E
528
ABSCESS OF LIVER. REMOVAL OF LARGE GALL STONE.
RECOVERY.
NG WAN, Chinese lukong, aged 38, was admitted on 30th May.
He had been ill with fever 4 days. The liver dulness was increased two fingers breadth below the cartilages and was very tender especially over the seat of the gall bladder. There was dulness in the right chest posteriorly with feeble breath sounds. He had never had dysentery. The temperature varied from 99° in the morning to 104° in the evening.
On the 6th June the liver was explored and pus found and next day under an anesthetic an incision was made below costal cartilage of 7th rib in nipple line and a tube was inserted into an abscess and two pints of pus evacuated. The temperature dropped at once and kept normal on 16th August as there was still a discharging sinus the patient was put under chloroform again and the sinus scraped. A calculus was felt and part removed. On 21st August he was again operated on and after some trouble a calculus was removed in pieces weighing 420 grains. The patient rapidly improved in weight from 114 to 127 tbs and general health and was discharged on 16th September with the sinus quite healed and the liver dulness normal. Throughout the case there was no jaundice or any bile discharged through the sinus,
SEVERE WOUND OF KNEE JOINT. SUTURE OF PATELLA.
RECOVERY.
A healthy Chinese male adult was admitted on 31st July at 11.45 p.m. with a severe wound of the kuce joint. The joint was washed out, the knee put up in McIntyre's splint and the patient put to bed.
Next morning under an anesthetic it was found that he had a clean cut wound through the parella about in. from the lower border and notching the outer condyle about 2 inches in depth. It was determined to give the patient a chance of preserving his leg and the wound was most thoroughly cleaned out by irrigation sponges and a nail brush across the bony section. Some time and care were bestowed on this and to this fact must be attributed the very excellent result. The patella was brought together by two silver wire sutures and the skin wound sewn with silk. The knee was then fixed in a McIntyre's splint. There was scarcely any fever throughout. The splint was removed on the 28th day and passive movement begun. The patient was discharged on 27th September and three months afterwards was seen here with a good useful leg. He was able to bend it about 45°.
PROTRUSION OF THE INTESTINES IN A NEW-BORN INFANT.
On April 8th at 9 a.m. a Chinese female child was brought to hospital immediately after birth. On removing the filthy wrappings, the cord with placenta attached and about two feet of intestines were found lying on the abdomen. On examination it was seen that the cord about two inches from the umbilicus was thinned out and attached all round an opening into the abdomen about one and a half inches in diameter through which the intestines had escaped. The child was crying a little but did not seem in any pain nor was it at all collapsed. The intestines were cleaned and after some trouble were returned, a ligature of silk was slipped round the opening and tied, and the cord then dissected off. At 6 p.m. this ligature unfortunately slipped and the intestines had again to be returned.. Three deep and three superficial silk sutures were now inserted.
The child throughout took milk well though there was occasionally some vomiting. The stitches were removed on the 6th day and the baby discharged on the 20th day quite well. There was no rise of temperature throughout the case save on the 3rd day when it reached 99.6. This abnormality is a rare one as no one who saw the case had ever seen anything similar. The absence of peritonitis- throughout the case is worthy of note.
Enclosure III.
Report of the Acting Medical Officer of Victoria Gaol.
VICTORIA GAOL, HONGKONG, 15th March, 1900.
SIR, I have the honour to forward you for the information of His Excellency the Governor the Annual Medical Report on the condition of Victoria Gaol during the year ending 31st December, 1899.
The total number of admissions to the Gaol was 4.789 as compared with 5.437 in 1898 and 5,076. in 1897 respectively; and the daily average number of prisoners was 434.53 as compared with 511 and 462 in the previous two years.