In a clinical lecture delivered by M. Gross, of Nancy, reported in the
_Revue Médicale de l’Est_, of November 15, he describes the treatment of
cystic goitre, known as Michel’s “mixed method,” as extremely useful,
and furnishes a case illustrating its advantages. Giving a rather
extended review of the various modes hitherto proposed for removal of
these growths, he points out their drawbacks, and the superiority of
Michel’s method over them. Briefly the latter consists in making a
vertical incision in the skin over the most prominent cyst, and then
dissecting carefully down through the various structures, until the wall
of the cavity is reached. A very fine trocar is then pushed into the
cavity with a canula, and through the latter the fluid is withdrawn.
After this a plaque of pâte de Canquoin, about three centimètres broad,
is applied to the cyst, the sides of the wound being protected by a
circular piece of diachylon. This is left on a day or two until an
eschar is formed, which soon after comes away, leaving a free opening
through, which the cyst can discharge, until it shrinks up, after
suppurating for a time.
It is claimed for this method that it is less likely to give rise to
dangerous hemorrhage than several others, while, the caustic only being
applied to the surface of the cyst, severe inflammation of the tissues
around is avoided. Other cysts, if present, are similarly treated
through the aperture of the first.—ARTHUR E. BARKER, in _London Medical
Record_.