242 in great. improvement in the general condition and later the ulcers healed completely. The patient is suffering no inconvenience from the pelvic l...

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242 in great. improvement in the general condition and later the ulcers healed completely. The patient is suffering no inconvenience from the pelvic lesion. REFERENCES. 1. Micheleau, E. : Gaz. hebd. des sci. méd. de Bordeaux, 1910, xxxi., 536; also Bull. et mém soc. de méd. et chir. de

Bordeaux, 1911, p. 462. 2. Busche, A. : Zeit. für orth. Chir., 1904, xii., 650. 3. Abadie, J. : Nouvelle Iconographie de la Salpêtrière, 1900, xiii, 425. Bramwell, B. : Clin. Stud., Edinburgh, 1909-10, viii., 245. Chipault, A., in Denton and Delbet’s " Traité de Chirurgie," Paris, 1896, vol. iii., p. 458. 6. Gowers, W.: Diseases of the Nervous System, London, 1899, i., 460.

4. 5.









trocar and cannula

(see- figure) which facilitates and simplifies the little

operation for introducing lipiodol into the trachea for getting an X ray picture of the bronchial tree. The

instrument is a small curved trocar and cannula mounted on a comparatively large handle at a suitable angle. Curved on the circumference of a circle of 16 mm. radius, the trocar has a sharp point which projects 32mm. from the cannula, which is 28 mm. long and 2 mm. in diameter, and has a fixed collar ; the trocar is rigid and moves easily in the cannula. The large-sized and comfortable handle contributes n






THE inhaler shown in the illustration preserves the simplicity of the open method and increases its safety. The gauze-covered mask is placed in a container which is situated at the side of the face and never above it, the lower part of the container being a greatly to the control of the instrument and to the large well which traps any excess of liquid ether. precision of the operation. One size only is needed, It is thus impossible for the anaesthetic to get into as the instrument is equally convenient for the theeyes of the patient, however freely it is used. largest and smallest trachea. As the result of the The apparatus is made of metal (mostly aluminium), X ray examination depends on the quality of the and is less than half the weight of an average Clover’s skiagram obtained, which in turn largely depends on inhaler. The whole apparatus may be boiled. Both good technique, an instrument the use of which tends the facepiece and the container may be rotated on to secure freedom from coughing, crying, and spasmodic the connecting tube, thus enabling the inhaler to be movements of the chest during the operation will go far towards securing with lipiodol a good representation of the bronchial tree. The curved trocar obviates flattening out of the trachea from anteroposterior pressure. In addition to the instrument described it is an advantage to have a tenotomy knife or a small double-edged knife for puncturing the skin. The instrument was made for me by Mr. R. Schranz, and can be obtained from the Genito-Urinary Mfg. Co., Ltd., of 28A, Devonshire-street, W.1. J. B.

CHRISTOPHERSON, C.B.E., M.D. Camb., F.R.C.P. Lond.,

Physician, City of London Hospital, Victoria Park, E.




A MODIFICATION of Steinmann’s pin, now in routine in the orthopaedic wards of St. Thomas’s Hospital, is here illustrated. It differs from the standard pattern only in that it has a screw thread at each end on to which fits a winged nut. When cords are attached to the pin, the nut prevents their slipping off, and even allows the cords to diverge from the line of the use

to any position of the head while keeping the container in a vertical position. A tap is fitted for oxygen or carbon dioxide administration when required. The aluminium cage which supports the gauze does not require hinges or retaining clips for its covering, which are weak points in the ordinary type of mask. The component parts are riveted together, thus avoiding the small and flimsy soldered joints of the conventional wire cage. A pad of gauze is placed over the framework, and the whole is slid into the container, which is just large enough to hold it comfortably and just small enough to keep the ;gauze in position. The apparatus is reasonable in price, compact, and easily controllable with one hand, while there is no mechanism to get out of order, thus enabling the anaesthetist to concentrate solely upon the patient’s condition and the surgeon’s requirements. Messrs. Reynolds and Branson, of 13, Briggate, Leeds, are the manufacturers. W. STANLEY SYKES, M.B. Camb.


limb-often a great help in removing pressure from bony prominences distal to the point of insertion. The ordinary insertor handle is used with a screwing motion while the thread is traversing the bone, and the time taken therefore is slightly increased. Nitrous oxide anaesthesia still suffices for adults, while, as extraction requires no anaesthetic. Messrs. Allen and Hanburys, Ltd., 48, Wigmorestreet, are the manufacturers.

previously, gentle


M.R.C.S., L.R.C.P. Lond.