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has employed. Under its influence septic wounds rapidly become uninfected. The author has been particularly pleased with glutol in cases of extensive laceration of the tissues of the fingers sustained by brake or switchmen, and often complicated by fracture of the phalanges. After cleansing the wound, reducing the fracture, and inserting a stitch, if necessary, he applies glutol, gauze, cotton and bandage, and extends the hand on a splint. In a week or ten days, if the wound is uninfected, on removal of the dressing, there will be no pain or inflammation. The scab that has formed is so firm that no splint is further required, and after the second dressing of a non-infected wound nothing need be done than to protect the injured member with a clean roller bandage until recovery is complete. In conclusion, Dr. Haig states that glutol is inexpensive in view of the small quantity required, and that its application is entirely painless.
URETHRITIS DUE TO BACTERIUM COLI COMMUNE.
Josipovice (Centrabl. f. d. Krankh. der Harn- u. Sexualorgane, B. vii., H. 10, p. 663) reports two cases of urethritis in which he found the bacterium coli commune in the urethral discharge. In one of the cases, which he relates in detail, he was able to establish the identity of the micro-organism by cultivation. Three days after sexual intercourse the patient noted a urethral discharge which he believed to be gonorrhoeal. There was increased frequency of micturition, with burning, and also constitutional disturbances, with headache and anorexia. There was slight fever and the tongue was heavily coated. The entrance to the urethra was oedematous and reddened. On pressure a drop of dirty yellow viscid pus escaped. On irrigating the anterior urethra anb then receiving the urine in two parts in separate vessels the wash water was found to contain an abundance of flaky pus and threads, while the urine in both receptacles contained no threads, but was turbid and deposited a considerable sediment on standing. Seven and a half minims of sandalwood oil in capsules were prescribed thrice daily, with rest in bed and a diet of milk and other bland food. On the second day, although the temperature remained high, no complication could be discovered. The discharge continued in abundance and the increased frequency of micturition was a source of distress. On
the third day the patient appeared brighter, with improved appetite and without fever. The discharge persisted, but it had lost its dirty color and the burning in micturition was less. By the fifth day scarcely a drop of pus could be expressed from the urethra. The first portion of urine passed now was turbid and contained threads, while the second was practically clear and free from threads. The swelling about the orifice of the urethra having subsided, injections of zinc chloride (one grain to six drachms) were begun and the disease soon came to an end. Microscopic examination of the secretion on the first day of observation disclosed the presence of bacilli coli commune but not gonococci. The examination was repeated on the following day and with similar results. Cultivation of the bacilli confirmed their identity.-New York Medical Record.
AMPUTATION OF A CARCINOMATOUS BREAST DURING LABOR.
J. Ives Edgerton (New York Medical Journal, Nov. 14, 1896) reports a case, occurring in the service of S. W. Lambert, of a pregnant woman with a hard carcinomatous mass in the right breast, which was removed just after labor had begun. The object was to obviate the increased growth which is apt to take place in these cases during the puerperium. Labor had just begun when the operation was performed, and it resumed its course when the effects of the anaesthetic had passed off. The second stage of labor started at the end of six hours from the time of operation. As the patient was weak, two hours later axis-traction forceps were applied, and the child easily delivered in eight minutes. Patient was out of bed on the twelfth day. Dr. Edgerton subsequently removed the axillary glands, the patient doing well.-University Medical Magazine.
TOTAL EXTIRPATION OF BLADDER.
M. Tuffier, in a communication to the Acadèmie de Medecine de Paris, reports an interesting case of total extirpation of the bladder for a diffused tumor of that organ. It was that of a man, aged forty, suffering from infilterated tumor of the left wall of the urinary reservoir invading all the mucuos membrane of the bas fons. On October 10, the speaker practiced ablation of the organ, the catheterism of the ureters was suppressed on
the seventh day and replaced by the hypogastric syphon. The patient left his bed in the first week of December, and for the last fortnight he has recommenced his work, wearing an appropriate apparatus. He does not suffer, has got strong, and has notably regained flesh. The histological examination of the bladder showed that the tumor was malignant.-Paris Cor. Med. Press and Circular.
A NEW METHOD FOR REDUCING HERNIA.
Stafford, in Am. Medico-Surgical Bulletin, advises continued pressure for reducing hernia. An ordinary rubber bandage, two and one-half inches wide and three yards long, is wound about the scrotum and penis, commencing below the center and drawing tighter at the lowest part until all the parts are covered. This is less painful and more effective than taxis. The same method is employid for prolapsed rectum.-Cin. Lancet-Clinic.
SOME IDEAS ON ALTERATIVES.
The word "alterative" (H. G. Reemsnyder, M.D., Ephrata, Pa.) is construed by a great many medical writers as a term that can be applied to any drug or remedy of whose therapeutics not much is known, and less written. Consequently our materia medica is full of so-called alteratives, many of which are seldom used and possess an action far different from that ascribed to them, but for want of a better term are thus denominated.
According to Brunton an alterative is a drug that improves the general condition of the body, stimulates nutrition, and regulates the waste elimination without exerting any preceptible action on individual organs.
This clearly defines the therapeutic action of those drugs called alteratives, a study of which is always interesting since it is to them that much of the success in the treatment of chronic diseases is due.
The knowledge of the fact that a great many chronic diseases and conditions are amenable to treatment with benefit by
alteratives is not by any means confined to the profession of medicine, but it has reached the laity and has spread through all the length and breadth of the land, as is evidenced by the general use of what are known as "blood purifiers," some of which have an enormous sale.
It is, therefore, essential to the physician to be acquainted with the drugs which are thus employed, as there is scarcely a condition of a chronic nature in which a tonic alterative will not be of benefit. Every physician must have noted that there are always a certain number of patients among his clientele who may be called "regulars," who require a course of medical treatment about every month or two, in order to preserve their peace of mind, if not that of their body; who come with a train of symptoms, as varied and as remarkable as they themselves are, and which are withal so vague and incomplete that no earthly physician can diagnose their troubles, who, nevertheless, will be greatly benefitted by an alterative which will improve the nutrition, eliminate waste, and not effect any individual organ.
Without doubt our best alteratives are to be found in the vegetable kingdom, and these have the advantage of being free from harm in prolonged administration, which can not always be said of the indiscriminate use of such powerful mineral substances as mercury or arsenic. Another advantage can be attained in the use of vegetable remedies in the preparation of the green drug, upon which point I belive almost all authorities agree.
There has been, however, on the part of our manufacturing chemists, somewhat of a tendency to ignore the demand for green drug extracts, so that it has become almost impossible to obtain reliable extracts, which are made from the green drug. However, we have one preparation of this character that experience has proved reliable, and which for certain therapeutic action is unsurpassed. I have reference to that known as iodia, which is composed of the active principles obtained from the green roots of stillingia, helonias, saxifraga, and menispermum, to which are added ferri phosphatum and potassium iodid. In theory this preparation presents an ideal formula, while in practice it produces certain beneficial results.
In addition to those cases mentioned as being susceptible to
marked benefit by the use of an alterative such as here indicated, this preparation has another and perhaps more important action, that of certainly curing syphilis. I have had ample opportunity to test this remedy in cases of syphilis in all stages, and I am in a position to positively assert that in this disease we can find. nothing which gives more promising effects, and which allows us to give more encouragement to the unfortunate victims.-Med. and Surg. Reporter, Jan. 16, 1897.
INSUFFIENCY OF THE BACTERIOLOGICAL DIAGNOSIS OF
Sponck (Sem. Med.) points out that although a bacteriological diagnosis of diphtheria is very easily and certainly arrived at, nevertheless cases exist in which bacteriologists disagree. Cultivation on serum, followed by microscopic examination, shows that there are three varieties of the bacillus. On serum these are differentiated only by size; the short bacillus, however, closely resembles the pseudo-diphtheria bacillus described by German authors. As regards virulence the short bacillus is regarded as extremely benign, the intermediate as less so, and the long bacillus as the most toxic of all. It might be thought that the small bacillus described by French writers was identical with the pseudo-bacillus of German authorities, but doubt is thrown on this by the results of experiments on guinea pigs. Though none of the animals affected died. The cultures used were in all cases pure. To determine whether or not two pathogenic specimens were true diphtheria bacilli recourse was had to antidiphtheria serum. If the true diphtheria bacillus had been present, this should have been capable of protecting a guinea pig from ill-effects. This was not found to be the case. Spronck concludes that there exists a pseudo-diphtheria bacillus, which is pathogenic to guinea pigs, hitherto unknown or mistaken for the short bacillus. Researches on the but slightly pathogenic pseudo-diphtheria bacillus showed that in time the cultures lost their virulence, and when spontaneously attenuated could not be distinguished from Von Hoffmann's pseudo-diphtheria bacilus. This proves that the relationship said to exist between the latter and the diphtheria bacillus can not be admitted without reservation. Probably Von Hoffmann's bacillus is derived some