TWO CASES OF FRACTURE. Reported by BABOO GOPAL CHUNDER Hocse
Surgeon,
Medical
College,
ROY,
Calcutta.
I.-FRACTURE OF THE RIBS. Shaik Foyzoo, aged fifty years, a coachman, was admitted into the 1st Surgeon's Ward of the Medical College Hospital on the 25th March, 1866, at 9 p. m., with fractured ribs ; the fracture extending from the apex of the left axilla, downwards and forwards, to the margin of the costal cartilages, below the left nipple, involving therefore all the ribs situated in that line, i. e., from the third to the eighth vib. There was emphysema of the left side of the chest, abdomen, left arm, and left side of neck. Breathing was very difficult ; and with each inspiration and expiration the fractured ribs sank. Percussion note on the left side was very clear, and tympanitic There was no bloody expectoration, and the at the lower part. pulse wea k. The fracture was due to a fall, which the patient sustained, on hi3 left side, from a tree about twenty feet high from the level of the ground. Ordered?A broad body bandage, a dose of morphia, gr. *, and rum mixt. ?j every two hours. 26th.?Pulse very feeble, could not be counted ; tongue cold; breathing hurried; was gasping in a sitting posture; rattling noise with the respiration ; large crepitation audible over the entire right lung and the upper part of left, but at its lower it was feeble and tubular. About ten ounces of blood drawn by Dr. Fayrer in the morning from the vein on the right arm. Ordered.?Stimulant mixt. ?j every hour. Brandy 4 oz., with beef tea, a little at a time. Milk and sago. Patient put on an inclined bed. 27th.?Dyspnoea a little less ; respiration 42 ; temp. 99? ; pulse still too feeble to be counted.
Continue medicine.
Vespere.?Pulse 128 ; respiration 36; temp. 101?. Continue medicine every two hours. 28th, vespere.? Pulse 108 ; respiration 27 ; temp. 102?. Free expectoration of a purulent substance, not tinged with blood ; dyspnoea less ; mucous rhoncus audible over both sides
of the chest.
Continue medicine every two hours. Tr. scillae Tr. camph : co. Spt. ether nitric
Aq. camph
:
...
m
x.
...
jj,
...
jss.
...
3L
M.
ter
die.
116
TIIE INDIAN MEDICAL GAZETTE.
From the next day he began steadily to improve ; the stimulant mixture was omitted, and the brandy and the cough mixture continued. The patient is now in the ward, convalescent ; the ribs united, the emphysema disappeared, and the lungs are performing their healthy functions. II?FRACTURES OP THE AND
FEJIUR, OF THE 5th AND 6th RIBS, COLIiES' FRACTURE OF THE LEFT FOREARM.
Lcciimoneb, aged 30 years, a female laborer, was admitted into the 1st Surgeon's Ward of the Medical College Hospital, on the'4t,h December, 1865, with fracture of the femur of the left side at its lower part, fracture of the 5th and Gth ribs of the right side, and Colles' fracture of the left forearm. She was at the end of the fourth month of her gestation, the uterus reaching an inch below the umbilicus. The fracture was due to a fall from the roof of a two-storied house, whilst she was engaged in working. The leg was put on a straight splint, and the forearm in a pistol shaped splint, and the chest fixed by a broad body bandage. 4th January, 1866.?Ribs united, and at the points of union the callus formed a swelling. Bones of the forearm united also, without any unevenness. The union of the thigh soft and very flexible. The union of the femur was soft up to the end of March, i. e., for about four months from the date of the accident, when it began to consolidate. She is still in the ward, unable to rest her weight on the broken leg. 12th.?Bone pretty firmly united, so that the patient could rest on that leg, and walk slowly with crutches when the splints were taken of. No miscarriage has occurred ; the foetus is alive.
[May 1,
1866.
Surgeon,
Medical
College,
ROY,
Calcutta.
I.-FRACTURE OF THE RIBS. Shaik Foyzoo, aged fifty years, a coachman, was admitted into the 1st Surgeon's Ward of the Medical College Hospital on the 25th March, 1866, at 9 p. m., with fractured ribs ; the fracture extending from the apex of the left axilla, downwards and forwards, to the margin of the costal cartilages, below the left nipple, involving therefore all the ribs situated in that line, i. e., from the third to the eighth vib. There was emphysema of the left side of the chest, abdomen, left arm, and left side of neck. Breathing was very difficult ; and with each inspiration and expiration the fractured ribs sank. Percussion note on the left side was very clear, and tympanitic There was no bloody expectoration, and the at the lower part. pulse wea k. The fracture was due to a fall, which the patient sustained, on hi3 left side, from a tree about twenty feet high from the level of the ground. Ordered?A broad body bandage, a dose of morphia, gr. *, and rum mixt. ?j every two hours. 26th.?Pulse very feeble, could not be counted ; tongue cold; breathing hurried; was gasping in a sitting posture; rattling noise with the respiration ; large crepitation audible over the entire right lung and the upper part of left, but at its lower it was feeble and tubular. About ten ounces of blood drawn by Dr. Fayrer in the morning from the vein on the right arm. Ordered.?Stimulant mixt. ?j every hour. Brandy 4 oz., with beef tea, a little at a time. Milk and sago. Patient put on an inclined bed. 27th.?Dyspnoea a little less ; respiration 42 ; temp. 99? ; pulse still too feeble to be counted.
Continue medicine.
Vespere.?Pulse 128 ; respiration 36; temp. 101?. Continue medicine every two hours. 28th, vespere.? Pulse 108 ; respiration 27 ; temp. 102?. Free expectoration of a purulent substance, not tinged with blood ; dyspnoea less ; mucous rhoncus audible over both sides
of the chest.
Continue medicine every two hours. Tr. scillae Tr. camph : co. Spt. ether nitric
Aq. camph
:
...
m
x.
...
jj,
...
jss.
...
3L
M.
ter
die.
116
TIIE INDIAN MEDICAL GAZETTE.
From the next day he began steadily to improve ; the stimulant mixture was omitted, and the brandy and the cough mixture continued. The patient is now in the ward, convalescent ; the ribs united, the emphysema disappeared, and the lungs are performing their healthy functions. II?FRACTURES OP THE AND
FEJIUR, OF THE 5th AND 6th RIBS, COLIiES' FRACTURE OF THE LEFT FOREARM.
Lcciimoneb, aged 30 years, a female laborer, was admitted into the 1st Surgeon's Ward of the Medical College Hospital, on the'4t,h December, 1865, with fracture of the femur of the left side at its lower part, fracture of the 5th and Gth ribs of the right side, and Colles' fracture of the left forearm. She was at the end of the fourth month of her gestation, the uterus reaching an inch below the umbilicus. The fracture was due to a fall from the roof of a two-storied house, whilst she was engaged in working. The leg was put on a straight splint, and the forearm in a pistol shaped splint, and the chest fixed by a broad body bandage. 4th January, 1866.?Ribs united, and at the points of union the callus formed a swelling. Bones of the forearm united also, without any unevenness. The union of the thigh soft and very flexible. The union of the femur was soft up to the end of March, i. e., for about four months from the date of the accident, when it began to consolidate. She is still in the ward, unable to rest her weight on the broken leg. 12th.?Bone pretty firmly united, so that the patient could rest on that leg, and walk slowly with crutches when the splints were taken of. No miscarriage has occurred ; the foetus is alive.
[May 1,
1866.
