Gambar halaman

excite cough when touched, whilst the anterior and lateral walls of the larynx are not so irritable. The wound healed by primary union, but in spite of the daily-repeated and longcontinued passage of bougies through the mouth, there was gradual cicatricial stenosis of the larynx, and a month after the operation no air passed through the mouth.—The President complimented Dr. Semon upon the interest of his paper, on account of its novelty, and the candour and lucidity with which it was written. Dr. Andrew suggested that the asthmatical attack which occurred during the operation, characterized especially by marked inspiratory dyspnoea, was due to narrowing of the trachea just below the point where it was unduly. distended by the bag of the tampon.

Dr. Semon felt sure there was no narrowing of the trachea, for he was able to explore it thoroughly with a goose-quill, and although the dyspnea was both expiratory and inspiratory, it was chiefly the latter ; but he believed it produced by reflex action from pressure on the nerves supplying the mucous membrane, and thought this borne out by some experiments which had been made. Mr. M. Baker suggested that the elastic bag of the tampon may have been pressed down and caused obstruction. Narrowing sufficient to produce dyspnoea would not be proved by a quill. Mr. Holmes had had but small experience in thyrotomy, but he had seen no need to employ sutures, and criticised the procedure suggested by Dr. Semon, of not completing the division of the cartilage, as diminishing the area for manipulation, and preventing the complete exposure of the ventricular bands. Dr. Semon explained that one object he hod in view was to preserve the anterior commissure of the vocal cords, and thus prevent that total loss of voice which Bruns had shown to follow after complete thyrotomy.The Lancet.

Treatment of Neuralgia by hypodermic Injections of Ergot.-Marino recommends the injection of from 0.15 to 0.25 gr. dissolved in distilled water. This may be repeated once or twice, though, perhaps not more than six times, and acts well in certain forms of neuralgic pains, especially in the douloureux. It appears to act less favorably in sciatica.—(Imparciale, No. 8, 1878.)

Treatment of Diarrhoa by Oxide of Zinc.--DR. JACQUIER has followed in the service of Dr. Bonamy at Nantes, the good effects of the employment of oxide of zinc in diarrhea. The formula which he has employed is the following: Oxide of zinc, 54 grains ; bichromate of soda, 71 grains ; in four packets, one to be taken every six hours. In all the cases which he observed by Puygautier, the cure was even more rapid, since in only one case were three doses of the medicine required. The results are considered to have been more satisfactory, inasmuch as in several cases the malady had . endured from one to many months, and other methods of treatment had not produced any improvement. Thus he concludes that, although by no means to be held as exclusive treatment, the employment of oxide of zinc deserves to be more generally known as useful in diarrhea.- British Med. Journal, Sept. 28 1878.

A huge Vesical Calculus.- DR. Brown, of Barnsbury, brought to the first meeting of the Islington Medical Society, on the 22nd, ultimo, a human bladder containing three stones, weighing in all one pound and a quarter, less twenty grains; the next half a pound, less forty grains. the third forty grains. The bladder is thickened and its mucous coat is ulcerated. There had been indications of stone for twenty-five years, and the patient was sounded at the time by two provincial surgeons. Shortly before his death he was again souuded by a London surgeon, who wished to operate; but the patient would not consent, and soon died. The sufferings of the patient were most severe, amounting often to torture, for which he was in the habit of taking a mixture of gin and beer. His death was preceded by a dry tongue, pain in the region of the right kidney. twitchings, tympanites, and drowsiness, which passed into coma, The urine during this period contained large quantities of blood and pus. The stones are smooth and of phosphatic composition. The surgeon who wished to operate is probably to be congratu lated on the resistance of the patient. The specimen will sho be given to the Royal College of Surgeons.— The Lancet.

Treatment of Diphtheria.-M. Kien, in the late epidemic of at Strasburg, has found that Schaller's method of treating diphtheria wish perchloride of iron--twenty drops. in twenty drops of water, in a teaspoonful or two of coffee every two hours—was exceedingly effective. In some cases, in which the medicine did not act sufficiently rapidly, M. Kien has given in addition syrup of eucalyptus, according to the plan of M. Goldschmidt. If the patients refused to take the perchloride of iron, a lotion was employed, such as was proposed by M. Mandl, of Paris, for application in chronic granular pharyngitis. The lotion was applied by means of a brush, as a wash for the sore places, two or three times a day. It was composed of carbolic acid, 0·10; pure iodine, potassium iodide, oa : 0.20; glycerine, 10.00. Independently of this, he gives salicylate of soda, 1-100, if symdtoms of fever present themselves ; the drug acts in in the same way as sulphate of quinine, whilst it is more easy to administer in a liquid form.- Gazette Medicale de Strasbourg, Nov. 1876.--The Practitioner.

Pilocarpin in Children's Diseases.Professor Demme of Berne has recently given an extended trial to pilocarpin in various dropsical affections of children. The cases treated were thirty-three in number, and the remedy was administered subcutaneously. Eighteen were cases of desquamative nephritis with dropsy after scarlet fever ; in three the same affections after diphtheria. In the remaining twelve cases the dropsy was due to the valvular affections of the heart, rheumatism, acute, long affections, &c. The age of the patients ranged from nine months to twelve years ; the dose varied from five milligrammes to two centigrammes. In some of the cases from two to four injections of a centigramme each were made in the twenty-four hours. Only in two cases were there any unpleasant symptoms, such as vomiting, hiccough, paleness of face, prestration, convulsions. In these cases the peculiar effects of the remedy were not observed. Professor Demme regards pilocarpin as an excellent diaphoretic and sialagogue. The former effect is more marked in older children, the latter in younger patients. Three to seven minutes usually suffice for the effect paren

of the drug to be produced ; this goes on increasing for fifteen minutes, and remains at its height for a half an hour or more, and then gjadually subsides. There is slight diminution of temperature. The pulse is increased in volume and in frequency by from twenty to sixty beats. As a result of the full effect of the pilocarpin there is a loss of weight varying from 120 to 675 grammes. Diuresis is only occasionally observed. There was watery diarrhea in two cases. Professor Demme thus summarizes his experience of the remedy: 1. Pilocarpin is an efficacious diaphoretic and sialogogue in the treatment of certain diseases of children. 2. In appropriate doses it is well borne by the youngest patients. 3. Unpleasant symptoms are of very rare occurrence, and can probably be altogether prevented by administering small doses of brandy before the injection. 4. The cases for which pilocarpin is especially suitable are the chymatous inflammations of the kidney with dropsy following scarlatina and diphtheria ; in the majority of these cases the flow of urine is decidedly increased, while the quantity of blood and albumen in the urine is diminished rather than augmented. 5. It is uncertain whether pilocarpin has any direct influence upon the action of the heart.-(Medical Examiner, July 18, 1878.)—The Practitioner.

Large Doses of Belladonna in Intes. tinal Obstruction.-Dr. Norman Kerr puts on record five cases of intestinal obstruction which he has successfully treated by the administration of belladonna in two grain doses every hour. The total amount of belladonna given ranged from five grains the lowest, through nine and fourteen grains, the highest. The accessory treatment consisted in fomentations, warm enemata, gruel and beef-tea per rectum ; ice, iced-milk and soda water by the mouth, Attacks of obstruction occurring afterwards were also treated successfully by the administration of belladonna. In no case was alcohol prescribed, but in one it was taken as two ounces of port wine before the belladonna treatment was begun. In the after treatment pulvis glycyrrhize composita has been found the most effectual remedy, as a preventative of obstruction.-British Medical Record.

Hypodermic Injection of Dialyzed Iron in Chlorosis.- Professor Da Costa reports vast improvement in the condition of a young woman, aged twenty-one, suffering from chlorosis after the injection of dialyzed iron hypodermically for a fortnight. Hitherto iron has not been used in subcutaneous injections, as it is liable to cause irritation and abscesses, even with the tartrate, which is one of the mildest forms. The solution of dialysed iron was found to be from these drawbacks, even used undiluted. The punctures caused by the syringe show no sign of inflammatory action. In no case was there that costiveness or disordered digestion which are but too often the after-effects of the use of iron. Daily injections of fifteen minims of pure dialysed iron were at first given, and this was gradually increased to twenty, twenty-five, and thirty minims per day. Under this treatment the colour gradually came back to the patient's lips, gums and tongue; her appetite was good her bowels regular, and her headache gone. She was considered practically cured.—(Philadelphia Medical Times.) The Practitioner.

of the Nature of Mumps. — M. Fehr, after observing several cases of mumps with the greatest exactness, decides that it is right to consider the disease as infectious, and that, as was already noticed by previous observers, it stands in a definite relation to acute exanthema, particularly to scarlet fever. The occasional swelling occurs in the neighbourhood of the glands themselves, whilst the surrounding tissues only become infiltrated at a later period. It is, to say the least of it, inaccurate to describe the disease as periparititis, as is usually done ; that it is not parotitis is shown by the fact that in very many cases of mumps it is the sub-maxillary which is either affected alone or is swollen at first. The infection is not due to propagation of inflamation of the mouth caused by secretions from the glands. The observation that in most epidemics of mumps there is a period of incubation lasting several days with the well-known febrile symptoms before the appearance of the local symptoms, as well as the spread of disease not only to sur

« SebelumnyaLanjutkan »