« ForrigeFortsett »
and landed in Boston the following morning. REPORTS ON PROGRESS A few separated themselves from the main
Comprising the Regular Contributions of the Fortnightly Departy at Montreal and made a side trip to
partment Staff. Quebec, arriving in Boston a day later. Without exception the members of our party rejoiced in their oboice of route, it gave us,
PATHOLOGY AND BACTERIOLOGY. as was annouuced in the prospectus, a maxi.
R. B. H. GRADWOHL, M. D. mum of comfort and sight-seeing-it gave so much of sight-seeing that for this alone the
ST. LOUIS. trip was well worth taking. Not one of us The Bacteriological Examination of the returned without a determination to do lower Blood of Cadavers.- M. Otten (Virchow's Canada again and thoroughly.
Archiv f. path. Anat., Band 184, Heft 2,
May, 1906) adds another chapter to the con. THE AMERICAN UROLOGICAL SOCIETY at its teption of Simmonds of Hamburg that the recent meeting in Boston elected Dr. Brans. bacteriological examination of the blood of ford Lewis, of St. Louis, to its presidency cadaver is a useful procedure in making the for the ensuing year. Official recognition pathological anatomical diagnosis in autopsy has not been coming this way with any great work. He reports about two hundred cases liberality from the national bodies, and it is in wbich there was a careful bacteriolog. a pleasure to note this exception. The other ical examination of the heart's blood of officers elected were: Secretary, Dr. Hugh cadavers, in 42% of which the blood was Cabot, Boston; treasurer, Dr. F. R. Hayner. sterile and in 58% it contained bacteria of Washington. The society will hold its 1907 various varieties. This blood was taken out meeting at Atlantic City.
at intervals after death varying for the most THE BRITISH MEDICAL ASSOCIATION AT
part from 16 to 24 hours after death, the body TORONTO.---The 1906 meeting of the British
being kept in a “cool room" during this time Medical Association will be held in Toronto,
before autopsy and blood examination. The Ontario, next August.
sum of his results coinicides with that of Sim
A cordial invitation is being extended to the American profession
inonds who reported that there is practically to attend. This is an exceptional occasion,
no invasion of the heart's blood post-mor. and an opportunity we seldom bave, it is to
tem, and that blood cbtained from this place be hoped that a large number of physicians
is just as useful for bacteriological analysis from the States” will avail themselves of it.
as that obtained from peripheral veins, all of St. Louis should send a strong delegation.
which the reviewer of this article respectfully Rates have not yet been announced, but they
denies. In the December number of 1904 of
the Annales de l'Institut Pasteur, the rewill be made.
viewer published an account of work done THE AMERICAN ROENTGEN RAY SOCIETY.
along this line with the blood obtained from -The seventh annual meeting of the Ameri.
dead bodies upon which autopsy had been can Roentgen Ray Society will be held Au.
performed for medico-legal reasons. Otten in gust 29, 30, 31, 1906, at the Cataract and In- his article neglected to acquaint himself with ternational hotels, Niagara Falls, N. Y. A the full literature on this subject by overlarge and interesting program containing the looking this artiole, the results of which conames of the best known X-ray workers in incided with that obtained by Cannon whose tbis oountry as well as a number from abroad, work is mentioned. This work of the rehas been prepared. An interesting feature viewer's showed that in 50 selected cases the of the meeting will be the exhibit of prints streptococcus was present in about 65% of and negatives. The railroads bave granted a the cases indiscriminately, even though the rate of a fare and a third on the certificate cause of death was of such a nature as gun. plan. The officers of the society are: Presi.
shot wound of the brain or abdomen, eto. dent, Dr. Henry Hulst, Grand Rapids, Miob.; The blood from the heart showed streptosecretary, Dr. Geo. C. Johnston, Pittsburg, cucci. but that from the peripheral veins was Pa.: treasurer, Dr. Leavitt E. Custer, Day- sterile in all cases excepting those in which ton, O.; vice-presidents, Dr. Russell H. there was intra vitam a general pus infeotion. Boggs, Pittsburg, Pa.; Dr. Clarence E. Skinner, New Haven, Conn.: Dr. G. Wil. The Histology of Callus.—Theodore Guem. liams, Richmond, Va.; Dr. Eugene W. Cald. bel (Virchow Arcbiv, Band 183, Heft 3, 1906) well, New York City. Full information re- says that the subject of histologioal investi. garding the meeting and application blanks gation of the structure of callus has often for membership may be obtained by address. been gone over, but with the newer methods ing the secretary, Dr. Geo. C. Johnston, 611 the subject needs revision. Normal and Fulton Building, Pittsburg, Pa.
pathological ossification was studied by Kolliker and Manasse, as well as by Kasso
OTOLOGY. witz, v. Recklinghausen and Ziegler. Strict examination in a quantitative way of the met.
ALBERT F. KOETTER, M. D. aplastic formation has not, however, been
A Case of Late Hereditary Syphilis of Both gone over. Guem bel determined to investi.
Labyrinths of the Ear.-(V. Behm, Arobiv gate this problem; for his material be thanks fuer Obrenheilkunde. -A patient twenty Recklinghausen who furnished him material
years of age, whose father bad been treated in the shape of fractured ribs and bones of
for syphilis, wus seized a year ago with sudthe extremities of children; also Bethe who den deafness of the left ear, for a balf year furnished him experimentally induced frao. increasing deafness of the right ear which up tures in the bones of rabbits and dogs from to this time had been very sensitive to noises. the physiological department of the Univer
Perforation of the nasal septum, cicatrized sity of Strassburg. He also used an ossify- scars of soft palate as well as the surprising ing myxoohondroma of the scapula in a results of a schmier cuse, on the bearing verimale patient of 56 years of age. The first
fied the diagnosis of bilateral syphilis of the material used was the callus on the right labyrinth. The exoruciating paips in the left ulna of a two years' old child which died
ear which appeared after six weeks were due in the hospital. The patient had a perineal
to a cicatrized retraction of tbe handle of the abscess; was affected with hereditary syphilis malleus in the healing of the synchronously and rachitic condition was simply a slight existing leutic affection of the tympanic
Flokety. rosary," separation of the epiphy. cavity, and was. relieved by the extraotion seal cartilages: a form of rachitis called by
achitis called by of the malleus and breaking up of the adhe. Recklinghausen “chondromalacia.”
A fracture of the ulna occurred on June 9,1902,
ne 8,1902, and were said by the author to be due to a and the patient died on July 8, 1902—age of specifio periohondritis of the left tubal emi. the fracture being five weeks. Autopsy pence. On account of the rapid return of the showed in addition to these clinical observa. tions cavities and broncho-pneumonio areas
hearing, this case serves as a warning, in
spite of the doubtful prognosis given by in the lungs. The callus had a thickness of
nearly all authors in hereditary syphilis, 24 to 3 mm. A cartilaginous area was seen
doubtful especially, if as in this case, the at the point of the fracture; osteoblasts were
di osteoblasts were late treatment and the simultaneous existence seen, but no osteoclasts. The bone and myx of adhesive processes in the middle ear, to ochondrom, from a male patient was well as
inaugurate in all cases an energetic inunction the bones of rabbits and dogs were sectioned
treatment and try all other anti-leutic remeand stained according to the thionin-phos. pborus method of Sohmorl. The sum of all these observations was, that in pathological Two Cases of Deafmutism Due to Ptomaine conditions of bone formation, metaplasia pie. Poisoning.-(W. Sohier Bryant, New York dominates. While in normal ossification, this Medical Record.)–Case I. Girl of two years plays an insignifioant role, in the ossification and seven months, always healthy, was taken of a callus, the formation of young bone sub- sick after eating fruit ice, with fever and stance follows in the wake of a meta plasia. symtoms of a gastro enteritis. Urine norThe onset of metaplasia depends upon the mal. After four days staggering gait, diff vascular supply; where there is poor vascu. culty in drinking, spasms of the face. One larization there is meta plastic growth of bone week after poisoning total deafness and as well in the periosteal as in the narrow dumbness. Ears show no changes. Same callus, with this difference, however, that condition after a year. Case II. Boy of two there is byaline cartilage only in the perios. and a half years. Seven weeks ago attack of teal callus, while in the narrow callus there fever, four weeks later child could not walk 18 hyaline cartilage and fibrous marrow and was deaf. Both cases are no doubt due formed. With the formation of blood vessels, to a toxio neuritis of the acoustic and toxic the metaplasia is arrested and there follows degeneration of the speech centers. Author final ossification, according to the endochon goes thoroughly into the differential diagno. dromal type The influence of division of sis as opposed to encephalitio processes, nerves upon the transformation of periosteal atropine poisoning, embolic infarots of the oallus has not yet been determined.
brain, meningitis and bulbar paralysis.
Ear Affections in Scarlet Fever.-(Sprague,
Providence, American Journal of Medical In cases of pain in the bip of doubtful ori. Sciences. )-Of sixty children who entered gin, examination of the kidney regions may the Rbode Island Hospital from January to discover the cause.
June, admitted to the soarlet fever division,
seven acquired acute suppurative otitis tion of the membrane. The etiology and media, three were already affected when they pathogeny of true cholesteatoma are still very entered the hospital therefore about 17 per muoh in doubt, at all events the formation cent, seven bilateral and three unilateral. takes place at the expense of the endotheOf the seven cases developed after admission, lium of the tympanio cavity, attic and antrum. four bad earache, increased temperature and Then follows the clinical picture of choles. acceleration of pulse; three had no pain, and teatoma and its complications. The diag. showed only high temperature. Of the sev. nosis is usually very easily made. Lucase enteen cases only two showed involvement of has found an odor peculiar to cholesteatoma mastoid and came to operation. Sprague di. in 98% of the cases, the author would not vides the scarlatinous middle ear inflamma. consider it as specific of cholesteatoma, but tion with the following forms: (1) Acute the result of the process of decomposition, serous; (2) acute suppurative; (3) acute Treatment: If the removal of the cholesteat. necrotic form. The acute serous inflamma- oma does not occur in the natural way, a rad. tion usually oocurs during stage of erup- ical removal of the petrous portion of tem. tiun, or at least during the first ten days. · poral bone and mastoid process by means of The symptoms are those of an ordinary ca- a radical operation. tarrhal otitis media. If the child is old
Etiology of Disturbances of the Auditory enough it complains of fullness, tinnitis,
Nerve Apparatus deafness and pain; in very small children
Appearing Suddenly.restlessness and rise of temperature are no
Stein (Monatsschrift fuer Ohrenheilkunde) ticed. During desquamation the external
quotes a number of observations wbere pacanal is full of scales and the activity of
tients blame mental disturbances as the cause
of subjective sensations of hearing or altera. the ceruminal glands is increased. In the
tion of the hearing as well as cases of funcacute suppurative inflammation, which usu.
tional disturbance which are caused by traually occurs in the latter stages of the dis
matio influence, even though the trauma be ease the temperature reaches 103 deg. F., and more. Patient complains of lancinat.
not such as to assume severe changes of testing pains radiating to head and neck, swell
ure in the labyrinth, or in the cranial cavity, ing of the glands of tbe neck and stiffness
and gives us several points of support for the
explanation of the phenomena of a disease of the muscles are often noted. Occasion. ally we find cerebral irritation, convulsion
heretofore called vasomotor disturbances of
the hearing. The necrotic or diphtheritic
Common to all cases as found and von iting. form leads to rapid softening of the tissues,
by the internal examination of the objective
symptoms of the disease a more or less adthe membrane and the ossicles and to inva. sion of the labyrinth. The secretion is col.
vanced arteriosclerosis, and by examination
of the hearing apparatus the symptoms of an ored and very fetid.
affection of the auditory nerve. Author believes that in mild cases the in
therefore, believes he may accept the alterafeotion takes place through the tube, in
tion of bearing, as well as the subjective imsevere cases by means of the blood or lymph route. He considers the ear seore.
pressions of hearing as the local phenomena
of a latent arteriosclerosis cerebri, made tion very contagious, in three cases where the child was dismissed after the disease had
manifest by the psyobio disturbance, or the run its course and the usual quarantine rules
injury, and the assumption of a vascular were observed, but the ears still suppurating,
spasm as most plausible, which on account another child of the same family took sick
of the impaired elasticity of the vascular with scarlet fever, when all other ways of
walls continued longer and its deleterious
results on the brain nutrition were brought transmission but that of the ear secretion could be excluded.
to bear on the auditory nerve apparatus.
Differential Diagnosis Between Abscess of Cholesteatoma of the Ear.-(De Stella, the Cerebellum and Suppuration of the Laby. Belgique Medical.)-There are two kinds of rinth.-(Neumann, Archiv fuer Ohren beil. cholesteatoma: (1) The secondary or false. kunde.)-Opposed to the symptoms common (2) The primary or true chclesteatoma called to both diseases vertigo, vomiting, character endothelioma.Author speaks of the several of the nystagmus, etc., Neumann has obdifferent sizes or kind and the seat of the served differential diagnostic points in several cholesteatoma. Whereas the secondary chol. cases. Whereas, in the labyrinth disease exesteatoma is very frequent, the true or endo. isting nystagmus with the progressive dethelioma is met with very seldom. For its struction of the labyrinth becomes weaker, it inception the following adds to its formation: increases in intensity with the extension and (1) Epidermization of the drum membrane; continued existence of the cerebellar abscess. (2) closure of the tube, and (3) large perfora. If there exists in the beginning of the laby.
the end quantity, peint
rinth disease nystagmus toward the diseased the quality of the ray emploved makes but side it soon changes the nystagmus in the little difference. Tha guantitv given in the visual direction toward the heatlhy side. In main, almost if not quite the only point of cerebellar absoess the nystagmus changes · importance. “Even if it is admitted that from the beatlby to the diseased side. Fin there are different categories of X-rays, with ally Neumann mentions as of differential different qualities, all are depilatory, and all diagnostic moment the fact that a nystagmus equally so waen equal quantities are comdue to cerebellar abscess will not be influ. pared.” te uses, as before stated, a static enced, in contrast to labyrinth dystagmus, by machine, and extremly hard tubes, making the opening of the labyrinth.
ten to twelve on the radio-chromometer of Benoist. By this combination be securee the maximum working in the minimum time.
The period of exposure can be reduced to six DERMATOLOGY.
o seven minutes, but it has been found to be ROBERT H. DAVIS, M. D.
better to let the sitting last from ten to fifteen
minutes according to the condition of the Radio-Therapeutics of Ringworm at the Mự. atmosphere. tubes, etc. If a coil is used, a nicipal Laboratory of the City of Paris at the moderate poltage and a reduced am pèrage is Hospital of St. Louis.-Saboraud (Brit. Jour required (60-70 volts for an average of 4 am. Derm., June, 1906) gives an exhaustiye ac. pères in the primary current). In regard to count of the methods in vogue at the above the all important question of quantity, he mentioned institution. His treatments ex. shows conolusively that the X-rays should be tend over such a wide series of Cases (about measured at their exit from the tube, and 4,000 a year), and over such a length of not as has been attempted in terms of the time (since the latter part of 1903), that the current that produces them. Holzknecht's results are reliable, and we seem to have pastilles were produced with this object. reached at last a specific for this so chronic The pastilles used by the author, and introuble. Upfortunatelj, the apparatus re- vented by himself and Dr. Noiré, are based quired is not easily obtainable in this coun. on the alteration caused by X-rays in Bristry, and considerable skill is necessary to get tol paper, coated with an emulsion of platthe proper results. He uses a dynamo of ino-oyanide of barium, in collodion with acethree-fourths horse power to work a static tate of starch. These pastilles ought to be machine of twelve discs of 75 centimeters placed at half the distance from the source of diameter, and a speed of 950 revolutions a the X-rays, or anticathode, that the skin is. minute. In the circuit between the con. In other words, they should be placed at 71 densers of the statio machine, and the two centimeters from the anticathode. The tube poles of the lube, is interposed a spinter also should not be so large that the pastilles metre (a kind of ball electrode), the separa. would have to be placed at a less distance tion of wbich, measures the spark in centime. than 21 centimeters from the glass. The ters, and the resistance inside the tube to the pastilles, while under the influence of X-rays, current which traverses it. A small, self-reg. should be covered by black paper, or if not, ulating tubę, of only 8 centimeters diameter the working should be in semi-darkness, for is employec. The tube is surrounded, at a daylight delays the color changes in the platdistance of 3 centimeters from its wall, by ino-cyanide of barium. His X-ray radio. an incasement, or shield, of "strong sheet meter has a standard tint, wbich he calls ''tint iron lined on its inside by a thick layer of in- B.” When the pastille, placed at 74 centisulating $bonite.” This covering is open to meters, has taken this tint, the skin, at 15 the tube on the side that does not give out centimeters, has received exactly the quantity X-rays. On the other side, opposite the point of X-rays necessary to cause the complete of emerghnce of the X-rays, this covering is depilation of the region without irritation, pierced by a hole to which is adapted the without dermatitis, and without compromis. whole selies of localizers. The localizers are ing the ultimate regrowth of the hair.” metallio cylinders, all of the same length, Naturally, the time of exposure varies from but of different diameters. Their variations day to day, and even from hour to hour, owin size ałe, of course, necesitated by the rar. ing to variations in the source of the ray, atiable dimensions of the patches on the scalp mosphere, tube, etc., but the assumption by which it is desired to X-ray. The length the pastilles of the proper tint shows when of the localizers is the same always, and, is the requisite amount has been given, and, in such that the skin, olosely applied to the ex. this trouble at all events, the therapeutic ternal orifice of eaob is 15 centimetres from effect is directly dependent on the amount, the anticstbode. His experience shows that, and not on the quality, of the X-ray used. in the treatment of ringworm at any rate. It is very important to place the pastile at
exactly 73 centimeters from the anticathode. Traitement de la Syphilis Par la Voie Rec(Whether the above 'ecbnique has not been tale.-Audry (Annales de Derm, et de Sypbaocurately carried oui, or for some other ligrapbie, Maroh, 1906) reports a series of reason, eminent rayists in this country have thirty cases treated in this unusual fashfailed to get such flattering results with Sa- ion. Mercury is given in suppositories of boraud's pastilles. Both Stelwagon and the grey oil, which are prepared as follows: Pusey have given adverse reports on their As many times four grammes of cacao butter use during the last year.-Ed.) The author. as one wishes suppositories are taken, and says that, with his experienced nurses, he softened by heat. When the cacao butter has never had a case of dermatitis in 7,000 loses its transparence by cooling, the gray exposures. He thinks that the factor of oil is incorporated into it, and it is allowed to idiosyncrasy in the occurrence of an X-ray cool in moulds. The gray oil being 40%, in dermatitis is accordingly neglible. In com- order to bave the suppositories contain gr. paring the color the pastile has assumed writh .01 of mercury, .025 gr. of the gray oil should the standard tint, the comparison should be be added to each suppository; for an .02 made by daylight. If one patch only exists gr, of mercury suppository, gr. .05 of the gray this can be thoroughly treated at a single oil must be added to each, eto. The gray oil exposure, but if it is necessary to depilate the ide prepared with meroury, oil of vaselin, and entire scalp, a series of ten or twelve expos. lazzolin. For adults the dose is gr. .03, for ures is necessary, but there need be no time children gr. .015 to .02 is sufficient. One supinterval between them. All is accomplished pository is used each day, the dose being genat one sitting, each area treated being cov. erally given in the afternoon. It was tried ered with a lead disc, retained in place by giving two day, but the patients the an elastic band, before the next area is ex. nlained of burning and pain at the anus. At posed. About fifteen days after the treat. The end of an onth, an intermission of four ment the hair falls out with the slightest or five days is made, and then the course betraction, their root ends being atrophic and gun over again. \he results sbarpened like tbe point of a needle. On the follows: (a) tolerance is at once established. eighteenth day, the head is washed with soap, In a few cases diarrhea occurre rubbing and pulling out with the fingers all thor does not consider this a the weak hair. The roots of trichophytic positories, since, always after
alcali's after a mild purghairs are the last to fall, and they must not ing, the treatment could b
nt child be recommenced, be allowed to remain, for they can infect new and there was no more nirouble. (b) There hairs. Daily washings with soap remove was no pain, or tenesmus,a of stra them. By the thirty-fifth day the head, thus There was never a trace of e erythema, treated should be entirely bald. From the (d) Except for a slight gingilvitis in first day of operation, the entire head is that had been salivated preilviously anointed daily with B tr. iodin (fresh) 1 ment before entering the hos part, alcohol (80%) 9 parts. The head thus ing abnormal presented its treated remains bald about two months. mouth. The mouth was always kept Then the new hairs begin to appear. The tic as possible, however. (e) Tibe new growth ought to be complete in four ous administration of iodide of poti months. When the color B has been ex- sioned no inconvenience, nor unitioward sym ceeded the regrowth may be retarded for a toms. (f) Long treatments are apparently month or six weeks longer, but baldness that hamless, as a child of three and C.
ild of three and on half years remains after six months is permanent. Over- was given more than 100 supposito ! exposure may occasion a cicatricial atrophy daily, in less than four months witithout which will cause a definite absence of re- least inconvenience either local cul general. growth, or, in place of the old hair which is (g) As to efficacy, he considers it e smooth, a growth which is crinkled and any form of treatment administered woolly may occur, or the new hair may be like mouth, with the exception of bica
ebloride of the old, but much thinner. Insufficient ap- mercury in large doses. In ge
donneral, the plication results in atrophic hairs, sharpened symptoms are modified by the f
Seourth day at the ends, and in the exclamation-point forms just as by the usual methods. The of alopecia areata. In these cases depilation
anick" and certain with respect may be pushed far enough for a cure to re- to lesions of the ano-genital regioni: 9
on, and the sult. In other cases, diseased hairs may 10 bucco-pharyngeal. Violent, generin
lized, papular syphilides were quickly influe
innced. main, and the whole process have to be
u Sr a violent,
two cases, during the treatment, gone over again. A second exposure should
papular outbreak occurred. Bot
pib these panot be made on the same place, within a tients were alcoholios.
dhe, put on in.
They wereeintbreak re. month.
jections of the gray oil, and the con
Dato remain, for the they must not