Regional surgery, including surgical diagnosis : a manual for the use of students

Front matter

EEGXONAL SUB&EEY

To he PuUisJied in Three Parts.

PaET II WILL INCLUDE THE TeUNK AND IJPPEE EXTEEMITT. „ III WILL INCLUDE THE GeOIN AND LOWEE EXTEEMITY.

CHAPTER I Tumours of Scalp and Vault of Cranium PAGE

Table of tumours of scalp

and vault of cranium . 2 Meningocele, encephalo-

cele, hydrencephalocele 3 Sebaceous cyst (congenital) .... 4 Nsevi .... 5 Moles . . . . 5 Sebaceous cysts (acquired) 5 Fungating sebaceous cysts 6 Vascular tumours . . 7 Gummata ... 7 Nodes — syphilitic, rheumatic, strumous . . 7 Sarcomata ~ periosteal,

central . , . . 9

Exostosis .... 9

PAGE

Fungous tumour of dura

Horns and papillomata . 11

Enlarged glands . . 11

Lipoma .... 11

Fibroma .... 11 Hsematoma — cutaneous, - subaponeurotic, sub-

pericranial ... 12

Pott's puffy tumour . 14

Nodes — traumatic . . 15

Hernia cerebri . . 15 Collections of cerebro-spi-

nal fluid ... 15

CHAPTER II Affections of Scalp and Vault of Cranium

Erysipelas

Hydrocephalus

Necrosis and sinus .

Cutaneous affections —

Osteoid thickenings round

Eczema .

anterior f ontanelie

Impetigo .

Craniotabes

Eczema impetigi-

Rodent ulcer .

nodes .

Sinus over mastoid pro-

Pityriasis .

cess ....

Psoriasis .

Shape of cranium in

Herpes zoster .

rickets ....

Alopecia syphilitica .

Hypertrophy of cranium —

Tinea tonsurans or

rickets, ostitis defor-

ringworm Tinea favosa mans, leontiasis ossea, osteomalacia

Tinea decalvans viii

Chapter III Page

PAGE

Contusions

Diagnosis of concus-

Scalp wounds .

sion and compres-

Fractures of skull — sion

Fractures of vault .

Diagnosis of compres-

Fractures of base sion— extravasated

Complications of injuries

blood, depressed

to the head — bone or foreign

Concussion body, pus

Compression

CHAPTER IV Aflfections of the Face

Acne vulgaris .

Molluscum contagiosum .

Lupus ....

Diagnosis of lupoid ulcer, rodent ulcer, and epithelioma

Leprosy ....

Ulceration — lupus, rodent ulcer, epithelioma, syphilis, struma

Cicatrices round mouth .

Contusion of eyelid, " black eye" .

Prominence of frontal eminences .

Prominence of cheek

Sinus ....

Salivary fistula

Abscess ....

Erysipelas

Cancrum oris .

Facial carbuncle

Malignant pustule or charbon ....

Nsevi ....

Sebaceous cyst

Facial paralysis — Bell's palsy ....

Facial spasm — convulsive tic ... .

32 33 33

34 36

36 37

37 37 38 38 38 38 39 39

39 40 40

Evidence of congenital sy

philis .

Affections of frontal si nus — .

Distension Exostoses .

Polypi .

Fracture .

Affections of paroti gland .

Simple tumours Malignant tumours Parotitis or mumps Abscess or parotid bubo

Congenital malformation of mouth — .

Microstoma congeni

tum Atresia oris Cicatricial narrowing of

mouth .

Emphysema of face . (Edema of face — Renal disease .

Myxcedema Morphcea

Strumous or scrofulous dia thesis —

Evidences in the face

CONTENTS IX

CHAPTER V Affections

PAGE

PAGE

Polypi — .

Mucous or gelatinous

Expsnsion of bridge of

Fibrous or sarcoma-

nose ....

tous (naso-pharyn-

Destruction of nose . .

geal, naso-orbital)

jjypgy'tj'opliy of nose .

Cancerous

XJlcerution lupusj roclent

Conditions simulating po-

ulcerj epitlieliom&j sy-

lypi . . . .

philis ....

Enchondroma .

Fracture of nasal bones

Osteoma ....

Coryza ....

Chronic discharge from

Ozsena ....

the nose

Ulceration of Schneiderian

Adenoid vegetations in

membrane .

the naso-pharynx .

Necrosis of nasal bones .

Affections of the septum

Foreig-n bodies in nose

Rhinolithes or nasal cal-

Deviation.

culi ....

Blood tumour .

Chronic thickening of mucous membrane .

Perforation and de-

Meningocele of nasal

struction fossa ....

Tumours .

CHAPTER VI Affections of the Lips

Congenital fissures — Hare-lip .

Median fissure of

upper lip Fissure of lower lip Fissure of lip and cheek, " macrosto ma" .

Ulceration of lip — simple, strumous, syphilitic cancerous Herpes labialis

62 62

62 62

63 63

Fissure of Hp, or " cracked

Chancre of lip . . . 64

Hard or infecting . 64

Soft or non-infecting 64

Mucous cysts ... 65

Nsevi .... 65 Hypertrophy, " strumous

Eversion following burns 66

X

CHAPTER VII Affections of the Jaws PAQ-E

PAGE

luiTiours 01 upper jaw — .

D/

JL umours oi lower jaw .

Hydrops antri, or

Closure of the jaw .

dropsy of antrum .

DO

Diseases of temporo-max-

iIIqvv ir\ini"

JLXlcll yiL/lLlu. . ■

/ o

Fibrouia • • •

fiQ

Chronic rlieumatic ar-

1 o

Osteoma .

Rheumatic anchylosis ...

Malignant tumours — sarcoma, carcinoma

Suppurative arthritis

Abscess of antrum .

Periostitis of lower jaw .

Alveolar abscess or gum-

Dislocation of lower jaw .

boil . . . .

Fracture of lower jaw

Necrosis ....

Fracture through glenoid

Fracture of upper jaw cavity ....

Ealargement or expansion

Alteration in shape of

of lower jaw lower jaw

In congenital syphilis Mercurial, rooky, or honey combed teeth

CHAPTER IX Affections of the Mouth

Stomatitis ... 84 Affections of the mucous lining of the cheeks . 85

Ranula ....

Sublingual sebaceous cyst Salivary calculi

CHAPTER X Affections of the Tongue Chronic superficial glossi tis, " smooth tongue "

Psoriasis linguae

Ichthyosis linguae .

Ulceration of tongue — Irritable ulcer .

Dyspeptic ulcer Syphilitic ulcer Cancerous ulcer

Diagnosis of epithelioma and deep syphilitic ulcer

87 87 87 89 89 89 90 90

Syphilitic affections of tongue .

Desquamative syphi

lis of tongue .

Chanci'e .

Mucous tubercles Chronic superficial

glossitis, psoriasis,

ichthyosis Gummata Ulceration Fissured tongue

82 83

85 86 86

92 93 93

93 93 94 94 xi

CHAPTER YIll— Continued

PAGE PA&E

Acute glossitis ... 94 Tongue-tie ... 95 Abscess .... 95 Nsevi .... 96 Macroglossia or hypertrophy 95

CHAPTER XI Affections of the Palate Cleft palate Arched palate

Elongation of uvula Ulceration of palate —

Syphilitic .

Epitheliomatous Perforation of hard late

Swelling or prominence on roof of mouth

Displacement forwards of soft palate .

Gummy tumours of palate ....

Necrosis of hard palate .

Abscess ....

CHAPTER XII Affections of the Gums

Polypoid growths . . 102 Vascular tumours . . 102 Epulis . . . .102 Epithelioma, " malignant epulis "... 103

Mercurial stomatitis

. 103

In lead poisoning

. 103

In scurvy

. 104

Gingivitis

. 104

. 104

CHAPTER XIII Affections of the Tonsils

Acute tonsillitis . . 105 Chronic tonsillitis . . 105 Syphilitic ulceration . 106

Malignant disease — carci-

nonca, sarcoma . . 107 Calculi . . . .107 Cliancre . . . .108

CHAPTER XIV Affections of the Pharynx Acute pharyngitis

. 109

Stenosis of pharynx

Chronic pharyngitis

. 109

Prominence of posterior

Strumous pharyngitis

. 110

wall of pharynx .

Syphilitic pharyngitis

. 110

Post-pharyngeal abscess .

Diphtheria

. Ill

Pharyngocele .

Ulceration — .

. Ill

Tumours ....

Syphilitic .

. Ill

Caries and necrosis .

Epitheliomatous

. Ill

Paralysis of muscles xii

CHAPTER XV Affections of the (Esophagus PAGE

Dysphagia , . . 115 Stricture— . . .116 Spasmodic . . 116 Cicatricial or fibrous 117 Cancerous . .117

PAGE

Paralysis of muscles

Foreign bodies

Scalds . . . .

Dilatation, cesopbagocele

Rupture .

CHAPTER XVI Tinea tarsi

Tumours — continued

Phthiriasis

MoUuscum contagio-

Hordeolum, or "stye"

sum

Inflammation and abscess

Xanthelasma, Or Xanthoma . . ...

Syphilitic affections —

Epicanthus

Chancre .

Anchyloblepharon, sym-

Secondary or tertiary

blepharon .

ulcers .

Entropion

Ecchymosis

Ectropion

Emphysema .

Trichiasis

Lachrymal fistula .

Meibomian or tarsal

Ptosis ....

cysts

Afl'ections of muscles of

Nasvi eyelids —

Papillomata

Levator palpebrarum

Sebaceous cysts

Orbicularis

CHAPTER XVII Affections of the Lachrymal Apparatus

Inflammation of the lachrymal gland . . 129 Cysts of lachrymal gland 129 Fistula of lachrymal gland 129 Tumours of lachrymal

gland . . . .130 Inflammation of lachrymal sac ... . 130

Fistula of lachrymal sac . 131

Epiphora . . . 131

Displacement of puncta . 131

Closure of puncta . . 131 Obstruction of canali-

Obstruction of nasal duct 132 xiii

CHAPTER XVIII Affections of the Orbit

PAGE

PAGE

Exophthalmos .

. 133

Enchondroma .

. 138

Orbital cellulitis

. 134

Fibroma .

» 138

Abscess .

. 134

Gummata

. 138

Periostitis

. 135

Hydatid cysts .

. 138

Caries or necrosis .

. 136

Aneurism

. 138

Orbital haemorrhage

. 136

Nsevus

. 140

Orbital emphysema .

. 136

Malignant growths .

. 140

Tumours of orbit

. 136

Extra-orbital tumours

. 140

Exostosis ,

. 137

CHAPTER XIX Affections of the Deck

Affections of lymphatic glands — . . . 142 Inflammatory — Simple adenitis . 142 Strumous adenitis 143 Syphilitic adenitis 146 New growths — Lym-

phadenoma , 146 Carcinoma . . 147 Lymphosarcoma . 148 Tables of tumours or swellings of neck . . 144 Cystic tumours . . 149 Hygroma or hydrocele 149 Deep sebaceous cysts 149 Bursal cysts . . 150 Hydatid cysts . . 150 Abscess .... 150 Bronchocele or goitre . 151 Cervical aneurism . . 153 Carotid aneurism . . 153 Diagnosis from other tumours , . 154

Aneurism at root of neck 155 Diagnosis of carotid, subclavian, and innominate

aneurism . . . 156 Aneurism of arch of

Arterio-venous aneurism . 157 Affections of sterno-mas-

toid muscle . . . 157

Anthrax or carbuncle . 158

Sebaceous cysts . . 160

Eruption on nape of neck 161

Strumous ulceration . 161

Strumous scars . . 162

Cancerous ulceration . 162 Fistulous openings in

Emphysema . . , 163 Cicatricial contraction

after burns . . . 164 xiv

CHAPTER XX Injuries of

PAGE

Wounds of throat . . 165

Fracture of hyoid bone . 167

Dislocation of hyoid bone 167 Fracture of cartilages of

Rupture of trachea . . 168

Scalds or burns of larynx 168 the Neck

PAGE

Foreign bodies in air-passages— . . . 168 In larynx . . . 169 In trachea . . 170 In bronchi or their subdivisions . . 170

CHAPTER XXI Injuries and Affections of the Cervical Spine

Sprains .... 172 Dislocation . . . 172 Fracture . . . .173 Cervical caries . . 175 Rheumatic arthritis, "spondylitis deformans " . 177 Curvature of cervical spine— . . . 177 Angular . . .178 General bowing . 178

Curvature of cervical

spine — continued

Lateral bowing . 179

Rigidity of cervical spine 180 Spina bifida . . .180

Hyperostosis . . . 181

Sarcomata . . . 182

Carcinoma . • . 182 Irregularities of spinous

processes . . . 183

CHAPTER XXII Affections of the Larynx and Trachea Acute laryngitis . . 184

(Edema glottidis . . 185 Croup, cynanche trachea-

lis . . . . 185 Laryngismus stridulus,

" spurious croup . 186

Diphtheritic laryngitis . 186

Chronic laryngitis . . 187

Ulceration of larynx . 188 Constriction of larynx or

trachea, " stricture " . 189

Necrosis of cartilages . 190

Dyspnoea. . . . 191

Aphonia .... 191 Paralysis of muscles of

vocal cords . . . 192

Spasm of glottis . . 193

Leprosy of larynx . . 194

Tracheocele . . . 194

Aerial fistula . . . 194

XV

CHAPTER XXIII The Ear— Affec

PAGE

Malformations . . . 195 Absence .... 195 Cutaneous affections . 196 Tumours .... 196 Hsematoma . . 196 Sebaceous cysts . 197 Fibrous or keloid tumour . . . 197 as of the Auricle

PAGE

Tumours — continued.

Vascular tumours . 197 Epithelioma, lupus,

rodent ulcer . . 197 Enchondroma and sarcoma . . 198 Tophi or chalk-staiies , 198 Hypertrophy . . . 198

CHAPTER XXIV The Ear — Affections of the External Meatus

Cerumen . . . .199 Parasites . . . .199 Foreign bodies . . 200 Otitis externa diffusa . 200 Otitis externa circumscripta . . . 201 Ulceration . . . 201 Caries . . . .201

Tumours— . . .201 Exostoses. . . 201 Sebaceous tumours . 202 Polypi . . .202

Discharge of pus, otor-

Discharge of blood . . 202

Di!?charge of watery fluid 203

PAGE

Nervous deafness . . 215 Deafness in congenital syphilis . . . .215

PAGE

Implication of internal ear

in fractured skull . 216 Meniere's disease . . 216

CHAPTER XXVIII The Ear — Diagnosis of the Cause and Seat of Deafness

History and symptoms . 218 Examination with speculum ... . 218 Examination of throat . 218

Tuning-fork . . .218 Inflation of tympanum . 219 Tinnitus . . . .220

EEGIONAL SUEGEEY

CHAPTEE I

ERRATA

Preface, Hue 18, /or " complication " read " compilation." Page 17, „ 1, after " cellulo-cuianeous " insert " erysipelas."

„ 40, „ 24, /or "tumour" reat? tumours."

„ 52, margiu,/or " syyhilitic " read " syphilitic."

„ 54, line 8, /or " calculous " read " calcareous."

„ 128, „ 9, for "entropion (212)" read "ectropion (213)."

3. Th-Q Bones of the Cranium. To this subdivision the term '^CmniaV^ may be applied.

4. The Brain and its Membranes. To this subdivision the term " Cerebral and Meningeal " may be appHed.

In the following table the tumours most commonly met with in this region have been arranged according to both these methods of classification :

xvi

CHAPTER XXVII The Ear — Affections of the Internal Ear

PAGE I PAGE

Nervous deafness . . 215 | Implication of internal ear Deafness in congenital sy- in fractured skull . 216

philis .... 215 I Meniere's disease . . 216

CHAPTER XXVIII The Ear — Diagnosis of the Cause and Seat of Deafness

EEGIONAL SUEGEEY