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Related post: tion was discovered. Amputation of the thigh was performed
on May 4th. A microscopical examination showed it to be a
periosteal sarcoma, and one which would probably return.
Resection of the Hip. — Photographs were shown of a boy
aged fourteen, upon whom resection of the hip had been per-
formed. When twenty months old he was injured ; since that
time the disease continued. Six years ago an abscess formed
behind the hip. Tlie deformity was of the usual variety seen
in disease of the hip, the knee being bent at an angle of ninety
degrees. The usual operation was performed. One week sub-
sequently the patient was doing well. The shortening of the
affected extremity measured three inches.
Absence of Right Ventricle of Heart ; Stenosis of Pulmonary
Artery. — Dr. Heinemajst presented the heart of an infant, aged
six months, who presented the rare abnormality of absence of
right ventricle of heart with stenosis of pulmonary artery.
192 PROCEEDINGS OF SOCIETIES.
Blood was conveyed to the lungs through the ductus arterio
sus. The only symptoms noticeable were sudden attacks of
dyspnoea.
Apoplexy; Miliary Aneurism. — Dr. Amidon presented a
specimen, showing distinctly the occurrence of miliary aneu-
rism. It was obtained from the brain of a patient who died
from apoplexy. The specimen had the appearance of small
tubercles connected together by means of a fine network.
This network was the capillaries of the brain. The specimen
was obtained by washing away the brain-matter.
Abscess of Kidney, — Dr. R, F. Weir related the history of
a patient who had an abscess of the kidney. He was run over
by an ice-cart, and for two jea.rs did not complain of any
trouble. He entered Roosevelt Hospital, presenting a tumor
in the region of the kidney. This was thought to be perine-
phritis. Aspiration was performed, but without result. It
was repeated with a large needle, when pus was obtained.
An incision was then made to allow of the free discharge of
pus. Death took place two months after the operation. At
the autopsy local peritonitis was discovered. An abscess was
found to have involved the kidney. At times pus was found
in the urine, but not continually. Dr. Weir thought the case
was one in which extirpation of tlie kidney might have been
performed with benefit.
1
]
Stated Meeting, June 26^ 1878.
Dr. E. C. Seguin in the Chair.
Ligature of Lingual Artery near its Origin ; Removal of Epi-
thelioma of Tongue, — Dr. Geo. F. Shrady presented an epi-
theliomatous tumor of the tongue and floor of the mouth,
which he had removed the previous afternoon at the Presby-
terian Hospital. The case was of particular interest from the
circumstances attending tlie operation. The patient was a
married woman, aged thirty-two, the mother of four children.
She noticed about eight months ago an ulceration on the letl
side of the tongue, about its middle. The ulceration gradu-
ally advanced, and after two months involved nearly the
PROCEEDINGS OF SOCIETIES. 1V>3
whole side of that organ, and subsequently the floor of tlie
mouth. When she was examined in hospital the Cost Of Mirapex left side of
the tongue presented an indurated and sloughy ulceration, ex-
tending from the top of tlie tongue backward to the reflection
of the anterior faucial pillar. The entire inner surface of the
gnm on the left side was covered with a fungous growth,
which overlapped the alveolar margin, and extended across
the floor of the mouth, under the base of the tongue, as far
forward as the frenum, inward as the median line, and back-
ward as the limits of the disease of the tongue. The patient
suftered much from neuralgia of the ear and face of the af-
fected side. A consultation of the surgical staff was held, and
it was decided that the disease should be removed. The oper-
ation and its possible results were explained to the patient.
She gladly accepted it, even if it should prove a temporary
relief from the intense suffering. Dr. Shrady determined to
remove the disease through the month, and, as a preliminary
step, to tie the lingual artery of that side near its origin be-
liind the digastric triangle, where the vessel passed under the
border of the hyoglossus muscle and above the extremity of
the greater cornua of the hyoid. In doing this the dissection
was carried down through the skin and fascia, exposing the
sheaths of the external carotid and facial arteries and internal
jugular vein, also the superior laryngeal and hypoglossal
nerves. The lingual was found, after a careful dissection,
and ligated. The operation lasted twenty minutes. The
finger was then introduced into the mouth, and the growth
separated from the inner side of the jaw. This was accom-
plished with but little assistance from the scissors. After the
mass was separated from the floor of the mouth, as far as the
median line, the tongue was secured by three strong ligatures,
one passing through the tip to the Mirapex 0.5 Mg right of the median line,
and one an inch on either side. The tongue was then spread
out and split longitudinally to its base. The incision was
carried outward behind the disease, and the whole mass re-
moved. The operation on the side of the tongue was nearly*
bloodless. There was, however, some bleeding from the floor
of the mouth.
Dr. Shrady said that he had seen the patient a few hours
13
194 PROCEEDESTGS OF SOCIETIES.
before the meeting of tlie Society, and twenty-four hours after
the operation. He found her quite comfortable, but suffering,
as might be supposed, from difficulty in swallowing her saliva.
The patient had been nourished by enemata since residing in
the hospital, and it was considered wise to continue that
method of alimentation, although a small quantity of milk
could be swallowed at short intervals.
Dr. Post said Dr. Shrady's case afforded a striking illus-
tration of the absence of anastomosis of the vessels on either
side of the tongue, as proved by the fact that ligature of the
lingual on the affected side made the section of the tongue
bloodless. He referred to a specimen in the museum of the
university, in which the injection of one side of the tongue
stopped at the median line, except along the line of the mu-
cous membrane.
Dr. H. B. Sands said removal of epithelioma of the
tongue was not only very difficult in practice, but unpromis-
ing in results. There was, perhaps, no form of cancer more
malignant, and none more prone to kill quickly after opera-
tion. In regard to the explanation of such untoward ex-
perience, he Mirapex 1.5 Mg was inclined to think that the difficulties in com-
plete removal offered the most satisfactory solution. In oper-
ating it was difficult to thoroughly expose all of the diseased
tissues, due to the fact that from the small size of the mouth
illumination was difficult.

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