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

THE CHARLOTTE MEDICAL JOURNAL
..PnPr^l strenethening measures, forced pWegmonous tendo-synovitis necrosis of
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Wdin^ and possTbly injections of some the tendon occurred in only one instance,,
prepTrition oFarseSc, supplemented by that of a woman seventy-two years old.
earlv aspiration of the effusion, this latter ^^^ Eltect ot Hypophysis-Extract Upon »
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having a favorable effect on the circulation ^^^ Bloodvessels.— (Wiener med. Wochand
nourishment of the regions involved
^chrift). The extract employed by Dr. J
and hastening the development of adhesions
p^^^ ^^.^g prepared from the posterior nervous (
which modify favorably the further course
j^^g ^f the hvpophysis, 1 ccm. correspond- 1
of the affection. The negative findings m jj,g (^ q q^ of t^e dried substance. About]
the heart, lungs and kidneys differentiate
t^^o per thousand of the efficient substance^
the polyserositis from disease in these or-
.ivere contained in the extract. Intravenousc
gans. He emphasizes the constant absence injection was followed in the first place by
of the usual symptoms of pleurisy or peri-
^ 1^^;^^ transitory lowering of the blood <
tonitis, also the simultaneous involvement pressure, passing into a moderate rise of
of all the serous membranes, suggesting pressure. The same phenomenon could be
some general cause, probably endotoxins determined over again by repeated infec-'
generated in some comparatively small tutJo„s.
The hypophysis-extract furthermore t
berculous focus, these endotoxins reaching gi^owed a well-marked diuretic action. The]
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and irricating the serous membranes. Some examination of excised arteries from beeves
old focus in the Ivmph glands or urogenital
j^^ Ri„ger's solution to which hypophyseal !
apparatus was discovered in all the cases
extract had been added, served to show that I
that came to autopsy. This assumption of
jj^g carotid, mesenteric, and femoral arter>
the etiology explains the benefit from prompt underwent shortening (as under the addil
evacuation of the effusion which removes tjon of adrenalin ), whereas the renal arteries i
quantities of these endotoxins while favor- ( become lengthened opposite findings undeii
ing production of adhesions. The author addition of adrenalin ), at least in their pen i
is convinced that many cases of alleged pj^gral portion towards the renal pelvis'
"pericardiac pseudocirrhosis of the Hver'^' r^-^^ findings upon the coronary arterieii
and "chronic hyperplastic perihepatitis" ^^gre not entirely uniform. The pupil ol
really belong in this class of polyserositis, ^j^^ excised eye of frogs is dilated by hypo i
The Hot Air Treatment of Acute Sup- pli>-eal extract as well as by adrenalin.
puratlons ol the Hand.-Islen(Munchener j^ ^^^ Method oi Sphincteiic Contro:
Med. Wochensch) gives the results obtained ^^^^J. colostomy.— Ryall, in The Edin i
from this method of treatment. Before re- ^^^j-gij Medical Journal, describes hismeth.
sorting to it the pus is evacuated, this being ^^ ^]^^^. ^i^^ rectus is split vertically atn
done under anesthesia. The incisions are ^^^e sigmoid is drawn out and divided at i
made on the palmar surfaces and sides of convenient point. The lower segment ii
the fingers down to the tendon sheaths, the closed and replaced in the abdomen. Th;
site of the suppuration sought, pus and upper segment is made less bulky by re'
necrotic tissues removed by irrigation with j^o^jng the appendices epiploicee and free 1
saline solution, and the wound cavity cov- ^^„ ^^ ^f mesenteric fat, but without in an i
ered with iodoform gauze. The hot air ^^^y interfering with its blood supply. Thj
treatment is begun on the day of the opera- artificial sphincter is then made in the fo :
tion, at first twice daily for a period of two lowing manner; A loop of muscle fibres;'
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hours, the gauze, if necessary, being previseparated
from the posterior aspect of tb
ously loosened by immersion of the affected
rectus on either side of the wound. Eaci
part in a warm saline solution. During the
joop is then drawn over to the opposite sic
interval an alcohol dressing, 90 per cent.,
qJ ^^^ wound, so that one loop overlaps ttj
is applied or one moistened with aluminum other. The overlapping loops thus form i
acetate. Abscess cavities are covered with ^.^^^ ^^^^ through this the bowel segment ;
iodoform, the pus never being expressed (jrawn. Sutures are then inserted to keeL
but washed out with a saline solution. It ^-^e muscle fibers together above and belo i
is important to remove dead skin. For the ^^^jgre the bowel comes through. Ancho i
hot air application Bier's apparatus is em- ^^^„ stitches are inserted through the sky:
ployed, the temperature varying from 90 to ^^^^ muscle inside to keep the bowel in pi
110° C. This method produces marked re- gition. The wound is then closed abo',j
lief of pain and greatly shortens the heal- ^^^j below the bowel and the cut edges 'i
ing process. The results were often sur- the latter are sutured to the skin. Adouhi
prising, suppuration ceasing after a few gpiiincter is thus formed consisting of long
days and the wounds assuming a clean ap- tudinal and circular fibres. The longitucf
pearance and closing in eight to fourteen j^^j fibres are those of the anterior portit
days. The tendons were preserved and the of the rectus and the circular fibres ai;
cicatrices were soft. In seventeen cases of formed by the loops from the posterior pj,1
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