Notices and Case and Procedural Reviews Mission Possible Reducing the Error Rate.
Reviews and Notices of Books.
1
591 foetus was probably between seven and eight months old, and had been dead (judging from the state of decomposition it presented) about a fortnight. A preparation has been made of it for the College by Mr. Sylvester. Edward’s-terrace, Caledonian-road, ISS2. Reviews and Notices of Books. .f What to Observe at the Bed-side, and after Death, in -Aledical Cases. Published under the Authority of the London Medical Society of Observation. Fcp.8vo,pp.l36. London, 1852. Tnis being the first appearance of the London Medical Society of Observation in print, it may be as well, perhaps, to inform our teaders, that the Association formed under this name consists of a president, secretary, seventeen ordinary (the number is limited to five-and-twenty), and five corresponding members; and that the objects of these gentlemen are, by the collection of records of cases, as well as by the accumulation of observations on the special phenomena of disease, to promote the advancement of accurate pathology and therapeutics, " and to exhibit the special advantages which may accrue to the science of medicine by the co-operation of several persons, working on a uniform plan, towards the elucidation of given medical questions." The first step, consequently, after the formation of the Society, has been, to frame certain systematic rules for recording the cases and observations made at the bed-side, or in the dead-house ; and this having been done, the members, by publication, offer their scheme or method to all willing to embrace it ; or, in their own words, " to those who desire to learn systematically with what amount of detail, and in what order, those phenomena (the clinical and anatomical phenomena of disease) should be looked for; and also to those who wish to record with accuracy the results of their experience."—(ft’g/acg.) In the present day, when the vast importance of the study of clinical medicine is becoming fully recognised, when it is even allowed by at least one of the Examining Boards-that of the University of London-that in order thoroughly to appreciate and understand the nature and phenomena of any disease, it is necessary to have witnessed the disorder-in fact, to have sedulously and carefully watched its progress and termination- any method which may assist us in doing so with accuracy must be welcome; for not only will it lighten the labour of those who are in earnest in the pursuit of medical knowledge, but it will also serve to dispel the erroneous notion, which some students appear to entertain, that a mere vague looking-on, or habitual sight of objects, constitutes observation. Whether the work before us will have the desired effect, we will not attempt to determine, but rather, by a quotation, enable our readers to form some opinion for themselves. Thus, at page 1, we learn that the clinical examination of a patient is to be conducted in this wise:- "1. Race-country of birth. 2. Sex-degree in which sexual characters are marked, (general conformation, external sexual organs, mammse, voice, beard, pubic hair, &c.) 3. Age-real and apparent. 4. Anatomical peculiarities :- Heig7tt-width from acromion to acromion. Form of trunk-natural curves of spine, antero-posterior and lateral dorsal; apparent relative size and length of thorax and abdomen ; patient high-shouldered or not ? Measurements-of head: circular (over superciliary ridges and occipital protuberance), across vertex (from ear to ear), along middle line (from root of nose to occipital protuberance); of neck: circumference opposite cricoid cartilage; of trunk: circumference opposite ensiform cartilage, midway between nipples and clavicles, at margin of false ribs, at level of umbilicus. Limbs-well or ill formed? proportional and symmetrical or not ? ’ll’eight" andso onfor seventy-two closely-printed pages, at which stage, the sufferer having died from exhaustion, the post- mortem examination commences. For physicians residing in Owhyhee, such directions as these may be useful ; but as in our own modest country, medical practitioners do not usually see their patients in a state of nudity, and as they are not in the habit, as far’as we know, of following up the request, " Put out your tongue," by the demand, " Show me your pubes," they will, we fear, experience some difficulty in following the directions laid down. Moreover, although we ourselves have been in the ’e constant habit for some years of taking notes of such important cases as have come under our notice, yet it must be confessed we have not done so in the minute manner recommended by the Society of Observation; and we certainly must allow, that until our practice dwindles down to the average of half a patient per week, or until our days shall have allotted to them a greater number of hours than twenty-four, we shall despair of being able to satisfy the authors of " What to Observe at the Bed-side, and after Death, in Medical Cases." Medical Societies. ROYAL MEDICAL AND CHIRURGICAL SOCIETY. TUESDAY, DEC. 14, 1852.—MR. HODGSON, PRESIDENT. A CASE OF FRACTURE OF THE THIGH-BONE OCCURRING SPON- TANEOUSLY. By BARNARD VAN OVEN, M.D. THE case narrated occurred in the person of the author, and was deemed so extraordinary by all who witnessed it, that he has been induced to send it to the Society. On the 25th May, .1852, he went to bed in perfect health, and fell into a sound sleep. At three o’clock in the morning he awoke in the act of turning, with a feeling of violent pain in the thigh, just above the knee, On putting his hand to the part he felt the belly of the vastus muscle in strong contraction. At the same moment a loud snap was heard. The swelling of the muscle immediately subsided, and he could feel the grating of the two ends of the bone. He did not experience much pain, and the part was flabby and swollen. From that time he never felt any severe pain at the part nor in the limb. He applied a cold wash to the limb, and the swelling began to subside. It was found on examination that a transverse frac- ture had taken place, three inches above the knee-joint; the bone was lying in proper position. In other respects the author was and had previously been in excellent health. Before the accident he was in the habit of taking a consider- able amount of exercise. He had occasionally suffered from slight neuralgic pains in various parts of the body if the digestive organs were in any way deranged. On the day be- fore the occurrence of the fracture he had felt a slight numb- ness in the leg and foot, below the knee, which was removed by a brisk walk. The limb was in the first instance placed on a M’lntyre’s frame, and the leg was placed in a sling, sup- ported by a cradle. After a few days, as this did not seem to limit the movements of the ends of the bone, a long splint was applied, and the leg was allowed to sling as before. The pro- gress of the cure was regular and rapid, and by the 9th of July the limb was considered sufficiently firm to allow of the splint being removed; and some short splints having been applied, he was allowed to get up, and shortly afterwards went out of town for change of air, and walked about with the aid of crutches, which, on the 10th of August, he changed for two crutch-handled sticks, with which he could walk for an hour without fatigue. On the 30th of September he returned to town and resumed his ordinary pursuits, and has since never felt any inconvenience. The author has been unable to find any record of a case of fracture of one of the larger bones by the action of the muscles alone, without the occurrence of any fall, blow, violent exertion, or other exciting cause. He is but fifty-six years of age; has led a perfectly regular life; is capable of considerable exertion; he is not aware of any heredi- tary tendency to disease, such as cancer or scrofula; he has never had syphilis, nor has he ever been salivated. This case, then, he considers to stand alone, and to be worthy of record. The author concludes by expressing his thanks to those pro- fessional friends who attended him during the treatment of the case. Mr. FERGUSSON rose and said, Dr. Van Oven had so clearly and explicitly stated his own case to the Society, that little could be added to it either in the way of detail or comment. He, (Mr. Fergusson,) however, thought it might be advisable to state his own impression of the case, which, in a,
Transcript of Reviews and Notices of Books.
591
foetus was probably between seven and eight months old, and hadbeen dead (judging from the state of decomposition it presented)about a fortnight. A preparation has been made of it for theCollege by Mr. Sylvester.Edward’s-terrace, Caledonian-road, ISS2.
Reviews and Notices of Books..f
What to Observe at the Bed-side, and after Death, in -AledicalCases. Published under the Authority of the London MedicalSociety of Observation. Fcp.8vo,pp.l36. London, 1852.
Tnis being the first appearance of the London Medical Societyof Observation in print, it may be as well, perhaps, to inform ourteaders, that the Association formed under this name consists of a
president, secretary, seventeen ordinary (the number is limitedto five-and-twenty), and five corresponding members; and thatthe objects of these gentlemen are, by the collection of records ofcases, as well as by the accumulation of observations on thespecial phenomena of disease, to promote the advancement ofaccurate pathology and therapeutics, " and to exhibit the specialadvantages which may accrue to the science of medicine by theco-operation of several persons, working on a uniform plan,towards the elucidation of given medical questions." The first
step, consequently, after the formation of the Society, has been,to frame certain systematic rules for recording the cases andobservations made at the bed-side, or in the dead-house ; and thishaving been done, the members, by publication, offer their schemeor method to all willing to embrace it ; or, in their own words," to those who desire to learn systematically with what amountof detail, and in what order, those phenomena (the clinical andanatomical phenomena of disease) should be looked for; and alsoto those who wish to record with accuracy the results of their
experience."—(ft’g/acg.)In the present day, when the vast importance of the study of
clinical medicine is becoming fully recognised, when it is evenallowed by at least one of the Examining Boards-that of theUniversity of London-that in order thoroughly to appreciateand understand the nature and phenomena of any disease, it is
necessary to have witnessed the disorder-in fact, to have
sedulously and carefully watched its progress and termination-any method which may assist us in doing so with accuracy mustbe welcome; for not only will it lighten the labour of those whoare in earnest in the pursuit of medical knowledge, but it willalso serve to dispel the erroneous notion, which some studentsappear to entertain, that a mere vague looking-on, or habitualsight of objects, constitutes observation. Whether the work
before us will have the desired effect, we will not attempt todetermine, but rather, by a quotation, enable our readers to formsome opinion for themselves. Thus, at page 1, we learn that theclinical examination of a patient is to be conducted in this wise:-
"1. Race-country of birth.2. Sex-degree in which sexual characters are marked, (general
conformation, external sexual organs, mammse, voice, beard,pubic hair, &c.)
3. Age-real and apparent.4. Anatomical peculiarities :-Heig7tt-width from acromion to acromion.Form of trunk-natural curves of spine, antero-posterior and
lateral dorsal; apparent relative size and length of thorax andabdomen ; patient high-shouldered or not ?
Measurements-of head: circular (over superciliary ridgesand occipital protuberance), across vertex (from ear to ear),along middle line (from root of nose to occipital protuberance);of neck: circumference opposite cricoid cartilage; of trunk:circumference opposite ensiform cartilage, midway betweennipples and clavicles, at margin of false ribs, at level of umbilicus.
Limbs-well or ill formed? proportional and symmetricalor not ?
’ll’eight" andso onfor seventy-two closely-printed pages, atwhich stage, the sufferer having died from exhaustion, the post-mortem examination commences. For physicians residing in
Owhyhee, such directions as these may be useful ; but as in our
own modest country, medical practitioners do not usually seetheir patients in a state of nudity, and as they are not in the habit,as far’as we know, of following up the request, " Put out yourtongue," by the demand, " Show me your pubes," they will,we fear, experience some difficulty in following the directions laiddown. Moreover, although we ourselves have been in the ’econstant habit for some years of taking notes of such importantcases as have come under our notice, yet it must be confessedwe have not done so in the minute manner recommended by theSociety of Observation; and we certainly must allow, that untilour practice dwindles down to the average of half a patient perweek, or until our days shall have allotted to them a greaternumber of hours than twenty-four, we shall despair of being ableto satisfy the authors of " What to Observe at the Bed-side, andafter Death, in Medical Cases."
Medical Societies.
ROYAL MEDICAL AND CHIRURGICAL SOCIETY.
TUESDAY, DEC. 14, 1852.—MR. HODGSON, PRESIDENT.
A CASE OF FRACTURE OF THE THIGH-BONE OCCURRING SPON-TANEOUSLY. By BARNARD VAN OVEN, M.D.
THE case narrated occurred in the person of the author, andwas deemed so extraordinary by all who witnessed it, that hehas been induced to send it to the Society. On the 25thMay, .1852, he went to bed in perfect health, and fell into asound sleep. At three o’clock in the morning he awoke in theact of turning, with a feeling of violent pain in the thigh, justabove the knee, On putting his hand to the part he felt thebelly of the vastus muscle in strong contraction. At the samemoment a loud snap was heard. The swelling of the muscleimmediately subsided, and he could feel the gratingof the two ends of the bone. He did not experience muchpain, and the part was flabby and swollen. From that timehe never felt any severe pain at the part nor in the limb. Heapplied a cold wash to the limb, and the swelling began tosubside. It was found on examination that a transverse frac-ture had taken place, three inches above the knee-joint; thebone was lying in proper position. In other respects theauthor was and had previously been in excellent health.Before the accident he was in the habit of taking a consider-able amount of exercise. He had occasionally suffered fromslight neuralgic pains in various parts of the body if thedigestive organs were in any way deranged. On the day be-fore the occurrence of the fracture he had felt a slight numb-ness in the leg and foot, below the knee, which was removedby a brisk walk. The limb was in the first instance placedon a M’lntyre’s frame, and the leg was placed in a sling, sup-ported by a cradle. After a few days, as this did not seem tolimit the movements of the ends of the bone, a long splint wasapplied, and the leg was allowed to sling as before. The pro-gress of the cure was regular and rapid, and by the 9th of Julythe limb was considered sufficiently firm to allow of the splintbeing removed; and some short splints having been applied,he was allowed to get up, and shortly afterwards went out oftown for change of air, and walked about with the aid ofcrutches, which, on the 10th of August, he changed for twocrutch-handled sticks, with which he could walk for an hourwithout fatigue. On the 30th of September he returned totown and resumed his ordinary pursuits, and has since neverfelt any inconvenience. The author has been unable to findany record of a case of fracture of one of the larger bones bythe action of the muscles alone, without the occurrence of any
fall, blow, violent exertion, or other exciting cause. He isbut fifty-six years of age; has led a perfectly regular life; iscapable of considerable exertion; he is not aware of any heredi-tary tendency to disease, such as cancer or scrofula; he hasnever had syphilis, nor has he ever been salivated. This case,then, he considers to stand alone, and to be worthy of record.The author concludes by expressing his thanks to those pro-fessional friends who attended him during the treatment ofthe case.Mr. FERGUSSON rose and said, Dr. Van Oven had so
clearly and explicitly stated his own case to the Society, thatlittle could be added to it either in the way of detail orcomment. He, (Mr. Fergusson,) however, thought it might beadvisable to state his own impression of the case, which, in a,
![REVIEWS AND DESCRIPTIONS OF TABLES AND BOOKS …€¦ · REVIEWS AND DESCRIPTIONS OF TABLES AND BOOKS 42[F] ... and the reviewer noticed no serious errors. ... Chapter III. Matrices](https://static.fdocuments.net/doc/165x107/5b6a40997f8b9af64d8bcc3a/reviews-and-descriptions-of-tables-and-books-reviews-and-descriptions-of-tables.jpg)
