THE CANADA LANCET,

A MONTHLY JOURNAL OF

MEDICAL AND SURGICAL SCIENCE,

CRITICISM AND NEWS.

VOL. XV. TORONTO, MARCH, 1883.

Original Communications.

A NEW MEDICAL BATTERY.

BY A. M. ROSEBRUGH, M.D., TORONTO, ONT.

are suspended in a drip-cup by the side of said acid-cells. The end of each hydrostat plate is pressed down upon the cells by means of spring bolts and clamping screws. This latter arrangement is quite effective but very inconvenient, as much time is spent in clamping and unclamping the plates-not merely when the battery is taken to the bedside of the patient, but also of necessity No. 7. whenever the battery is used. In the new battery the pressure upon the hydrostat plates is made automatic by simply placing bearings upon the lid of the battery case. When the lid is closed the acid-cells are firmly covered, and when the lid is open the bearings are removed and the plates may be moved without loss of time. Again, in the McIntosh battery, when the appaAbout two years ago I read a paper before the ratus is used each hydrostat plate (with the eleToronto Medical Society on the construction of ments attached) is raised from the drip-cup, rotagalvanic and faradic batteries, which paper was sub-ted upon its horizontal axis, and the elements sequently published in the Canada Lancet. Since immersed in the acid solution. When the then a new departure has been made in the con- séance is ended, each hydrostat plate is lifted struction of portable galvanic and portable faradic from the fluid, and, before it can be replaced batteries, as well as in the instruments where the in the drip-cup, must again be rotated upon two are combined. But perfection has not yet its horizontal axis. This manipulation is not been attained; the model battery has yet to be specially inconvenient, but unfortunately the dripproduced. Medical batteries, though highly fin- ping of the acid solution from the zinc and carbon ished-even ornamental-are still too complicated elements commences before the horizontal rotation and too difficult to be kept in working order, and is completed, and, unless very special care is taken, withal too expensive, to become popular with the the metal parts on contiguous plates are liable to profession. We are not all practical electricians, become spattered. This is obviated by the expeand we require a battery that is simple in its con- dient illustrated in the accompanying figures. struction, almost automatic in its action, and easily kept in order. As a contribution to this end, I propose to describe a modification of the portable galvano-faradic battery which I have recently adopted with advantage, and to which I wish to call the attention of the profession.

These improvements are two-fold

Ist. In the method of securing the necessary pressure on the hydrostat plate or plates.

2nd. In the method of putting the battery into action and out of action.

This battery was made for me in Toronto, and is a modification of the battery invented by Dr. McIntosh, of Chicago. In the McIntosh battery the horizontal plate to which the elements are attached is padded on the under side to form a hydrostat plate, one-half of which is used to cover the acid-cells when the battery is not in action, while the elements, attached to the remaining half,

FIG. 1-The elements at rest. 7, 8, 9. The three hydrostat plates in position. 2. The extra space to the right for overlapping of the first hydrostat plate (containing the induction coil.)

Fig. 1 represents the position of the hydrostat plates of an eighteen-cell combined galvano-faradic battery when the elements are at rest. The elements from 1 to 18 are resting in the drip-cups, six

By these modifications the battery is ready for use as soon as the lid is open. The elements may be displaced to the right and back again to the left without loss of time and without being rotated: and, moreover, in the original battery, any one of the zinc or carbon plates may be easily removed, rapaired, or replaced without the help of an electrician.

pairs being attached to each of the four hydrostat elements in circuit may be increased or diminished plates, and on the left hand side thereof. The gradually without breaking the circuit. overlapping part of each hydrostat plate covers the top of six acid cells, which latter are to the right of each drip cup. In the McIntosh battery the elements of any one series, as from 7 to 12, can be immersed in two ways: first, by lifting and then rotating on the horizontal axis, and second by allowing the projecting hydrostat plate to override the screw-cup, on the adjoining plate to the right (1 to 6). Both methods are objectionable, the latter obviously so, and the former for reasons already named.

To sum up, the advantages claimed for the new battery are as follows: 1, cleanliness; 2, economy of time; 3, simplicity in management; 4, simpli

BRIEF DIRECTIONS FOR OPERATING THE BATTERY.

In the apparatus as modified by me the battery-city of construction. case is elongated to the right, to the extent of half the width of a hydrostat plate, so as to provide a space for overlapping to that extent. When the elements of the first series (1 to 6) are immersed, space is left for the overlapping of the hydrostat plate of the second series, which, in turn, makes way for the third, and so on. When the third series of elements are immersed, the end drip-cup to the left is left uncovered. This may be covered by the narrow plate or cover removed from the right, as represented in Fig. 2.

The Acid Solution. Bisulphate of mercury 3iv.; bicromate of potash (pulverized) iii.; sulphuric acid (pure) v.; water 3xxx. It should stand two or three hours to cool, before using. The cells should be filled a little more than half full. The mercury bi-sulphate keeps the zinc plates amalgamated, and prevents them from corroding. After using the battery, say 12 or 15 times, a little fresh battery solution may be added, but the cells should not be filled more than two-thirds full; it is well to keep a supply of the solution ready prepared. After using the faradic current 8 or 10 times the weakened solution may be withdrawn from No. 1 cell, with a syringe, and a fresh solution substituted.

The Hydrostat. The battery is constructed so that when the case is closed and locked, pres sure is exerted upon the soft rubber hydrostat pad (14 Fig 1,) and the acid solution is kept from spilling. The top of the cells should be perfectly even, and nothing should be allowed to accumulate on top or underneath them, or on the bottom of the box. In case of a long journey it is well to make the hydrostat doubly secure by increasing the pressure. This can be done by inserting 1, 2, or more thicknesses of blotting paper under the cells on the bottom of the box. Special care should be taken that the empty or drip cells (14) do not stand higher than the cells containing the acid solution, (13,) they might be a trifle lower. Moist sponges should be kept outside the case and the case should always be kept in an upright position. To Test the Strength. When the solution

The screw-cups 6 and 6 of the first and second series, and 12 and 12 of the second and third series, are connected by a spring or wire, this connection being facilitated by the supplemental posts 6 and 12. The positive electrode is connected with No. 1, and the negative with No. 18. The cord of the negative electrode is bifurcated, so that, by a step by step arrangement, the number of is fresh any single cell will cause the spring of the

induction coil to vibrate when it is connected with the primary coil at B and P (below No. 1). Simply connecting B with No. I post by the wire coil, will test the strength of No. 1 cell, and connecting B with No. 2 post will give the strength of No. I and No. 2 together. To test the strength of No. 2 cell separately, the two covered electrode cords are used; one is inserted in B post and the other in P (below No. I post), one of the tips of the free ends is inserted in No. I post and the other in No. 2 post. By removing the tip from No. I post and inserting in No. 3 post-No. 3 cell is tested, and so on. If the second series of plates (7 to 12) are immersed in the acid solution the individual

FIG. 3. The faradic coil. B the battery post for one end of spring wire. The other end of wire is inserted in 1 or 2 post. S, the posts for the secondary or induced current.

cells may be tested in the same manner. No. 8

In testing the strength of the faradic current it is sufficient to connect the cords [to N and P (secondary)] and take a moistened electrode in each hand. The strength of the faradic current is increased by withdrawing the tube from the core of the induction coil, (and between the two secondary posts N. and P.)

The strength of the galvanic current (constant current) is roughly tested by applying the two electrodes to the forehead an inch or two apart. Six cells should cause a burning sensation, and a flash of light when one electrode is removed. A galvanometer is more accurate.

The weakest faradic or induced current is derived from P.P.N, -the strong from N.S. P.

THE NEW YORK MEDICAL CODE.-The members of the State Medical Society at Albany, by a vote of 105 to 99 have approqed the new code of ethics by which allopathic physicians are allowed to consult with any legally qualified practitioner. The closeness of the vote, however, indicates how strong a feeling exists against the change among the conservative members of the profession; but when the new code has been in force longer, its opponents probably will be more reconciled to it.

INJURY.

cell is tested by inserting one of the free tips in NOTES OF A CASE OF SEVERE RAILWAY No. 7 post and the other in No. 8, and so on. To prevent confusion in this test, it is well to have one of the branches of the bifurcated cord eliminated, as for instance, by tying it up in a knot.

After the cells have been used 10 or 12 times for 10 or 15 minutes at a time, the strength will be reduced so that it may require the current from two cells to operate the vibrator. When the strength of the solution is so reduced that two or 3 cells will not affect the induction coil, the battery should be charged with a fresh solution. A weak solution cannot be depended upon. The point of the screw should just touch the platinum projection on the vibrator, and the hammer on the end of the vibrator should stand about of an inch from the end of the core of the induction coil. It is sometimes necessary to start the vibrator with the finger. The elements should not remain in the solution longer than necessary. After being used they should be rinsed, but they should not remain long in water. The drip cups should be emptied occasionally.

BY J. F. MACDONALD, M. D., HOPEWELL, N. S.

(Reported by Mr. I. M. Maclean)

On the ninth of August last, C. B., æt. 58, while employed with his fellow workmen on the Railroad track, was struck down by an approaching engine, the wheels of which passed over his left leg above the ankle, so severely lacerating the soft parts and crushing the bones as to necessitate amputation three inches below the knee. Some projecting part of the engine entered the perineum, severed the sphincter ani, injured the os pubis and, making its way to the bladder, produced a ragged wound in the neck of that viscus, of fully an inch in length, through which the urine constantly found an exit.

The amputation was performed as soon as possible after the accident, and the perineal wound thoroughly cleansed and dressed anti-septically. Owing to the peculiar situation and the severity of the perineal wound, the introduction of a catheter

was found to be impracticable for the first five or Aug. 24th.-Morning-pulse 82, temp. 100-4°; six days, and, as a consequence, the continuous scrotum, &c., considerably œdematous. A quandribbling of urine rendered a very frequent renew-tity of fluid evacuated by incision. Evening-al of the dressing necessary. Even after the suc-pulse and temp. normal. Aug. 25th.—General cessful passing of the instrument, the flow of urine condition good. did not entirely cease, this being sufficiently accounted for, by the size of the laceration in the neck of the bladder and by the frequent plugging of the catheter with mucus, &c., which prevented its being retained for any great length of time. The instrument required to be changed very often. The perineal wound at each dressing, and the bladder (per cath.) once or twice daily, were well washed out with carbolic acid lotion.

The great difficulty experienced in keeping the patient dry and clean, the presence of some severe bedsores which the greatest care did not succeed in preventing, and the trying influence of the hot summer weather aggravated in no small degree, the condition of matters for the first few weeks.

Aug. 26th.-Seventen days after the accident, the stump having firmly healed, except where the ligatures protruded, secondary hemorrhage occurred, which was controlled by compression and cold applications.

Aug. 27th.-Evening-pulse 82, temp. 100-4°. Stump discharging a large quantity of purulent matter mixed with blood clot, odor offensive, Daily syringing of the stump with carbolic lotion. Urine flowing per cath. Very little through wound.

Aug. 29th.-Patient doing well. Considerable discharge from stump and perineum. Ligatures have all come away.

Aug. 31st.-Stump has healed firmly with the exception of one opening to admit of drainage. A few drops of urine per viâ nat. without aid of catheter.

Aug. 9th.-11 p. m. (the night after the accident). Pulse 89, temp. normal. Skin moist. Aug. 11th.-Morning-Pulse 80, temp. 100°. Sept. 1st. Some fever last night. Slight delir. Evening-pulse 92, temp. 100-4°. Aug. 12th.-ium. Morning-pulse 75, temp. 100°. Evening-pulse 92, temp. 99°. Aug. 13.-Morning-pulse 76, temp. 100-5°. Evening-pulse 78, temp. 99o.

Aug. 15th.-Catheter passed and temporarily retained. Pulse and temp. normal. Hot weather oppressive and patient manifests considerable uneasiness and distress. Perineal wound painful.

Aug. 19th.-Morning-pulse 65, temp. 99-8°. Evening-pulse 72, temp. 100-8°. General condition good.

Aug. 20th.-Pulse and temp. normal. The painful condition of the perineum, the necessity of frequent dressings, the warm weather and presence of some bed sores, interfere with rest at night, necessitating, occasionally, hypodermic injections of morphia, or sleeping draughts..

Sleepy and semi-comatose all afternoon. Evening-pulse 82, temp. 100-4°. Very restless. Sept. 3rd.-Small quantity of urine per via nat. Patient now able to sit on a chair for a short time daily.

Sept. 5th. Urine again coming through the wound. In the evening severe chills followed by slight fever.

Sept. 6th.-Morning-pulse 93, temp. 102-8° Evening-condition improved. Pulse 79, temp. 99-8°. No symptoms of pyæmia. No recurrence of last evening's chill. Passed two or three cupfuls of urine per via nat. None from the wound. Sept. 8th.-Sleepy and drowsy. Stump still discharging. On examination, the end of the tibia was found slightly necrosed.

Sept. 9th.-Urine flowing through the wound.

Aug. 21st.-A drowsy or semi-comatose condi- Purulent discharge from stump continuing. Stimution all afternoon. lating injections applied two or three times daily to the end of the bone. Patient still in a drowsy

Aug. 22nd.-Morning-drowsy condition passed away. Patient doing well. Pulse and temp. nor-condition. mal. In the evening, a good deal of fever. Pulse 90 and temp. 102-5°. No rigors.

Sept. 10th.-Chilliness complained of. No definite rigor. Drowsiness passing off.

Sept. 11th. Some urine still dribbling from wound. Pulse and temp. normal.

Sept. 17th. Urine has ceased coming through the wound. Stump doing well. No trouble from the bone.

When I arrived I found her propped up in bed, face dusky, features pinched, anxious, and wearing an expression of pain. Resp. rapid, about 40; temp. 103°, pulse 136, rapid, weak, intermittent,

Oct. 9th. An abscess, which formed behind and shuffling. On physical examination, whole