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Extracts from Home and Foreign Journals.
IMPROVED TECHNIQUE OF VAGINAL LIGATION OF THE UTERINE ARTERIES AND INDICATIONS IN UTERINE FIBROMATA.
Dr. Augustin H. Goelet, in a paper presented to the N. Y. State Medical Society (Medical Record), thinks that this operation has not been given the consideration it deserves as a conser. vative surgical measure, and that it has a distinct place in gynecological surgery.
The purpose of the operation is to produce atrophy of these tumors by cutting off the nutrition afforded by the uterine arteries which furnish the uterus with two-thirds of its blood supply.
The indications for the operation are interstitial fibroids which do not reach above the level of the umbilicus and small subperitoneal growths which spring from the wall of the organ below the fundus, and where extensive adhesions have not formed with adjacent structures through which the tumor might receive nourishment.
He thinks that ligation of the vessels, en masse, including the surrounding tissues at the base of the broad ligament, does not positively assure complete obliteration, that with the shrink. ing of the tissues in consequence of the compression the ligature loosens and the circulation is restored. He, therefore, clamps and ties the vessel, then divides it, tying afterwards the uterine end of the artery which bleeds because of its anastamosis with
the ovarian. In those cases where this method was adopted the tumor has undergone complete atrophy.
While the operation has a limited application it possesses some advantages which commend it, viz.:
1. It involves little or no risk when carefully executed.
2. It does not involve a tedious convalesence.
3. It is quickly and easily performed.
4. Its immediate result is to afford prompt relief of the symptoms.
5. Its ultimate result, which is manifest within six months, is complete or almost complete atrophy of the tumor.
6. It does not unsex, mutilate nor disable the patient.
ARTIFICIAL RESPIRATION IN INTRATHORACIC OPERATIONS.
Tuffier and Halleon (Gazette Hebdom. de Med. et de Chir., No. 95, p. 1131) report experiments upon dogs under chloroform, in which, by means of a tracheal tube and bellows, the movement of the lung may be so controlled as to avoid pneumothorax after opening the pleural cavity, and to stimulate normal respiration during such operations. By this method, aided by an incandescent lamp, much of the pleural cavity and the mediastinum is accessible to operation. The insufflated air should he sterilized by heat. No complications or disturbance of pulmonary circluation have followed this procedure.-Medical News.
THE ABSORPTION OF IRON IN THE INTESTINE, AND ITS RELATION TO THE BLOOD.
In the Press medicale for February 10th M. Chassevant states that M. Cloetta has made some experiments in regard to the elimination of iron in the economy (Archiv. fur experimentelle Pathologie und Pharmakologie, 1897). For this purpose he used ferratin, which exercises no caustic action on the tissues. His experiments demonstrated that, in dogs which were subjected to
a milk diet, the iron injected into the veins in the form of ferratin was eliminated by the large intestine. Quincke had also ascertained this by micro-chemical examination. The author also investigated the means of assimilation of this element when administered by the digestive tract, and he found that twenty per cent. of a dose of ferratin introduced into the stomach of a dog subjected to a milk diet was absorbed.
According to M. Cloetta, the organic combination of iron with albuminoid matter is necessary in order to insure its absorption. For instance, two dogs were experimented upon as follows: Their food consisted of a soup made of starch, sugar, glucose, and distilled water. To the nourishment of the first dog a solution of iron chloride representing sixty milligrammes of iron was added; to that of the second dog, a solution of ferratin representing forty milligrammes of iron. The villosities of the dog to which ferratin had been given presented the characteristic action of the iron absorbed. The iron contained in the intestine of the other dog was not absorbed and formed masses at the base of the villosities. The organic iron combined with albuminoids is evidently absorbed in the intestine, penetrates the chyle, and enters the circulation by the mesenteric veins.
Experiments made by Cloetta with new-born dogs demonstrated that the presence of iron salts in the food was not immaterial to the formation of hemoglobin, that there was no absorption of iron salts, and that the liver seemed to regulate absorption in the same way as it did glycogenesis.-N. Y. Med. Jour., March 6, 1897.
THE TREATMENT OF CEREBRO-SPINAL MENINGITIS BY HOT BATHS.
Dr. M. Jewnin reports five successful cases. Noting the reports of Aufrecht (one case) and of Woroschilsky (two cases), he details his own. The temperature of the daily bath varied from 99.5° to 104° F., but the duration was not stated. So far as this report shows anything, it may be said that these baths are harmless, and, further, that they quiet the patient. It is also to be noted that whereas most authors call attention to the great emaciation which results from the disease, so that in this respect it recalls tuberculosis or carcinoma, under this method
there was no marked loss of weight, but, on the contrary, three of the five made a distinct gain.-Therapeutische Monatshefte, Heft 11, S. 581.
CLINICAL NOTES ON THE ANALGESIC EFFECT OF
Lactophenin, the most recently introduced of the coal-tar products having antipyretic and analgesic properties, while in use in Germany since 1894, in the literature of which place many favorable reports of its action are to be found, has apparently not become well known to the profession of this country.
Chemically it is a phenetidine derivative, containing lactic acid in place of the acetic acid constituent of phenacetin. It is but slightly soluble in water, and is practically tasteless.
The writer's experience has been limited to its action as an analgesic. The number of cases reported is not large, but still it is sufficient in number and variety to show that lactophenin is a valuable agent for the relief of pain.-Chas. S. Potts, M. D., of Philadelphia, in The Therapeutic Gazette January, 1897.
TREATMENT OF CONSTIPATION.
Abstain from administering cathartics in slight transient disturbances of digestion; rather let Nature take her own course.
Never put a patient on a one-sided diet for too long a time; the exclusion of vegetables, fruits, and starchy foods in general from the diet is frequently the cause of marked constipation. A hygienic mode of living, regular habits, less business strain and worry, and more outdoor life and exercise, are of greatest importance to prevent constipation.
The treatment of habitual constipation demands a hygienic mode of living, correction of faulty diet, increased amount of vegetables, fruits, starchy foods and fats (butter); also the patient should be impressed with the importance of not worrying and not bothering much about his bowels; train him to have an evacuation once a day at a certain time, either giving him no drugs whatever, or administering a very slight cathartic for a short period, then gradually diminishing and ultimately discontinuing its use.-Einhorn, in Post-Graduate.
KAYSERLING'S METHOD OF PRESERVING ANATOMICAL SPECIMENS.
At a recent meeting of the Vienna Obstetrical and Gynecological Society (Centralblatt für Gynakologie, January 16, 1897), Dr. Endletsberger described the method, which, it seems, has undergone several modifications since Kayserling described it in the Berliner klinische Wochenschrift, 1896, No. 33. It is said to be particulary suitable for use in museums, being reasonably cheap, taking very little time, and preserving the preparations so perfectly that they are serviceable for histological examination for a long time, the natural color being preserved even to the slightest shade. A section of a foetal brain shown by Dr. Endletsberger looked quite fresh, although the preparation was three weeks old. The same was true of a multilocular cystoma showing hemorrhages, also a section through a myomatous
The method, as at present practiced, is a follows: The specimen is wrapped in wadding in such a way as to give it the desired attitude, and kept for from twenty-four to forty-eight hours, according to its size, in the following solution:
Then for the same length of time it is kept in ninety-five per cent. alcohol, and during this immersion in alcohol it regains the color which it had partially lost in the formalin solution. It is then ready for permanent immersion in the following solution: 50 parts; 10 "" 3 " 150 66
The preparation must be kept in a dark place until the process is completed.-N. Y. Med. Jour.
EXTRAORDINARY HEREDITARY PROLIFICACY.
A. Valenta (Wiener medicinische Wochenschrift, No. 3, 1897) refers again to the extraordinary case of plural pregnancies