« ForrigeFortsett »
thoms do not treatment, . If the
taken. He is of opinion that if the symp. Prof. Arthur Robinson, the president of the toms do not yield after three or four months section of Anatomy gave some introductory of medical treatment, an exploratory opera. remarks on the teaching of anatomy in uni. tion should be done. •If the growth could versities and medical schools. He concluded not be removed, the opening of the skull as follows: “It should, therefore, be the ob. would do gocd, inasmuch as it would infalli. ject of anatomists to avoid entangling med. bly prevent blindness supervening on the ical students in a superfluity of detail. They optic neuritis; in itself no small thing, since should insist upon a thoroughly sound knowlthese cases might go on for years. As regards edge of the general relations and arrangeoptic neuritis bis experience warranted him ments of the more important organs and in saying that this first appeared always on parts of the body, a good knowledge of the the same side as the lesion. The chief risk general principles which underlie the rela. of the operation was froni shock; the patient tionships and arrangements and the advan. should be kept warm with bot water cans on tages derived from them. They should enthe operation table, whioh should be fitted deavor to make their students acquainted with a proper adjustable bead rest, and with the general laws of growth and developthroughout the operation, the brain should be ment and with abnormal conditions so far as kept irrigated with 1.5000 corrosive sublimate they are produced by deviations from general solution at a temperature of 115 deg. F. This prevented cooling of the nerve tissues and tended much to prevent shock and also stopped capillary oozing. The brain tissue should be handled as gently as possible. The skull should be opened by first making a tre. pbine hole, then by marking out the area of bone to be removed with a saw, and finally removing tbe bone with bone forceps, all trac. tion being directed carefully away from the nerve substance. There was never any need to remove parts of the brain in order to expose the growth; the brain could always be pulled aside witb spatulas. All vessels, arteries and veins, should be ligatured as long as possible. Bleeding to the bone could al. ways be arrested with wax, and troublesome venous oozing was at once arrested by the administration of oxygen. As regards anestbetic Sir Viotor uses chloroform; by means of the Vernon Harcourt regulator this could be administered in any desired amount. While opening the skull and dura 2 per cent of cbloroform in the air sufficed completely to
SIR VICTOR HORSLEY. anesthetize, but in the subsequent proced. ures often per cent was enough to keep the laws of growth and development, and, carry. patient sufficiently under the quantity being ing on the work done in the Biological De. again raised to 2 per cent during the closure partment, they should draw attention to of the wound. Asepsis and antisepsis should man's relations to other animals in all cases be carried out with the greatest care, as oper. where such relations are evident, and are in. ations on the central nervous system are structive of the methods by which man has particularly liable to be followed with septic been evolved and the means by which he reinfection.
tains bis place in the world. In addition, Dr. W. S. A. Griffith delivered the address however, they must see that their students acin Obstetrics on “The Teaching of Obstet. quire a sufficient knowledge of the detail of rics," and Sir James Barr the address in the various parts of the body and their relaMedicine on "The Circulatiun Viewed from tionships to enable them to deal successfully tbe Periphery.” Dr. Donald MacAlister was with any emergency of daily life.” the president of the Therapeutic section and An interesting disoussion on arterio-scleroin his address advocated reciprocity be- sis engaged the combinud attention of the tween Canada and England in medical sections of Medicine and Pathology, and practice. As he is president of the General Prof. Welob, Dr. Klotz, Prof. Aschof, and Medical Council in Great Britain he evi. Dr. Clifford Allbutt among others took part dently spoke with authority.
in the discussion.
The following is a synopsis of th econtri. bution of Mr. Oskar Klotz, Resident Path
A forum of original experience, to which scientific contributions are invited.Responsibility for views promulgated imited to author.
cussion on the Forms of Arterio-sclerosis, their Classification and Experimental Pro. duction: Experimental arterial lesions which VIOFORM—ITS USE IN OTOLOGY. can be produced in animals are two kinds: either a degenerative one, affecting mainly the media, or a regnerative one, in which the
B. P. REKO, M. D. intima proliferates, while little or no degen
CHICAGO. erative change is seen. It is found, too, that
Ear Department, Rush Medical College. the substances which are used to produce the
This but an attempt to record my experiformer belong to the class of high pressure
ence with vioform as to its clinical aspect in does not in itself lead to the medical lesions noted; there is a direct degenerative action
otology. Its value in general surgical work of the drug on the muscle fibres of the
has been extensively demonstrated by Tavel, media. Elastic fibres become affected later.
Krecke, Schmieden, Wehrle and others. It
has been recommended as a substitute for The latter once giving way leads to aneur. ismal dilatation. The degeneration is of a
iodoform and, indeed, the cbemical and bacfatty nature. The intimal regeneration is
teriological tests as well as the clinical invesconsequent to bacterial toxins, tbe prolifera.
tigations would undoubtedly confirm that tion being confined to the endothelial and
opinion. Therefore I can restrict myself to subendothelial cells. When only intimal le
a mere recapitulation of the acknowledged
facts. sions are present aneurisms are not formed.
Vioform is a derivative of chinoline, whose The character of these lesions can be com.
antiseptic, antizymotio and antipyretio propared to those in man to a certain extent. Here lesions entirely of a degenerative nature
perties become still more prouounced by the are met with in the Moenckeberg type of peri
introduction of one atom of iodine and
chlorine. It is a grayish-yellow powder of pheral arterio-sclerosis, and with the form of this disease as it is found in the aorta, both
great stability to light, heat and moisture. of wbich processes are confined to tbe media.
It is practically insoluble in water and, as it The experimental bacterial lesions of vessels
is much lighter than water, it forms a tbin simulate the endarteritis chronica deformans
film on the surface. Compared with iodoform,
it possesses the following advantages: which develop the pearly intimal plaques.
1. Its bactericidal power is greater than RICHARD T. HEWLETT.
that of iodoform, whose styptic, deodorizing (To be continued.)
and infection preventing action it retains.
2. It is non-irritant, being neutral and therefore non-caustic.
3. It is non-toxio. A GEORGIA INDEPENDENT SOCIETY. - The 4. It is stable and readily sterilized with. “Atlanta Constitution" is autbority for the out decomposition. statement that a new State Medical Associa. 5. It is practically odorless. tion is being formed through the efforts of a Its only disavantage is that it cannot be number of leading physicians of Georgia. used for subcutaneous injections, since abThe promotors insist that they are in po scess formation is liable to occur. sense making a fight on the Georgia Medi. My attention was first directed to this prepcal Association, but objecting to some of the aration at the Ear Clinic of Prof. Politzer in features of the American Medical Association Vienna, and afterwards in the Austrian army, they are forming a body in which they will be where vioform has been adopted for use. free to act for themselves.
My intentions were to keep record of the MAKING COCAINE FIENDS.—William Jay
effects of this remedy in cases of middle-ear Sobieffelin, the wholesale druggist, declared
suppuration, based on the rhodan kali (poat a hearing at Albany, that there were drug
tassium sulphocyanide) test of the saliva. stores in New York City which gave away
Prior observations at the clinic of Prof.
Politzer led me to ascribe great value to this cocaine for the purpose of developing the habit and creating customers. He says that
test in diseases of the middle-ear, since absence 20 per cent of the cocaine manufactured in
or only traces of rhodan kali (potassium sul. this country is converted to illicit uses. His
phocyanide)-KCNS-in the saliva suggests remarks suggest that the public is insuffi.
a disease of the middle-ear with lesion of ciently protected against unscruppulos drug Vide: Alexander & Reko: "Beitrag zur Verwertung der gists. - Texas Med. News.
Wiener Klinische Wochenschrift, 1902, No. 42.
Rhodanprobe des Speichels bei Ohrenerkrankungen.'
the tympanio plexus, while the reappearance MEDICAL MISCELLANY
Juglans is a good vermifuge and it is disease would indicate a favorable progress. plain
claimed that it bas destroyed tape.worms. Where bilateral suppuration permitted a more critical comparison of the different anti. MORTALITY FROM HOMICIDE AND V10septics en vogue, I improved the oppor. LENCE.—The number of homioides and deaths tunity to test the superiority of vioform by violence in the United States in 1905 over jodol, airol and dermatol. In all ob.
was 9,212, as against 8,482 in 1904. Sui. served cases vioform acted as an ideal anti- cides, 9,082, as against 9, 240 in 1904. Killed septio and siocative, hastening the reappear on steam railroads, in 1905, 3,142; injured, ance of the rbodan kali (potassium sulpho. 15.904. Killed on electric and elevated rail. cyanide) in the cases where a cure was per roads, 464; injured, 2,622. These statistics, formed. In acute suppuration I found it of collected by the Chicago Tribune, are unoffi. better advantage to follow the dry treatment cial, but perhaps they are none the less trust. and use boric acid for the first days after per.
worthy on that account. We murder and foration, as it readily dissolves in the secre- manslaughter nine times as many as the Gertion, and does not easily interfere with drain. mans; four times as many as the English. age. The after-treatment consisting of the use Sootch and Welsh. America seems to be a of vioform as dusting powder finished the little careless, to put it mildly. process of resorption speedily. Of special interest to me were cases of radical opera- THE KLEPTOMANIAC. — “A New York spetion, where I could observe, whether or not cialist got, on a certain morning, the card of vioform would shorten the time of recovery, one of the richest of our Western millionaires, which in uncomplicated cases amounts to He went down instantly and found a wellabout four weeks, as indicated by the typi. dressed man, who said: cal reappearance of the rhodan kali (potas- "'I am here, sir, on a delicate and painful sium sulphocyanide) at that time in all our matter. My wife is a victim of kleptomania, observed cases (fifteen) at the Ear Clinic of and, knowing your skill in mental diseases, I Prof. Politzer. Unfortunately my observations have brought her on for treatment under in this direction were limited to a single you.' case of radical operation during the time of “'Bring the lady to see me tomorrow mornthis investigation, but in this case the de- ing,' said the physician. cided favorable action of rioform on the “ 'It will be best not to bring her to your course of the healing process was very much office,' faltered the millionaire. 'The sight pronounced. The granulations were clean of other patients might excito her. I sug. and small, and the restoration was performed
gestin two weeks, as shown by the rhodan kali “ 'I'll receive her in my drawing-room. (potassium sulphocyanide) test. Similar re. Will that be better?' asked the physician. sults were obtained by Lindt and Sieben. “ 'Oh, much better,' said the other, in a mann, who use vioform exclusively. Lindt relieved tone. observed that vioform does not tend to favor “And the next day the Western millionaire abnormally marked granulations, and does led into the physician's drawing-room a not harm epithelial growth in the exposed young woman of singular beauty. She was middle-ear cavities after radical operations. magnificently dressed, but her eyes were furi.
Siebenmann found that wounds after radi. tive and restless, and when she thought no cal operations were repaired quicker than by one was looking at her, she secreted under her airol or dermatol. "Vioform is recommend. coat three or four valuable ornaments. The able for after-treatment in radical operation, physician and the Westerner smiled slightly as it excites less granulations than under the at one another. . . application of iodoform, and the new forma “The physician, after his examination of tion of epithelium progresses quioker there the patient, told the husband to return the fore."
next day alone.. My observations are not limited to the use “‘And when I come,' the husband ans. of vioform in otological cases. I use vioform wered, “I'll bring back these things that she very extensively in my private practice after has taken.' operations in the nose, where tampons of vio .“ Do,' said the said the physician, form gauze may be left for days without be “'I will,' said the Westerner. coming malodorous owing to decomposition. “But he didn't. He won't. He and his From my observations I am led to the con. wife are thieves, and they have worked their viction that vioform deserves first rank among kleptomania dodge in nearly every city in the antiseptics in use in rhino-laryngology. America."
THE MEDICAL FORTNIGHTLY
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Contributions and books for review should be addressed to Dissolve the sulpbate of iron and the sal. the Managing Editor, 319 and 320 Century Building. St. Louis, Mo.
icylate of soda separately and then mix. One tablespoonful every three hours until the
stools are blackened. SEASONABLE THERAPEUTICS
In summer diarrhea, the following is of
value: APPLICATION FOR PAINFUL AND BLEEDING
Decoct. hematoxyli (5%). HEMORRHOIDS. —
Acidi sulphurici arom....... aa 3 ii Stovaine................... (grs. ....... 7 grs.
Spiritus chloroformi.......... 3 vi Adrenalin, 1 to 1,000........ I drm.
Tinot. opii campb ............ Water......... ............. 6 drms.
Tinct. card. comp..........aa 3 i Moisten a tampon of cotton, apply to the
One teaspoonful in water after each move. painful part, and cover with a piece of rub. ment of the bowels. ber dam.
In cases of uloerative colitis, Yeo recom. Or the following suppository may be used:
mends the following combination as a rectal Stovaine.................... Igr. Orthoform......
19 grs. Adrenalin solution, 1 to 1,000. 4 drops
Argenti nitratis............ 3 88-i Extract belladonna.......... gr.
Aquae dest....... ....... Oi-ii
Elevate the hips and allow the water to Coca butter.................. 45 grs. Make into a suppository.—La Presse Medi.
; flow in slowly from a siphon bag.–Merck's cale Belge.
Archiv. DIARRHEA IN INFANCY. — The following combinations are recommended by Yeo in A CONSCIENTIOUS PATIENT. — “Medicine the treatment of diarrheas occurring in in won't help you any,” the doctor told his pafanoy:
tient. “What you need is a complete change Sodii bicarb........ ...... gr. iv of living. Get away to some quiet country Pulv. rhei.... ....... gr. iss place for a month. Go to bed early, eat more
Pulv. cinnamomi........... gr. i roast beef, drink plenty of good, rich milk M. Ft. chart. No. i.
and smoke just one cigar a day.” One such powder to be taken twice a day. A month later the patient walked into the
When ourds of milk are present in the doctor's office. He looked like a new man, stools the following combination is recom. and the doctor told him so mended:
“Yes, doctor, your advice certainly did Pulv. ipecao. et opii........ gr. xv the business. I went to bed early and did Pulv. guaranae............ gr.
all the other things you told me. But, say, Pulv, sacchari albi......... gr. xlv doctor, that one cigar a day almost killed me M. Ft. chart. No. x.
at first. It's no joke starting in to smoke at One powder every two or three hours. my time of life.”—Everybody's Magazine.
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Prepared only by send a $1.00 bottle free to Physicians accompanying their request with 25c. to pay forwarding charges. A copy of the 18th edition of my book of 340 pages, on the
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