Page images
PDF
EPUB

In the large majority of cases, the requirements of any operation upon the prostate consist in the removal of the obstructing area and depressing the bladder opening into the prostate, so that the bas fond may be properly drained.

In many cases the obstructing area of the hypertrophied gland can be satisfactorily reached and effectually removed through a perineal opening by means of galvano-caustic incisions.

Experimental Investigations on Peritonitis Caused by Stomach Contents.

At a recent meeting of the German Surgical Congress, Conrad (Med. Press & Cir., vol. 73, no. 3291) reports his experience thusly:

The stomach contents were injected into the peritoneal cavities of animals. In most cases there was a mixed infection. In the healthy stomach even, there were always pathogenic microbes upon which the acid gastric juice acted harmfully. In diseased stomachs their number was greater. He had investigated the degree of infectiousness of stomach contents. He introduced 1 ccm. acid gastric juice into the rabbit's stomach. With small quantities the animals did not die until 50 ccm. had been injected. All other animals remained healthy even when large quantities had been introduced. When the acid of the juice was diminished in quantity, however, the animals quickly died of acute peritonitis. The virulence of the microbes was diminished by the acid of the gastric juice. It was the same in his opinion with the human subject, and this was of great importance in operations on the stomach. Thus in carcinoma of the stomach with but little acid in the gastric juice, the escape of stomach contents was very dangerous, much more so than when there was a normal degree of acidity in the contents of the stomach. He had repeatedly tried the effect of washing out the abdominal cavity with normal saline solution after the escape of gastric contents into it. Such washings out were generally practiced by surgeons after operation in perforative peritonitis. The experiments were made in such a way that certain measured quantities were injected into the peritoneum, and after being

dispersed over the whole abdomen they were removed again. When acid streptococcus stomach contents were injected, 5 to 15 ccm. were certain to prove fatal. Some of the animals were improved at first by washing out, but they all died in the end. Injections of acid stomach contents were made up to 40 ccm. and the results were more favorable. Some of the animals died, but some were saved by the washing out.

NOSE, THROAT AND EAR.

UNDER CHARGE OF RICHMOND MCKINNEY, M.D., MEMPHIS.
Laryngologist to East End Dispensary, and to Presbyterian Hospital.

A Study of Hyperplasia of the Pharyngeal Lymphoid Tissue. Lartigau and Nicoll (Amer. Jour. Med. Sc., vol. 123, no. 6). present an interesting and exhaustive study of this subject, closing with these conclusions:

1. Adenoids consist essentially of hyperplastic pharyngeal lymphoid tissue. The epithelium and fibrous tissue changes are inconsistent and variable, and independent of the age of the patient. The new-formed fibrous tissue is largely perivascular in distribution. It may occasionally be one of the factors in the process of disappearance of the adenoid.

2. The hyperplastic pharyngeal tonsil often contains microorganisms, and these are mainly pyococcal forms. The bacteria for the most part lie near the surface; and the infection usually occurs from the surface, with or without demonstrable lesion of the epithelium.

3. Primary tuberculosis of adenoids is probably more common than most previous studies show. 16 per cent. of our series contained tubercle bacilli, 10 per cent. with characteristic lesions of tuberculosis. The tubercle bacilli were present in small numbers.

4. The lesions in primary tuberculosis of the adenoid are generally close to the epithelial surface and focal in character. Occasionally they may be found in deeper parts of the pharyngeal lymphoid tissue.

5. The pharyngeal tonsil may be a portal of entry for the tubercle bacillus and other microorganisms in localized or general infections.

Acute Inflammation of the Tonsils.

At a recent meeting of the Berlin Medical Society, Beckmann (Med. Press & Cir., vol. 73, no. 3293) discussed this subject. He said the disease was well characterized. The inflammation might extend to the nose and then give rise to suppuration of the accessory cavities. If the tonsils were removed in a child with snuffles, these ceased at a stroke. In disease of the middle ear, the tonsils needed to be borne in mind and treated. He also attributed a number of cases of rheumatic paralysis to the tonsils.

In cases of recurrent rheumatism when the palatal tonsils were not diseased, he had repeatedly found inflammation of the pharyngeal tonsils, and when these were removed the rheumatism ceased. These seemed to be very important as regards the development of tuberculosis.

From these the tubercle bacillus got into the lymph-stream and were deposited in the glands. At the time when these developed at puberty the bacilli might break loose and set up tuberculosis.

The treatment of acute inflammation of the pharyngeal tonsils consisted in insufflations, removal of the secretions, and gargling. Operation was indicated only when there were ear complications. For the prevention of recurrences extirpation must be performed, but this ought to be radical.

GYNECOLOGY AND OBSTETRICS.

UNDER CHARGE OF T. J. CROFFORD, M.D.

Professor of Gynecology, Memphis Hospital Medical College,

AND

W. D. HAGGARD, M.D.

NASHVILLE. TENN.

Professor of Gynecology and Abdominal Surgery in University of the South (Sewanee) Gynecologist to the Nashville City Hospital; Professor of Gynecology,

Infected Ovarian Cysts.

University of Tennessee.

R. Peterson (Amer. Jour. Obstet., vol. 45, no. 294) concludes:

1. Suppuration of an ovarian cyst is a most serious complication and is productive of a high mortality, with or without operative interference.

2. The contents of every suppurating cyst of the ovary should be subjected to searching microscopic and bacteriologic examination in order that more light may be shed upon the etiology and pathology of the condition.

3. There is good reason for the supposition that certain ovarian cysts reported as suppurating did not in reality contain pus, but that the gross appearances were due to certain changes in the fluid contents as a result of necrotic changes in the cyst wall.

4. When suppurating cysts of the ovary, shown definitely to contain pathogenic bacteria, have been removed by the abdominal route, the majority of the patients have died of general peritonitis.

5. Hence better results may be expected from vaginal incision and drainage in similar cases when the suppurating cyst does not reach much above the limits of the pelvis, since the liability of contaminating the pelvic peritoneum will be greatly diminished.

The Early Diagnosis of Uterine Cancer; Operative Limitations. J. O. Polak (N. Y. Med. Jour., vol. 76, no. 3) says: 1. The early diagnosis is possible.

2. The earliest symptoms differ, depending upon whether the disease begins during the menstrual life or after the menopause.

3. During menstrual life compare every bleeding with what it has been in the same woman. Be suspicious of intermenstrual spotting and serous discharge.

4. After the menopause, any serous or sanguineous discharge is significant.

5. Examine every woman over thirty who may exhibit any menstrual vagary or persistent leucorrhea.

Finally. Limit radical operations to those cases in which the disease is confined to the uterine tissues.

Memphis Medical Monthly

Memphis Medical Monthly, established as the Mississippi Valley Medical Monthly, 1880 Memphis Lancet, established 1898.

LYCEUM BUILDING, MEMPHIS, TENN.

Subscription Per Annum, One Dollar in Advance.

Official Organ of the Tri-State Medical Association of Mississippi, Arkansas and Tennessee, Memphis Medical Society, and Yazoo Delta Medical Association. RICHMOND MCKINNEY, M.D., EDITOR

C. H. BRIGHT, BUSINESS MANAGER.

DEPARTMENT EDITORS.

W. B. ROGERS, M.D.

A. G. SINCLAIR, M.D.
T. J. CROFFORD, M.D.
C. TRAVIS DRENNEN, M.D., Hot Springs, Ark.
LLEWELLYN P. BARBOUR, M.D., Boulder, Col..

W. D. HAGGARD, M.D.,.Nashville.

B. F. TURNER, M.D.

A STEP IN PREVENTION.

ON another page of this issue of the MONTHLY will be found a resolution introduced by Dr. J. L. Minor, of this city, at a recent meeting of the Memphis and Shelby County Medical Society, having as its purport a request that the Memphis City Council take steps to lessen the possibility of the propagation of infection by the use of dirty utensils by barbers, and to decrease the probability of malarial infection by the destruction of the now commonly accepted carriers of such-mosquitoes.

This resolution was quite timely, and in keeping with the trend of scientific opinion as derived from frequent and reliable observations. It is a well-known fact that individuals have been infected with the parasite of "barber's itch," an exceedingly disagreeable and loathsome disease, by the failure on the part of the barbers to carry out even the most superficial requirements of hygiene in shaving their customers. It is also well authenticated that people have been infected with the contagion of syphilis from the use of instruments in the hands of a barber who had previously used the same instruments upon customers who bore external manifestations of this disease.

Here the ounce of prevention could easily be put into practical application, for it would not be a great hardship to require barbers to have fresh towels for every customer, and to either

« PreviousContinue »