1841.
Report of M. M. S. Hospital at Macao.
469
comminuting that bone, remained flattened and uneven at the sur- face of the wound in front. The incision which had been made to extract it was three inches in length, parallel and close to the anterior tibial artery. Several loose portions of bone were removed, warın water dressing applied, the leg rolled, and its position fixed.
The wound quickly granulated and healed, with the exception of a sinus anteriorly, which was kept open by portions of loose bone still felt deeply in the wound. These gradually becoming more superfi- cial, were taken out with little injury to the soft parts; in a month the patient was dismissed, the leg being straight and strong.
In September, a man aged 40, from the island of Honam near Can- ton, entered the hospital suffering excruciating pain from retention of urine. On examining the patient, it was discovered that he was fre- quently subject to these seizures, but they were of short duration compared with the present, which was three days. The bladder was readily recognized, distended with fluid rising up to the umbilicus, the pulse quick, and countenance anxious. The urine was imme- diately drawn off by a silver catheter; it was dark, of strong am. moniacal odor, and exceeded two quarts. The next day it was again necessary to renew the operation, and for many days after- wards, changing the size. The prostate was five times its natural size, and the urine deposited large quantities of thick white sedi- ment, which on examination was found to be chiefly the magnesio- phosphates. Active purging, with the daily use of the catheter, in three weeks restored him to his usual health; he returned subsequent- ly to offer thanks, and had continued well. As future attacks might reasonably be expected, a silver catheter was made for him at his own expense, which he learned how to use. Other cases of reten- tion from stricture, or enlarged prostate, have been similarly treated, with the warmest thanks for the relief imparted.
Two cases of dislocation, one of the humerus into the axilla, and the other of the first phalanx of the thumb upon the anterior surface of the metacarpal bone may just be noticed. Both had been dislocated for more than six weeks when they applied for admission. The first was occasioned by a fall from the mast to the deck of a ship, and the other from a blow. In the one case, extensive and counter-exten- tion was steadily maintained for two hours and a half, by means of ropes and pullies; and the other for a considerable length of time and repeatedly, by a small cord fixed with a clove hitch; but neither of them could be reduced, although the system was nauseated by tartarized antimony. Farther efforts could not be employed.