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

XXXIV THE CHARLOTTE MEDICAL JOURNAL.
The Differential Diagnosis of Acute been useless, and have not diminished the
Leultemias.— Schultze (Munch, med. number of cases among infants. Neither
Woch,) mentions the difficulty that exists has sterilization of milk. To have a bad
in differentiating; acute lymphoid and mye- effect milk must be full of bacilli from masloid
leukemias. In the chronic cases the titis. If milk was the cause, all the people
differential diagnosis is easy, but acute „.ho drink the same milk should be affected
cases are quite the re-erse, for here one has by it. On the contrar}-, only those exposed I
to differentiate the lymphoblast, the ante- to the contagion have the disease. Out of
cedent of the lymphocytes, from the myelo- autopsies on 1447 infants made by the j
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blast, which is the parent cell of the granu- author tuberculosis was found in 5,36 cases.
lar leukocytes. The two cells are practi- In all these cases the bronchial glands were
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cally identical in size, each possesses infiltratedr The older the children, the .
strongly basophilic protoplasm, and their more frequently was tuberculosis found,
nuclei are similar. Schridde describes a if jt came from milk the younger children
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narrow,
the lymphoblast,
clear border about the nucleus of should
but for most observers who are
have
kejit
it more
in the home
freciuentlv.
are less
Infants
affected
this is not a practical differential point,
Schultze makes use of the so-called oxydase
reaction (indophenoblausynthe.se) for
differentiating these cells and especially for
differentialiug the tissues of lymphoid from
than those of an age to mingle with the
public. Many of the chronic coughs and
asthmas of old 5)eople are tuberculous, and
the disease is transmitted to the infants of
the familv. Prophylaxis must deal with
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those of myeloid leukemia. For carrying the removal of all cases from the family,
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out this reaction a 1 per cent, aqueous solu- not with the care of milk and meats.
tionofaxnaijhthol and 1 percent, aqueous The Early Diaanosts of Puimonary
solution of dimethylparaphenyk-ndiamin Tubercuiosis.—Mausmann ( iJeut. Arch.
(E. Merck) are needed. The naijhthol, f. u\n. Med.) has been impressed by the
which is only slightly soluble, is warmed number of gastric cases in his practice
and then filtered after cooling. The two which presented evidence of apical lesions.
solutions, when united, form a blue color Those who raised no sputum he often sent
under the action of light through an oxi- to a lung specialist, and frequently his
dative synthesis. In the presence of an diagnosis of incipient pulmonary tubercuoxidative
ferment the process is greatly ac- losis was reversed. Feeling that he was
celerated. Myeloid tissue, when treated correct, he decided to examine the fasting
with these solutions, is stained blue, owing stomach early in the morning for small
to the presence of an oxidative ferment, particles of bronchial secretion. The au-
while lymphoid tissue remains unstained, thor's first patient gave no history of cough,
The method is especially applicable to but had definite signs in one apex, the
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The Ro3e of Huinan Contagion in Infantile
TubercuScsis.—Coniby (Arch, de
Med. des Enf.) says that the role of milk
and meat, of food products and intestinal
chief complaints being a feeling of fulness
and weight in the epigastrium. A very
small particle of mucous, enclosing pus
cells and lymphocytes, and a few alveolar
epithelial cells, were obtained from the
tuberculosis, is a small one in the causation stomach, and when stained showed about
of tuberculosis in infants. Children are ten tubercle bacilli in a field. In tiie last •,
born neither with tuberculosis nor with a two months he has had six similar cases,
])redisposition to the disease. If the chil- all with the same result. The writer bedren
of tuberculous parents are removed lieves the usefulness of this method and i
immediately from the surroundings in which suggests that some of the so-called "closed"
the parents
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cough and spit, and are brought
up in good hygienic surroundings, they
urow up strong and well. If they remain
ill their homes they die of tuberculosis, deor
"healed'' cases may be shown by this
means to be in reality "open" cases of tnberculosis.
Hot Air in Surgery.
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rived from the infected house. Pallor, Ronaniy and Muller have applied hot air J
emaciation, narrow chest, and micropoly- in surgery, at the Hospital Gouin since Febadenopathy
are symptoms not of a tuber- ruary, 1907. These applications have been
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culous predisposition, but of latent tuberculosis.
Transmission of tuberculosis by
chiefly made on diabetic andtraumatic gangrene,
cancerous ulcerations of the breast,
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heredity does not exist, neither does predis- epitheliomas of the neck of uterus, can- ':
position. Those who assert that they do croids and certain cutaneous affections. He ,i
are guilty of misinterpreting simple facts,
In the immense majority of cases tubercuemployed
Gaiff's apparatus.
There is not the least doubt that this
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losis is derived from the family by inhala- method is called upon to play an important I
tion. The measures taken against animal part in surgical therapeutics.—La Presse 'tuberculosis
and tuberculous milk have Medicale. i
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