« ForrigeFortsett »
urethral secretions, and illustrative case bis.
tories are appended. T. A. HOPKINS, M. D.
Antigonococcus Serum.-J. C. Torrey, New
York City (Jour. A. M. A.,Jan. 27,) gives a Chronic Discharge in Organic and Functional
preliminary report of good results in the Disorders of the Deep Urethra ; Diagnosis and
treatment of gonorrheal rheumatism with an Therapy.-J. M. Thompson (Med. Rec., Deo.
antigonocooous serum made by the inocula30, 1905) devotes the first part of his long
tion of large rabbits with oultures from an paper to a general consideration of the fac.
acute, untreated case of gonorrhea. The tors involved in these disorders of the poster.
best serums were obtained by inooulations ior urethra, and points out sopie of the rea.
at intervals of five or six days with cultures sons that make their treatment difficult. He
from six to fifteen days old. The rabbits were divides the processes of this region that are
always inoculated intraperitoneally. While characterized by persistent or periodic dis.
he tbinks that the most important factor in charge from the meatus, or appearing in the
the good results obtained with the serum is urine, into the organio and the functional
its bactericidal action, he is inclined to be. affections. In the former group are classed
lieve that there is also an antitoxio aotion. obronio posterior uretbritis, chronic prosta.
Experiments with guinea-pigs seemed to in. tis, ohronio seminal vesiculitis, and chronio
dicate this, and clinical evidence also pointed cystitis-processes that follow & history of
the same way. In some of the cases of simple or specifio inflammation of the urethra
gonorrheal rbeumatism treated with the due to the gonococcus, pus organisms, trau
serum there was a deorease of pain in the matic, and toxic sources. No matter how
joints within twenty-four hours after the first closely the discharge may resemble that in
administration, and this seems most reasonthe functional disorders, it is to be remem.
ably explained by a neutralization of some bered that pus is the distinguishing element. of the gonotoxin. 'Mainly, however, the serum The funotional disorders include uretbror.
acts, in his opinion, by destroying the bac. rbea, prostatorrhea, spermatorrhea, and phos
teria. It seems possible, he says, that it supphaturia, all of which result from what may
plies enough immune bodies to dispose of the be termed abnormal physiological activity,
comparatively few gunovocci in the chronic due to sexual continence, excess, indiscretion,
forms of the disease, though not enough to or persistent ungratified sexual desire. The
bring about the destruotion of the great functional types are non-inflammatory, and
number of gonococoi that are present in the pus is not present in the discharge, whether
the urethra in acute gonorrhea. Experiit appears at the meatus or in the voided
mental evidence fully to substantiate this urine. Each of the four organic conditions
theory is yet lacking. The serum, however, is then discussed in connection with the
has been found to contain both precipitins corresponding funotional disorder that simu
and agglutinins for the gonocoocus. lates it, and in this way the differential diag. noria is elucidated. The treatment of each Observations on Nephroptosis and Nephrogroup is then described. In dealing with the pexy.–Arnold Sturmdorf (Med. Rec., Jan. functional disorders the author lays more 13, 1906) considers tbat vioos of skeletal ccn. strees on the personality of the physioian formation play an important part in the pro. and general hygienic rules than on purely duction of nephroptosis. Omitting theoreti. modioinal agents. Massage and the cold cal consideration, he says, normal kidney steel sound are valuable mousures in the later support may be practically defined as the stages of the cure. The following plan of resultant of two essential factors, a retaintreatment for the organic lesions is first out. ing pressure of adequate intensity and a relined and then amplified in detail: (1) Grad. ceptacle of accurate conformation. The ual dilatation with steel sounds; (2) copious retaining pressure is exerted by the normal irrigation with dilute solutions (pure astring. tension of the general peritoneal sao applied ents, pure antiseptio, or antiseptio and to the anterior kidney surface in the man. slightly astringent); (3) topical applications ner of an inflated cushion, propping the with concentrated solutions (same as in 2);(4) organ against its receptacle. This pressure internal urinary antisepsis; (5) meatotomy is reflexly regulated by the activity of the when the meatus is constricted, and to permit abdominal muscles. The receptacles ap. proper dilatation; (6) massage of prostate and plied to the posterior kidney surface are seminal vesioles; (7) administration of oleore. formed by the deolivity existing on each side sins for acute exacerbations and relapses (8) of the anterior aspect of the lower dorsal hydrotherapy, electricity, medicinal tonics, re. and upper lumbar spine. They are funnel. constructives, etc., p. r. n. Drawings of the shaped recesses, narrow below in the male, microscopical structures to be found in the more cylindrical and shallow in women, a peouliarity more marked on the right side oontinence in children, if not accounted for and appearing with the broadening of their by some evident external malformation, is frepelvis at the advent of puberty. Deviations quently due to a congenital stricture and not in the conformation of these receptacles from to 'essential incontinence," or to “congenital the lines of the posterior kidney surface con irritability,” as it is usually alleged. In stitute the main predisposing factor in the adults every stricture is not necessarily the production of nephroptosis. The causes of result of trauma or gonorrhea, and gonorrheal such deviations are embraced in the whole strictures develop much more quickly on the category of congenital and acquired skeletal basis of an already existing congenital stenabnormalities. The treatment should, there. osis. The treatment is gradual dilatation, fore, in many cases have been begun in the only rarely is it necessary to resort to in. developmental period of the osseous frame- ternal or external urethrotomy. • work. The restoration of normal internal as
Antigonococcus Serum in Gonorrheal Rheuwell as normal external conformations should
matism.-- Prefacing his remarks with a gen. be our orthopedic aim; the organic and functional spinal deviations of early life, the in.
eral description of gonorrheal rheumatism, fantile paralyses, the muscular and ligament.
its peculiaritis, eto., J. Rogers, New York ous insufficiencies should receive considera
dera. City (Jour. A. M A., Jan. 27), reports a tion from the point of normal internal as
number of cases successfully treated by the well as external topography. Much is be. Antigonococous serum made by Dr. John ing accomplished in the correction of ex
Torrey and elsewhere described by him. The ternal skeletal abnormalities; much may be
ordinary treatment is notoriously unsatisfac. accomplished by attention to the visceral
tory, and while the serumtherapy has its limdisplacements induced by such abnormali.
itations like all others, it appears to be a real ties. Kidney dislocations once developed,
benefit in these cases. It should be remem. nothing short of surgical fixation will re-es.
bered, however, that it has little or no effect tablish its normal stability. Palliative treat
on existing urethritis, and so long as any ment undoubtedly yields results, but of tem
traces of this persist there is danger of a porary duration.
recrudescence of artbritic symptoms. He
calls attention to some of the difficulties of Congenital Stenosis of the Urethra.-Faxton
diagnosis, especially in women, in whom it is E. Gardner (Med. Rec., Deo. 23, 1905) says
often undetected, and states that the use of that this malformation is much commoner
the serum may be of value, as it will relieve than one would be led to suppose from the
the pain in a few days if the patient is gon. very scanty literature of the subject. Foisy,
orrheal. · The possibility of a complication in a recent thesis collected 104 cases, and now
by another infection must of course be conthe reported instances of the condition have
sidered, but most joint and serous membrane reached a total of 110. The author outlines
affections occurring in the course of a gonor. the development of the urethral canal, and
rhea can usually be attributed to the gono. says that the chief points to be borne in mind
coccus. In any suspicious case be advises are the following: (1) The urethra is formed
the injection of from 20 to 60 minims every by three embryological portions : (a) the pos.
day or every other day, beginning as soon as terior urethra developed from tbe urogenital
possible after the arthritic symptoms ap. sinus, and separated from the next portion
pear and continue as long as the pain and by the cloacal membrane; (b) the spongy
disability last. Aside from an occasional portion developed from the urethral groove
erythema, he has observed absolutely no ill and closed during the first stages of its devel.
effects. The earlier the disease is recognized opment by the cloacal membrane, at its pos.
and the treatment commenced the better of terior extremity, and the epithelial wall of
course are the results. the glands, at its anterior; (c) the balanic A Non-Operative Method of Treating Prosportion developed independently. (2) The tatitis.-W. Benbam Snow (Med. Rec., Jan. spongy and the balanic portions; i. e., the 10,1906) says that he has treated about forty whole anterior urethra are not derived as the cases of prostatitis in patients of different posterior, from a bollow embryonio organ, but ages by means of the statio wave current on the contrary develop in a solid, continu. and vacuum tubes. In no case has there ous mass of epithelial cells. It is therefore been failure to produce some degree of im. not surprising that congenital strictures are provement, and in 75 per cent of the cases more common in the anterior than in the so treated there has been complete relief posterior urethra. The symptoms are then from the symptoms and a cessation of the described at length, and it is stated that disposition to relapse. The technique of the nooturnalincontinence and diurnal frequency method is described and several especial of mioturition are obaracteristic features. In- electrodes devised by the author are figured.
He attributes the effect of the treatment FAVORITE PRESCRIPTIONS mainly to the mechanical contraction produced and arrives at the following conclu. FOR EPISTAXIS. sions: (1) Where simple congestion is pres. B Adrenalini chloride .........
... gr. ss ent in the early stages of the affection the re Acid boraci................ gr. xlv lief is prompt; (2) when the gland has been Aquae cinnamoni........ enlarged for a number of years with resulting Aquae camphorae. ........Aa 3x infiltration and development of vesical irrita Aguae destillatae, q. s. ad.... 3iij tion and obstruction of the urethral passage, M. Sig.: Instill into nostrils with a the lesion is capable of being abated and the dropper.-Med. News. congestion relieved with the absorption of in.
FOR FLATULENCE.— Wein, Therap. Zeit., filtrated exudates, the hyperplastio tissue only remaining; (3) in the aged, in whom the
Le Progrés Medical for September 2, 1905, gland has become greatly enlarged, and is
gives the following formula :
B dense and hard from the growth of hyper
Sodium bicarbonate........ plastic fibroid tissue, the inflammatory pro
Magnesium carbonate......aa 4 grams.
Rhei pulv....... cess will be abated, affording a degree of re
Oil of fennel......... lief to the obstruction commensurate with
Oil of caraway............ the site and extent of the inflammatory pro. coss. The dilatation of the bladder which
Oil of peppern,int..........aa 2 grams. bas intervened may be greatly relieved and
M. Make twenty pills, two to be taken cured in most cases by the persistent appli.
i after each meal. cation of the electrioal current over the pubis PSORIASIS. - Shoenaker recommends the and by an electrode carried high into the following application locally in the treat. rectum and pressed forward against the blad. ment of psoriasis :der, together with judicious washing of the B Acidi salicylici. bladder and the use of strychnine. The cur. Sulphuris sublim ............aa 3) rent applied in this manner induces tempor. Olei eucalypti.......
5s arily contraction of the muscular coats, and
Ung. aquae rosae..... .... 3j finally restores sufficient tone to enable the M. ft. unguentum. organ completely to empty itself.
Sig.: Rub a small amount in well on the patches.
Internally, he recommends : ERGOT is said to be our best remedy in Bb Creosoti .....
........... mij epidemic cerebro-spinal meningitis.
Pepsina (scale)...... ........ gr. ij
M. ft. capsulae no.j. TOOTHACHE.-H. B.. Ray gives the fol.
Sig.: One capsule three times a day, after lowing advice on the treatment of toothache
meals. by the practitioner: Toothache is essentially an inflammatory condition, and
He also recommends chrysarobin in the in 99 per cent of the cases there is a cavity in
treatment of psoriasis, combined as follows: the tooth. In those cases where there is a
Bo Olei ca dini....... ......... 388 cavity, but no nerve exposure, the treatment
Chrysarobini................. gr. xx
Ung. zinci oxidi.............. 3j is simple-apply a sedative and exclude the secretions of the mouth from the cavity;
M. ft. unguentum. prompt relief will follow, and then advise
Sig. : Apply locally to the affected areas. the patient to visit a competent dentist. A
-Jour, A.M.A. very effective agent, and one always at hand, is the oil of cloves. It should be applied by
For diarrhea due to exhaustion after fep. saturating a pledget of cotton with the
ers, Dr. Waring recommends nux vomica remedy and introducing it into the cavity
savity with opium and iron.
withi with a toothpick or other pointed instrument; that being done, the secretions are kept out CHRONIC URTICARIA OR HIVES.-Ichthyol by filling the cavity with a little beeswax, a in from 1 to 2-grain doses to children and 5 bousebold remedy always at hand. The way to 6-grain doses to adults relieves and cures. can be applied by warming over a lamp on At the same time an ointment should be ap. the point cf a knife and forcing into the car. plied to the affected parts, or even all over ity. The wax filling serves not only the pur. the body. The strength of the ointment pose of keeping the secretions of the mouth should be about 2 drachms of ichthyol to an ont, bat prevents thermal changes from affeot. ounce of petrolatum in children, and 1 ounce ing the nerve when hot and cold things are of ichthyol to 1 ounce of petrolatum for taken into the mouth. --Southern Clinio. adults. — Medical Summary.
tire prendriatics no one dieder sted at
SPIRIT OF THE MEDICAL nore the local trouble and investigate the PRESS.
general and special condition of the patient's
entire organism. The author discourages the DIET IN NEPHRITIS.-F. C. Shattuck, Bos. use of mydriatics or repeated ophthalmoton (Jour. A.M.A., Jan. 6), lays down the scopic examinations once the diagnosis is following as the leading principles pertaining made. The proper dietary is described at to the dietetic treatment of nephritis: 1. Such length. The food should be rich in phoscontrol as we may have today of nepbritis phates and should contain much refuse. lies in diet and mode of life rather than in The husk of the grains, especially of wheat, drugs. 2. Such drugs as are usful are so in fulfills both requirements. Drinking large their effect on the general organism and amounts of distilled water is also recom. the heart rather than on the kidneys di. mended. Turkish baths, especially with the rootly. 3. In all cases of nephritis the electric cabinet instead of the ordinary hot main aim is to spare the kidneys unnecessary room, are useful, and alcohol and narcotics work, remembering that the urinary system must be prohibited. Drugs are of little use; is but one, of the many, making up the body.
the iodides are usually disappointing, but 4. In acute nephritis, as well as in the acute
catopborsis and external applications may exacerbations of the chronio form, Doctors, be used with toore assurance. To arouse the Diet and Quiet should work together. Star.
dormant, debilitated nerve the violet' ray, vation for a few days, regulated by the intens. high frequency current, and mechanical vi. ity of the process and the strength of the bration are of service, but their use requires patient, is the keynote bere. 5. In the careful analysis of each case. - Medical Rec. ohronic forms the aim is to lengthen life. ord, January 6, 1906. Especially in the contracted form of kidney disease, many years of life and comort may EARACHE. --Albert Bardes emphasizes the depend on the physician's skill in adapting fact that the importance of this symptom is sound principles to the particular case and still not recognized as it should be by either in securing the co-operation of the patient in the laity or the profession, and he discusses persistently carrying out the directions the nature, etiology, and symptomatology of given. Dietary restriction should, in the middle ear infections. Of the treatment be main, be quantitative rather than qualitative. says that as soon as earache begins the paAloohol in moderation is not necessarily a tient should be kept quiet, put to bed and poison and may be an aid to digestion. 6. placed upon a fluid diet and in other ways The excess of proteid, not proteid itself, is treated as we would treat a patient with a barmful to the chronically sick kidney. 7. high fever. The bowels are to be kept open A varied diet is more likely, than a monot. and a single dose of morphia may be given onous one, to promote the making of good to insure rest and comfort. Dry heat or else blood and improving the general nutrition. an ice-bag can be applied to the ear. The and that of the myocardium in particular, former is more acceptable to most patients. 8. The amount of albumin is in itself no Every three hours the ear should be gently guide as to the extent of dietary restriction. irrigated with a hot solution of bichloride 1 Shattuck remarks the advisability of a rela to 5,000 after which a few drops of a 12% tively dry diet in dropsical cases, propor- solution of carboeglycerin can be instilled. tioned to the degree of dropsy, be thinks Under no consideration should a person be physicians have erred in forcing water, and be allowed to suffer pain longer than twenty. that the main service von Noorden has ren. four hours. If the pain continues and the dered is in advocating the limitation of drum-head is inflamed and distended pallia. liquids.
tive measures are worse than useless and any
attempt to abort the inflammation by means EYES AND EARS THAT MIGHT BE SAVED; other than surgical is dangerous and valu. AN APPEAL TO THE GENERAL PRACTITIONER. able time is lost in so doing. In bulging
-Samuel S. Wallian says that patients suf. drum-head should be treated in the same way fering from atrophy of the optic nerve or loss as a septio formation in any other place. It of the special senses, should be under the care should be freely inoised rather than simply of the general practitioner, because these sub. punctured or allowed to break.- Medical jects are, with few exceptions, the victims of Record, January 20, 1906. some form of dyscrasia. This may be from accident from constitutional or specific infec. THIGENOL is described as the sodium salt tion, or from one or more bad hygienic habits. of the sulphonic acid of a synthetic sulpho Nearly all of them are badly nourished, usu. oil, and has the same therapeutic action as ally in the sense of being injudiciously fed. iohthyol, but without its odor and staining The general practitioner oan temporarily ig- qualities. ·
limited to author,
CLINICAL THERAPEUTICS little thought and consideration to that inevi. A forum of original experience, to which scientific contri
table fate which awaits him, if he does not butions are invited. Responsibility for views promulgated let up on the strain which is his daily por.
tion for days of the week. REST AND TREATMENT.
These individuals are familiar patients to
all physicians and demand intelligent and It is important for every physician to ap. thoughtful consideration of their needs from preciate the therapeutio value of rest, and the physician. Rest is of course of para. to remember, as Sir Lauder Brunton ex. mount importance, but more is needed, and presses it, that "in the case of every organ when the routine is established, wherein rest, of the body we find that rest is one of the feeding, massage, eto., are given their just greatest boons when disease is present.” demands, then must be considered appro.
However, rest is not the only consideration priate medicinal measures, calculated to in. which is demanded, for as Brunton further sure help to the blood forming funotions of says, "Rest will not do everything you want, tbe body. It is here that the well deserved and one must use alone with it various indi. and valuable combination pepto-mangan cated remedies.” This implies that we must (Gude) is of inestimable help and service. study the indications for remedies which go First, because it is tolerated by the stomach along with the conditions in which rest is to and the ingredients being assimilated go to be a therapeutic agent. Rest is a remedy stimulate the bematopoietic organs, and thus near at hand, and yet it is not honored as it improve the quality of the blood. It is should be and too often the drug remedies are especially indicated in all cases where ane. ingloriously depended upon, whereas the mia is a feature, and if given with care and happy combination of both brings about a consideration for the end to be desired, it is consunu mation devotedly to be wished
of great value. Rest is apt to be the dream of the house. The results justify the assertion that this wife; the speculation of the overworked bus. combination of iron with manganese will pro. iness man; the hope of the tired school girl duce lasting results upon the blood, thus in. and willing boy. All are waiting for that creasing its power and efficienoy to restore tomorrow (which will never come) when they normal functions to all of the organs of the can rest and recuperate from the abnormal body, overcome the effects of abnormal fafatigue to wbiob they are subjeoted.
tigue, and increase the whole range of enerIn the meantime the daily grind goes on, gizing influences so essential to physical and the reserve of energy decreases and ere long mental welfare. Few pbysicians appreciate a receiver must be appointed to care for the what oan be done with the combination of bankruptcy in which they find themselves. pepto-mangan (Gude) with rest, in the class The good fat and blood has gone and not of cases, thus mentioned. To secure results, until regeneration succeeds the degeneration, a definite routine must be established and will their function of health be recuperated. faithfully carried out, the physician all of the The blood state must be investigated, as it is time remembering that it is keeping everlast. the remaining asset upon which must rest ingly at it that wins the race in the treat. the future of the patient. It must be built ment of such cases. then, "and not till then" will fortune smile on the unfortunate victim of abnormal fa. tigue Denurtition must cease, good blood and honest fat must become real factors in
In the palpitation accompanying dysmen. recuperaticn.
orrhea, cactus will give you speedy relief. To secure this desired end rest and other
A chloral solution kept constantly applied proper remedies must be sought. In the overworked, nervously exbausted mother and
to a boil is said to be of great advantage. housewife, with all of her attending woes, FOR URINE IN THE TOXEMIAS OF PREGworry, insomnia, loss of appetite, constipa- NANCY.-In eclampsia, says Williams (Sur. tion and naturally concomitant loss of gery, Gynecology and Obstetrics), the total weigbt, we find anemia, causing starvation to amount of nitrogen is greatly diminished, nerve centers and the whole range of possi. while the ammonia coefficient remains prac. bilities which can originate from this de. tically normal. In vomiting (acute yellow plorable state. The same applies to the stren. atrophy), on the contrary, in spite of the gous girl and adolescent young woman where scanty amount of urine, the amount of total the daily generation of nerve energy is used nitrogen remains approximately normal, while in her endeavors to keep in line with her fel. the ammonia coefficient is wonderfully ele. lows in school and social work. Then again, vated (from the normal 3 or 5 per cent to as in the business man wbo in his routine gives high as 46 per cent of the total nitrogen).