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ages. Not only has this progress been made in a very short period in relation to the existence of human life in the world but in a phenomenally short time in relation to the development of scientific knowledge along the lines that alone could render the fulfillment of the ancient dream of specifics possible without the assumption of pure luck or supernatural agencies.
Rare and New Lung Diseases. The Maryland Med. Jour., Jan. 1918, editorially calls attention to the following: Fibrous Bronchiolitis, first recognized 1901, showing greyish white nodules resembling military tubercles on section, the same casting shadows by X-rays, this disease following irritating gases, measles and pertussia. Principal symptoms dyspnoea and cyanosis. Pulmonary Blastomycosis not recognized much before 1914, resembling acute tuberculosis in onset and signs, but microscopically negative as to tubercle bacilli and often positive as to blastomyces. KI and tonies may help. Coccidioid Granuloma, known in California for about 21 years, usually begins like pulmonary tuberculosis, later developing skin lesions. All pulmonary cases thus far observed have been fatal. Pulmonary Aspergillosis, known for about 20 years, begins like bronchitis, with cough, sputum soon becomes purulent and blood-streaked, indigestion, night sweats, evening fever, emaciation, bronchial dilatation. Haemoptysis may be the initial symptom. It may be relieved spontaneously, leaving induration. KI and as advised. Sporotrichosis may simulate tuberculosis, as to cough, sputum, apical dullness and rales. Differentiation by identification of fungus. Organism thrives on some vegetables and has apparently been conveyed by handling coffee. Chiefly reported from Mississippi Valley. Streptotrichosis strongly resembles tuberculosis. Organisms frequent on food stuffs and may lodge in tonsillar crypts. It may invade a single apex and gradually spread to other parts of the lungs. Diastomiasis occurs in Asiatics, who may live 30 years with this disease or become spontaneously cured. Thus far, it has not been reported in native Americans or other foreigners. Actinomyeosis, long known and well described but liable to be confused with tuberculosis. Never diagnose a pulmonary infection without examination of sputum-and, we may add, the examination should be repeated sufficiently often.
Sarcoma of the Prostate is reported by B. de Saussine in the Arch. de Med. des Enfants, in a boy 412 years old. The irritation at first caused frequent voiding of urine but dysuria followed and complete retention requiring the use of the catheter developed in two weeks from the onset of symptoms. Death occurred from ascending infection. Necropsy showed a tumor as large as a mandarin orange, surrounding the prostatic urethra, purulent systitis and some pyelonephritis.
Radiographic Examination of Recruits. “From a study of 977 cases we believe that the following conclusions are justified:
“1. That it is practical to make X-Ray examinations of the chests of soldiers at the rate of two cases per minute.
“2. That while six men were used in this series, the number could easily be reduced to four, and only one of them need be a Roentgenologist.
"3. That one man can easily develop one hundred plates every three hours.
“4. That an individual can interpret plates at the rate of two per minute, leaving the rejected or doubtful cases for further study.
“5. That in the 977 cases examined we found 3.6% of the cases with definite tuberculosis, sufficient to disqualify them for military service, and an additional 3.2% with tuberculosis which will require further interpretation and observation to determine whether their tuberculosis should disqualify them or not.'
(Signed) Lewis Gregory Cole,
Major M. R. C. U. S. A.
Banti's Disease. Chas. Norris et al., Am. Jour. Med. Sci., Dec. 1917, consider that this is neither clinically nor atomically an entity, the argument being obvious to any one who is inclined to doubt the propriety either of starting with a peculiar and rare case to find other cases to match, or with a definition depending on the coincidence of unusual conditions, and of giving his own or a technical name to the symptom complex. It seems, however, that they ascribe rather too much importance to syphilis as an explanation of the symptom complex of Banti's disease.
Perthe's Disease. C. B. Francisco of Kansas City, Med. Herald, Jan. 1918, reviews the literature brieflly. The disease is a benign deforming osteochondritis, due to delayed ossification of the epiphysis and juxta-ephiphyseal cartilage of the neck and an isolated area of the acetabulum, characterized by slight limp and pain. 80% of cases occur in boys between 5 and 10. Diagnosis is established by Roentgenology. Extension and massage, without fixation are the means advised.
Gastro-Enterostomy. C. W. Lippman of San Francisco, Calif. State Jour, of Med., Jan. 1918, analyses 100 cases : 17 required re-operation, 3 for return of ulcers, one gastrojejunal and two in the stomach itself, 6 for adhesions found, 5 for symptoms supposed to signify adhesions but in which none were found, 3 for too large or relaxed stoma; 12 more were not relieved though further operation was not indicated, making 29 bad results. 8 cases resulted fatally, 12 could not be followed up and 51 gave good results. The last included 12 of stenosis of the pylorus for which gastro-enterostomy is a logical operation granting that the lesion itself cannot be directly attacked. So far as peptic ulcer is concerned, there were 39 successful and 37 unsuccessful cases. Of the 8 fatal cases, 4 were moribund at the time of operation, 1 each died of haemorrhage and of peritonitis, 2 of shock and 4 of pneumonia.
Tuberculous Meningitis Treated by Sterilized Air. Felix Ramond and Francois have treated 9 patients by withdrawing about 40 c.c. of fluid by lumbar puncture and injecting air sterilized by passage through a red hot platinum canula, sufficiently long to allow cooling to room temperature before reaching the cerebro-spinal space. They warn against the consequent change in volume if the air is injected at temperatures much different from that of the body. They admit that all the cases died but temporary improvement was noted in
The analogy to the treatment of tuberculous peritonitis is obvious.
Contusion of Penis by Water. Peyre, Jour. de Med. de Bordeaux, Dec. 5, 1917, reports a workman subjected to a pressure of 150,000 kilos. There was rupture laterally, an enormous haematoma and haematuria developed. The outcome is not stated.
Blood Pressure Sign in Pneumothorax and Pleural Effusion. Williamson, London Lancet, says that while ordinarily the blood pressure in the arms and legs is nearly the same, distention of the pleura causes a diminution of 10-20 m.m. pressure in the leg as compared with the arm of the same side. At first thought, this seems natural but even the crudest conception of vascular anatomy leads us to inquire as to the explanation and, especially whether, if direct pressure on the aorta acts as a mechanic cause, why the pressure is not equally reduced in both legs. If this sign is corroborated, the explanation must be sought in a rather recondite innervational phenomena, through the vaso-motor nerves.
Intra-Venous Injections in the 18th Century, and Earlier. Le Progres Medical, Dec. 22, 1917, reproduces an illustration from Laurence Heister's Surgery, published 1750, showing, somewhat diagramatically, the veins of the elbow and anterior surface of the arm distended by a tourniquet, the left hand of the surgeon holding a trochar introduced into a vein, while the right hand is squeezing a bladder connected with thé trochar. The method is, however, much older, Heister himself alluding to it as somewhat dangerous and fallen into desuetude, after having enjoyed a considerable vogue about 1660-1680, and being ascribed to Major or Wrenn. It seems to have been employed chiefly in apoplexy and dyspnoea, when deglutition was difficult or impossible, also to avoid the action of the digestive juices on medicaments. Leprosy, gout, epilepsy, consumption, scurvy, venereal disease (the various ones being strangely confused by most authors in the 17th and early 18th centuries) and malignant fevers are also mentioned. Purmann practiced the method successfully on himself but the general experience was that sudden death or stupidity, delirium or melancholy might develop and the French Senate officially condemned the use of intravenous medication. (Note: Aside from the more obvious factors connected with ignorance of asepsis, embolism, etc., it should be remembered that the success of this and many other procedures in medicine depends to a large degree upon the availability of rubber whose introduction lies within the memory of many persons still living. Ed.)
Antiseptic Action of Acriflavine, Proflavine and Brilliant Green. Gulbransen and Thornton, Brit. Med. Jour., states that the antiseptic action is slowly progressive, without interfering with phagocytosis or the welfare of the body cells generally. The flavine compounds may be safely used in the peritoneum and their action is enhanced by the presence of serum while brilliant green, like most other antiseptics has its action reduced by the presence of serum. The practical choice is obvious.
Contents and Index of the Philippine Journal of Science, Volume I (1916) to Volume X (1915). Manila. This beautiful index, of 442 pages, is in keeping with the Journal to which it forms a complete guide. A glance at its pages gives
a feeling of pride in the amount and character of scientific work accomplished by our fellow citizens in the Philippines.
Buffalo Medical Journal
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