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SURGICAL OPERATIONS WITH GALVANO - CAUSTIC.
It is well known that a fine platinum wire can be made instantly white hot, by means of a current of electricity passed through it from a battery of sufficient power. In difficult cases of hemorrhage, where the bleeding vessels cannot be ligated, either from their situation or other circumstances, the actual cautery is resorted to by surgeons as an effectual mode of arresting bleeding, and a white - hot wire of platinum is as good a cautery as is needed in almost every case.
Pushing its use a little further, we find that from its flexibility it can be used to strangulate polypi, or other soft growths, while its tenuity enables us to cut into and through soft structures, making for the surgeon a novel form of surgical instrument.
Doctor R. Voltolini, of Breslau, who has introduce l it into laryngoscopal surgery, has removed growths in the larynx near the vocal cords by catching the morbid formation in a loop of very fine platinum wire, and then with a Middedorf battery, which he uses, heating the wire to a white heat, and by some little traction at once severs the tumor. He claims that it is an exceedingly mild way of operating, little or no pain being experienced, and no hemorrhage supervening during the operation, whilst its action can be limited to one spot without cauterizing or affecting neighboring parts. He says large or small growths may be removed equally as well by it, and for the larynx, where blood trickles down into the trachea and produces a troublesome cough, in the older methods of operating in this region, this method is far superior, as that objection is obviated. In one case in in aural surgery, where it was necessary to make a permanent opening in the membrana tympani, he successfully used the heated platinum wire, after being unsuccessful with the knife from the
jumping of the patient when the instrument came in contact with the delicate drum membrane, although he was fully under the effects of an anesthetic. The patient was blind from cataract, and entirely deaf, with constant noise in his ears. Catheterization of the eustachian tube, which was found open and in its normal state, had no effect whatever; and no sound of any kind from the outer world could be distinguished by him even through an ear trumpet.
One tympanum was opened by cauterizing it with the platinum wire heated by electricity, and no pain was produced, although he was not under an anæsthetic, and in a few days the other tympanum was treated in the same way with a similar good result, and no unfavorable symptoms resulted from its use; and in uine days after the operations, the ear passages were lean and the drums healed; the tinnitus lessened, and the uncomfortable feelings about the head improved, although the hearing was not benefitted, because the internal ear was permanently disorganized. This is a very practical and easily applied procedure, and in the way of removing hemorrhoidal tumors, vaginal, rectal and nasal polypi, as well as soft growths in other passages, it certainly is, we think, destined to be a valuable acquisition to the surgical operators' list of instruments.
In Paris, Doctors F. Mallez and A. Tripier have applied this electrical cautery to stricture of the urethra with considerable success, and report thirty cases cured in this way. No further catheterization or dilatation of the urethra appears to be requisite after the operation; in fact the treatment is considered complete thereupon. The Philadelphia Compendium of Medical Science says:
"The battery employed by M. M. Mallez and Tripier consists of eighteen medium pairs, with the proto - sulphate of Mercury. The urethral electrode consists of a guide, whose extremity closes the terminal opening of an india rubber catheter, destined to protect the parts which are not to be cauterized. This guide is made of several twisted wires, which terminate in a cylinder that varies in length from eight
to fifteen lines.
"The surgeon placing himself on the right of the patient, the positive electrode, which consists of a broad carbon button, is fixed by means of an elastic band to the internal sur◄ face of the left thigh, contact with the skin, being prevented by several discs of moistened agaric. The urethral electrode cover by its protecting catheter, is now carried down to the anterior face of the obstruction, when the circle is closed at the positive electrode. The patient soon experiences a burning sensation at the point undergoing cauterization; but this is slight, and diminishes as the eschar is formed. The guide is then to be gently pushed, so as to maintain its opposition with the stricture couterizing in this way both from before, backward and laterally. By pushing the catheter over the guide, so as to allow only a small portion of the latter to project, the duration and the depth of the lateral cauterization may be limited at will that from before backward continuing without interruption. Finally, when the obstruction is destroyed, the catheter passes without difficulty over the terminal button of the guide."
A new battery has just been shown us which answers the purpose, and is very compact. It is of French manufacture, and operates with a liquid composed of Bichromate of potash, one part; water, ten parts; Sulphuric acid, two and a half parts.
B. W. J.
LIGHTNING AS A SURGEON. - The London Lancet reports. the case of a boy in Russia, whose leg was amputated at the knee by a stroke of lightning. The division of the limb was effected through the superior extremity of the tibia, the patella and the femur not having been touched. The healing of the wound was very rapid, and by the use of the ordinary means. The severed leg was dried up, the tibia being black, stripped of the flesh.
PARASITES IN VACCINE LYMPH. In the fluid of true vaccine lymph, Dr. Haller, of Jena, found large quantities of red or reddish-brown micrococcus and mycrothrix chains, The particles of the former are so small that even with a magnifying power of one thousand linear they still appear as small points.
SURGICAL ARTICLES DEFERRED. Notice of Cullerier on Venereal. Ovariotomy. Vaccination, by Prof. John C、 Morgan. Mode of Vaccination, by J. C. Shafer, M. D.
Materia Medica and Special Therapeutics.
PROF. E. M. HALE, EDITOR.
NOTES ON SPECIAL THERAPEUTICS.
AMMONIUM MURIATICUM AND ACONITE IN OVARIAN NEURALGIA. — In the Medical Press and Circular, Dr. J. Marengo Curran details several cases of Ovarian Neuralgia, which he treated successfully with the above medicines, after the unavailing use of the ordinary (allopathic) treatment.
The symptoms presented by the cases (six in all) were, in the aggregate, as follows: Pain, dull and aching, or violent and unendurable in one or the other iliac regions, extending along the anterior surface and inner side of the thigh; attended with swelling and tenderness of the ovary, high, quick inflammatory pulse, dysuria, and loss of sleep.
In some of the cases the pain was chronic, i. e., it lasted all through the month, and got worse at the menstrual periods. In other cases the attacks were violent, acute, and had rather the appearance of Ovarilis.
In all these cases, the following prescription was made: "An eight ounce mixture, containing two drachms of muriate of ammonia, with five drop doses of tincture of Aconite."
This is rather an indefinite way of giving the amount of Ammon. mur. used, but as the allopathic dose is five to ten grains, it is probable that a tablespoonful was ordered, repeated every few hours, and each dose contained five drops of aconite.
Homopathists are well acquainted with the magical effects of Aconite in many forms of neuralgia. In ovarian neuralgia it is one of our most successful remedies. The symptoms of the six cases referred to were very similar to the aconite - ovarian - symptoms, and it is possible that the ammonia had nothing to do with the alleviation or cure of the disease.
On consulting Hahnemann's Chronic Diseases, however, we find many symptoms of Amm. mur., which may have been due to ovarian irritation (if they occurred in female provers), namely:
"Stitches in the left side of the abdomen over the hip, when sitting, and when stooping in the standing position.
"Feeling of distention in the groins, with pain in the left groin when seated, and tension and digging in the right groin.
"Pressure with tension in the left side of the abdomen, near the ring, as if something was pressing out; tearing and tensive pain in the groin when walking; cutting and stitches in both groins as far as the small of the back, with tenesmus of the bladder every half hour in the evening; stitches in the right groin and through the hip when sitting; pain as from a sprain in the left groin, obliging one to walk crooked; pain as from ulceration in the left groin, felt only when walking. The muriate of ammonia has a high reputation among German physicians as a remedy for painful muscular affections, hemicrania, neuralgia and prosopalgia. The pernicious habit of mixing medicines, which the allopaths still cling to, is the chief obstacle to any advancement among them, of a definite knowledge of special therapeutics.
HYPOSULPHITE OF SODA. I. Scrofula. Mrs. M., aged 15. Right leg very much swollen, several running sores from knee to hip. Patient very weak from the great suppuration; menstruation tardy and very scanty; appetite poor, bowels costive. Gave Soda hyposul. 3 iij;