MEDICAL INDEX - LANCET. A MONTHLY MAGAZINE OF MEDICINE AND SURGERY, -BY JOHN PUNTON M. D., EDITOR AND PUBLISHER. PUBLICATION OFFICE, 532 ALTMAN BUILDING, KANSAS CITY, MISSOURI. All communications to THE INDEX-LANCET must be contributed to it exclusively. The Editor is not responsible for the views of contributors. Each contributor of an original article is entitled to a reasonable number of extra copies of THE INDEX-LANCET. Reprints of papers will be furnished at cost, order for which must accompany manuscript. All communications should be addressed to the EDITOR. ENTERED AT THE POSTOFFICE IN KANSAS CITY, MISSOURI, AS SECOND CLASS MAIL MATTER, Professor of Clinical Gastro-Enterology in the Detroit College of Medicine; consulting GastroEnterologist to Harper Hospital, Etc. Enteroptosis or Glenard's disease is often due to a complication of causes. Among these repeated pregnancy is one of the very frequent for the reason that it produces a diminution in the tension of the abdominal wall. Rapid pregnancy presents conditions which favor this diminution and may superinduce enteroptosis. It is probably true that four-fifths of the cases of enteroptosis occur in women. The neuropathic condition of pregnant women may have some explanation in this displacement and consequent gastric and intestinal disturbance. Maillart has devoted much study to the relation which exists between pregnancy and enteroptosis, and has stated that he finds a certain relationship existing between enteroptosis and congenital neurasthenia. Individuals who suffer from ptosis and become pregnant will have an increased pressure of the intra-abdominal walls. This pressure will vary directly as the uterus increases in volume. Pregnancy produces a marked improvement in the digestive functions in these cases and there is no reason why this improvement cannot be made permanent through proper treatment. This digestive betterment is especially noticeable in the latter months of pregnancy. We may hold, therefore, that normal pregnancy does not exert a bad influence on the ptosis. If after delivery the viscera are sustained for some time a contraction of the abdominal wall takes place and in due time the organs will continue in position. While the uterus is pregnant and enlarges, the organs which are displaced are steadily forced up into their normal position and the stretched mesenteries thus have an opportunity to regain their tonicity. After delivery the abdominal walls recede holding the organs in a nearly normal position. Though pregnancy is admittedly often a predisposing cause for enteroptosis. I beg leave to submit the report of a few cases in which I have found pregnancy itself serve as a cure of enteroptosis. Case No. 1. On January 1, 1897, Mrs. T., age 32, the wife of a dentist in Detroit, Mich., consulted me for what she called indigestion. She gave this history: She had taught school before marriage, broke down with nervous prostration and has been sick ever since. At times she could not sleep and on account of an attack of bronchitis was compelled to go South. Since *Read before the American Gastro-Enterological Association at Washington, D. C., May 1, 1902. then she has had trouble with her stomach. When she consulted me first, she complained of headache, pain after eating, eructations of gas, sleeplessness and a feeling of exhaustion. She had lost fifteen pounds in weight. An examination of her blood, urine and stomach contents proved them to be normal. On physical examination she was found to have an enteroptosis. I applied an abdominal support and treated her case in accordance with the usual methods, and the improvement, while apparent, was slow. I explained to her husband that it would be helpful to her if she were to become pregnant. He assured me that they had endeavored to prevent this up to the present time, for the reason that they did not think she was strong enough to carry a child. After explaining her condition to him carefully, she became pregnant three months later. During the time of pregnancy all her symptoms gradually disappeared, she became stronger and seemed to be practically well. After delivery she was kept in bed longer than the usual time, so as to be sure there would be no dragging on the mesenteries. She had the freedom of the bed for three weeks and was not allowed to get out of it, excepting for micturition and defecation. I applied a firm band to the abdomen which was tightened morning and night, so that the organs would remain in situ. At the end of three weeks she was allowed to get up for an hour a day and gradually for a longer time, and none of her former symptoms returned. This improved condition has continued now four years and she seems to be practically well. Case No. 2. Mrs. B., age 37, consulted me August 3, 1899. She had been pregnant eleven years previously and from that time had been troubied in many ways. During the past year she had been compelled to live on milk and lime water. At the time I first saw her she had no appetite. Solids would produce pain in the stomach. Acids would make her mouth sore, she vomited large quantities of mucus, had eructations of gas, vertigo and dizziness, ringing in the ears; could walk only a short distance without being exhausted and bowels were constipated. An examination of her blood and urine proved them normal. The stomach contents showed hyperchlorhydria. There was large quantities of mucus in the feces. On physical examination she was found to have a pronounced enteroptosis. By applying a suitable support, electricity and by symptomatic treatment she began to improve. Eighteen months ago she became pregnant and, after delivery, she was kept in bed for three weeks with a tight fitting bandage. She has made an apparently complete re covery. Case No. 3. Mrs. F., age 31, consulted me November 10, 1899, for exhaustion and dyspeptic difficulties. At this time she complained of distress after meals, bloated feeling of the bowels, belching of gas, constipation, backache and bloated sensation in the stomach. She felt weak and tired all the sleeps poorly and is exceedingly nervous. She has lost fifteen pounds in weight. An examination proved an enteroptosis. She became pregnant in March, 1900, when all of her symptoms gradually disappeared. After delivery she was given the same care as the other two patients and has made a complete recovery. Case No. 4. Miss R., age 26, consulted me January 18, 1901. She complained of fullness after meals and sharp pains, eructations of gas, backache and bloated sensation in the stomach. She felt weak and tired all the time, slept poorly, lost sixteen pounds, bowels constipated, mucus in stool. An examination proved an enteroptosis. Under rational treatment she improved in weight, so that on May 23 she weighed 124 1-2 pounds, a gain of eight pounds. She was married the following month, became pregnant and, after delivery, was kept in bed for three weeks with the bandage applied, as suggested by Dr. Rose before this association last year, and has remained well ever since. In conclusion let me say: 1. That the dispensing with the abdominal bandage after pregnancy according to the new method of obstetricians predisposes to enteroptosis. 2. Pregnancy favors and assists the cure of enteroptosis. 3. Patients with enteroptosis need not, on its account, hesitate to be exposed to pregnancy 4. The disagreeable symptoms of enteroptosis seem to disappear, while the patient is carrying the child. 5. Keeping the patient in bed after delivery and applying an effective band is very helpful in the cure of enteroptosis. 6. Early convalescence after delivery and insufficient support to the abdomen predispose the patient to enteroptosis. 32 West Adams Avenue. 'SOME RECENT DISCOVERIES ABOUT ATOMS AND THEIR ELECTRIC CHARGES. PROF. LUCIEN I. BLAKE, Lawrence. Kansas Professor of Physics and Elect. Engineers. It was discovered in 1877 by Pfeffer, a botanist, that when cane sugar was dissolved in water, the solution formed exerted a pressure upon the walls of the containing vessel of one or more atmospheres according to the amount of sugar present. This is called osmotic pressure. Ten years later Vant, Hoff, a Dutch chemist, proved that the particles of substances in solution moved freely in all directions through the solvent just as gas molecules and that osmotic pressure followed the law of gaseous pressure. About the same time Arrhenius a Swedish physicist, noting the many solutions which exerted a greater osmotic pressure than they should by Vant, Hoff's law, found such exceptions were all conductors of electricity. In these the solvent dissociated many of the molecules into their atoms or groups of atoms which possessed charges of electricity, definite in quantity and sign. Each atom or group with its charge is called an ion. Thus salt in water is broken up into positive sodium and negative chlorine. Sulphuric acid in water dissociates into hydrogen and group SO 4. All bodies in solution act therefore like gases. When an electric current is sent through a solution (electrolyte) the ions move in two opposite streams-the negative ions toward the entering current (anode) the positive ions toward the current's exit (Kathode). The ions thus tend to collect at the electrodes. The solutions in plant and animal cells exert high osmotic pressure on cell walls and electric charges are present on the ions. Similarly a current cannot pass through gases without preliminary dissociation of the gases into ions. Such dissociation may be produced by high voltages as in the electric spark or lightning; by intense heat; by ultra violet. rays or by X-rays. Ionization of the upper layers of our atmosphere by the sun's rays so that these layers become conductors, probably bends the waves in wireless telegraphy to follow the earth curvature. In highly rarefied gases J. J. Thomson of Cambridge, England, found that streams of negatively charged particles carried the current, and that these particles were all of the same size and kind independent of the material of the *Delivered before the Kansas City Academy of Medicine, April 26, 1902. electrodes and of the gases. These negative particles he proved were but onethousandth of the size of the smallest atom Hydrogen. He called them Corpuscles. He has discovered them present among the atoms of all matter hurled out from white hot bodies as the sun, and existent in our atmosphere, where they possibly form initial nuclei of our rain drops. Thus in both inanimate and animate nature we find under conditions, both ions and corpuscles with their electric charges. In the two realms are their actions similar? But there is another kind of so-called solution-colloidal, which, however, is not a true solution. It possesses no osmotic pressure, does not conduct the current, and has no ions. But it is of startling significance in living matter. One class of colloids consists of finely divided particles of metals their sulphides or oxides suspended in a solvent. Their solid particles are comparable with waves of light in size; under certain conditions these colloids are coagulated or precipitated, but on removing the conditions they do not return to their original state; they are irreversible. A second class is gelatinous, like fats, a framework of drops in a liquid or a jelly like texture with liquid drops throughout it. With rise of temperature, these liquify and on cooling "set." They are reversible. Bredig in 1899 and since, found finely divided platinum remained suspended indefinitely in water and acted identically as the organic ferments. It deoxydized H2O2, was inhibited by excess of acids, was poisoned by cyanide of potassium. The catalytic action of the yeast plant and of various ferments of the human body is identical in action with this platinum colloid so that such action which has been previously ascribed to living matter is purely physical and as we shall see essentially electrical. Hardy, in 1900, found that the substances in colloids possessed electric charges from their contact with their liquids. In colloids consisting of suspended particles a neutralization of their charges will cause precipitation or coagulation. An electronegative colloid will precipitate upon introduction of a few positive ions. The coagulating ion is always of the opposite sign to the electrified colloid. The silt of the Mississippi is first deposited to form its delta by the ions of the Gulf of Mexico. Thus the addition of acids, salts or alkalies may render the colloidal solution more stable or isolectric or coagulate it. With reversible colloids these are properties of broadest import. Such colloids are essentially characteristic of plants and animals. The Proteids, Proptoplasm, Lecithin the tissues of nerves and muscles, the fats are all reversible colloids. All the processes of life are identified with these coloidal substances? But it would seem now that their actions are to be relegated back to physical processes which are essentially electrical. Colloidal hydrosols are maintained in solution by their electric charges but pass to hydrogels by neutralizing their charges either by the current or by ions. Near point of electric equilibrium, they are very sensitive to gelation or solution. Slightest change in their charges alters their physical properties. Increase in their charges has the same effect as to increase the viscosity of their liquid. Streaming of protoplasm which is necessary for cell divisions and growth requires a certain viscosity. Excess of negative ions may prevent this viscosity and toxic effects result. Prof. Loeb proved the negative ion (1 toxic to the fertilized egg of the sea urchin. Bivalent anions have greater toxic effect. The positive ions are anti-toxic to the C1. Parthenogenesis is produced by ions which increase viscosity of protoplasm sufficient for streaming and consequent cell division and growth without fertilization. Prof. Matthews found irritability of nerves is increased by negatively charged ions. Nerve stimulation is gelation of the colloid lecithin. Anaestheties produce solution, that is prevent gelation. Darwin detected in the sensitive plant, drosera, the propagation of the motive impulse as a cloudy precipitation of a colloid in the plant tissue. C1. Br. 1 and Fl. increase in toxic effects in this order, but since these possess equal negative changes there is involved possibly the motion of the ionic charge. This motion may be increased by light. Red light inhibits the movements of the Amoeba, violet stimulates. Since the charges of the ions have such fundamental effects in all living processes it is probable that the action. of drugs and possible of food stuffs is due to electrical energy resident in them and is not a thermal process as usually believed. The chemist and the electro physicist and physiologist and the physician should work together in this common field so new and so promising. *HEREDITARY DANGERS AND RADICAL REMEDIES. J. M. LATTA, M. D., Millerton, Kan. "From time to time there returns on the cautious thinker the conclusion that considered simply as a question of probabilities, it is unlikely that his views upon any debatable subject are correct. Here, he reflects, are thousands around me holding on this or that point opinions differing from mine-wholly, in many cases; partially in most othersEach is as confident as I am of the truth of his convictions. Many of them are possessed of great intelligence; and rank myself high as I may, I must admit that some are my equals, perhaps my superiors. Yet while everyone of us is sure he is right, unquestionably most of us are wrong. Why should not I be among the mistaken? True, I cannot realize the likelihood that I am so. But this proves nothing for though the majority of us are necessarily in error, we all labor under the inability to think we are in error. When I look back into the past I find nations, sects, theologians, philosophers, cherishing beliefs in science, morals, politics and religion, which we decisively reject. Yet they held them with a faith quite as strong as ours. Nay, stronger of their intolerance of dissent is any criterion. Of what little worth, therefore, seems this strength of my conviction that I am right. A like warrant has been felt by men all the world through, and, in nine cases out of ten, has proved a delusive warrant. Is it not then absurd in me to put so much faith in my judgment."-Herbert Spencer. This lack of faith is not so barren and impractical as it seems. In our private conduct we must act upon our judgments be they ever so imperfect, but in public affairs a decision is much more difficult and the responsibility is far less pressing. We are not compelled to decide. In many public questions the conditions are too numerous, too widespread, too complex, too obscure to be understood. Here it is safer to do nothing than to risk a serious blunder. The evil is not one fatal to society since society has grown under it, and relief may come in some unforseen way, as it has in most other cases. We may, therefore seriously question the propriety of meddling. Our ancestors had this meddling habit and put without hesitation their judgments upon all subjects into the forms of law. We have not all of their self-confidence, but we still have too much. The last four hundred years has been largely spent in repealing bad laws. Yet while we thus labor to abolish the mischievous meddlings of our ancestors, we still insist upon establishing similar meddlings of our own. We no longer coerce men for their spiritual good, but we still feel called upon to coerce them for their material good. Not recognizing that the one is as useless and unwarrantable as the other. *Read before the South Kansas Medical Society, Apr. 29, 1902. |