Musculoskeletal diseases

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Musculoskeletal diseases

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Musculoskeletal diseases

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St George's Hospital Reports, Vol. IX

CONTENTS
I. Report of the Medical Registrar, Dr. OWEN, for 1877
II. Report of the Medical Registrar, Dr. OWEN, for 1878.
III. Report of the Surgical Registrar, Mr. W. H. BENNETT, for 1877
IV. Report of the Surgical Registrar, Mr. W. H. BENNETT, for 1878
V. Report of the Post-mortem Department for 1877, by Dr. EWART
VI. Report of the Obstetrical Department for 1877, by Mr. G. S. HARPER
VII. Report of the Obstetrical Department for 1878, by Dr. H. BLAKE
VIII. Report of the Ophthalmic Department for 1877, by. Mr. MCHARDY
IX. Report of the Ophthalmic Department for 1878, by Mr. MCHARDY
X. Report of the Out-patients' Ophthalmic Department for 1878, by Mr. MCHARDY
XI. Notes from the Department for the Treatment of Diseases of the Throat for 1877 and 1878, by Dr. WHIPHAM
XII. Report of the Orthopaedic Department, by Mr. HAWARD .
XIII. Report of the Aural Department for 1877 and 1878, by Mr. DALBY
XIV. Report of the Dental Department for 1877 by Mr. C. WINTERBOTTOM
XV. Report of the Dental Department for 1878, by Mr. A. WINTERBOTTOM
XVI. On the Treatment of Gout by Salicylic Acid, by Dr. BARCLAY
XVII. On the Results of the Treatment of Compound Fracture of the Leg in this Hospital, with special reference to Lister's Antiseptic Method, by Mr. HOLMES
XVIII. Clinical Lecture on a Case of Enchondromatous Tumour of the Brain, by Mr. Pick
XIX. Abstract of a Case of Diabetes, illustrating the Effects of Remedies, by Dr. CAVAFY and Mr. BERTOLACCI
XX. Report on the Cases of Tetanus, by Mr. E. C. STIRLING
XXI. Some Cases of Mitral Disease without Murmur, by Dr. WATNEY
XXII. Observations on Outbreaks of Diphtheria in Rural Districts, by Dr. WILLIAM OGLE
XXIII. On a Novel Method of reducing Dislocation of the Shoulder, by Mr. J. JONES
XXIV. Notes on some forms of Intestinal Obstructions, by Dr. E L. Fox .
XXV. On Ichthyosis, by Mr. G. GASKOIN
XXVI. On Chrysophanic Acid, by Mr. WYNDHAM COTTLE .
XXVII. On Warty Growths, by Mr. WYNDHAM COTTLE
XXVIII. On the Opening and Drainage of Joints, by Mr. J. H. MORGAN
XXIX. History of an Illness, by Mr. S. WILSON HOPE
XXX. Case of Tympanic Abscess, by Dr. E. C. BABER
XXXI. Exophthalmic Goître, by Dr. W. B. CHEADLE

LIST OF ILLUSTRATIONS
Charts of Analyses of the Urine in a Case of Diabetes
Warty Growths
Membrana Tympani in Case of Tympanic Abscess
Microscopic Appearances of Medulla in Exophthalmic Goître

Thomas Burchmann, [No age stated], [No occupation stated]

Occupation or role: [No occupation stated]
Age: [No age stated]
Gender: Male
Date of admission: 13 Nov 1840
Date of death: 22 Jan 1841
Disease (transcribed): Ulceration of cartilages of knee. Partial ankylosis. Abscess in thigh
Disease (standardised): Ulcer (Leg); Ankylosis (Joints); Abscess (Thigh)
Admitted under the care of: Tatum, Thomas
Medical examination performed by: n/a
Post mortem examination performed by: n/a
Medical notes: n/a
Body parts examined in the post mortem: Leg

Type of incident: n/a

Thomas Kersey, 27, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 27
Gender: Male
Date of admission: 14 Apr 1841
Date of death: 25 Apr 1841
Disease (transcribed): Dilatation of heart. Disease and rupture of one aortic valve
Disease (standardised): Disease (Heart, blood vessels)
Admitted under the care of: Seymour, Edward James
Medical examination performed by: n/a
Post mortem examination performed by: n/a
Medical notes: n/a
Body parts examined in the post mortem: Thorax, abdomen, cranium

Type of incident: n/a

Mary Ching, 41, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 41
Gender: Female
Date of admission: 5 Mar 1851
Date of death: 18 Mar 1851
Disease (transcribed): Acute rheumatism. Fever. Pericarditis. Enlarged glands of intestines
Disease (standardised): Rheumatism (Tissues); Fever (Systemic); Pericarditis (Heart); Enlargement (Intestinal glands)
Admitted under the care of: Nairne, Robert
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Ogle, John William
Medical notes: 'This woman was admitted labouring under an attack of acute rheumatism. She stated that she never had a similar illness previously, that on 24th ult., during the menstrual flux she was seized with pains in her joints which had increased ever since, and on her admission they were inflamed, red swollen & tender. She was perspiring freely, the pulse was frequent & very soft, the joints excessively painful’
Body parts examined in the post mortem: Thorax, abdomen, cranium

Type of incident: n/a

Mary Hely, [No age stated], [No occupation stated]

Occupation or role: [No occupation stated]
Age: [No age stated]
Gender: Female
Date of admission: 30 Apr 1851
Date of death: 27 May 1851
Disease (transcribed): Gouty with anasarca. Liver very granular, peritoneum thickened. Kidneys somewhat altered. No albumin in urine. Heart flaccid, atheromatous & calcareous deposits. Fibrous tumours of uterus
Disease (standardised): Gout (Joints); Edema (Systemic); Disease (Liver, peritoneum, kidneys, heart); Tumour (Uterus)
Admitted under the care of: Nairne, Robert
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Barclay, Andrew Whyte and Ogle, John William
Medical notes: 'An elderly woman who had never borne children, was admitted with great enlargement of the abdomen & swelling of the legs. It appeared that she had suffered from cough for some years, which had become unusually severe since last Xmas, accompanied by much dyspnoea’
Body parts examined in the post mortem: Abdomen, thorax

Type of incident: n/a

William Cook, 82, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 82
Gender: Male
Date of admission: 5 May 1851
Date of death: 20 Jun 1851
Disease (transcribed): Fracture of the femur, high up. Ankylosis, entire, between the head of the femur & the ilium, evidently the result of ‘diseases’ of the joint. Vomicae in lungs
Disease (standardised): Fracture (Thigh); Ankylosis (Thigh); Disease (Joints); Suppuration (Lungs)
Admitted under the care of: Hawkins, Caesar Henry
Medical examination performed by: Blagden, Robert
Post mortem examination performed by: Ogle, John William
Medical notes: 'This patient, who was very old & feeble, was knocked down by a butcher’s boy while walking. He fell on his back & on being raised found he was unable to walk. He was found to have a simple fracture of the upper part of the left thigh’
Body parts examined in the post mortem: Hip joint, thorax, abdomen

Type of incident: Trauma / accident

Mary Ladd, 8, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 8
Gender: Female
Date of admission: 12 Nov 1851
Date of death: 15 Feb 1852
Disease (transcribed): Morbus coxarius. Excision of head of femur. Ulcerative perforation into the pelvis obviated only by thickened peritoneum
Disease (standardised): Disease (Hip); Excision (Leg); Ulcer (Pelvis); Perforation (Pelvis); Thickening (Abdomen)
Admitted under the care of: Hawkins, Caesar Henry
Medical examination performed by: Holmes, Timothy
Post mortem examination performed by: Ogle, John William
Medical notes: She had met with some injury to the thigh about four years ago. She recovered some motion of the limb, though not completely.
Body parts examined in the post mortem: Hip joints, abdomen, thorax and cranium
Type of incident: Trauma/accident

Sarah Wilkie, 6, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 6
Gender: Female
Date of admission: 21 Apr 1852
Date of death: 16 May 1852
Disease (transcribed): Disease of the hip joint and femur. Effusion of fluid and lymph under the arachnoid at the base of the brain. Fluid in ventricles. Death by coma and convulsions
Disease (standardised): Disease (Hip); Disease (Leg); Effusion (Brain); Lymph (Brain); Coma (Brain); Seizures (Brain)
Admitted under the care of: Keate, Robert
Medical examination performed by: Holmes, Timothy
Post mortem examination performed by: Holmes, Timothy
Medical notes: The child had been ill for about a year, her symptoms being referred to the left hip.
Body parts examined in the post mortem: Cranium, thorax, abdomen and hip joint
Type of incident: n/a

Susanna Barber, 14, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 14
Gender: Female
Date of admission: 9 Aug 1843
Date of death: 9 Sep 1843
Disease (transcribed): Diseased Hip. Phthisis.
Disease (standardised): Disease (Hip); Tuberculosis (Lung)
Admitted under the care of: Keate, Robert
Medical examination performed by: n/a
Post mortem examination performed by: n/a
Medical notes: n/a
Body parts examined in the post mortem: Thorax and abdomen
Type of incident: n/a

John Newbold, 43, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 43
Gender: Male
Date of admission: 26 Oct 1843
Date of death: 21 Nov 1843
Disease (transcribed): Rheumatic pains and paralysis from lead.
Disease (standardised): Rheumatic diseases (Joints); Paralysis (Central nervous system)
Admitted under the care of: Wilson, James Arthur
Medical examination performed by: n/a
Post mortem examination performed by: n/a
Medical notes: n/a
Body parts examined in the post mortem: Thorax, abdomen and legs
Type of incident: n/a

Henry Bestram , 31, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 31
Gender: Male
Date of admission: 28 Aug 1844
Date of death: 4 Sep 1844
Disease (transcribed): Hypertrophy and increased vascularity of bones of skull. Effusion of milky fluid in subarachnoid tissue. Fluid in ventricles with thickened membrane. Disease of hip joint.
Disease (standardised): Hypertrophy (Skull); Vascularity (Skull); Effusion (Brain ); Disease (Hip)
Admitted under the care of: Seymour, Edward James
Medical examination performed by: n/a
Post mortem examination performed by: n/a
Medical notes: About six years before his admission he appeared to have had a fit which proceeded from mental excitement. Three of four years afterwards his sight had become dim and he had paralysis of one side.
Body parts examined in the post mortem: Cranium, thorax, abdomen and hip joint
Type of incident: n/a

Henry Brown, 32, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 32
Gender: Male
Date of admission: 21 Aug 1844
Date of death: 6 Nov 1844
Disease (transcribed): Pus in knee joint, with ulceration of cartilage, exposing the bone, and soft ankylosis. Diffuse cellular inflammation of the arm. Membranes of brain, slightly thickened, with opaque fluid. Blood tinged serum in pleura.
Disease (standardised): Suppuration (Leg); Ulcer (Leg); Ankylosis (Leg); Inflammation (Arm); Thickening (Brain )
Admitted under the care of: Tatum, Thomas
Medical examination performed by: n/a
Post mortem examination performed by: Hewett, Prescott Gardner
Medical notes: n/a
Body parts examined in the post mortem: Cranium, thorax, abdomen, right inferior extremity and right superior extremity
Type of incident: n/a

Mary King, 15, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 15
Gender: Female
Date of admission: 6 Nov 1844
Date of death: 24 Nov 1844
Disease (transcribed): Chorea. Disease of clavicle. Diffuse inflammation in neighbourhood. Old adhesions of right lung. Endocarditis. Large intestine filled with faeces adhering to its coats. Organs of generation congested. Brain and chord natural.
Disease (standardised): Chorea (Central nervous system); Disease (Clavicle); Adhesions (Lung); Endocarditis (Heart); Congestion (Genitalia)
Admitted under the care of: Macleod, Roderick
Medical examination performed by: n/a
Post mortem examination performed by: Lee, Henry
Medical notes: At the age of 12, before any appearance of catamenia, became affected with chorea which commenced gradually but soon became severe. She was also drowsy and felt pain across the forehead.
Body parts examined in the post mortem: Thorax, abdomen and brain
Type of incident: n/a

Andrew Wright, 3, [Occupation not stated]

Occupation or role: [No occupation stated]
Age: 3
Gender: Male
Date of admission: 3 Sep 1845
Date of death: 10 Sep 1845
Disease (transcribed): Hydrocephalus. Congestion of the pia mater and brain. Softening of the central white parts. Lungs congested. Caries of spine
Disease (standardised): Hydrocephalus (Brain); Congestion (Brain, lungs); Caries (Spine)
Admitted under the care of: Macleod, Roderick
Medical examination performed by: Hewett, Prescott Gardner
Post mortem examination performed by: Fuller, Henry William
Medical notes: 'It appeared that this child had been ailing about three weeks, had lost his appetite, become restless, flushed in the face, & had slight convulsive movements in the limbs, with twitchings of the muscles of the face. He was very thirsty, extremely heavy & drowsy, yet unable to obtain any quick sleep, for when dozing, he constantly started, and occasionally screamed violently. His bowels had been much confined’
Body parts examined in the post mortem: Cranium, thorax, abdomen

Type of incident: n/a

William Day, 48, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 48
Gender: Male
Date of admission: 28 Jan 1846
Date of death: 11 Mar 1846
Disease (transcribed): Diffuse cellular inflammation of right leg. Partial ankylosis of knee joints, with absorption of cartilages and softening of the extremities of the bones. Congestive pneumonia. Heart dilated and atrophied. Specks of atheroma in aorta.
Disease (standardised): Inflammation (Leg); Ankylosis (Leg); Pneumonia (Lung); Disease (Heart); Plaque, Atherosclerotic (Arteries)
Admitted under the care of: Tatum, Thomas
Medical examination performed by: Gee, Adolphus John
Post mortem examination performed by: Pollock, George
Medical notes: This patient was admitted with rheumatic gout of the knee and elbow joints of ten years.
Body parts examined in the post mortem: Thorax, abdomen and lower extremities
Type of incident: n/a

Frederick Danossky, 63, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 63
Gender: Male
Date of admission: 24 Aug 1846
Date of death: 13 Sep 1846
Disease (transcribed): Paraplegia. Hypertrophy and condensation of the bones of the skull. Brain healthy. Spine and spinal chord healthy. Hypertrophy of prostate. Hypertrophy and chronic inflammation of bladder and kidneys. False passage in urethra.
Disease (standardised): Paraplegia (Central nervous system); Disease (Skull); Disease (Prostate); Disease (Bladder); Disease (Kidney); False passage (Urethra)
Admitted under the care of: Wilson, James Arthur
Medical examination performed by: Fuller, Henry William
Post mortem examination performed by: Hewett, Prescott Gardner
Medical notes: This patient was admitted suffering from partial paraplegia, chiefly affecting the left leg.
Body parts examined in the post mortem: Cranium, spine, thorax and abdomen
Type of incident: n/a

Elizabeth Adams, 30, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 30
Gender: Female
Date of admission: 13 Dec 1848
Date of death: 17 Dec 1848
Disease (transcribed): Acute rheumatism. Endo and pericarditis. Fatty heart.
Disease (standardised): Rheumatic diseases (Tissues); Endocarditis (Heart); Pericarditis (Heart); Disease (Heart)
Admitted under the care of: Nairne, Robert
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Handfield Jones, Charles
Medical notes: This patient stated that her illness had commenced with pain and swelling of the right knee and that she had been confined to bed.
Body parts examined in the post mortem: Thorax and abdomen
Type of incident: n/a

Charlotte Ashwell, 26, [Occupation not stated]

Occupation or role: [Occupation not stated]
Age: 26
Gender: Female
Date of admission: 4 Apr 1849
Date of death: 16 Apr 1849
Disease (transcribed): Caries of the right temporal bone. Meningitis. Circumscribed abscess in the middle lobe of the right hemisphere
Disease (standardised): Caries (Skull); Meningitis (Brain); Abscess (Brain)
Admitted under the care of: Nairne, Robert
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Gray, Henry
Medical notes: 'The history of this case which was afterwards obtained from her father was to the effect that some 6 weeks since, on returning form the country she had boils all over her body, and on exposure to cold they had been repressed, after which she was seized (about a fortnight ago) with pain and discharge from the right ear; three days before her admission she had become delirious’
Body parts examined in the post mortem: Cranium, thorax, abdomen

Type of incident: n/a

William Cook, 22, [Occupation not stated]

Occupation or role: [Occupation not stated]
Age: 22
Gender: Male
Date of admission: 6 Dec 1848
Date of death: 22 May 1849
Disease (transcribed): Caries & abscess of the hip joint
Disease (standardised): Caries (Hip); Abscess (Hip)
Admitted under the care of: Keate, Robert
Medical examination performed by: Holl, Harvey Buchanan
Post mortem examination performed by: Gray, Henry
Medical notes: 'About the middle of September last this patient contracted syphilis & became in consequence an out-patient of the Lock Hospital. He had a primary sore on the penis & a bubo in each groin. He was put under the influence of mercury & five weeks afterwards (his mouth being still sore), he began to feel pain in the left hip & knee & walked lame. Five or six days afterwards he became disabled & was made an in-patient at the Lock. In about a fortnight afterward some enlargement had taken place around the joint, & an issue was made just behind the trochanter major’
Body parts examined in the post mortem: Thorax, abdomen

Type of incident: n/a

Emma Baker, 4, [Occupation not stated]

Occupation or role: [Occupation not stated]
Age: 4
Gender: Female
Date of admission: 11 Jul 1849
Date of death: 15 Jul 1849
Disease (transcribed): Abscess after periostitis. Secondary abscesses of lung
Disease (standardised): Abscess (Periosteum); Periostitis (Periosteum); Abscess (Lungs)
Admitted under the care of: Tatum, Thomas
Medical examination performed by: Holl, Harvey Buchanan
Post mortem examination performed by: Pollock, George
Medical notes: 'This child was admitted with the right leg put up in splints in consequence of a supposed fracture of the tibia, but the only account that could be learnt from the parents was the the little patient was supposed to have hurt his [sic] leg while playing with some other children. On removing the splints no fracture could be detected but the limb from the knee downwards was much swelled & inflamed. There was considerable fever & much restlessness’
Body parts examined in the post mortem: Cranium, thorax, abdomen, right lower extremity

Type of incident: Trauma / accident?

Elizabeth King, 40, [Occupation not stated]

Occupation or role: [Occupation not stated]
Age: 40
Gender: Female
Date of admission: 28 Nov 1849
Date of death: 30 Nov 1849
Disease (transcribed): Lateral curvature of the spine. General anasarca. Lungs healthy. Extravasation of blood on the surface of the heart. Ascites. Congestion of the liver. Cysts in both kidneys
Disease (standardised): Spinal curvatures (Spine); Edema (Systemic); Extravasation (Heart); Ascites (Peritoneum); Congestion (Liver); Cyst (Kidneys)
Admitted under the care of: Bence Jones, Henry
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Gray, Henry
Medical notes: 'This patient, who was a good deal deformed by lateral curvature owing, as she stated, to an accident 5 or 6 years before, had suffered from swelled legs more or less for the previous 12 months. After childbirth in August last she also observed that her abdomen was more prominent than natural & she had increased in size up to her admission. She had long suffered from shortness of breath & palpitations of heart’
Body parts examined in the post mortem: Thorax, abdomen

Type of incident: n/a

James Chaplin, 11, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 11
Gender: Male
Date of admission: 22 Feb 1850
Date of death: 2 Mar 1850
Disease (transcribed): Abscess of face and disease of the hip joint
Disease (standardised): Abscess (Face); Disease (Hip)
Admitted under the care of: Tatum, Thomas
Medical examination performed by: Rouse, James
Post mortem examination performed by: Holl, Harvey Buchanan
Medical notes: No history could be obtained of this case. The child was admitted with a very large abscess occupying the whole of the left side of the face.
Body parts examined in the post mortem: Head, thorax, abdomen and right lower extremity
Type of incident: n/a

Edward Price, 40, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 40
Gender: Male
Date of admission: 27 Jun 1850
Date of death: 30 Jun 1850
Disease (transcribed): Granular kidneys. Hereditary gout. Recent pleurisy and pneumonia. Large heart. Lithate of soda on valves. Specks of [lithate of soda] in larynx. Large deposits in joints
Disease (standardised): Disease (Kidney); Gout (Joints); Pleurisy (Pleura); Pneumonia (Lung); Disease (Heart); Deposits (Larynx)
Admitted under the care of: Nairne, Robert
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Holl, Harvey Buchanan
Medical notes: This patient had been in the Hospital about five years previously labouring under gout with albuminous urine. He applied on the present occasion for admission in consequence of epistaxis.
Body parts examined in the post mortem: Larynx, thorax, abdomen and joints
Type of incident: n/a

Harriet Underwood, 22, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 22
Gender: Female
Date of admission: 16 Jun 1852
Date of death: 27 Aug 1852
Disease (transcribed): Rheumatic gout. General tuberculosis. Deposits of scrofulous matter in lungs, kidneys, intestinal glands and spleen. Exceedingly small heart
Disease (standardised): Gout (Joints); Tuberculosis (General); Tuberculosis (Lung); Tuberculosis (Kidney); Tuberculosis (Intestinal mucosa); Tuberculosis (Spleen); Small (Heart)
Admitted under the care of: Wilson, James Arthur
Medical examination performed by: Barclay, Andrew Whyte
Post mortem examination performed by: Ogle, John William
Medical notes: This girl had been suffering from a severe form of rheumatic gout almost constantly during two years.
Body parts examined in the post mortem: Thorax and abdomen
Type of incident: n/a

William Gay, 6, [No occupation stated]

Occupation or role: [No occupation stated]
Age: 6
Gender: Male
Date of admission: 12 May 1852
Date of death: 25 Sep 1852
Disease (transcribed): Scrofulous deposits in the right cerebral hemisphere, also in the lungs. Hepatized lung. Disease of the hip joint with dislocation of the head of the bone. Diseased os innominatum
Disease (standardised): Tuberculosis (Brain); Tuberculosis (Lung); Disease (Lung); Disease (Hip); Dislocation (Hip); Disease (Pelvis)
Admitted under the care of: Tatum, Thomas
Medical examination performed by: Holmes, Timothy
Post mortem examination performed by: Holmes, Timothy
Medical notes: On admission it was stated that this boy had been lame for a long while and he ad kept to his bed for the last five months.
Body parts examined in the post mortem: Cranium, thorax, abdomen and left hip
Type of incident: n/a

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