the 6th May; it did not rise again to 100°; the wound took a long time in filling up, but he was eventually discharged cured on the 17th August.
ANESTHETICS.
Since October 1st a regular diary has been kept of all cases in which anesthetics have been employed and a resumé is now appended.
Anaesthetics have been administered to 60 cases.
Average time taken to produce Anesthesia, 6'.32". Average duration of operation, 14.20".
Average quantity used, 22 drams.
Europeans.
Men. JVomen.
13
1
Children.
0 14
Chinese.
Men. Women. Children.
33
10
3 46.
Chloroform has been the anaesthetic used throughout and has been administered with Krohne and Seissman's modification of Junker's Inhaler. No dangerous symptoms have at any time occurred in the administrations and little or no trouble has been experienced in producing anesthesia.
FRACTURES AND DISLOCATIONS.
The following fractures and dislocations were treated during the year :---
Skull,
Skull (base),
Femur,
Tibia,
Tibia and Fibula (compound).
Humerus,
Radius and Ulna,
Metacarpal,.
Patella,
Nose,
Ribs,
Foot,
Dislocation of shoulder,.
77
ל
knee,
7
7
.6
4
4
.4
2
1
1
1
.1
Alcoholism.--This disease was, as is usual in plague years, much more prevalent, there being 101 cases admitted as against 54 in 1897; no less than 8 proved fatal, the cause of death being delirium
tremens.
Poisoning. There were 13 cases of poisoning during the year with three deaths, in each of these opium was the poisonous agent.