June 1835

/69r cont'd/ Monday June Jst. Come to the last month of my stay in Paris. Went to the Hotel Dieu-Roux has a case of pistol wound in a young man 1-ball entered anterior to the tendon achille's /69v/& passed out at the outer ankle, breaking the malleolus2 Tapirus[?]-the treatment is the constant application of cold-he has a case of tumor in the internal aspect of thigh three or four inches above knee-he intends operating tomorrow moming. Went on to H. St. Louis-was too late for Biett-he has commenced now making his visit at 9 o'clock-went round with Alibert-he had nothing of any importance-he is treating all his cases by local applications-he lectures on Wednesday on the Dermatoses Teignenses [sic]3-very interesting & difficult division to treat-At Me. Lachapelle's tonight had very easy manoeuvres-seizing feet of inft., when there is breech presentation-supposing, that any thing should require such an operation. Tuesday June 2nd. Went down to Hotel Dieu this morning. Went round with Breschet-nothing very particular-Roux performed extirpation of the tumor this morning-it was osteo sarcoma4 & attached by means of an osseous peduncle5 to the femur-this he was forced to cut away with the saw. Mott from New York was at the operation. A very gentlemanly looking man with something of the precise manners of a quaker about him.6 Tonight at Me. Lachapelle's we applied the crochet in presentations of lower extrem'. & hips.7 l Dupuytren had held a course at the H6tel Dieu on gunshot and sabre wounds. (Warner, Against the spirit of system, p. 115.) This would seem to indicate that the presentation of such wounds was not exactly a rare event despite the ban on duelling. 2Malleolus: ankle. This is the diminutive of malleus from its supposed resemblance to a mallet. 3Dermatoses Teignenses: dermatoses is a general term for skin diseases. Bateman criticises Alibert, to whose lectures the diarist is referring, for confusing Willan's classification of skin diseases by adopting "the ancient confusion of terms". This confusion includes his use of "les teignes" for the Willanist group of porrigos, contagious conditions, marked by the development of pustules and fever. The group includes porrigo scutulata or ringworm. (Bateman, A practical synopsis of cutaneous diseases, pp. xvi, 225-6.) 4In the entry for Sunday, November 9, 1834, the diarist writes the term as a single word: osteosarcoma. In this present case the fleshy tumour or excrescence was developing on the femur …