MEDICAL PROGRESS

1890 Journal of the American Medical Association (JAMA)  
reports seven cases of actinomycosis observed by him in three years. The first two cases occurred in a young printer and his betrothed. The abscesses which had formed were incised, cleansed and dressed antiseptically. Up to the present time, eighteen months after the operation, there has been no re¬ turn of the disease. The third case occurred in a chimney sweeper. In this case also the ab¬ scesses were opened and scraped out, but from time to time the disease recurred. In the last year the
more » ... e last year the writer has observed three other cases similar to the ones already described, and one case of cutaneous actinomycosis of unknown origin occurring in a chimney sweeper. In the writer's opinion the treatment should be of a radical character, though the prognosis, even in cases where there is abscess formation with mixed infection, is not unfavorable.-WienerMed. Woch. O'Dwyer's Intubation of the Larynx.-Guyer reports {Cent, für Klin. Med.) the results of intubation of the larynx, as performed in the Children's Hospital of Zurich. Up to the end of May, 1889, the operation had been performed on account of acute laryngeal stenosis in twentyseven cases. Of these thirteen recovered, of which two were infants, aged 8 and 13 months respectively ; the remainder varied in age from 2 to 8 years. In all these cases the diphtheritic character of the stenosis was proved by the affec¬ tion of the larynx and by the membrane coughed up. In all the cases the stenosis was so severe that there was only a question of choice between tracheotomy and intubation. In the fourteen cases which died the cause of death in eleven cases was extensive bronchial diphtheria; in two, pneumonia ; in one, nephritis. In most of the cases the children were able to dispense with the tube after five or six days. In four cases in which removal of the cánula gave rise to bad symptoms its replacement was followed by excel¬ lent results. The reporter believes that intuba¬ tion will not supplant tracheotomy, but merely limit its applicability. Treatment of Diabetes.-Dr. Robin has made some interesting observations of patients suffering from diabetes, in which he carefully ex¬ amined the chemical composition of the urine and studied the influence of various substances upon it. He reaches these conclusions : Biological chemistry shows that in diabetic patients there is not only an exaltation of the various processes of nutrition, but also an increased functional activ¬ ity of special organs, chiefly the liver and the nervous system. In consequence, this undeniable increase in the functional activity of the general nutrition and of the hepatic cells, brought about by a direct or reflex nervous irritation, must be made the point of departure for the therapeusis of diabetes. A priori one may be sure that any remediable measure which in any wise retards the general changes, or those of the nervous system, will certainly lessen the glycosuria. Still, there is a prospect of success with a remedy only when it exercises its restraining influence upon the general changes by means of its primary influence upon the nervous system, and when it does not act too powerfully upon the functions of this sys¬ tem. The therapeutical remedies which impair nutrition must be banished, for it has been clinic¬ ally as well as experimentally proven that they do not yield useful results. The therapeutical indications in diabetes are as follows : 1. One must remove from the organism, by means of suitable diet, the materials that form sugar, and deprive the liver cells of the substance that gives rise to their functional irritation. 2. One must restrict the excretion of assimi¬ lated materials and the formation of glycogen by means of therapeutical remedies which check the chemical processes of organic life by means of their primary action upon the nervous system.-Inter. Klin. Rundschau. Creolin in Gynecology.-Extensive experi¬ ments have been made by Chéron {Annals of Gynecology) with creolin in 2 and 5 per cent, so¬ lutions. The weaker solution was used for vesi¬ cal injections in cases of gonorrhoea. Neither poisoning nor pain resulted ; the discharge from the urethra diminished and soon disappeared, in¬ jections being made every other day. Gonorrhoeal vaginitis was quickly improved by irriga¬ tion of the vagina and vulva with the 5 per cent, solution. In purulent cervical endometritis the diseased tissues were first carefully cleansed with absorbent cotton, after which an application of the 5 per cent, solution was made. After a few applications the suppuration ceased. Creolin gauze was found to be an excellent substitute for iodoform gauze in cases of suppurative and hemorrhagic endometritis in which a tampon was re¬ quired. From the foregoing it was concluded that creolin has a vety positive effect upon the microbes of gonorrhoea and of pus, and that in ordinary doses it is neither painful nor toxic. Alcohol in Puerperal Fever. -Dr. A. Martin, of Berlin, reports {Internat. Klin. Rund¬ schau) his experience with alcohol in the treat¬ ment of eighteen cases of puerperal fever. Of these eighteen patients, all of whom were very ill, some of them, indeed, moribund when the treatment was begun, five died, three of them only from the infection. The amount of alcohol administered was enormous ; thus, one of the pa-Downloaded From: http://jama.jamanetwork.com/ by a University of Arizona Health Sciences Library User on 05/28/2015
doi:10.1001/jama.1890.02410120021002 fatcat:z6mp7tnvqfakfcwxn6jnzzyf54