Reports of Societies

1907 Boston Medical and Surgical Journal  
In some instances Lentz and Tietz 83 found the increase in the number of typhoid bacilli was enormous. In one case a series of 8 v. Drigalski-Conradi plates showed a single typhoid colony among about 24,000 colonies of fecal bacteria. The second series of blue plates, made after the enrichment produced by growth on the malachite green agar, showed 350 typhoid colonies to a single colony of a fecal bacterium. This was an increase of four and a half million. They admit that alkali-formers present
more » ... ali-formers present in the feces sometimes grow so profusely on the green plates as to render the method valueless. In the examination of 6 out of 51 typhoid stools the second series of blue plates showed either fewer typhoid colonies than the first, scries, or none at all. With paratyphoid stools there was always an increase. Lentz and Tietz M examined during one year at the Bacteriological Institute in Idar 2,737 stools. In 510 of these typhoid bacilli were found, in 144 paratyphoid bacilli. The paratyphoid bacilli were found in the stools of all the 44 cases of paratyphoid fever examined. In 25 of the 44 cases the diagnosis could be made solely by means of their malachite green method. fe» Klinger74 and SymanskilM have reported favorable results with the procedure of Lentz and Tietz. Friedel38 found it of value in paratyphoid infections but did not succeed in isolating the typhoid bacillus. In tests made by Bonhoff,11 B. coli grew in malachite green media that inhibited the growth of B. typhosus. In a concentration that checked both colon and typhoid bacilli both types of paratyphoid bacilli developed profuse growths. (To be continued.) Repor t s of Societies THE AMERICAN SURGICAL ASSOCIATION. All his cases, with the exception of one, were females; the youngest was twenty-eight, the oldest seventy-two years of age. The greatest number occurred in the fifth decade of life. His figures show that 28, or 35%, of the 80 patients traced ¡ire alive and well to-day, 9 having been operated upon within the hist three years. Four others died from six to eight years after operation, when 2 died of recurrence ; the other two of diseases not connected with the original trouble. Five lived from three to five years after operation. Three, though living, show 3 N. Y. Mod. Hoc., Doc. 15, 1801; Jour. A. M. A., July 29, 1905. signs of recurrence. Forty to 50% died within three years after operation. Dr. Meyer calls attention to the fact that eight of his fatal cases died of métastases in the absence of either local or regional recurrence. Regarding the wisdom of invariably cleaning out the supraclavicular space at the time of operation, he states that his own experience has pointed rather against such a procedure. It was done in none of his eases that remained well from five to twelve and onehalf years after operation. Concerning the preservation of the subscapular nerves, as advocated by Küster in 18S7, he states that he himself always tries to do so; still, he has in three instances seen a recurrence take place around the second subscapular nerve. In spite of this observation he would, of course, not consider the removal of these nerves warranted, in view of the resulting disability with regard to the proper use of the arm. Dr. Meyer emphasized the fact, that every one of his patients has the perfect use of her arm. Only one of his living patients has a somewhat pronounced edema of the arm. The post-operative neuralgia or neuritis of the brachial plexus has proved to be transitory in every instance. As to prognosis, he considers the cases with involvement of the supraclavicular glands to offer little hope of permanent cure. Nevertheless, he believes it imperative, even in these cases, to extirpate, whatever can be reached with the knife, so long as métastases do not forbid such ¡i procedure. So far as he has been able to determine from the partially, somewhat, incomplete pathological records of the cases reported, the prognosis is less favorable in the case of adenoeareinonia than of scirrhus. Dr. Meyer expresses the opinion that it is often more the degree of malignancy of the disease than its duration prior to operation that determines the final result, lie has seen several cases in which, despite most timely and thorough operation, internal métastases occurred with astonishing rapidity. lint, just because of the known treacherous, perhaps even infectious, nature of malignant disease, he thinks if would be wrong, even in view of tho apparent hopelessness of such cases, to encroach upon the magnitude of the operation. It is because of the uncertainty as regards the virulency of the disease in the given case that radical work becomes a necessity in every instance, and this, he thinks, is best accomplished by an operation such as he practices, consisting in the removal of both pectoral muscles, with the diseased breast, glands and surrounding fat in one mass. Dr. Lewis S. Pilciier, of Brooklyn, presented a contribution to the symposium on END RESULTS FOLLOWING OPERATIONS FOR CARCINOMA OF THE 1ÎREAST. IIis paper dealt particularly with 18 cases in which the evident extension of the disease at the time they first presented themselves was great enough to arouse suspicion of possible infection of the lymph nodes above the clavicle. In 4 eases glandular masses in the neck were distinctly palpable; of the 14 in which the examining linger could not appreciate the presence of diseased nodes in the neck, section revealed infected nodes present in 11; and in only 3 cases appreciable disease was not recognizable upon section. Of these last mentioned 3 cases all have remained well from the time of operation, a period of five, one and one-half and one year respectively. Of the four cases in which the supraclavicular glands were palpable before operation, one case died throe months after operation, evidently from internal metas-
doi:10.1056/nejm190706131562407 fatcat:5chykzen6jgvnpgjlrwmrmpi5u