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66 NOTES OF HOSPITAL PEACTICE.
there remained. It did not lacerate the cord, but merely
pressed on it, causing paraplegia.
The case at present under observation received the wound
in the back, not far from the lower angle of the scapula, the
bullet entering in an oblique direction. After receiving the
injury the patient Buy Effexor Xr fell down, and, on examination, there was
found to be paralysis of both arms and legs. One month sub-
sequently the paralysis of the arras disappeared. It is at the
present time about a year since the receipt of the injury, and
in that time only slight improvement has taken place, and
this improvement is confined to one of the lower extremities.
There is incontinence of the faeces and urine. It would seem Purchase Effexor Online
that the paralysis of the upper extremities was due to haemor-
rhage, for in no other way could an injury so far down (the 150 Mg Effexor
eighth dorsal vertebra) involve the nerves forming the brachial
plexus, unless, indeed, the ball glanced upward along the
spinal Cheap Effexor Xr canal. The theory of haemorrhage Effexor Xr 150 Mg is still further
strengthened by the improvement in the paralysis a month
after the injury.
GERMAN HOSPITAL.
Encephalopathie Saturaina. — A case of this rare form of
lead-poisoning has been recently under observation at this
hospital, and was specially interesting from the fact that re-
covery took place. The history was as follows : A man aged
thirty-eight had for several years Effexor 300 Mg worked 300 Mg Effexor in the smelting-
works of a lead-factory. For three years he suffered from
lead-colic, attended with diarrhoea, 150 Mg Effexor Xr which at the end of that
time changed to constipation. Two weeks before entering
delirium came on. It was attended with insomnia.
On admission the patient was delirious, and so much ema-
ciated that he had the appearance of a skeleton. There were
also convulsions of a clonic character, as well as a tremor of
the body. There was no paralysis, either local or general.
The right pupil was dilated, and the left contracted. Effexor Xr Online Epis-
taxis occurred Effexor 37.5 Mg at intervals, but was not an important symptom.
GEEMAlSr HOSPITAL. 67
After admission the patient was placed upon iodide of potas-
sium 225 Mg Effexor to the extent of one hundred and twenty 37.5 Mg Effexor grains daily,
and at night forty grains of chloral was administered. Three
weeks after entering the hospital the patient began to im-
prove, and at the present time recovery is complete. The
characteristic lead-line about the gums was quite distinct, but
no sign of lead could be detected in the urine.
A fall description of this rare form of lead-poisoning can
be found in the fifteenth volume of Ziemssen (not yet trans-
lated), which treats of toxicology. It is there mentioned
that encephalopathie saturnina is the rarest form of the
affection, and nearly always fatal; and the above-mentioned
case, which was well marked, proves of interest in extending
our knowledge on the subject.
Lumbo-Colotomy ; Carcinoma of Rectum and Vagina. — A
married woman, fifty-eight years of age, entered hospital with
advanced cancer of rectum and vagina. She had been two
years suffering from the disease, and was supposed to have
piles, which caused hgemorrhage from the rectum. On exam-
ining the patient it was found that there was a cancerous mass
involving both the vagina and rectum. The calibre of the
rectum was so small as barely to allow the admission of the
point of the little finger. Much pain was complained of during
examination. It was decided to perform lumbo-colotomy, and
on June 5th Dr. Stachelberg performed Amussat's operation.
Previous to the operation the colon was injected with air, and
on cutting through the abdominal walls it was secured and
opened without difiicnlty. It was found that the faeces did Effexor Purchase
not pass through the incision, but continued downward through
the rectum. After five days, however, they passed entirely
through the opening, and, as is usually found, pain in the rec-
tum ceases in great part when faeces cease to pass over it. It
is now nine days after the operation, and unfortunately there
has been, within the last day or so, a tendency of the faeces to
pass along the rectum.
Symes's Operation; Necrosis of Foot; Tetanus. — A man,
aged forty-six, entered hospital suffering from syphilitic ne-
crosis of the foot, which had lasted for seven years. An ex-
amination showed that the metatarsal bones were Effexor Xr 75mg the seat of
68 CLESriCAL REPORTS OF THE
disease. It was decided to perform Symes's operation, as of-
fering the best chances for the patient. The stump did well,
but on the third day the patient developed tetanus, which
continued for three weeks. It was found necessary to admin-
ister chloroform during the active period of the tetanus, and
subsequently chloral was given in one-drachm doses, morning
and evening. After three months the patient was able to
walk, when the stump was protected by a cylindrical ap-
paratus.
Bellevcte Hospital, June 15th.
EDiroR New York Medical Journal Effexor Xr 37.5 Mg :
In my article in your June issue, explaining the use of Dr.
Hutchinson's apparatus for the cure of popliteal aneurism,
the credit of suggesting a rubber suspensory tubing should
have been given to Dr. Crosby. I desire to state, also, that the
ligation of the right femoral artery, in the case of Joseph
Temple, was performed by Dr. Crosby, and not by Dr. Wood.
[Martin Burke, M. D.
class in general surgery.
Selected Cases by Dr. T. E. Satterthwaiie.*
Pyo-'pneuTnoihorcm i/reated hy Free Incisions into the
Pleural Cavity and the Insertion of Setons. — Edward Roehig,
nine months old, was brought to the Dispensary on Jan-
uary 21, 187G. About Christmas of 1875, the child, who had
previously been healthy, was taken with pain in the Buy Cheap Effexor right side
of the chest, which two Effexor Xr 75 Mg weeks later became swollen, pain-
' Thanks are due to Dr. T. -J. Louglilin for liis assistance in the prep-
aration of these notes.
I
DEMILT DISPENSAEY. 69
fill, and had an erysipelatous look. An abscess soon formed,
was opened, and Effexor 225 Mg liberated about "half a pint of matter,"
as the mother expressed it. When examined January 21st,
an opening was found between tlie second and third ribs,
about three inches anterior to the axillary line. A probe
entering could be freely moved about in the pleural cavity.
A Effexor 150 Mg flexible Effexor Buy Online catheter was then introduced, and carbolic acid in
a two-per-cent. watery solution was syringed in, until the
cavity had been thoroughly washed out. Finding that the

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