THE TREATMENT OF PULMONARY TUBERCULOSIS BY INTRAVENOUS INJECTIONS OF CHINOSOL WITH FORMALDEHYDE
1408 any danger. The duodenum readily turned back off the aorta. After removal 'of the testis the peritoneum was replaced, the retro-peritoneal area was drained with a tube, and the abdominal wall was sutured. The whole operation took one hour ; there was no marked shock, and bleeding was insignificant. The patient's convalescence was interrupted by a mild attack of pneumonia, but he left the hospital three and a half weeks after the operation with the wound soundly healed. Institute, reported
... s follows : "Small round-celled sarcoma of the epididymis and testicle. The growth consists of closely packed rounded cells with dark nuclei and very little protoplasm. The globus minor shows almost perfectly homogeneous infiltration with sarcoma cells. The left iliac glands and the left lumbar glands are normal, and show no sarcoma cells." The growth is peculiar in that it appears to have primarily affected the epididymis and to have spread to the testis, and not to be a primarily malignant growth of the body, as is usual. The case was perhaps a fortunate one as a first operation in that it occurred in a thin boy, but that a truly radical operation on the lymphatic area in malignant disease of the testis is possible cannot be disputed. In fact, the operation went a step further than Jamieson and Dobson's ideal operation, in that it cleared the whole of the external iliac artery and vein, instead of the upper third only, and their dictum that the operation "is exceedingly difficult and dangerous, if not impracticable," does not hold good in boys, at any rate. WHEN so much publicity is being given to the prevention and treatment of tuberculous conditions, the history of what seemingly is a rapid and perhaps permanent cure of a pulmonary tuberculous case may be of interest to readers of THE LANCET. Some of my professional brethren more fortunately situated as regards cases for extended trial of the treatment might see if their results were as pronounced. Last year, when in Bootle, Liverpool, the intravenous injection of formaldehyde in pulmonary tuberculosis was brought to my notice by Dr. F. W. Baker Young, who used the apparatus as recommended by Dr. Robert Maguire of the Brompton Chest Hospital, but modified the strength of his solutions, and used as a medium sterilised distilled water instead of saline solution. I have heard and read of various germicides being used intravenously, but so far have not heard of anyone using chinosol, a quinine potash compound, and a very powerful germicide. In the following cases I used it in conjunction with formaldehyde with most gratifying results. CASE 1.—The patient, a man aged 54 years, had been ailing for almost 12 months with a history of haemoptysis, pleurisy, cough, and profuse expectoration, and of having lost a considerable amount of weight. Acting on the advice of his medical attendants he spent four months at a sanatorium, and, although he put on 21 pounds in weight, when he left he was in a very weak condition, and the cough and expectoration had decreased very little. He tried as well as possible when at home to keep up his sanatorium methods, and for five weeks held his own as far as his weight was concerned, but was not getting any stronger. He then began to lose weight, and for the three weeks before coming under my care lost 1 pound, 1 pounds, and 2t pounds respectively. Under the intravenous injection of chinosol and formaldehyde he recovered his weight, rapidly regained strength, and at the end of four weeks' treatment was able to walk-without unduly distressing himself-two or three miles at a time.