A MODIFICATION OF ROUGHTON'S SPLINT FOR POTT'S FRACTURE
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323 eye from the fixation point of the perimeter is measured by means of a steel rod 33 centimetres in length which can be fixed to a hole in the front of the box (if the chin-rest is used) (Fig. 1) or into a hole in the upright which supports the arc one and a half inches below the fixation point of the perimeter if the instrument is used without the chin-rest. The distal end of the rod in the latter case impinges on the patient’s cheek while the upright is in the hand of the observer, as shown in the illustration (Fig. 2). With a little practice sufficient steadiness is obtained to take the fixation field in cases of paresis of the ocular muscles, and to measure the angle of a squint without using the chin-rest. It is very useful for examining the visual field in patients confined to bed. The different parts of the instrument fit into a wooden box ten inches long, four and a half inches wide, and two inches in depth. The weight is little and it can readily be carried in a small hand- bag with many other articles. The charts are three and a quarter inches in diameter and are gummed at their upper margins for ready insertion into a notebook. This instru- ment has been made under my direction by Messrs. Ferrier, 56, Beresford-street, Walworth-road, London, S.E. The workmanship is excellent. The charts are supplied by Messrs. Adlard, Bartholomew-close. The cost is moderate. G. T. BROOKSBANK JAMES, F.R.C.S. Eng., Assistant Ophthalmic Surgeon, Westminster Hospital; Assistant Surgeon, Royal Eye Hospital, Southwark. THE "IDEAL" INHALER FOR THE ADMINISTRATION OF SOMNOFORM AND ALLIED ANÆSTHETICS. THIS is the name that has been given by the makers to an apparatus which I have devised and have been using almost daily for over three months. The accompanying illus- trations so clearly denote the construction and method that very little further explanation is necessary. Briefly, the chief advantages of this inhaler are as follows :-1. It is simple in construction, unbreakable, and cannot get out of order. 2. The truncated-shaped lint cone being kept in position by a four-armed spring can immediately be removed and replaced at a cost of practically nil. 3. By leaving the air valve B open when applying the face-piece the patient is able, however small the quantity of air in the supplemental bag, to take a deep inspiration, which becomes saturated with somno- form in passing through the mask. On closing the valve B after the first inhalation the bag becomes automatically filled, hence obviating the need of removing the face-piece until full narcosis has been obtained. This hastens the induction of anaesthesia and at the same time prevents any waste of the anesthetic, about half a drachm (2.5 cubic centimetres) of which will usually produce a narcosis of from one to three minutes’ duration, according to the temperament of the patient, though more in the form of further doses can be given as required. 4. The supplemental bag is an improvement on the ordinary variety in that it is reversible ; hence it is quite a simple matter to keep it thoroughly aseptic, and being made of a new kind of rubber it can be terilised in boiling water. To release the bag the rubber ring A encircling the neck should be pushed upwards on to the metal collar provided for that purpose 5. With this inhaler somnoform very advantageously takes the place of nitrous oxide as a preliminary anaesthetic to presenting ether, chloroform. &c. Where ether is selected Clover’s ether container should be previously attached. The inhaler can be obtained from the Dental Manufacturing Company, Lexington-street, London, W., who regard so highly the reversible supplemental bag that they are seriously thinking of making gas bags on the same principle. Reading. VERNON KNOWLES, L.D.S. R C.S. Eng. VERNON KNOWLES, L.D.S. R C.S. Eng. A MODIFICATION OF ROUGHTON’S SPLINT FOR POTT’S FRACTURE. THE accompanying illustration shows a modification that I made in Roughton’s splint nearly a year ago and which I now venture to introduce for the treatment of Pott’s fracture into the ankle-joint. As in Roughton’s pattern, the splint is made of wood and it can be seen to be shaped for the outer side of the leg and foot, the oval fenestra being opposite the external malleolus, but instead of the leg- and foot-pieces being at right angles they together form an acute angle four- fifths of a right angle, and the sole-piece also is fixed at an acute angle with the leg as well as with the foot-piece, the angle in each case being four-fifths of a right angle. In the larger-sized splints the angle of flexion of the foot-piece should be nine-tenths of a right angle. In treating Pott’s fracture it is taught that after reducing any displacement the foot should be flexed at right angles to the leg, the lule being to avoid an extended or inverted position of the foot. To flex the foot beyond the right angle so that it forms an acute angle with the leg would appear to be even a better plan, for when the ankle is placed in the position of full (dorsal) flexion the wider anterior part of the astragalus occupies the intermalleolar space and thus presses aside any encroaching fragment which may be separated from the inner malleolus and also prevents reparative material narrowing the articular cavity. The splint was designed in accordance with these principles. The limb is fixed with strapping to the splint, which is evenly padded, and the tilting of the bottom foot-piece maintains not only full flexion of the foot but also inversion. Massage can be applied as the limb rests on the splint, the knee being well flexed to relax the tendo Achillis, and then, as Pott says, ’’ everything will in general succeed very happily." The splint may be obtained from Messrs. Down Bros., St. Thomas-street, London, S.E. London. SYDNEY R. SCOTT, B. S. Lond., F. R. C. S. Eng. SYDNEY R. SCOTT, B.S. Lond., F.R.C.S. Eng THE LEICESTER CREMATORIUM.-The Leicester town council has appointed Dr. C. K. Millard, medical officer of health of the borough, and Dr. Allan Warner, the assistant medical officer, medical referee and deputy medical referee respectively at the Leicester Crematorium. The appointments are made under the provisions of the regulations made by the Home Secretary in pursuance of Section 7 of the Cremation Act, 1902. Before allowing any cremation to take place it will be the duty of the referees to be satisfied that all the requirements of the Cremation Act and the regulations made thereunder have been complied with and that there exists no reason for any further inquiry or examination.
Transcript of A MODIFICATION OF ROUGHTON'S SPLINT FOR POTT'S FRACTURE
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eye from the fixation point of the perimeter is measured bymeans of a steel rod 33 centimetres in length which can befixed to a hole in the front of the box (if the chin-rest isused) (Fig. 1) or into a hole in the upright which supportsthe arc one and a half inches below the fixation point of theperimeter if the instrument is used without the chin-rest.The distal end of the rod in the latter case impinges on thepatient’s cheek while the upright is in the hand of theobserver, as shown in the illustration (Fig. 2). With a littlepractice sufficient steadiness is obtained to take the fixationfield in cases of paresis of the ocular muscles, andto measure the angle of a squint without using thechin-rest. It is very useful for examining the visualfield in patients confined to bed. The different parts ofthe instrument fit into a wooden box ten inches long,four and a half inches wide, and two inches in depth. The
weight is little and it can readily be carried in a small hand-bag with many other articles. The charts are three and a
quarter inches in diameter and are gummed at their uppermargins for ready insertion into a notebook. This instru-ment has been made under my direction by Messrs. Ferrier,56, Beresford-street, Walworth-road, London, S.E. The
workmanship is excellent. The charts are supplied byMessrs. Adlard, Bartholomew-close. The cost is moderate.
G. T. BROOKSBANK JAMES, F.R.C.S. Eng.,Assistant Ophthalmic Surgeon, Westminster Hospital;
Assistant Surgeon, Royal Eye Hospital,Southwark.
THE "IDEAL" INHALER FOR THE ADMINISTRATIONOF SOMNOFORM AND ALLIED ANÆSTHETICS.
THIS is the name that has been given by the makers toan apparatus which I have devised and have been usingalmost daily for over three months. The accompanying illus-trations so clearly denote the construction and method thatvery little further explanation is necessary. Briefly, the chief advantages of this inhaler are as follows :-1. It is simple
in construction, unbreakable, and cannot get out of order.2. The truncated-shaped lint cone being kept in positionby a four-armed spring can immediately be removed andreplaced at a cost of practically nil. 3. By leaving the airvalve B open when applying the face-piece the patient is able,however small the quantity of air in the supplemental bag, totake a deep inspiration, which becomes saturated with somno-form in passing through the mask. On closing the valve Bafter the first inhalation the bag becomes automatically filled,hence obviating the need of removing the face-piece until
full narcosis has been obtained. This hastens the inductionof anaesthesia and at the same time prevents any waste ofthe anesthetic, about half a drachm (2.5 cubic centimetres)of which will usually produce a narcosis of from one tothree minutes’ duration, according to the temperament of thepatient, though more in the form of further doses can be givenas required. 4. The supplemental bag is an improvementon the ordinary variety in that it is reversible ; hence it isquite a simple matter to keep it thoroughly aseptic, andbeing made of a new kind of rubber it can be terilised inboiling water. To release the bag the rubber ring A encirclingthe neck should be pushed upwards on to the metal collarprovided for that purpose 5. With this inhaler somnoformvery advantageously takes the place of nitrous oxide as apreliminary anaesthetic to presenting ether, chloroform. &c.Where ether is selected Clover’s ether container should bepreviously attached. The inhaler can be obtained from theDental Manufacturing Company, Lexington-street, London,W., who regard so highly the reversible supplemental bagthat they are seriously thinking of making gas bags on thesame principle.Reading. VERNON KNOWLES, L.D.S. R C.S. Eng.VERNON KNOWLES, L.D.S. R C.S. Eng.
A MODIFICATION OF ROUGHTON’S SPLINT FORPOTT’S FRACTURE.
THE accompanying illustration shows a modification thatI made in Roughton’s splint nearly a year ago and which Inow venture to introduce for the treatment of Pott’s fractureinto the ankle-joint. As in Roughton’s pattern, the splint ismade of wood and it can be seen to be shaped for the outerside of the leg and foot, the oval fenestra being oppositethe external malleolus, but instead of the leg- and foot-piecesbeing at right angles they together form an acute angle four-fifths of a right angle, and the sole-piece also is fixed at anacute angle with the leg as well as with the foot-piece, theangle in each case being four-fifths of a right angle. In the
larger-sized splints the angle of flexion of the foot-pieceshould be nine-tenths of a right angle. In treating Pott’s
fracture it is taught that after reducing any displacementthe foot should be flexed at right angles to the leg, the lulebeing to avoid an extended or inverted position of the foot.To flex the foot beyond the right angle so that it forms anacute angle with the leg would appear to be even a betterplan, for when the ankle is placed in the position of full(dorsal) flexion the wider anterior part of the astragalusoccupies the intermalleolar space and thus presses aside anyencroaching fragment which may be separated from the innermalleolus and also prevents reparative material narrowingthe articular cavity. The splint was designed in accordancewith these principles. The limb is fixed with strapping tothe splint, which is evenly padded, and the tilting of thebottom foot-piece maintains not only full flexion of the footbut also inversion. Massage can be applied as the limb restson the splint, the knee being well flexed to relax the tendoAchillis, and then, as Pott says, ’’ everything will in generalsucceed very happily." The splint may be obtained fromMessrs. Down Bros., St. Thomas-street, London, S.E.London. SYDNEY R. SCOTT, B. S. Lond., F. R. C. S. Eng.SYDNEY R. SCOTT, B.S. Lond., F.R.C.S. Eng
THE LEICESTER CREMATORIUM.-The Leicestertown council has appointed Dr. C. K. Millard, medical officerof health of the borough, and Dr. Allan Warner, the assistantmedical officer, medical referee and deputy medical refereerespectively at the Leicester Crematorium. The appointmentsare made under the provisions of the regulations made bythe Home Secretary in pursuance of Section 7 of theCremation Act, 1902. Before allowing any cremation totake place it will be the duty of the referees to be satisfiedthat all the requirements of the Cremation Act and theregulations made thereunder have been complied with andthat there exists no reason for any further inquiry or
examination.
