PRACTICAL NOTES

1897 Journal of the American Medical Association (JAMA)  
Comby administers in the morning fast¬ ing for three days, one of the following powders ; Santonin 5 centigrams ; calomel 10 centigrams. Apply locally at night as the child retires, for three days, the following salve inside the anus : Glycerite of starch, 20 grams ; Neapolitan unguent 10 grams.-Presse Med., March 27. Prophylaxis of Tumefaction of the Cervical Ganglia Consecutive to Eczema of the Scalp in Infants.-Antiseptic cleanliness and relief from the pruritus are the requisites, and
more » ... ardt recom¬ mends for the purpose, washing the child's hands and cleaning his nails every two hours, washing his playthings at the same time and changing the clothes and bed linen frequently. The eczematous regions should be moistened for an hour with fresh Goulard's lead water, and then the following salve applied: Salicylic acid 0.50 gram ; menthol 1 gram ; linseed oil and lime water ää 50 grams. Externally.-Semaine Méd. March 31. To Preserve Steel Instruments from Rusting.-Dr. Maréchal in 1893 placed several perfectly new steel instruments, including bistouries, Pravaz' needles, a nickel watch (open), etc., in the following solutions : 1, an aqeous 2per cent, solution of sodium bicarbonate ; 2, ditto sodium carbonate ; 3, ditto sodium bor¬ ate ; 4, ditto sodium benzoato ; 5, alcoholic 2 per cent, solution of sodium benzoate ; 6, alcohol, 95 per cent., 5 grams to 1 gram sodium borate ; 7, alcohol 95 per cent. ; 8, water. In 1895, two years later, the instruments in the first six solutions were found absolutely intact, without a trace of rust, even when tested with potassium sulfo cyanid. But those in the 7th and 8th were completely covered with rust. He therefore recommends keep¬ ing steel instruments in one of the first six solutions to preserve them from tarnish and rust.-Gaz. Med. de Liège, April 1. Influence of Tobacco on the Nervous System.-Buccelli concLudes from his investigations of 200 patients with nerve and brain troubles, and others, that tobacco affects the normal nervous system to a comparatively trifling extent, but as soon as the condition of perfect integrity is impaired, its effect is extremely and progressively pernicious. The subcortical and bulbar nerve centers suffer particularly then from the toxic effect of tobacco.-Riv. dipatolog. nerv., 1896, page 327. Traumatisme of the Biliary Passages.-Terrier and Auvray assert in the Revue de Chir., No. 1, that no case of injury to the bili¬ ary passages has recovered without puncture or incision, and that better results follow prompt and adequate laparotomy than mere puncture which has often to be repeated. They state the indications for operative treatment as follows : In case of laceration of the gall bladder, suture or ablation, accor¬ ding to the extent of the injury. Lígate an injured ductus cysticus, and conclude with cholecystectomy. Temporary drainage of injured ductus hepaticus, and suture of an injured ductus choledochus, or cholecyst-enterostomy after double lig¬ atures. Although these indications are still partially theoretic, they should be borne in mind in cases of the kind. They report twelve recoveries in twenty-one cases of injury to the biliary passages treated by puncture ; four recoveries in seven cases treated with tardy laparotomy, and recovery in both of the two cases treated with prompt laparotomy. Hoffa's Method of Treating Congenital Luxation of the Hip Joint. -Professor Hoffa (Würzburg) has been in Paris recently, and many were interested in witnessing his operation as he per¬ formed it at one of the hospitals. Since Lorenz emphasized the importance of retaining the muscles, he opens up the artic¬ ulation with a front, lengthwise incision at the edge of the greater trochanter, opens into the capsule in the direction of the neck of the femur, and by twisting the femur outward, reaches the acetabulum, which he hollows out to the required shape, and replaces the head in it, which completes the opera-tion. The wound is tamponed with sterilized gauze, without suturing, and a plaster cast applied. Six deaths occurred in his first 190 cases, but only one in his last 100. Absolute asepsis is the indispensable requisite of success ; massage and gymnas¬ tics are also important factors. If suppuration occurs, there is imminent danger of anchylosis. He has had no relapse in his last 44 cases of bilateral luxation with pronounced lordosis. Almost normal position and abduction of the extremities was secured. The best age for the operation is between 3 and 4. It is diffiult to reduce the femur in older subjects, and Kirmisson's sub-trochanteric osteotomy is to be preferred, or for bilateral luxations Hoffa's "pseudo-arthrosis," which consists in sawing off the head of the femur and fixing the end to the pelvis. He exhibited at the Acad. de Méd., a six-year-old child success¬ fully operated by this method.-Bulletin, March 16, and Therap. Woch., March 28. Antitoxins In the Blood After Recovery from Streptococcus Infec¬ tion.-Neufeld concludes his report of experimental investiga¬ tion in this line with the statement that all results were nega¬ tive, and hence the outlook does not seem very favorable that we shall be able to secure artificially in animals what Nature herself is unable to accomplish in human beings recovering from streptococcus infection, namely, an accumulation of anti¬ toxins in the blood.-Deutsche Med. Woch., March 11. Rectal Injections In Diabetes with Threatening Coma.-The obsti¬ nate constipation in diabetes is due to the more or less para¬ lyzed condition of the bowels, unaffected by purgatives taken into the stomach, or else the violent evacuation induced may lead to serious accidents. Dr. P. A. Teschemacher recom¬ mends an injection of 10 to 40 grams of glycerin three or four times a week, retained half an hour in the dorsal decubitus, if possible. He also rests the stomach by administering alimen¬ tary injections four times a day, composed of 50 grams of wine, the same quantity of bouillon, to which somatóse has been added, two eggs and a pinch of salt. At this time nothing should be taken into the stomach but a few swallows of wine or brandy, a little beef tea, and pounded ice to quench thirst. -Semaine Méd., March 20. Tests In Cases of Apparent Death.-Ieard suggests that certainty can be attained in doubtful cases by the subcutaneous injection of some stain, soluble in water, non-toxic, non-caustic, and containing a substance not found normally nor accidentally in the organism. If the stain is then found in the blood or some remote part of the body, it must have been absorbed, and there is still life remaining, as absorption ceases absolutely with life. He recommends fluorescein for the purpose, as 1-1000 gram will discolor perceptibly forty-five liters of water. Half a gram injected subcutaneously, will stain in a few minutes the skin, eyes, mouth, urine and serum a brilliant green, if there is still life. The iodids are also effective ; 25 centigrams will be found by the starch test in the urine and saliva in a few minutes, if it is absorbed. Three grams of potassium or sodium ferrocyanid can be injected and can be readily distinguished in the urine by testing it with perchlorid of iron, which forms Rus¬ sian blue with it. Another way is to pass a thread through a fold of the skin. It is thus moistened with the serum, and turns bright blue after dipping it into weak hydrochloric acid, and then into perchlorid of iron, if the injected salt has been absorbed. He also states that aromatic substances are elim¬ inated by the bronchi to such an extent that they are easily detected if they have been absorbed. These tests should reas¬ sure those who are haunted by the fear of being buried alive. -Journal des Se. Méd. de Lille, Aprii 3.
doi:10.1001/jama.1897.02440190035006 fatcat:nhzczayeajc5deqj3ssq677rdq