Myeloid tumour with complete absorption of the shaft of the humerus, following double fracture--excision--death / by Shirley Deakin.

Deakin, Shirley.

Date:: [1884]

Credit: Myeloid tumour with complete absorption of the shaft of the humerus, following double fracture--excision--death / by Shirley Deakin. Source: Wellcome Collection.

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$lifl§§ I I 1884.] Deakin, Myeloid Tumour. 437 myeloid disease. I was further driven to this operation by the refusal ot the patient to have his arm amputated, as the movements and nutrition of his forearm were perfect. I was also anxious to save the limb. The very free loss of blood, both during and after the operation, prob¬ ably was concerned in the unfavourable result, the patient dying twenty- four hours afterwards; but the frequent vomiting and the great distension of the abdomen, and tympanites seemed to be due to some internal rup¬ ture inducing peritonitis and death from shock. I. W. Turner, set. 24 years; Eurasian, admitted to the Civil Hospital, Allahabad, on the 29th of September, 1883, and died from exhaustion on the 17th of November, 1883, following removal of myeloid tumour ot left humerus resulting from fracture. Present History—On the 31st of March last, he got behind a ticca gharry (hackney carriage), bearing all the weight of his body on his el¬ bows ; the horse plunged forward suddenly, when he was thrown off on his left arm—the arm lying under him ; he stood up immediately after and walked home, a distance of about 200 yards ; he felt as though something were “ rushing through the arm,” and he was unable to take off his coat when he reached home. A native doctor was sent for, and the left upper arm was put in splints for fracture of the humerus ; after twenty-nine days the splints were removed, and the patient was made to use his arm by lift¬ ing light weights, after which the arm became painful and swollen, when it was again placed in splints. Three weeks after an eruption of “ red blotches” appeared, scabbing over and lasting for a month ; he was told it was chicken-pox ;* this eruption was most marked over the injured arm, one or two blotches only appearing on the face; the arm continued swollen, but pain had diminished. Dr. Deakin examined the patient at the Colvin Dis¬ pensary on the 4th of July, 1883, when he found a fracture of the humerus in two places at the lower end of the upper third and at the upper end of the lower third. There was no union, and the ends appeared to be separated by a fluctuating mass. The patient was put under a course of mercury, producing slight ptyalism ; this had apparently the effect of producing union of the upper fracture. This apparent improvement only lasted for a short time, as when next examined the middle fragment was again loose. Previous History—Had a chancre four or five years ago ; has been in good health since, excepting an attack of fever once a year. Has two brothers, both of whom are living and in good health. (One brother, who is at present a guard on the E. I. R., states that when a boy he fractured his thigh-bone in two places; the fracture united, and he has never been troubled since.) Present Condition—Body muscular ; left upper arm swollen from about three inches below the shoulder to about two inches from the elbow ; skin hot, red, and having a glazed appearance ; unable to move the arm without support, the forearm and hand are unaffected. On manipulation a feeling of fluid is imparted to the touch ; the site of fracture can be distin¬ guished by free movement above and below, leaving about four inches of thickened mass in the centre ; no friction discernible. 1 Smallpox was prevalent in Allahabad at the time ; it is usual, however, to call mild cases chicken-pox, according to the predilection of the patient. In my opinion the two diseases—if they are two—cannot be distinguished. No. CLXXIV_April, 1884. 29$