14 
POPULAR SCIEI^CE NEWS. 
[January, 1S90. 
I Specially Compiled for The Popular Science Neio8.\ 
MONTHLY SUMMARY OF MEDICAL 
PROGRESS. 
by w. s. wells, m. d. 
Suture of the Quadriceps Femoris-Tenuon. 
— Dr. W. T. Bull presented to the section in sur- 
gery at the New York Academy of Medicine, Nov. 
II, 18S9, a young man, aged 17, who, on the 29th of 
last April, was admitted to the New York Hospital 
with a cut across the knee received from a circular 
saw. The injury was three-quarters of an inch 
above the patella, laying open the joint and denud- 
ing the internal condyle of the femur of its cartilage, 
and severing the quadriceps femoris. A three-inch 
incision was made upward trom the center of the 
wound, and the ends of the tendon were approxi- 
mated and sutured with catgut. A drainage-tube 
was inserted and removed on the fourth day. The 
patient was up and around, with his limb in plaster 
of Paris, on the tenth day. He was discharged at 
the expiration of the fourth week, and the plaster 
dressing was removed three weeks later. Motion 
had gradually been restored to the joint, and at the 
present time the power of extension was normal, 
and there existed no interference with flexion. 
Dr. R. G. Wiener, at the same meeting, showed 
a patient whose tendon he had sutured at a point 
below the patella. The operation had been done in 
this case some five years ago, by Dr. Sands at the 
Roosevelt Hospital, and with good results as to 
union and motion. In December last the patient 
had fallen down stairs, and had ruptured the tendon 
once more, when he came under the speaker's care 
at Charity Hospital in June last. The patella was 
found to be four inches above the joint, and the 
power of extension was entirely absent. On the 
29th of June an incision nine inches in length was 
made, laying bare all the tissues down to the joint. 
No remains of the patellar tendon could be dis- 
covered. It was impossible to make the patella 
approach its proper relation to the joint, and the 
operator then divided the quadriceps femoris tendon 
above the patella, and, after restoring the latter to 
its proper position, drilled both it and the tibia, and 
secured the patella to the latter with stout wire. 
The continuity of the tendon above was then re- 
stored by suture. After a lapse of two weeks, pri- 
mary union was found to have resulted throughout. 
Dr. a. M. Phelps presented to the Academy of 
Medicine, New York, lately, a boy, about 7 years 
of age, who had been submitted to excision of the 
astragalus for tubercular disease of the ankle-joint. 
The disease relapsed, other bones becoming in- 
volved, and a surgeon had condemned the case for 
amputation. The patient then came under Dr. 
Phelps' care, and he opened the joint, followed 
sinuses down to the bones, and scraped nearly all 
the bone out of the periosteal covering except in the 
cuneiform. After suitable dressing without ligation 
• of the vessels, the Esmarch bandage was taken off 
and the cavities allowed to fill with blood. The 
dressing was not changed for three weeks ; union 
was primary; at the end of five weeks the bones 
had become solid, there having been reproduction 
of the OS calcis, cuboid, and scaphoid. There was 
very good motion of the ankle-joint, the child walk- 
ing as well as he had ever done. The operation 
was done last May. A plaster of Paris dressing was 
worn some time after the fifth week. 
Dr. Phelps also presented an Italian girl, who, 
when 5 years of age, had had extensive osteo-myelitis, 
involving, apparently, the entire tibia, fibula, and 
femur. The knee was anchylosed at a right angle. 
The patient had lain in bed five years. The ques- 
tion was debated whether to amputate or to exsect 
the knee. The latter method was adopted in No- 
vember last, and it was Dr. Phelps' intention on 
cutting down upon the knee to perform Fenwick's 
operation, making the end of one bone concave and 
the other convex, but he found tubercular or fatty 
degeneration in the interior of the femur and tibia, 
and consequently scraped them out, leaving only 
the shell, which he coaptated in a straight line by 
wires, allowing the cavities to fill with blood. 
When the first dressing was changed, at the end of 
five weeks, the clots had organized and formed bony 
union. 
Dr. Powers inquired of Dr. Phelps what histolog- 
ical changes took place in the reproduction of bone 
through blood-clot. 
Dr. Phelps replied that the blood-clot itself was 
not supposed to organize, but that it acted as a 
framework for the growth of the cell-tissue which 
took place in it, constituting the normal elements 
in that particular locality. As the new tissue 
formed, the blood-clot became absorbed. 
Dr. Robert Abbe presented a woman to the 
New York Academy of Medicine on whom he had 
excised the sheath of the flexors of the thumb and 
index and little fingers because of the growth of 
melon-seed bodies, now recognized to be the result 
of tubercular inflammation. The case was inter- 
esting in connection with the question of secondary 
operations to free divided tendons. Notwithstand- 
ing complete removal of the sheath of the tendons 
in this case, and in other cases, freedom and power 
of motion had afterward been complete. The 
wound, of course, must be kept antiseptic, and 
primary union take place, without any pus. In his 
case, only voluntary motion was resorted to ; this 
was begun on the sixth day. 
Dr. Curtis related the case of a girl who, last 
winter, had suflfered from an attack of cellulitis in 
the hand. When he saw her she had entirely re- 
covered, but the right fore finger was bound down 
by adhesions in the tendon at the metacarpo- 
phalangal joint. He laid back a flap, found the 
tendon and its sheath bound together in a mass of 
fibrous tissue, dissected them apart, put the finger 
in extension, closed the wound, kept up active 
motion, and had a result of normal power and 
motion. 
Dr. p. de Tullio, assistant to Professor Cantani 
in the University Clinique at Naples, has lately 
suggested {London Medical Record) a method of 
applying cold air directly to the interior of the 
lungs in cases of pulmonary hemorrhage. The 
apparatus consists of a metal box through which 
run several tubes, A^hich communicate with an 
outer larger tube leading to a mouthpiece, which 
the patient holds between his lips. The box is 
filled with ice, or with a mixture of snow and salt, 
so as to cover the tubes. Air is then pumped with 
a suitable bellows into the tubes, and in its passage 
through the box containing the refrigerant substance 
it becomes cooled down to 0° centigrade. This is 
ascertained by means of a thermometer introduced 
into the tube at some distance beyond the box, 
through an aperture which can be closed with a 
cork. Dr. de Tullio reports three cases in which 
severe h.-cmoptysis was arrested by this plan, when 
drugs, ice to the chest, and the other usual measures 
had failed. It does not, of course, cure the condition 
on which the bleeding depends, but it is an effectual 
remedy for the symptom. 
he asserts, to arrange phonograms by means of 
which the hearing can be accurately measured. The 
operation of the apparatus is simple. The ear-piece 
is applied to the ear which is to be tested, and a 
phonogram which is audible to the patient is 
sounded. The acoumetric scale is then descended 
until a phonogram is reached which cannot be 
heard. This marks the limit of hearing for that 
ear. In this manner the source of sound remains 
always at the same distance from the ear, and only 
the intensity of the tone differs. 
Milk sugar in cardiac dropsy is regarded by Ger- 
main See as the most reliable and least harmful diu- 
retic. He attributes the good effect of milk diet almost 
exclusively to the lactose. One hundred grammes 
(3% OZ-) of lactose will produce an enormous diure- 
sis, increasing the daily discharge in twenty-four 
hours to two and one-half liters, and daily over- 
reaching this, until on the third day, four to four 
and one-half liters are voided. Milk sugar, there- 
fore, removes cardiac dropsy surely and rapidly, and 
only fails if Bright's disease complicates it. 
M. G. See has recently pointed out, before the 
Academy of Medicine, that iodide of potassium, far 
from being a depressant, is really a cardiac tonic, of 
almost equal value to digitalis or strophanthus in 
certain cases. Indeed, he says that iodide of potas- 
sium is the real cardiac drug {vrai medicament du 
cacur), since, when prescribed in cases of uncom- 
pensated mitral lesions or affections of the myocar- 
dium, it increases the cardiac power and raises 
vascular tension. Thus, by subsequently causing 
dilatation of the arterioles, it enables the heart to 
recover its power, and affords also better facilities 
for the coronary circulation, thus improving the 
nutrition of the heart muscle. 
According to the Deutsche Medizinal-Zeitung, 
Lichtwitz maintains that Edison's phonograph fills 
the requirements for an acoumeter. It is possible, 
Dr. Rodriguez Mendez, professor of hygiene in 
the Medical Faculty of Barcelona, has just published 
in a new Spanish journal, La Medicina Practica, 
some notes of a case of a peculiar affection of the 
fingers and nails which appears to have been due to 
the patient's trade, that of a confectioner. Poncet, 
of Paris, and Albertin, of Lyons, have also noticed 
the existence of this aflfection among those who are 
engaged in the calling of a confectioner. Dr. Men- 
dez's patient was a man about 40 years of age. His 
trouble was a combination of onychia and parony- 
chia, caused by immersing the hand in hot and cold 
syrups. 
G. W. Watson, in the Ohio Journal of Dental 
Science, says: "I have very good authority for 
saying that diseased roots and teeth have a great 
deal to do in starting tubercutar trouble in the lym- 
phatic glands of people predisposed to this disease. 
Tubercle bacilli, gaining admission to the jaw 
through the diseased teeth, speedily infect the 
structures in their neighborhood. It would be 
right, therefore, for us to look well to the teeth of 
patients having a tubercular tendency, and see that 
they keep their mouth in a thoroughly healthv and 
aseptic condition." ♦ 
The cases of antifebrin poisoning are multiplying. 
Dr. Pauschinger {iluench. Med. Wochenschr.) reports 
one such case — that of a strong man, 34 years old 
who took at intervals of one hour five powders, each 
containing one gramme of antifebrin, for the relief 
of a supposed fever, when violent diarrhoea ensued, 
which confined him to his bed for ten days. 
Dr. E. Fuerth ( Wiener Med. Presse) reports 
another case in which a girl suffering from pain in 
one side of her head, took four grammes of antife- 
brin as a remedy. Nausea, eructation, pains in the 
