Page images
PDF
EPUB

the respiratory passages, bronchial catarrh, with or without emphysema, asthma, whooping-cough, etc. This treatment gives as good results in pulmonary complications of a number of parasitic diseases, scarlet fever, typhoid fever, etc. This new doctrine, seducing at first sight, presents in practice an almost insurmountable difficulty. It demands doses of antiseptics which would certainly have a dangerous effect on the organism. And so it is probable that pulmonary antisepsis would bave ever remained in the theoretical state without the ingenious idea of Dr. Albin Meunier, of Lyons, of employing vehicles which permit the administration hyperdermically or by the stomach, of antiseptics without any danger to the patient, and in very active and rapidly absorbed doses. This work of our learned confrér was communicated this year to the L'Academie de Médicine.

Le Bulletin de Thérapeutique, of the 15th and 13th of January and the 28th of February, have drawn the attention of the scientific world to it. Pulmonary antisepsis is obtained by subcutaneous injections of microbicedic substances, and is to be applied only by the physician. Also to simplify the treatment Dr. Albin Meunier has had made a series of antiseptic capsules, to permit the introduction of the medicines by the stomach. These capsules have as a base phenol, eucalyptol, iodoform, menthol, etc. These medicines are alone or combined with each other, and two or three capsules are usually taken with each meal. Experience has shown that it is best to alternate these various sorts of capsules and modify, every week for instance, the antiseptic combination employed. Numerous researches have proved that volatile essences very favorably modify broncho-pulmonary affections. As antiseptics they arrest the development of the bacilli, as balsams they diminish the cough, transform favorably the nature of the secretions and cause the oppression to disappear.

All the patients treated with the antiseptic essences are struck with the incredible rapidity with which the breath and the urine are impregnated with the odor of the medicine. This, which often takes place in a few minutes, is the evident proof of the almost instantaneous impregnation of the organism.

This treatment produces no disagreeable stomachic affects; it is perfectly tolerated and permits the association with it of reconstructive medication. It has given most favorable results, ameliorates always, and often cures. It may even be said that if the patient has not arrived at the last stages, if lesions have

not been produced that are incompatible with life, cure is the rule. In all consumptives, in the first and second stages, submitted to vigorous pulmonary antisepsis, we have had a return 'of the appetite, increase of weight, disappearance of the night sweats and diarrhoea, and a very favorable transformation of the stethoscopic signs.-L'Union Medicale.

ANTIPYRINE.

M. Huchard communicated to the Société the result of his researches in regard to antipyrine. He found it very efficacious in neuralgic manifestations, but it was more often without effect in nephritic and hepatic colic. He found it positively harmful in angina pectoris, in renal affections accompanied by albuminuria, in the renal form of typhoid fever, in arterio-sclerosis, and in general in all diseases in which one should avoid diminishing the excretion of urine.

On the contrary, this medicine was of great service in nervous polymeric by moderating the renal congestion. M. Huchard cited the works of Legronx, Grummer and others, and his own researches.

In the discussion which followed, M. Philbert said that he had employed antipyrine to great advantage in whooping-cough. -L'Union Medicale.

SOCIETY PROCEEDINGS.

DETROIT MEDICAL AND LIBRARY ASSOCIATION.

STATED MEETING, APRIL 16, 1888.
THE PRESIDENT, CHARLES G, JENNINGS, M. D., IN THE CHAIR.

EXHIBITION OF PATIENTS.

CEREBRAL COMPRESSION RELIEVED BY TREPHINING. DR. H. O. WALKER exhibited several patients on whom he had operated for cranial injuries. The first case reported was that of a man who had been brought to Saint Mary's hospital, speechless, with a paralysis of the right arm and leg. He had kept him under observation a few days, and the paralysis becoming more complete, it was agreed in consultation that cerebral compression existed. He operated the following day. He had the head shaved and every antiseptic precaution fulfilled. Then

Q

making an incision over that portion of the fissure of Rolando, where the motor area of the arm is supposed to exist, he removed two buttons of bone, and with a lithotomy scoop removed about two ounces of blood clots. He filled the opening with iodoform gauze. The dressings were removed the next day, except the gauze, it being very important in these cases to secure complete drainage. This man speedily recovered, the paralysis disappeared, speech returned, and he left the hospital perfectly well. He had promised to be present this evening, but had not been able to attend.

The next case was one of a boy, who in playing on the roof of a house had fallen. When he saw him he was unable to speak. He watched him carefully, and the next day there was no improvement, and he noticed a slight paralysis of the left arm and leg. He decided to operate, the functions interfered with being the same as those in last case, motion of the arm and leg and speech. The head was prepared as in the last case, and on making an incision a fracture of the squamous portion of the parietal bone was discovered. The depressed bone was elevated, and although he regarded recovery as very doubtful at the time, the function of the arm gradually returned, and he finally reached the healthy condition he exhibited this evening.

The next case was a man thirty years of age. Last June a wagon tongue had fallen on his head, producing considerable depression of bone. He recovered, but was troubled with convulsions. Last March he entered the hospital, and the skull was trephined at the point of injury. No convulsions had since ensued.

The next case was a young man, who had fallen from the cars, producing a compound fracture of the skull. He had operated on Saturday, and went to see him Sunday and again on Monday, when he found the bed torn up, and he thought he was dead, but found him sitting by the stove in the back kitchen. It had appeared to him best to trephine in this case, lest the man should be the subject of convulsions like the last patient.

He regarded this series of cases as a satisfactory evidence of the wisdom of surgical interference in cerebral injuries. He had trephined several times in the old days and his patients had died, and our improved results were due to antisepsis and a better knowledge of the cerebral topography.

OVARIAN Cyst. DR. J. H. CARSTENS exhibited a multiocular ovarian cyst removed from a young lady who had felt perfectly well, but whose mother had brought her to a doctor on account of the suspicions she aroused. The temperature after operation had not risen above one hundred, and the wound had healed perfectly.

PUERPERAL FEVER. A discussion ensued on puerperal fever in which the following members participated: Drs. Carstens, Mills, Shurly, S. P. Duffield, Flintermann, Wight, Yemans, Wyman and Emerson. The following resolution was adopted:

“That the Publication Committee be requested with the assistance of the health officer, to prepare a statement for publication regarding the present condition of the city in respect to puerperal fever, such statement to be submitted to the association at its next meeting." Adjourned.

F. W. MANN, M. D., Secretary.

CORRESPONDENCE.

EXPERT TESTIMONY?

EDITOR OF THE PHYSICIAN AND SURGEON: At the inquest held over the body of the supposed Mrs. Palmer, in this place, lately, a certain "doctor" gave testimony of such profundity (?) of learning that it occurred to me that it would be valuable to the profession.

He says that “he found the rings of the trachea softened or broken down," and reasons that she (Mrs. Palmer) was choked to death—“can't see any other way than by the band.” (I am quoting from his testimony as published in the Alma Record of February 10, 1888.) Now, I claim that it is almost impossible for a man, with his hands, to break the rings of the trachea. I believe that it occurs only when the rings of the trachea are calcified. Understand that I am talking of the trachea, and not of the larynx. So is deponent. The “International Encyclopædia of Surgery” gives only eleven cases in the whole literature on the subject. Tidy, in his “Medical Jurisprudence," mentions not a case in which the rings were broken, but does mention five cases in which they were torn. Dr. Kieler, in Tidy, Volume III, page 265, concludes:

“I. That ordinary falls on the larynx are not capable of causing fractures of the laryngeal cartilages, whilst even falls. from a height with superadded force are unlikely to do so.

.

[And the larynx is many times more easily broken than the trachea.]

"II. Severe pressure applied from before backwards so as strongly to compress the larynx against the vertebral column, or violent blows inflicted over the larynx by means of a heavy body may cause fractures of the larynx. [Not the trachea.]

(The italics in “may” are mine.) "III. Violent compressions applied to the sides of the larynx (as in ordinary manual throttling or strangulation by grasping) are, of all applied forces, the most likely to produce fractures of the alæ of the thyroid cartilage, or even of the cricroid cartilage.

“IV. That the condition of the larynx in regard to the absence or presence of ossific deposit, materially influences its liability to fracture from external violence."

One may satisfy himself of the difficulty of breaking a trachea by trying to break the rings of the trachea of a dead dog, or by experimenting upon a chicken's windpipe. Any force, furthermore, sufficient to produce such an effect would, leave external marks. Tidy says, Volume III, page 265, “Given fractures of the larynx, the application of enormous force is indicated.” (I am compelled to quote remarks about the larynx because the literature does not afford examples of such accidents in the trachea.)

But perhaps, after all, the witness does not mean that the trachea was broken, but rotted. Let us assume that that is his meaning. Now, you and everybody else with good powers of observation know that cartilage is second only to bone in indestructibility, as will witness the windpipe of a rotting fowl. The tissues around may have been soft and so may the membrane between the rings, but not the rings.

He says that he found the left side of the hyoid bone “loosened so that by a little pressure it would pass under the other side." I do not know exactly what he means by “would pass under the other side.” He had already said that he found the head “twisted to the left on shoulder.” This would make the maceration go on faster on the left side, and the bone would become loosened first in that side.

He said, "I placed the lungs in water to see whether there was blood in them; if so they would sink.” The blood, if present, could be seen without that test, and it is not possible for a hæmorrhage so large to occur in the lung as to make it sink. Understand me: I am not talking about the transudation of

« PreviousContinue »