Vol. 60, 1909 - University of North Carolina at Chapel Hill

122
THB CHARLOTTE MEDICAL JOURNAL.
"^'SeZZir^:':^^ s^ve as an ex- ^'e adrenal^ was ad.iniste.d subcu^
.p,e of U.e use and action of the adrena. —usl^^^^
.^^rhlo^id? solutt^1
hn solution m one of the cases citea Dy
^^^^^ ^^^^ minutes, as the attached histories
*
P Vortv-two years old, contracted gonor- of the cases show, there was a sudden allerhea'for
the first time about twenty years viatinn of the attackin more severe cas«
ato and since then has had it at intervals the dose was increased to 1 Cc, which put|
r;e'4raryears During the last three an end to the attack within five minutes,
years the patient noticed a thin stream. A s,a,istics ol General Anesthesia.—
physician diagnosed a stricture of the ure-
^,g^,|,pj. (Deutsche Med. Wochensch.) gives
thra and employed bougies for three months. ^ ^^^^^ ^^ ,^ ^^^^^^ among 71,052 anes-
The stream of urine improved. After a
^j^g^jj^j, j^ (he year 1908, that is about 1 ini
lapse of a year and a half the patient again
^^^^.^^^ ^^ .^ somewhat higher for chlorofoni)'
noticed a thin stream, and since about four
-^^^ ^^^^^^ although the latter is the more
weeks was obliged to urinate frequently,
Qf,p„ f^iio^.ed bv post-operative pneumonia I
and there was some difficulty in urination
^^^ e^grmany, however, ether has displaced i
The examination showed a stricture ot ^^,„roform to such an extent that the lalte) i
the cavernosus urethra. The stricture was .^ ^^^^^, employed in onlv about oiie-fourti i
discovered by means of a button-sound, ^o.
^^ ^^^ ^^^^^ -^j^^ ^^^ Esmarch inhaler ha;
18, Bougie No. 12 entered the stricture
^^j^j^^j^g^j its prestige. The developmen' i
but did not pass through. Bougie iNo. lU I
^^ ^^^^^ anesthesia has done much tore
passed through easily. At intervals ot two
^^^^ ^^^^ dangers of anesthesia— at least 2; j
r^^^
method preferred by th(
j
days bougies were introduced of a contmu- ^^^ ^^^^^
ally increasing size up to 18. At this point ^^^j^^j. consists in the administration o ,
it was not only impossible to pass a larger ^^^^,,^^1 ^^^ the evening of the operation an( ;
size, but even No. 14 could not be intro- ^^ ^ 0005-0 0008 grm. scopolamin and CO'.'
duced. Ten grammes of a 1;5000 solution ^^ ^ ^^ morphin, one to two hours be for. 1
of adrenalin was injected into the urethra jj^j.(,Qg;g 'j-jig anesthesia is slowly initii;
of the patient and allowed to act for a tew ^^^^ ^^^ ^^^^ ^p ^^ tj^^ p^i^t of arrest o J
minutes, whereupon it was possible to mtro- ^.^ ^^^^ prevention of resistance, but no
duce a No. 19 bougie. The same experi- ^^ formerly to the point of complete arresii
ence was repeated twice in the course of the
^^ ^^^ reflexes. This plan has the advantl
treatment. In both instances the injection
^^ ^^.^^ ^^^^ humane by avoiding an;
^
of the adrenalin solution made it possible
^^j^j^^l excitement before, during, an.i
to introduce a larger sized bougie, up to-
^^^^^ operation, while vomiting and post)
No. 26. The urinary stream is normal and
^^^tive pain are prevented and the danj
the patient is able to urinate without dith-
^^^ ^^ pneumonia greatly reduced.
""""He comes to the conclusion that adrena- P«»ys"«»"'*--Wi«1^7ski( Wi^en.klfei
lin is a good adjuvant in cases of stricture Woch.) has seen during the last five yea
of the urethra that are complicated by con- 35 cases of a simultaneous inflammation
. several serous membranes, fatal m four n
^^
stances. The polyserositis develops in threl
On the Treatment ol Bronchial Asthma, gtgges. In the first there is merely a serof!
— JagicC Berliner klinische Wochenschrift) effusion in the pleura, pericardium aiij
calls attention to the fact that we possess a peritoneum, but no fev:r or appareil
, . , ,. t v,^ 1, otto^T..= r.f changes n the internal organs or glanc
remedy m adrenalin to check attacks of
^^^^^ ^|tients complain only of gener,
acute asthma. He states that he has seen ^^^^,,^33 ^^^^ vague pain in the chest ati;
such prompt and strikingly good results abdomen. Adhesions form and the condj
follow this method of treatment in several tion grows worse under increased tempenj
cases of genuine bronchial asthma in vari- ture, with debility and irregular stoo ,
ous instances in the last three years that he Exceptionally the condition may inipro^i
considers adrenalin preferable to all other and the improvement may persist tor se
indicated remedies, such as morphine, atro- eral years. The third stage is charactej
pine chloral hydrUe, etc: This pertains ized by high fever, cachexia and edema .j
especially to the use of adrenalin in the case the feet, and autopsy reveals cheesy d,:
of very young individuals in whom there generatien of the lymph glands, Parench,.
are no complications, such as emphysema matous degeneration of the internal orga.,,
or diseases of the heart and arteries. No and tubercles disseminated over the sera;;
untoward after-effects, even after a long- membranes while the lungs and digesti,
continueduse of this remedy, were observed, tract are intact. Treatment consists ]
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