British medical journal . on with the medical officer ofhealth (Dr. Linton), and wo agreed that the case wasprobably not diphtheria. A fmiher swab was taken andexamined by Dr. Linton, who reported the presence of afew diplocoooi resembling pneumococci, abundant strepto-cocci, and Hoffmans bacilli in fair numbers. Further progress was uueveuttul — the temperaturerapidly came to normal, the pain subsided, but the mem-brane persisted for several days, gradually diminishing insize and not separating en masse, as in diphtheria. Therewas never any haemorrhage. The points that were relied upon as dis
British medical journal . on with the medical officer ofhealth (Dr. Linton), and wo agreed that the case wasprobably not diphtheria. A fmiher swab was taken andexamined by Dr. Linton, who reported the presence of afew diplocoooi resembling pneumococci, abundant strepto-cocci, and Hoffmans bacilli in fair numbers. Further progress was uueveuttul — the temperaturerapidly came to normal, the pain subsided, but the mem-brane persisted for several days, gradually diminishing insize and not separating en masse, as in diphtheria. Therewas never any haemorrhage. The points that were relied upon as distinguishing fromdiphtlieria were: (.1) The absence of toxaemia (the generalcondition, apart from exhaustion from lack of nourish-ment and pain, remaining good); (2) the marked pain onswallowing; (3) the liigh initial temperature; (4) absenceof iuvolvement of vocal cords ; (5) separation of membraneby dissolution, and not en masse; (6) absence of Klebs-Loeffler Wells. FRANCIS ElLEY, , , POSTERIOR I have been written to by several surgeons ask-ing me to de-scribe my methodof doing the doubleoperation forgastric or duodenalulcer (April 25th,p. 914), and as someconfuse my pro-cedure with thatof M. Roux, whichis a much morecomplicated andprolonged affair,I append a diagramshowing the com-pleted A to a = 3 in.,B to E = 2 in., o to c= IJ in. - G. Gore Gillon,,Surgeon, AucklandHospital, A CASE OF GANGREXOLTS LITTRES occurrence of gangrene of Meckels diverticulum in ahernial sac appears to be of sufficient rarity to make itworth while to put the following case on record. Apartfrom the rarity of the condition found, the case presenteda gi-eat deal of interest from a diagnostical point of view,though it need scarcely be said that a correct diagnosiswas not made before operation. On .June 5th, 1914, I was asked by Dr. Johnson, ofCallington, to see in consultation a
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Keywords: ., bookcentury1800, bookdecade1850, booksubjectmedicine, bookyear185
