Vol. 60, 1909 - University of North Carolina at Chapel Hill

290 THE CHARLOTTE MEDICAL JOURNAL.
not only completely healed over, but has
been so built up as to virtually make it stand
out as the others.
The patient, a mulatto, has only a modified
color of the joint, it being rather white,
while to the feel it is very velvety.
CASE II., E. N., FIRST, SECOND, THIRD FIN-
GERS, FIRST AND SECOND JOINTS OF
LITTLE FINGER TORN AWAY BY
RICE THRESHING MACHINE.
After trimming out and endeavoring to
save as much of his hand as possible for
two or three weeks, freeing it from all infection
( the patient having been seen six
hours after he had met with the injury on
a rice plantation some miles down the river )
I found that in several places, especially
the joint of the little finger, there was virtually
no covering, and in these placef- egg
membrane was rather freely used, as well
as over the end of the index stump.
Patient is now well, and by having saved
one phalanx of the little finger, as well as
replacing parts of the first, second, and
third metacarpo phalangeal joints covering,
this man is able to perform a fair amount
of work and especially carry on part of his
labor, using n hoe in the fields.
CASE III., C.H., SLOUGHING UNGUAL FIRST
AND SECOND INDEX FINGER JOINTS;
PHALANGES EXPOSED AND NE-
CROSED bones; ABSENCE OF NAIL
AND skin; METACARPOPHALAN-
GEAL JOINTS DOUBLE SIZE.
(CHEMICALLY PURE CAR-
BOLIC ACID burn).
This case was referred to me by a physician
with request that amputation be made.
After I had seen her once, she went to
the hospital, without my knowledge, and
there she tells me a consultation of surgeons
was held and they decided to amputate her
hand. She again reported to me and I
found a virtuallj' indescribable condition.
Considerable cellulitis of the hand existed.
The finger had only last phalangeal joints;
necrosed bones, foul smelling, were showing
protruding through a sloughing mass
of tissue unenveloped with skin. The metacarpo
phalangeal joint was as large as her
thumb, and the finger was so foul smelling
as to have tempted me to ask my assistant,
a young woman to whose care and patience
much of the construction of the new finger
is undoubtedly due, to open wide the windows.
The history of the case was that at some
time she had shown evidence of syphilis,
and had a mild attack of hemophlegia, but
had been successfully treated by her physician.
She implored me many times, in the name
of the Almighty, not to amputate her finger,
.
and at times her prayers were almost pa- j
thetic. Large doses of anti-syphilitic prep-
arations were administered and her finger j
and hand carefully treated by all known '
anti-septic methods. Great patience was ,
shown by each of us in the separate sittings.
At different times, necrosed bones of twO;'
last phalangeal joints was removed by in-
cisions bejng made on the side of the finger i
avoiding the tendon, or at least, what was]
left of it. By the application of splints, we,'
succeeded in keeping the member in excel-
lent position. 1
WHITE FINGER GROWN ON BLACK HAND.
It was most interesting to see the white
tissue growing on the jet black hand,
and, to our surprise, to find new nail cells
sprouting. As the weeks passed, and ever
months, the finger began to assume origiiia
proportions, as a part of a nail had growr
and the two joints were partially restored
with a distinct line of pinkish white anc
black in evidence.
While the patient has no control overthfmovements
of the two joints, partial iiexioi
and extension of finger exists, she has to al
appearances a slightly shrunken wliitt
finger grafted on a black hand. This pati.
ent, a woman about sixty years of age, was
seen and hand dressed seventy-two times ii
the space of three months.
This case seems incredible, but it is thi
greatest proof of my twenty years of stud} i
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