Poliencephalomyelitis and Allied Conditions

1903 Boston Medical and Surgical Journal  
of Meckcl's diverticulum, 1 ruptured tuba) pregnancy, 2 vaginal hysterectomies. Although pressure and heat have been used for more than a quarter of a century for preventing hemorrhage, the methods heretofore employed for this purpose were in the developmental stage and in consequence were but seldom employed. Baker Brown, in 1802, heated a heavy clamp by the aid of the actual cautery, until the pedicle of an ovarian tumor was rendered dry and bloodless. His results even in this pre-aseptic
more » ... his pre-aseptic period were better than his confrères', which may have been due in part to this method. The instrument perfected by Downes, known as the electro-thermic angiotribe, is unquestionably ELKCTOIO Anuiothihr. of practical value, as shown by the results in the foregoing cases, no secondary hemorrhage having taken place. The femoral was clamped in a thigh amputation and the anterior and posterior tibiáis in an amputation of the leg. In an operation upon a dog 1 clamped the femoral and applied the current until the vessel parted, having been completely charred; yet no hemorrhage or edema followed. I performeel complete gastrectomy on a dog and found the method, with the use of the proper electrothermic angiotribe, of marked improvement over the usual technique. I also found the clamp useful doing a gastro-enterostomy. The fold in the stomach of the proper size is grasped with the DiitixT Current transformer. electro-thermic angiotribe anel pressure and heat applied. A similar process is carried out on a folel of the intestine at the desired point of union. Su-turcs passed one-fourth of an inch beyond the cauterized areas unite the stomach and bowel. The compressed area will slough in from 30 to 86 hours, as shown by actual experience with e'.ogs. The most interesting case to me was the resection of fourteen inches of the intestine on a man ; following numerous experiments on dogs. The ease with which we may resect the bowel, and the perfect asepsis assured by the use of the electrothermic angiotribe, is certain to eliminate the mechanical appliances now in use for this purpose. The wide range of usefulness of this instrument renders a surgical outfit incomplete without it. The advantages of the use of the electro-thermic angiotribe are : the exclusion of the ligature ; hemostasis en masse or of isolated blood vessels ; aseptic gastrectomy ; gastro-enterostomy and resection of intestine ; appendectomy ; salpingectomy ; extrusion of septic material during operation being rendered impossible ; sterile occlusion of the Fallopian tube ; absence of irritable and painful stumps ; less tendency to post-operative adhesions ; rapidity of operation ; no secondary hemorrhage from slipping of ligatures, or suppurating sinuses due to ligatures ; less pain subsequent to operation, and there is no puckering or dragging on the tissues ; value in removal of cancer as there can be no danger of The term " inflammation " as applied to affections of the nervous system has led to the same confusion as in other organs. It is well for practical purposes to limit its meaning to the exudative phenomena produced by an irritant acting temporarily, with accompanying signs of general infection, and thereby to distinguish lesions which may be called inflammatory from others in which these phenomena are not present. For example, in the present state of our knowledge we shall not be very far wrong in making a sharp distinction between degenerative affections of chronic, continuous course like progressive muscular atrophy, with its accompanying bulbar manifestations and diseases of acute onset, ending in death, or in partial or even complete recovery, such as poliomyelitis or poliencephalitis. It is safe to assume that the causes which lead to degenerative
doi:10.1056/nejm190306181482503 fatcat:urqw7tb4ijcq5acnbecketjmzu