WILLIAMS (F. H.). Some of the Physical Properties and Medical Uses of Radium Salts; with Report of Forty-two Cases Treated by Pure Radium Bromide. The Medical News, Vol. lxxxiv., p. 241. Of the rays from radium salts the alpha rays constitute the largest part of the radiation, are easily absorbed and are slightly deflected by a strong magnetic field. The beta rays are not so easily absorbed; they are more strongly deflected by the magnetic field, and in a different direction, but in the same direction as cathode rays. The gamma rays are the most penetrating, and are not deviated by the magnetic field. The rays from radium produce both harmful and beneficial effects on animal tissues. These rays cannot be used for diagnosis or prognosis, either by means of radiographs or of the fluorescent screen, on account of their inability to show sufficient differentiation between the tissues; therefore, for these purposes they cannot replace the X-rays. Radium is of value as a therapeutic agent, and the use of its salt for therapeutic purposes needs much the same kind of experience as is required for the successful therapeutic use of the X-rays. Caution must be observed, for radium if not properly protected causes severe burns, which do not manifest themselves for a week or more. Exposures will vary in different cases, but as a general rule it may be said that when the beta and gamma rays of pure radium bromide are used together (the alpha rays are absorbed by the mica covering the capsule) for the treatment of superficial lesions, and the radium capsule is placed on the part treated, the length of exposure should be one-half to two or three minutes. But an exposure of many hours would be necessary if weaker forms of radium are used. In a case of acne each pustule was exposed to the radium through an opening in a sheet of lead foil, and healing took place. Four cases of lupus responded very satisfactorily. In one of these cases the area in which the disease was most severe was selected for the employment of the radium and the other parts treated with X-rays. The radium-exposed surface improved the more rapidly. Radium has also shown its superiority in the treatment of keloid tissue, and markedly so in rodent ulcer. Of 23 patients with epidermoid carcinoma eleven have healed and twelve are improving, and here again its superiority over X-rays is manifest. In comparing the relative value of Radium rays and X-rays, the writer says that except for certain classes of cases (lympho-sarcoma) and the present superiority which the X-rays have of being able to cover larger areas than radium, the advantage at this time lies chiefly with radium. It is, however, too early to give a final and definite opinion as to the value of radium salts as a therapeutic agent. Sufficient time has not yet elapsed to enable us to know how permanent the excellent beginnings will prove. In experimenting with the beta and gamma rays, the author finds that the former are more numerous, more easily absorbed and can be entirely cut off by placing a certain thickness of aluminium over the capsule, which, however, in no way hinders the thorough penetration. of the gamma rays. Further, he has found no irritation result from an exposure to the gamma rays, that was twenty times as long as that given when the beta and gamma were used together. The next step is to test the healing power of the gamma rays, and then, by excluding the beta rays, it may be possible to treat deep-seated new growths. The present tests have shown that the beta rays should not be used with the gamma for such new growths. LOUIS SAVATARD. DUBOIS-HAVENITH. 5 Rodent Ulcer Treated by X-Rays. La Presse AN extensive ulcer situated over the left parieto-temporal region; amps. 20 volts were used-the kind of tube is not mentioned-with an exposure of ten minutes daily, at 10cm., for the first three months (except for two intervals of eight days), when an inflammation occurred, apparently not due to the X-rays. The ulcer is healing well, though, in spite of this, the writer has little faith in a permanent cure. LOUIS SAVATARD. WHITE (A. CAMPBELL). Liquefied Air. Medical Record, 1904, p. 93. THE writer, after mentioning that liquid air can now be obtained in sufficiently large quantities to be of general service, gives a brief description of the method of its manufacture, its physical properties and the uses to which it can be put, with and without the aid of the Röntgen and ultra-violet rays. It may be used (1) to produce local anæsthesia; (2) to reduce inflammation; and (3) to produce inflammation. It is an antiseptic and produces oxygen either as a liquid or vapour. As much or as little anesthesia as is desired can be produced in three seconds' time. The anesthesia lasts longer, and is followed by less slough than is obtained by any other freezing mixture because of its perfect freedom from moisture. It can be applied either with a swab or by a spray, and limited to any area desired. When the liquefied air is applied to the skin it becomes perfectly anæmic. This is usually followed by a blush due to secondary congestion. This redness will be the nearest approach to sloughing following an application, providing an incision is made, as an incision relieves the congestion. If no incision whatever is made the frozen part becomes elevated, and looks like an urticarial spot. If the freezing has been sudden and severe this spot develops into a painless and non-sensitive bulla. There is no pain attending the application as an anesthesia, and the anaesthesia. due to the paralysis of the nerve endings last from thirty to forty minutes. A minute should elapse before making an incision, and if an abscess or pus cavity is being opened, after thorough evacuation of contents the cavity should be sprayed. An inflamed part can be exposed to the cold dry vapour emanating from a vessel of boiling liquid air and any degree of temperature can be given, and the temperature of the part treated can be reduced to any desirable point. Another method is to soak a towel in the liquid and apply quickly and intermittently to the part until it has been thoroughly chilled. Or a glass bulb filled with the liquid and rolled over the surface of the part is another efficient means of accomplishing the same result. This latter method is particularly applicable in endeavouring to abort acute adenitis, periostitis and other inflammations. To produce an inflammation the liquid air must be applied directly and intermittently to the skin. The best example of this effect is seen in chronic indolent ulcers when a healthy granulating surface is obtained after only a few treatments. Liquid air may be used to destroy any foreign growths upon the skin, but care must be used to avoid excessive freezing. If a nævus, birthmark or fibroid tumour is treated judiciously it can be removed much more quickly and with less pain than by any other method. The writer records a case of inoperable scirrhus mammæ which he removed with liquid air applications. The patient had suffered from severe hæmorrhages two or three times a week. After the third application the hæmorrhages stopped, and this was attributed to an obliterating endarteritis produced by the treatment. In many of these cases a discreet use of the Röntgen rays has been found of assistance, particularly when the slough is likely to cover a large area. In the treatment of carbuncles, of not more than three inches in circumference, liquid air seems to act as a specific, while in lupus vulgaris and lupus erythematosus excellent results are reported. LOUIS SAVATARD. Short Motes on Selected Papers. By I. WALKER HALL, M.D. General. The Hæmolytic Properties of Extracts of Malignant Tumours. Micheli and Donati. Riforma Medica, 1903, No. 38. From 15 tumours extracts were prepared (10 carcinoma, four sarcomata, and one endothelioma). Seven were inactive, five were hæmolytic for all the blood corpuscles used, three only for some varieties. The extracts are autolytic, but become inactive on the addition of blood serum and after filtration through a Chamberland filter. The hæmolytic substances. probably appear during autolysis. Blood serum, when added to organ extracts, also prevented hæmolysis of blood corpuscles. Radium as an Analgesic and Nerve Tonic. Darier (A.). Lancet, March 5th, 1904, Vol. i., p. 652. In cases of cyclitis and iridocyclitis and cancer the radium rays have rendered the parts anææsthetic. In convulsive neurosis applications of radium to the temples were followed by cessation of the attack. Action of Radium on Some Organisms. Dixon and Wigham. Dublin Journ. of Med. Sci., March, 1904, p. 161. development of seeds and the growth of plants is unaffected by radium rays. The growth of bacillus pyocyaneus, bacillus prodigiosus, bacillus anthracis, and bacillus typhosus was inhibited, but the organisms were not killed. The Action of Radium upon Simple Forms of Animal Life. Willcock (E. G.). Journ. of Phys., 1904, Vol. xxx., p. 449. The radium rays do not incite any direct response on the part of the sense organs. Only the forms which contained chlorophyl gave a response other than that of being injured or killed by the rays. The resistance of the lower animals to the lethal action of radium rays varies with the different species. Hydra fusca disintegrates in four hours, hydra viridis shows no sign of injury in 24 hours. Orcein Test for Hexose and Pentose. Bial (M.). Zeit. f. klin. Med., Bd. 50, S. 417. When a few grains of orcein, 5cc. HCl, Primary Alveolar Sarcoma of the Liver in a Child aged four Malignant Chorion-epithelioma and Analogous Changes in Teratomata of the Testis. Risel (W.). Arbeiten aus dem Patholog. Inst. zur Liepzig, S. Hirzel, 1903. A colossal and important work, not suitable for abstracting, but of great interest to those attracted by the subject. Recurrent Lipomyxoma. Bender (0.). Deutsche Zeit. f. Chirurg., 1903, Bd. 70, S. 316. In the course of eleven years lipomyxomata were removed four times from the axilla of a man æt. 52. There were no metastases. Histologically, the tumours consisted of small nodules of mucoid and fatty tissue separated from each other by fibrous septa. There were numerous vacuolated cells present, the vacuoles being filled with fat or serous fluid. Circulatory System. Function of Hæmolymph Glands and Spleen. Lewis (T.). Journ. of Anat. and Phys., 1904, Vol. xviii., p. 144. There is a limited destruction of lymphocytes in the hæmal and hæmal lymphatic glands and to a less extent in the spleen. Polymorphonuclear and eosinophile cells are also destroyed probably by the action of a ferment. A proliferation of lymphocytes occurs in all glands of the series. Some evidence is adduced to show the derivation of eosinophiles and the other leucocytic varieties from lymphocytes. Phagocytes appear to originate from the endothelial cells lining the sinuses, capsule, trabeculæ and reticulum of the hæmolymph glands. Respiratory System. The Cells of Pleuritic Effusions in Typhoid Fever. Vincent (H.). C.R. de la Soc. Biol., 1903, S. 1,305. In two cases of typhoid the cells of the pleuritic effusion were determined. One case showed numerous endothelial cells and red blood corpuscles. A culture made from the fluid was sterile but guinea-pigs injected with the same died from tuberculosis. The patient later developed tuberculosis. In the other case There was a marked excess of endothelial cells with but few erythrocytes, and typhoid bacilli were obtained on culture. Alimentary System. Gastric Tuberculosis. van Wart (R.). Johns Hopkins Hospital Reports, 1903. A large solitary tubercle in a man. Genito-Urinary System. Lectures upon Uræmia. Ascoli (G.). Jena, G. Fischer, 1903, 295 pp., 22 illustrations. The clinical symptoms, pathology and pathogenesis are described in 12 lectures. All the recent work is included and the theories of cyto-toxines and nephrotoxines fully cited. F |