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ARTICI E III.—Case of Obstruction of the Bowels, caused by Swallowing a Leaden Bullet. By G. V. CUMMING, M.D., GarrisonSurgeon, Vizagapatam.

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AMONG the families of the garrison an interesting case occurred. boy, aged 11, named Dixon, son of a European pensioner, was admitted into hospital on the 15th of October 1850, complaining of pain in one spot of the abdomen-a little below and to the left of the umbilicus-and which, he said, was occasioned by his having inadvertently, two days before, swallowed a piece of lead with which he had been amusing himself. The portion must have been of considerable size, as, in describing it, he said it was nearly as large as a half rupee, but thicker, consisting of two leaden pencils which he had melted into what he called a flat bullet. On the lead slipping down the pharynx he was nearly choked, but the mother, who happened to be present at the moment, said, that by rubbing the throat and upper part of the neck with her hands she succeeded in forcing it downwards. Instant relief was now experienced; but next morning the pain in the abdomen, of which he complained on admission, commenced. In the hope of expelling or facilitating the descent of the bullet, a dose of castor oil, with a few drops of laudanum, was at first prescribed, and a few leeches were applied to the pained part as a precautionary measure. Next morning, though the bowels were several times relieved, the pain, still in the same spot, seemed rather worse, but it was scarcely increased on pressure. The oil was now repeated, and hot fomentations were ordered. Several dejections were again obtained, but otherwise no perceptible benefit accrued. In the space of two days, however, the pain shifted its seat to midway between the umbilicus and the os pubis, showing that the bullet had gone lower down; the pain was also more diffused, occupying a space about the size of a watch. Slight fever now existed. Obstinate constipation also soon occurred, which, for nearly three days, resisted the frequent administration of croton oil, pills of calomel, colocynth, and scammony, two doses of jalap, and the use of active purgative clysters. Prior to the action of these medicines on the bowels, excessive irritability of the stomach set in, almost every fluid taken being immediately rejected, and the pyrexia previously noticed still continuing. Two days afterwards, however, the febrile heat was succeeded by an opposite state of the system,-one of great depression. Cold clammy sweats existed, and he had also frequently-recurring, but not severe, convulsive fits, each being easily removed for the time by dashing a little cold water on the patient's face. Under these circumstances the remedies chiefly resorted to were artificial heat and diffusible stimuli to rouse the system, effervescing draughts, and one or two doses of creasote to allay vomiting, with anodynes at night, sinapisms, and subsequently a blister to the epigastrium. To the abdomen hot fomentations

were from the first sedulously applied. The pulse, previously thready, became latterly so weak, that any attempt to raise the head was apt to induce syncope. Cramps, too, of the hands and feet supervened, and constipation again existed. In short, the symptoms were such as to excite an apprehension that poisonous effects from the lead had at last manifested themselves. The sulphate of soda, therefore, was given in solution for two days in small frequently repeated doses, along with a few drops of the tincture of henbane, but seemingly without any improvement, although several scanty evacuations were procured. Twelve days had elapsed since the patient's admission, when the idea fortunately suggested itself to me, that in the event of the bullet being obstructed in its farther descent, by any accumulation of hardened fæces, which the previous purgatives might not have removed, the introduction into the rectum of O'Beirne's tube might have a happy effect. The fixed pain at this period was situated just above the pubis. In the absence of the regular instrument, the elastic tube of Read's stomach-pump was inserted, and, with some difficulty, pushed up twelve inches, so that it must have passed through the greater part of the sigmoid flexure of the colon. Warm water was now freely injected, and a remarkably copious stool, nearly filling a chamber utensil and presenting scybala, was the result; but the bullet could not be found in the dejection. In the course of the day he passed another stool, containing a lumbricus, but without the bullet. Next morning the fixed abdominal pain had entirely gone. A dose of turpentine was now exhibited, and he passed at stool another worm, but still no trace of the bullet. On this day he had only two of the convulsive fits, which were the last. Under the use of wine and light nutritious diet, with no other medicine than merely a vegetable tonic and one or two purgatives, he rapidly improved in appearance; and on the 6th of November, twenty-one days after his admission, he was discharged from hospital quite well, excepting that he was a little weak. In this case my impression is, that the bullet must have passed at stool, either in the large evacuation obtained directly from the use of the tube, or in the others which succeeded it; but that, from the examinations not having been made with sufficient care, it escaped detection. Had the dejections been merely thrown out, subsequent attempts might have discovered the bullet. It seems, however, that, agreeably to the usual practice, they were all cast into the backwater, situated directly in the rear of the hospital, and thus removed.

Since writing the above, the boy has presented me with a bullet, made by himself at my request, which, he says, in size and shape is very similar to the one which he had swallowed. Öf this, the drawing given in the margin conveys an accurate idea. It is a quarter of an inch in thickness.

VIZAGAPATAM, December 14, 1850.

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ARTICLE IV.-On Micrometers applied to Microscopes. By WILLIAM ROBERTSON, M.D., F.R.C.P., Ed.

THE ordinary stage-micrometer, as constructed by the best English and foreign opticians, cannot be directly applied to the measurement of very minute objects. Although it can be procured at a moderate price, and with divisions beautifully ruled on glass at intervals of th of a millimetre apart, the scale is far too coarse for the use of the histologist; and it is usually quite impossible, in examining certain objects under high magnifying powers, to bring their edges into proper focus while the ruled lines of the scale continue tolerably defined.

The eyepiece-micrometer, consisting of a scale ruled on glass, and inserted in the stop or diaphragm of the ordinary negative eyepiece, is a very convenient instrument, enabling the observer, when using a magnifying power of 500 or 600 diameters, to estimate spaces of about both or 30th of a millimetre with tolerable precision, in favourable circumstances. But the breadth of the lines on the best ruled eyepiece-scale is so considerable, and the shadows caused by their channels so perplexing, even when the illumination is carefully managed, that, where extreme accuracy is required, other apparatus must be employed.

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The cobweb screw-micrometer, when well constructed, is a far more perfect instrument; but, as Mr Quekett remarks, "the measurements made by it are by no means so delicate as they appear to be." In taking a unit, from which to construct the scale, a stage micrometer must be employed, and on the accuracy with which this is graduated depends, of course, the exactness of the subdivisions effected by means of the screw. This objection applies equally to all eyepiece-micrometers; but the screw-instrument has the positive disadvantages of being constructed of parts very apt to become deranged, and capable of being replaced by none but a first-rate workman. The effects of friction cannot be wholly obviated; the screw is apt to wear, and to wear unequally; and the uniformity of all its parts,even when it leaves the workman's hands,-may be reasonably suspected. The price is necessarily so high as to preclude its general employment by those engaged in microscopic observations.

Welcker's Micrometer.-In Henle and Pfeufer's "Zeitschrift für Rationelle Medicin" (band X. heft 1), Hermann Welcker, a medical student at Giessen, proposes a new kind of micrometer, capable of furnishing indications of extreme delicacy, and in elegance of principle and cheapness far surpassing the cobweb screw-micrometer.

The following description will enable any one familiar with the

'Practical Treatise on the Use of the Microscope, p. 196.

NEW SERIES.-NO. XVI. APRIL 1851.

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elementary principles of trigonometry to comprehend the mode of constructing and using such an instrument :—

Construction.-Across the stop of an ordinary negative eyepiece, two very fine threads, from a small spider cocoon, are stretched at right angles to each other, and, by means of a little copal varnish, are fixed in such a position that the shorter intersects the longer thread, cutting off about one quarter of its length. The relative position of the threads is shown in Figs. II. and III., where they are indicated by the letters A B and C D. To the upper part of the tube of the microscope is fixed transversely a brass plate, along which plays a pointer, firmly attached to the eyepiece immediately beneath its milled rim. The appearance of this apparatus is shown on a reduced scale in Fig. I. Upon the edge of the brass plate is drawn

Fig. I.

an arc of a circle concentric with the eyepiece, and this arc is then subdivided into degrees, and any fractional parts which may be required.1

By experimenting with a stage micrometer, we next endeavour to ascertain how far the pointer must be moved, in order that the crossed thread shall traverse a space in the field corresponding to th of a millimetre. By simply manipulating on the stage of the instrument, the stage micrometer can easily be put into the position shown in Fig. II., the long line A B accurately coinciding with a line of the micrometric scale. The eyepiece is then cautiously rotated, till the cross in the field, passing along the imaginary dotted circle in Fig. II., seems to touch the next line of the stage-scale, the long line now assuming the position a b. The arc traversed by the pointer during this rotation is then read off,-we shall suppose it an arc of 80. The sine of the corresponding arc of the dotted circle will, of course, indicate exactly Tooth of a millimetre; and from this simple foundation any measurement-i. l., the length of the chord of any given arc in that circle-may be calculated; for the chord of any are being equal to twice the sine of half that arc, the value of the chord of 80 is found as follows:

1 This mode of division is preferable to a less exact method of constructing the scale, recommended by Welcker. The former involves, it is true, a little calculation in making measurements, but this disadvantage is more than compensated by the superior accuracy of the results obtained.

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The same result may be obtained from the following proportion, both sine and chord being supposed drawn :—

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The equivalent number 0100244 is the required value of the chord of 80 in fractional parts of a millimetre. This or some other chord having been carefully determined by the instrument-maker, or observer, it should be noted down, as essential for the exactitude of all measurements to be afterwards made. It will save trouble if its logarithm be also recorded.

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