Vol. XXIV. No. 9.] 
POPULAR SCIEI^ICE NEWS. 
143 
fourth metacarpals in the neighborhood of the pro- 
posed incision. Moderate flexion of the patient's 
hand enabled the operator's finger to define the 
position and direction of the outer (radial) connect- 
ing slip, which varies slightly in different subjects; 
its middle averaging perhaps three-quarters of an 
inch above the knuckle line. With an ordinary 
sharp-pointed tenotomy knife a longitudinal incis- 
ion, one-eighth inch in length, midway between the 
third and fourth metacarpals, and just to the distal 
side of the slip to be divided, is carried through the 
skin and superficial fascia. The exact location of 
the slip having now been determined by means of a 
probe, the deep fascia is incised at the lower edge 
of the slip and the point of the knife carried 
directly upward, that is, toward the wrist, beneath 
the slip, which parts with the characteristic creak- 
ing sound and feel. If not sufficiently tense to 
divide easily, it may be made more resistant 
by directing the patient to flex the fingers a 
little more strongly. The dressing consisted of a 
pledget of absorbent cotton held in place by adhe- 
Bive strapping. 
"A marked increase in range of independent ex- 
■ tension was at once evident, and within a few days 
the patient remarked a greater precision of touch, 
there being no tendency to the lateral twisting which 
had before annoyed him, and which was at this 
time observable in the other hand. Union of the 
wound was complete when the dressing was re- 
moved on the third day, and the result of the 
operation was so satisfactory to the patient that he 
at once submitted the other hand to be operated on. 
The motion attained in both cases was so satisfac- 
tory that it was deemed unnecessary to divide the 
slip going to the little finger tondon. In some 
extreme cases, however, this also would probably 
require division, in which event it would be well to 
bear in mind its lesser length, and not mistake for 
it the common extensor tendon, going to the fifth 
digit." 
*»v 
I Speci.illy Compiled for Popular Science Neto8.\ 
MONTHLY SUMMARY OF MEDICAL 
PROGRESS. 
by maurice d. clarke, m. d. 
The Tenth International Medical Con- 
gress, the largest, so far, of them all, was held 
• at Berlin, August 4-9. Prof. Virchow, the famous 
pathologist, who delivered the address of welcome, 
was chosen president of the Congress. 
The Present Status of Suspension in the 
Treatment of Locomotor Ata.xi.\.— In the I'ro- 
gr.es Medical, Dr. Raoult, of Paris, examines the 
results obtained by diflferent observers, in different 
countries, who have conscientiously used this mode 
of treatment for ataxia. It seems that in England 
and America the results have not been as favorable 
as those obtained in Germany and France. An 
American observer explains this by saying that the 
French people are more impressionable than the 
Anglo-Saxons, and present symptoms more func- 
tional than organic. In all probability said observer 
has been looking for a cure instead of amelioration. 
Among the recent contributions to this subject 
the majority still favor suspension. Balaban. 
of Paris, in his These de Paris, reports nine cases 
of tabes treated in this manner under the direc- 
tion of Dujardin-Beaumetz. In eight cases the gait 
was considerably improved, and the incoordination 
and lightning pains diminished. In one case the 
vesical troubles disappeared, and in three cases the 
anaesthesia. In but one case were the results unsat- 
isfactory, and treatment was suspended after twenty- 
five trials. Dujardin-Beaumetz reports twenty-five 
cases treated at L'Hopital Cochin, with good results 
in the majority of cases. In four patients the gait 
was much improved, while in six patients no 
improvement was noticed. In those cases where 
the improvement was but slight, it occurred before 
the fifteenth day of treatment. After that time the 
symptoms remained stationary. Dr. Ladame 
treated fifteen cases of locomotor ataxia, twelve 
males and three females. He reports on eleven 
cases, four having disappeared. Of eleven cases 
only two were not benefited by suspension. Dr. 
Mouisset treated eight atactics, and in one case 
only was the method unavailing. Dr. Thiberhein 
reports twenty-six cases, nineteen of whom took ten 
or more treatments. Of these, seventeen have been 
ameliorated and two not. Observers in Germany 
and Russia have likewise met with favorable results 
in the majority of cases treated a sufficient length 
of time. 
E.xtraction of a Key fko.m the Trachea. — 
Dr. M. G. Sloan, of Dexter, Iowa, writes to the 
Journal of the American Medical Association : A 
boy, aged two years, was brought to my office by his 
father, who stated that the boy had swallowed a key 
a few minutes before. The patient was voiceless, 
dyspnoia was constant and alarming, and there was 
a frequent croupy cough. There was great retrac- 
tion of the soft parts about the clavicles and in the 
infra-mammary regions in inspiration. It was very 
evident that the foreign body was somewhere in the 
air passages, and it seemed to me probable that it 
had not passed much below the larynx, as I could 
on no other theory account for the complete aphonia. 
However, neither with the finger nor with a pair 
of laryngeal forceps was I able to reach it through 
the mouth. It was plain that relief, to be of avail, 
must be speedy. Accordingly, after ineffectually 
trying a vigorous shaking with the patient inverted, 
I proceeded to perform tracheotomv under chloro- 
form anjesthesia. The operation just above the 
isthmus of the thyroid was chosen, and in making 
the incision in the trachea I was so fortunate as to 
come directly upon the lower and smaller end of the 
offending key; and now came the part of the affair 
that seemed to me to be of peculiar interest. The 
key, or at least the large end of it, was so much 
wider than the diameter of the trachea that with the 
ordinary laryngeal forceps I was wholly unable to 
remove it from its position, as the blades of the 
instrument would slip off" at every effort to grasp 
and remove the foreign body. It was only by taking 
a stout pair of polypus forceps that I was enabled to 
extract it. The key was of steel, and measured 
thirty millimetres in length, and, at the widest part, 
thirteen millimetres in width. I have not been able 
to find in any authority accessible to me a table 
of the diameters of the trachea at different ages, but 
I am confident that in this patient it did not exceed 
seven and a half or eight millimetres. Relief to 
respiration was perfect, and as soon as the little 
fellow had perfectly regained consciousness he 
audibly' expressed his satisfaction with the result, as 
I held my finger over the tracheal opening to enable 
him to use his vocal organs. No tube was used, as 
I could see no indication for it, and the incision was 
allowed to close, which it did inside of forty-eight 
hours. A pretty severe broncho-pneumonia came 
on on the second day and lasted four or five days. 
The patient is now practically well. 
cessfully performed before quite a large audience 
of physicians. The operation lasted one hour. 
Chloroform or ether could not be administered with 
safety on account of the heart and kidney lesions 
which existed. This case is one which, so far as we 
know, is a unique one of its kind. — St. Louis Med. 
and Surg. Jour. 
A Curious Case — The following is reported in 
the American Lancet: An interesting case, owing 
to the mistaken diagnosis and curious termination, 
occurred in one of Phil.idelphia's leading hospitals 
during the past month. A man was run over by a 
carriage, his injuries consisting of a fractured rib 
and an injury on the left side of the head directly 
over the speech centre ; one side of the face was 
paralyzed, and he made no answer to questions. 
It was believed the !.kull was fractured, and trephin- 
ing was advised. One of the physicians, however, 
was doubtful regarding the fracture, though all the 
symptoms were indicative of its presence, with the 
exception of a perfectly healthy appearance, very 
contradictory to the injury. The man was asked 
if he could speak, but no reply was received. 
Finally a pencil and paper were handed him with 
the request he write his name. In response to 
further inquiries he said he was a deaf mute and 
had had facial paralysis since birth. The case is 
of interest, showing how an incorrect diagnosis 
may be reached, though the symptoms present 
point strongly to its correctness. 
Fracture of a Rib from Coughing. — Mr. E. C. 
Masser reports in the British Medical -Journal for 
April 26, 1890, the case of a man, aged fifty-four, 
who was suffering from bronchitis and Bright's dis- 
ease. One evening he sent for the reporter, saying 
that he had great pain in his side. Upon inquiry it 
was ascertained that during a violent fit of coughing 
he had heard a snap, and had since felt a sharp pain 
in the same spot. Examination revealed the pres- 
ence of a fracture of the rib. This healed as readily 
as could be expected in a man with bronchitis, and 
there were no signs pointing to any previous dis- 
ease of the rib which would render it especially 
brittle. 
Compound Comminuted Fracture of the 
Patella. — In the British Medical Journal, Altham 
reports a case of compound fracture of the patella, 
with comminution and avulsion of the ligamentum 
patella. The entire bone and ligament were re- 
moved, together with small pebbles and dirt, the 
joint thoroughly cleaned and drained posteriorly, 
and the wound accurately united. The result was 
very good, the joint freely movable; patient could 
go up and down stairs, the only thing noticeable in 
the gait being a slight swinging movement of the 
leg as it was brought forward. 
Trephining Under Hypnotism. ^It is not gen- 
erally known that Dr. A. B. Shaw trephined a man 
in St. Louis on May 15th last, while the subject was 
under hypnotic influence. The case was one of 
traumatic epilepsy, Jacksonian convulsions and 
hemiplegia existing. Dr. Benno von Steinmetz 
hypnotized the patient, and the operation was suc- 
TuE Origin of Hospitals.— In the Lancet is an 
archseological summary of the most recent discov- 
eries and researches regarding primitive institutions 
for the care and cure of the sick and wounded. 
Hospitals existed in India as early as the fifth 
century, B. C. In Ceylon, according to the English 
orientalist, Turnour, King Pandukabhayo estab- 
lished a hospital in his palace, and one of his 
successors, King Dutthagamini, in the second cen- 
tury before Christ, established eighteen sucii insti- 
tutions in as many different localities, with a 
medical staff for each, and the remedial agents 
of those days. The Buddhist King, Asoka, as 
shown by Dr. Buhler, had, about the year 250 
B. C hospitals both for man and animals. There 
were, doubtless, many other founders of hospitals 
whose names are lost, but the Lancet thinks that 
