Three Cases of "Hypertrophic Pulmonary Osteo-Arthropathy," with Remarks
Authors: W. Thorburn
Journal: BMJ (1893)

HYPERTROPHIC PULMONARY OSTEO-ARTHROPATHY.F2 zoi 115 patient's condition was as follows: On the right side of the face there were three small isolated patches containing pus.On the left side there was one small subcutaneous abscess, but only minute traces of lupus.On the upper gum and on the hard palate there was still well-marked lupUs, in spite of two operations with the cautery.On the whole, however, the man's condition has been far better since May, 1891-when his disease was surgically treated after his return from 'sea-than after any previous operations of a similar kind,-showing that Koch's treatment had had a decided influence lor good.CASs ir.-This ptitlent, a woman now aged 33, had suffered from lupus of the nose and neck for some years before coming sunder my care (in March, 1890).The disease was scraped and -cauterised on many occasions during some eight or nine years with variable but always temporary improvement.In January, 1891, Koch's treatment was begun and continued for four months.After the last of the injections the cautery was freely applied.Since then the disease has remained almost 0-.11completely in abeyance; there has been no further formation of nodules, and, in the patient's own words, " the only sign of the disease has been a slight break in the outer skin now and then."The only treatment required during the last two years has been an occasional touch of lunar caustic.Very similar results have been obtained in several other ecases.My sole object in publishing these cases is to call attention to a point which I believe to be at the present time in some danger of being overlooked, and it would be dnteresting to know if my experience in this respect can be confirmed by that of others.I venture to think that it is time that the after-histories of the cases of lupus in which Koch's treatment was tried at the end of 1890 and the begin- -ning of 1891, and especially of those cases in which local treatment was applied after the injections of tuberculin, should be brought before the profession.Koch's method therefore appears to me to be of real value in the treatment of lupus as a preliminary to local treatment by the ordinary methods.The cases, however, must be care- fully selected for the purpose.I consider the injections altogether unjustifiable when lupus is complicated by tuber- culosis of the lungs or other internal organs.THE ANTARCTIC EXPEDITION.-The Antarctic Expedition, con--sisting of four Dundee whalers, which sailed last September Ihas just returned from a voyage which was most successful as a commercial venture owing to the large number of seals obtained.The medical officers of the ships undertook to make such scientific observations as might be possiblc,' and it is understood that many valuable observations on the meteor- ,ology, geology, and natural history of the Antarctic regions have thus been obtained.The description given by one of them in the Times shows that the duties of the doctors were of the most multifarious description, and the writer describes how while the ship's crew were away killing seals the captain 'sat in the crow's nest from early morning till late in the even- ing, the two engineers relieved one another at the engines, the cook or the steward was on the look-out on deck or on the ibridge, and the doctor was at the helm.