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ables the patient to dispense with the regard to the influence of unilateral cas use of the catheter and to discharge urine tration on the growth of the prostate are spontaneously. The bladder troubles, very contradictory, and further informaalso, are much relieved, and the general tion is needed before any definite concondition is improved. In the selection clusion can be reached on this question. of suitable cases attention should be paid to the condition of the niuscular structure of the bladder. If the detrusor

FRACTURE OF THE FEMUR FROM MUSmuscle be paralyzed to such an extent

CULAR ACTION.- Dr. Irving S. Haynes that the bladder cannot be completely reported in the New York Medical Jouremptied even by the use of a catheter,

nal the case of J. W., an athlete, thirtyit would be useless to expect a restora

six years of age, who, while bowling, tion of normal function as a result of re

had attempted to throw a heavy ball, in moval of the obstruction to the flow doing so had lost his equilibrium, and, , of urine. In two of the cases here re

in endeavoring to regain it, had brought corded, however, good results in this

such a strain upon the left femur as to

fracture it in the middle. The line of respect were obtained in spite of considerable weakness of the detrusor. In

the fracture had extended slightly obmany cases the diminished size of the

liquely from above and inward, downprostate after double castration permits usually robust health, and had been free

ward and outward. He had been in unof the more ready introduction of a catheter, and thus wards off the dangers

from any specific disease ; hence the of retention. In the author's opinion,

manner in which the fracture had been the treatment of hypertrophy by double

produced was of unusual interest. castration compares favorably with other

Dr. J. W. S. Gouley recalled the case operative measures in being simpler in

of a healthy young man, under thirty performance and less dangerous. It can

years of age, who, while endeavoring to be performed without subjecting the pa

hurl a ten-pound dumb-bell to a considertient to the risk of general anesthesia,

able distance, had thrown back his right and necessitates but a very short stay

arm so far that it was beyond the conin bed, which with regard to old and

trol of certain muscles, with the result enfeebled subjects is a very important

that the humerus had snapped just bepoint. The operation, it is stated,

low the deltoid insertion. Of course, in should be recommended only to those

this case the weight of the dumb-bell whose sufferings have attained a high

had been a decided factor in addition to

the muscular action. The fracture had degree, and can no longer be relieved

united satisfactorily. No disease of the by mere symptomatic treatment. The author met with no objection to the

bone had been found, although the operation from any of his patients,

speaker said that when fracture occurred all of whom were well satisfied with

in this way he was usually suspicious its results. The recorded instances of

of the existence of malignant disease of

the bone. It was not uncommon for Silccess are so numerous and striking that the author has been led to the con

fractures of bone to occur from very clusion that the surgeon is certainly

slight causes, such as movements in bed, justified in suitable cases of enlarged

where there was malignant disease of

the bone. prostate in advising and performing this operation. Although a more extended series of observations is needed before a AN EASY AND READY METHOD OF clear and absolute judgment can be CIRCUMCISION. -- John W. Ross, Surformed on this new method, there can geon, United States Navy (Retired), be no doubt, the author holds, that this says in the Medical Record, August 31, procedure is a valuable addition to the 1895: Retract the foreskin ; insert the operative means of dealing with ad glans penis up to the corona into the vanced and grave forms of prostatie open mouth of a glass test tube ; draw hypertrophy. The observations with the foreskin well forward over the end

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of the tube ; tie a strong, small silk varies for different individuals ; in some cord very tightly around the foreskin

1-3 grn. (0.02 gme.) will give the desired immediately in front of the flange of the relief; while in others no results are obtube ; amputate the foreskin one-eighth tained until 2-3 grn. (0.04 gme.) is of an inch in front of the constricting given at a dose. When the correct dose cord by a circular sweep of the knife; is found, it is seldom necessary to inunite the mucous and cutaneous edge of

crease it.

The value of codeine, accordthe stump of the prepuce by eight or ing to the author, lies in its power to ten fine interrupted sutures ; cut the reduce the irritation or excitability of constricting cord ; remove the tube ; the nerves governing the pulmonary cover the cut edges well with powdered mechanism.

mechanism. It gives rise to no gastric iodoform ; encircle the anterior half of disturbances, and is not constipating. the penis with a roller bandage of iodo The author found that in unusually form gauze, allowing the meatus to pro- susceptible patients a peculiar dulness ject slightly for facility of urination followed the use of codeine, which, howwithout soiling or removal of the dress ever, is only transient, and much to be ing; and keep the patient in bed, with preferred to the results which ordinarily the penis elevated, for from twenty-four follow the use of many other preparations to forty-eight hours.

used for the relief of cough.

A Few Points N OBSTETRICS.-EwCodeine IN IRRITANT COUGH.-C. W, ing (Medical and Surgical Reporter, AugIngraham( American Medical and Surgical ust 24) advances a few aphorisms relatBulletin) says : One of the most valuable

ing to obstetrics. preparations the author has ever used

1. Examine the urine a week or so for the relief of irritant cough is a mix

before the expected confinement. Albuture of codeine sulphate and ammonium

min need not cause alarm, unless presbromide. The addition of the latter

ent in large quantity, in which case the assists expectoration and increases the

woman should be restricted to milk diet, effect of the codeine ; or, rather, a smaller

given one-tenth grain of sulphate sparamount of codeine will accomplish the

teine four times a day, and bowels kept desired results when given in junction with ammonium bromide. His

open with cream of tartar, the object befavorite prescription is as follows :

ing, of course, to relieve congestion of

the renal veins. Codeine Sulph. (Merck's) 16 grn. (1 gme.) 2. Make no digital examination withAmmonium Bromide.

320 grn. (20 gme.)

out first cleansing the hands and nails, Water.

2 f. oz. (60 c.c.) Syrup. To make 4 fl. oz. (120 c.c.)

together with the external genitals, Teaspoonful, 2 to 4 times a day.

with a solution of bichloride of mercury In cases accompanied with bronchial (1 to 2000) and ethereal soap. catarrh, or in those in which a. more

3. Empty the rectum thoroughly with powerful expectorant is desired, the

an injection of warm water. above prescription may be modified, as

4. Make as few examinations as posfollows :

sible during progress of labor, and each

time dip the hand first in the antiseptic Codeine Sulphate.

16 grn. (I gme.) solution. Ammonium Bromide.

320 grn. (20.7 gme.) F1. Ext. Yerba S. 72 to 1 fl. oz. (15 to 30 c...)

5. If the presenting part emerges Syrup. To make 8 f. oz. (240 c.c.)

slowly from the womb, do not allow Two teaspoonfuls, in wine or syrup, from 2 your impatience to so get the better of to 4 times a day.

your judgment as to induce you to Dr. Ingraham recommends that care " assist nature" by pulling on the os. should be taken to obtain a reliable prep- Probably all the deep pathological tears, aration of codeine, as many inferior calling for surgical interference, found grades yield results which indicate that on the right and upper anterior sides of morphine is one of their component the cervix, are caused by the finger of parts.

The dose of codeine (for adults) the accoucheur.

con

MARYLAND

drewes and Mr. J. Parry Laws (British Modi. cal Journal, August 31) that it is extremely difficult to find evidence of the presence of

Medical Journal. the typhoid fever bacillus in ordinary sewage

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and that instead of sewage being a favorable soil for its multiplication, as stated by many, it gradually, but surely, exterminates it. Again the undoubted communication of certain diseases, as smallpox, through the medium of the air, lends probability to the existence of similar organismis in the air of sewers. What more natural than to suppose that specific germs can rise into the air with tbe malodorous volatile substances and can be wafted about as freely as the latter. Here again the same investigators have shown that the micro-organisms of sewer air bear no relation whatever to those of sewage, and that the predominant organisms of sewage are entirely absent from sewer air. “If,” say they, “'sewer air is free from those special organisms which exist in immense numbers in every drop of sewage, how infinitely improbable, nay, almost impossible, becomes the existence of pathogenic organisms which can only be present in sewage, relatively speaking, in most minute proportion." This seems to dispose of the matter and hence we may conclude that it is an error to regard sewer air as one of the modes by which the germs of lisease may be spread and this gives additional emphasis to the necessity of attention to the character of the water supply. The term “water-borne" is now applied to such diseases as typhoid fever, cholera and dysentery to indicate the increasing realization of the view that looks to this source and this alone for their origin.

WASHINGTON OFFICE: Room 22 Washington Loan and Trust Co. Buildin::.

BALTIMORE, OCTOBER 5, 1895.

***

There is no question whose solution is of greater importance to the health of individ

uals and communities Are Sewer Emanations than this. From time Dangerous ?

immemorial we have

been accustomed to look upon the emanations from decaying organic material as in some way dangerous and that which was offensive to our sense of smell has come to be regarded as of necessity noxious to our physical well-being. But it is remarkable how little scientific evidence there has been to substantiate this view. The micro-organisms of certain diseases, as typhoid fever and cholera, are excreted with the stools, it is true, and thus find their way into the sewers, and it was quite natural to suppose that their harmfulness did not stop here. It was supposed that sewage swarmed with the specific germs of various infectious diseases. But it has been shown by Dr. An

WITHIN the past few years physiology has added to our store of knowledge many new

and importaut facts. None, The Ductless however, are more remarkand other Glands. able than those relating to

the uses and functions of the so-called ductless glands. It has not been so long ago since these glands were supposed to be useless and therefore redundant parts of the human body and their study was not considered worth the time it would consume.

An excellent review of the advances inade in this field, as also in the physiology of some of the ordinary secreting glands, was given

by Professor Schäfer of University College, example, will produce appreciable, though London, in an address entitled “Internal Se transient, effects. cretions," at the recent meeting of the British Similar results have been obtained in the Medical Association.

case of the pituitary body, death from removal, Before noticing this-even briefly--it may evidence of a secretion tending to increase be well to define sone of the terms which are contraction of heart and arteries and influenused in such investigations. A secretion is cing nutrition. material which is removed from the blood by The relations of pancreatic disease and a gland. It usually undergoes some sort of diabetes have been well established, both exchange in passing through the gland. It is perimentally and clinically. Frerichs found either poured out again upon surfaces con lesions of the pancreas in 20 per cent. and nected with the exterior, or is returned to the Rokitansky in 43 per cent. of cases. Extir. blood from the gland directly. The former pation of the organ in animals is followed glands are known as external secretions, the rapidly by glycosuria in extreme degree, latter as internal secretions. The latter are polyuria, wasting and death. This has been supplied by the ductless glands, but not by proven not to be due to the loss of the them exclusively; some of the ordinary se pancreatic secretion or of the secreting struccreting glands, the liver, pancreas, etc., also ture. If one-fourth of the gland be allowed supply them. The knowledge of this is a very to remain or if a portion of it be grafted in an recent acquisition of physiology and much re unusual situation, the symptoms of diabetes mains to be learned regarding it, but we know do not occur. that the interual secretions are of no less im Of the same nature and origin are doubtless portance thau the better known and ordinary the changes taking place in eunuchs and ones, such as the bile, pancreatic juice, urea, others as the result of loss of the generative etc.

organs. Professor Schäfer considers in succession the Now, with reference to the mode in which liver, the kidney, the pancreas, the thyroid, these effects are produced. Professor Schäthe pituitary body and the supra-renal cap fer points out that there are two theories. sules, and shows that they all elaborate such 1. That of internal secretion. 2. That of auinternal secretions. The facts with regard to totoxication. In the first the organ at fault the thyroid are well known and practically is supposed to form something which is essenutilized since the discovery by Ord of myx tial to the normal processes of the body and edema and the value of thyroid extract in that the absence of this consequent on the redisease.

moval of the gland leads to toxic effects. In With reference to the supra-renal capsules, the other excretory products are supposed to Professor Schäfer has confirmed the observa accumulate from the same cause which in tions of Brown-Sequard and others showing the healthy condition of the gland it is able that an invariable fatal result follows the re to dispose of. Of these Professor Schäfer moval of these glands. The blood of aninials gives his adhesion to the former for reasons thus treated is poisonous to other animals. which he gives at length. The principle to which this effect is due is The subject is one of extreme interest and found in the medulla and not in the cortex of the utmost practical importance. It is of the glands. Its properties have been in most ably treated in the address, which gives vestigated and among other things it is found much information in a condensed form not to exert a powerful action on the voluntary readily accessible as yet to physicians in muscles, the blood-vessels and heart, resemb general. That it has a vast future there can ling in this respect the action of veratrine. be no doubt, for in spite of the advances This principle is absent from the capsules in which have been made in elucidating it durAddison's disease and some cases of this dis- ing the last few years a great number of points ease appear to be distinctly benefited by oral still remain obscure. Nevertheless, the way administration of the extract of the capsules. which the physiologist has attempted to show A very remarkable circumstance is the infini may be followed by the practitioner, and the tesimal quantity of this principle required to result of these physiological experiments produce the effects named. One millionth of may now be utilized for the diagnosis and a gramme per kilogramme of body weight, for treatment of disease.

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MEDICAL ITEMS.

Charity Hospital at Berlin. He was chief of the medical and surgical staffs in the war of

1866 and 1870. He was associated with VirWe are indebted to the Health Department

chów and Müller in several medical works. of Baltimore for the following statement of

He attended the late Emperor Frederick in cases and deaths reported for the week end

his last illness. ing September 28, 1895.

The new buildings of the University of the Cases

City of New York will be formally opened
Diseases.

Deaths
Reported

October 19. They are on University Heights

overlooking the Harlem River. Between Smallpox..

$50,000 and $60,000 have been received as Pneumonia..

8 gifts during the summer. Phthisis Pulmonalis.

17 Measles.

6

The American Pharmaceutical Association Whooping Cough..

held its Forty-third Annual Meeting in DenPseudo-membranous

5

ver, Col., August 14. There were 450 memCroup and Diphtheria. Mumps..

bers registered and 231 new applications for Scarlet fever.

membership. The Committee on Prize Essays Varioloid.

awarded the second prize to Dr. Alfred Dohme Varicella.

for his contributions to the chemistry and Typhoid fever.

14 7

pharmacognosy of ipecac and stramonium.

Dr. Dohme also delivered an admirable adThe Index Medicus fund has now 105 sub

dress as Chairman of the “ Section on Scienscriptions; 95 are still needed.

tific Interests," and four other papers. MouHarvard Medical School had 454 students treal was selected for the place of meeting in last year.

It also has nearly 100 teachers. 1896. The following officers were elected : There was not a complete skeleton in all President, James M. Good, St. Louis ; ViceEurope until 1658, when one was set up in Presidents, Charles E. Dohme of Maryland, Vienna.

A. Brandenberger of Missouri and Mrs. Mincr In Norway and Sweden no couple can be

of Kansas; Treasurer, S. A. D. Shepperd, married without producing a certificate of

Massachusetts; Secretary, Charles Caspari, satisfactory vaccination in both.

Jr., Maryland. The Milner Fothergill gold medal in ther

The daily papers announce the death of the apeutics has been awarded by the University

celebrated man, Professor Pasteur, in Paris, of Edinburgh to Dr. Edmund Smith of York,

on September 29. His death was due to an for his essay on the digestive ferments. apoplectic stroke eight days prior to death

and a second attack on the day before. For Dr. Horatio N. Hollifield of Sandersville,

some years he had been the subject of hemiGa., a native of Howard County, Md., dierl

plegia. He was born at Dole, Javra, Decemon September 24, aged 63. He was a gradu

1822. After passing through the Uniate of Jefferson Medical College of Philadel

versity of Paris he held chairs successively in phia. He leaves a widow and two children.

the faculties of Strassburg, Lille, the Ecole Dr. George Dock, Professor of Theory and

Norinale and the Ecole des Beaux-Arts. He Practice of Medicine in Michigan University,

was not a graduate in medicine. He was a says the Homeopathic Department of that

member of the Institute and Academy and a University is almost defunct and is kept alive

grand officer of the Legion of Honor. He only by the appropriations of the Legislature.

was the author of numerous works on chemProfessor Henri Adolf Bardeleben of Berlin istry and bacteriology. His best known work died September 24, aged 77. He was born in was in connection with fermentation (for Frankfort-on-Oder and after studying in Ber which the government granted him an annual lin, Heidelberg and Paris, became professor pension of 10,000 francs) and hydrophobia. in the University of Giessen in 1848. Subse His “ Pasteur Institute" has a world-wide quently he held the chair of surgery in the celebrity. At his request his remains were inUniversity of Greifswald. In 1868 he became terred there, although the Government dedirector of the surgical clinic in the Royal sired that they should rest in the Pantheon.

ber 27,

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