Sessional_Paper_1904 — Page 529

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Fractures.-The following fractures were treated during the year:-

Femur,

.10 cases with 1 death.

Humerus, .....

.12

Forearm,

7

*

Clavicle,

2

Jaw,

77

Patella,

2

Leg,

8

Skull,

Ribs,

with 10 deaths. with 1 death.

Dislocations.--The following were under treatment:--

13

1

Thigh,

Shoulder.

.1 case.

2

.1 3)

.1

Jaw,....

Elbow,

Operations. There were 192 operations performed during the year. Amongst the more important were:-

Liver Abscess. 5 cases alluded to above.

Abdominal Section.—2 cases. One was for tubercular disease and as the case was interesting it has been inserted in the Appendix. The second case was for injury simulating internal trouble so the abdomen was opened. The patient eventually died from the effects of extensive hæmorrhage (retroperitoneal}.

Penetrating wounds of the abdomen with protrusion of omentum.-Both cases did well. In my own the omentum was ligatured and removed and in Dr. LAING'S it was returned after thorough cleansing.

Lithotomy.-Three cases were operated on with one death-one by yourself, one by Dr. LAING and the third by Dr. Koch. The fatal case was done by the suprapubic method, not a very sucessful method here as far as I can gather.

Strangulated Hernia.-One case with a fatal result. This occurred in an old Chinaman who had evidently had the trouble for some time. He died of shock shortly after the operation and the gut was found to be gangrenous with commenc- ing peritonitis.

Ovarian Tumour.-One case in a European. The tumour was a dermoid cyst lull of fat and hair. She convalesced rather slowly but eventually left

hospital all right. The operation was performed by Dr. LAING.

Appendicitis. Two cases were operated on and both did well.

Double Amputation at same time. This was done for dynamite injuries. I removed the right arm and Dr. LAING the left. The patient stood the operation well. Unfortunately though he recovered he was totally blind as both eyes had also been injured.

Ligature of Femoral.--Two cases, both sucessful. One was a case of revolver bullet wound through the thigh. The patient nearly bled to death 48 hours after the injury and the femoral was ligatured. As gangrene supervened the leg was amputated below the knee. He recovered and left for home. The second case, under Dr. LAING, had the misfortune to have a popliteal aneurism opened by mistake, not here however, and the femoral was accordingly ligatured. He is doing well.

Splenectomy.Three cases with 2 deaths. One died on the sixth day and it was not possible to determine the cause as the ligature had been firmly tied and there was no evidence of peritonitis. The other fatal case had in addition to a ruptured spleen a fractured leg, a fractured thigh and a smashed arm which was amputated. He died shortly after.

Anesthetics.-Chloroform was administered 201 and ether 3 times without any fatal result.

We find the previous administration of morphia gr. and hyoscine gr. once or twice most useful in the case of all Europeans. It is given hypodermically 2 or 3 hours before and the dose if necessary repeated an hour previous to the operation. They require much less or it abolishes almost entirely the struggling stage,