KÖSTER (H.). Diet in Nephritis. Nord. Med. Arkiv., 1903. Bd. 36, Häft 4, No. 17, p. 1. (Feb. 22, 1904.) FROM a series of careful, reliable and extended observations, Köster draws the following conclusions: 1. Pure milk diet only should be ordered in acute nephritis, uræmia and the acute exacerbations of chronic nephritis. It should only be discontinued when all acute symptoms have disappeared. 2. When treating chronic nephritis, commence with milk or milk and vegetable diet, but when the albumin output and the sediment become constant in amount and extent, gradually introduce a mixed dietary. This rule applies to all forms of chronic nephritis except when lardaceous infiltration is suspected. 3. In oedema and ascites mixed food may be continued if the patient specially desires it, although its administration should be accompanied by careful examinations of the urine. 4. When there are many red blood corpuscles in the urinary sediment, flesh food should be given sparingly. No difference need be made between red and white meats. 5. It is well to order a pure milk period at intervals and to examine the urine for the urea and albumin output, so as to obtain comparative figures. 6. The urinary albumin is only influenced by the amount of albumin in the food. The early morning urine contains the smallest quantity of albumin; that passed after breakfast generally contains the largest percentage, although cases occur which present individual variations. WALKER HALL. HEUBNER (0.). General Infection by Oidium Albicans. Deutsch. med Wochenschr., 1903, Nos. 33 and 34. A CHILD, 15 months old, had diptheroid membranes upon both tonsils, together with high temperature, dyspnoea and a vesicular and hæmorrhagic eruption. The buccal cavity was otherwise free from thrush, but the oidium albicans was present in the membrane. Cultures were made and after injections into rabbits the oidium was found in the heart, liver, spleen, kidney and spinal cord. When the tonsils of the child were examined the upper layer of the membrane was composed chiefly of threads or mycelia, and in the deeper layers conidia were found. In the neighbouring lymphatics the organism was also present, and it was also found in the capillaries of the renal cortex. Where the conidia were visible the tissue was necrosed. The lungs were quite free. WALKER HALL. ROGOZINSKI (K.). The Absorption of Bacteria from the Intestine. Verhandlungen d. Naturwiss-klane de Akad. in Krakau, Bd. 42, Ser. B. (Centrlb. f. path. Anat., 1904, S. 152.) By reliable methods and experiments Rogozinski shows that in the lacteals and mesenteric glands of normal animals bacillus coli communis, bacillus subtilis, bacillus mesentericus vulgatus and cocci may all be fully demonstrated. When dogs were fed with food contaminated by bacillus prodigiosus, b. kiliense and b. mycoides, these organisms were found in the lacteals and mesenteric glands in each case, although bacteriological examinations of the blood, liver and spleen gave perfectly negative results. The views of Porcher and Desonbry and Neisser and Opitz are stated, and Rogozinski ascribes his results to better modes of experimentation than earlier workers. The facts obtained appear to throw considerable light on certain cryptogenetic intestinal infections, post-mortem and agonal wandering of intestinal bacteria, the relation of food to tuberculosis and the passage of micro-organisms through the bowel wall and peritoneum. The paper is well worth the perusal of those interested in the subject. WALKER HALL. MAXIMOW (A.). Changes in the Mast and Fat Cells during Cicatrization. Ziegler's Beiträge, 1904. Bd. 35, Heft 1. MAXIMOW continues his previous studies (vide Med. Chron., 1903, Vol. xxxix., No. 231, p. 199) on the changes in cicatricial tissue. The method of experiment is still the same, viz., the introduction of celloidin chambers into the subcutaneous tissues of the white rat. It will be remembered that Maximow draws a sharp line of distinction between the mast cells and the plasma cells, polyblasts and clasmatocytes. He considers that the granules in the mast cells are concerned directly with the metabolism of the tissue cells, but whether or not they constitute a reserve supply the experiments do not decide. The mast cells are not transformed into polyblasts, but are frequently destroyed by these latter cells. In newly-formed connective tissue mast cells are not to be found. During the progress of the inflammatory changes fat disappears from the cells of the subcutaneous tissues. Whether the fat is simply used up by the cells, or the fat cells develop into polyblasts is not certain, but the ordinary type of fat cells is always absent. WALKER HALL. Therapeutics. LEECH (J. T.) and HODGSON (J. F.). Pure Carbolic Acid in the Treatment of Smallpox.. Lancet, Dec. 26, 1903, p. 1,781. THE writers make a further contribution on the local use of pure liquid carbolic acid by painting over the vesicles. They have tried the remedy in 136 cases, and find that the vesicles dry up and abort, the subsequent pustular changes being greatly diminished in severity, and practically prevented. KREPS. R. W. MARSDEN. Pathology of Reflex Treatment of Anuria from Calculus. A WOMAN with left-sided renal colic, who had previously suffered from the same symptoms, also on the left side, laboured under complete anuria for two days. The author discusses the possible causal conditions:-Blocking of one ureter with absence or functional inhibition of the other kidney, or blocking of both ureters. He points out the need for caution in the interpretation of the two left-sided attacks; cases are known in which the pain of renal colic was distinctly on the one side and yet the corresponding kidney was quite healthy; whilst the kidney of the opposite side contained the stone which gave rise to the symptoms. On cystoscopic examination, no opening of the right ureter could be found. The opening of the left ureter was seen, and on trying to pass a catheter along it an obstacle was encountered about two centimetres from the orifice. This obstacle gave the impression of a calculus, and after many vain attempts to push it out of the way with the catheter some hot glycerine was injected through the catheter, when, on further manipulation with the instrument, the obstruction suddenly yielded and the urine began to appear. A catheter was then introduced into the bladder (the instrument in the left ureter still remaining) but no urine was obtained. The diagnosis was:-Absence of the right kidney, with blocking of the left ureter by a calculus. During the ensuing ten hours a large amount of urine passed along with a small concretion. On the following day the patient felt quite well and made no complaints of pain, although a number of cystoscopic examinations and catheterisations of the ureter had been made. In the light of this case, Kreps discusses the question of reflex anuria, as to whether it really occurs. He quotes cases which prove beyond doubt that the function of a healthy kidney may be temporarily inhibited by sudden obstruction of the ureter of its fellow. He strongly urges the necessity of cystoscopy in such cases with catheterisation of the ureters so that, if possible, the obstruction may by this means be removed. J. DIXON MANN. GAUDIER (M.). Pharyngeal Irrigation. Bulletin Général de Thérapeutique, December 30, 1903. M. GAUDIER recommends, in the early stages of all kinds of sore throats, irrigation by means of Seltzer water. A glass cannula fixed to the nozzle of a siphon by a rubber tube is held between the teeth and jets of soda-water are thrown against the fauces in the intervals between the breaths. The process is cooling, soothing and depletive to the mucous membranes, cleanses and massages the tonsils, and even evacuates superficial abscesses. Four or five siphons should be used per diem. W. PERCY STOCKS. BEHREND (MOSES). The Danger of Inflating the Stomach with Carbonic Acid Gas. Report of three cases with autopsies. Philadelphia Medical News, December, 1903. THE writer records three cases in which disastrous results followed from the use of CO2 gas for diagnostic purposes. The technique was identical in each case. One drachm of sodium bicarbonate in half a glass of water, followed by one drachm of tartaric acid in the same amount of water. 2 CASE I. M.P., aged 68. Vomiting immediately after food. No hæmatemesis. CO2 produced an evident distension of the stomach, the patient became distressed and died within 20 hours, after repeated vomiting of large quantities of blood. Autopsy. Gastric ulcer near cardiac end of stomach with rupture of subjacent blood-vessel. CASE II. G.S., aged 73. Vomiting immediately after eating; no pain, no blood. CO, produced no distension, but patient became extremely prostrated immediately after its use and died on the following day. Autopsy. Carcinoma of the oesophagus and cardiac end of the stomach. CASE III. C.M., aged 52. Epigastric pain, no vomiting. CO2 produced no evident distension, but patient became distressed, passed into a semi-conscious condition and died five days later. Autopsy. Malignant disease of the oesophagus. The writer concludes that CO2 must be used, if at all, in carefully selected cases. It is infinitely more dangerous where there is disease of the oesophagus and cardiac end of the stomach, possibly due to pressure exerted within narrow limits. F. G. HACK. KER (CLAUD B.). The Open-Air Treatment of Broncho-Pneumonia. Scottish Med. and Surg. Journ., 1904, p. 33. IT is but a few years ago that broncho-pneumonia was looked upon as, of all diseases, the one to be treated with the warmest, and often this means also the stalest, of air. The plan of circumvallating the patient in a moist-aired curtain-closed bed is still rife. Dr. Claud B. Ker is, therefore, to be congratulated upon showing clearly that even in this disease the "open-air" method is not only not to be considered questionable or even bold, but that it is actually an excellent mode of rendering assistance to the patient in combating the disease. He has had under his care during the last few years a large number of broncho-pneumonias complicating whooping-cough. After giving almost all the various methods of treatment suggested for such conditions a trial, he began to treat the patients by the "open-air " method. He gives his results in this paper, and they are founded upon a study of 150 cases, not selected in any way, one half of which were treated entirely indoors, and the others either partly or entirely out of doors. His results are eminently satisfactory, for he not only shows that the death-rate was reduced from 66.9 per cent. to 31.5 per cent., but also he states that many symptoms in the course of the disease were alleviated or much improved. There was no favourable influence on the infection itself, the whoops being unaffected in number or severity; but the patients took their food ravenously, their general health was improved, and they slept much better. Cases developing pulmonary tuberculosis became rarer. S. VERE PEARSON. HARRISON (A. T.) and WILLS (W. K.). Light Treatment. Bristol Medical Journal. Vol. xxi., p. 303. THE writers have successfully treated three cases of acne vulgaris with the X-rays, though fresh infection was not prevented. Two of the cases returned after some time in an active condition, but soon improved again. The X-rays do clear up the skin, but afterwards hygienic precautions must be taken to prevent a fresh outbreak. Two cases of intractable eczema resembling Paget's disease of the nipple are reported as having been much relieved by X-rays. Of 50 cases of lupus vulgaris, treated by means of X-rays or the London Hospital lamp, all had received some, if not considerable, benefit, though in a few cases no very great diminution in the affected area had taken place either on account of the long duration of the disease, the depth of the individual nodules, or super-imposed scar tissue the result of previous surgical operations. Several cases of tuberculous ulceration and dactylitis have greatly improved under X-rays. One case of lupus erythematosus treated by the Norman-Walker method is reported improved. Rodent ulcers have cleared up satisfactorily under X-rays. Some cases of favus and tinia tonsurans have been treated by the X-rays for depilatory purposes with good results. LOUIS SAVATARD. LEONARD (C. L.). The Röntgen Rays as a Palliative in the Treatment of Cancer. American Medicine, 1903. Vol. vi., p. 854. UNTIL the permanence of the cure of cancer by Röntgen rays is proved primary radical removal of the diseased tissue should be recommended |