CASES FROM PRACTICE IN A BENGAL VILLAGE. By Surgeon-Major K. P. Gupta, F.R.C.S.E.

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While staying at my country house on the east bank of the Hooghly, about 28 miles north of Calcutta, for a few days in the summer of 1880, many patients came to consult for ..sundry complaints, and it may not prove uninteresting if I '

select a few cases.

Dislocation of the Radius forwards. Hurro Tewar, set. 48, a fisherman, fell from a gab tree and

dislocated his right elbow joint. Immediately after the accident he presented himself at my house, and on examina- tion I found the radius displaced forwards. The ulna was in its proper place. I made my bearer put his fingers on and press the prominence caused by the displaced bone while I applied extension. The dislocation was thus easily reduced and the head of the radius returned to its place with a snap which was distinctly heard. Forward dislocation of the radius is very common, and

is generally caused by a fall on the palm of the hand by which, the lower end of the radius being driven backwards, the upper end is tilted forwards with the whole force of the leverage of the bone. In this instance the man was

up on a gab tree plucking its fruit, and when he fell he must have attempted to save hinself by putting out his

right palm extended or spread out and striking the ground forcibly with it.

2.?Old Inguinal Hernia right side: apparent cure for 12 years, and then fatal relapse.

Gurudas, set. 68, was subject to hernia while a young man, for which he wore a truss. But for the last twelve years he has had no hernial protrusion, from which he fancied he was cured and left off wearing a truss. On 25th May last, while standing on a stool and cutting down a large jack fruit, he fell down. The next day after midday his old rupture came down. It should be mentioned that latterly his health had broken down from repeated attacks of fever. He was sick two or three times and brought up all his food. Taxis was first applied with no effect. He was then put into a warm hip bath for twenty minutes and taxis was again applied without success. Tincture of opium and Spts. choloroform were administered.^ ice was procured the next day from Chinsurah and applied. A dose of oil had been

reluctantly given in the morning at the earnest solicitation of the patent, who assured me that in his old attacks a purga- tive always cured him. No motion after the oil. In the afternoon an enema was given, the injection did not go far in?it was rejected as by some obstruction. I passed my finger and also a short tube up into the rectum, but did not find any obstruction. It should be mentioned that lumps were visible since morning?one of them was very painful and pitted on pressure. Operation was refused, and the man died in the evening. The point of interest in this case is the fact that a hernia, which was apparently cured for twelve

years, returned as soon as the patient's health became bad and he made a slight exertion.

3.? Case of Intestinal Obstruction. (?) On May 27th, at about 2 P. m. Gopal Manjee, set. 46,

strongly built and muscular man, was brought to my house from Doomurda, a village about 8 miles up the river on its

west bank, suffering from suppression of urine, absolute constipation of the bowels and acute pain in the abdomen.

Face anxious, surface of body cold, a small wiry pulse ; there was no tympanitis or fulness or swelling in any part of the abdomen.

Previous history.?On Sunday, the 23rd May, he passed one scanty stool?none since. His urine was dribbling since yesterday morning ; no gonorrhoea ; complete stop- page for the last three hours. No history of any previous illness. I passed a catheter and drew out about 1? oz. of high-colored urine. An enema of castor oil, soap and warm water was thrown up, but it brought away nothing save one or two scvbalse. The patient felt scarcely relieved, though his pulse was somewhat improved. He went to a relative's house and there passed a stool. In the evening his friends came and asked me what food should be given him ; they also said that the man was complaining of a burning sensation in the hands and feet. 1 ordered milk diet and a little oil to be rubbed on the hands and feet. Contrary to my advice the friends allowed the man to have a cold bath, after which collapse set in. According to the Hindu custom he was removed to the river side (the holy Ganges) and plunged in the water. He revived and walked to his friend's house which stood on the river bank. He talked on different subjects, and then wanted to go to stool. After passing a stool he relapsed to his former state and died. I did not see him after he left my house, his friends gave me the account the next morning. llemarks.?This was rather an obscure case. There was

suppression of urine and intestinal obstruction, both of which were relieved?but he died from collapse after a cold bath.

4.?Retention of Urine after Chronic Gonorrhoea aggra- vated by some heating drug.

Bhuban, set. 35, Brahmin cook, has had gonorrhoea for two years, for which he tried various native medicines without being cured. At last one of his relatives went to the shrine of the God Tarakessur who is reputed to cure diseases after doctors and kobirajes give them up, and got a certain drug. He took it and felt greatly heated and his urine completely stopped for the first time. In this state he was brought to me, and I found his abdomen greatly distended and the patient in agony for not being able to make water. I passed a catheter and drew out 3 or 4 pints of turbid and decomposed urine mixed with mucus. There was no impediment to the passage of the catheter except a slight spasm at the neck of the bladder, probably caused by taking the particular medi- cine. With this case I stop now, and may resume the series in a future issue.