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

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THF CHARLOTTE MEDIOAL JOURNAL
vator " sold in the shops and fitted to any curred that there might be some antogonism
corset now in use. Cardiac pain is often between the two organisms, because he
confused with pain in the adjacent bones, noticed that there was a decrease of diphparticularly
where these have gouty deposits theria coincident with the "^crease of cereon
the anterior parts of ribs, in which case, brospinal fever. He then found tha pure
the tincture of iodine renders good service, cultures of meningococci were killed by
Likewise an intercostal neuralgia may cause antidiphtheritic serum He, herefore,
"cardiac" pains Vaso-motor disturbances, treated four cases of cerebrospinal fever by
especially in arterio-sclerotic patients, may antidiphtheritic serum and all recovered,
develop anginoid states (in connection with The success hoped for by this method has,
cold damp weather). Vascular crises play however, not been realized Antipneumoan
important role in the most diverse car- coccal serum seems more likely to be of use
diac sensations, and obstipation, flatulence, than antidiphtheritic, owing to the close
irritation of the walls of the stomach, dis- resemblance of pneumonia to cerebrospinal
nroportion in the size of heart and thorax fever, and of the pneumococcus and meninmav
develop cardiac pains. gococcus to one another. He has used it
once, owing to the presence ot some Gram
The Surgery of Lingual Thyroids.j^j.^.g^iplococci
in the cerebrospinal fluid.
Low, in The Edinburgh Medical Journal.
^^ ^.^^^^ ^^^^^^ followed its use. Jevers
discusses the anatomy of thyroid deposits
^^^ j,^^^^^ however, noted improvement
in this situation and says that as excision
^fter its injection, saving that the patient
of these lingual deposits has been fol owed
^^^^^^ ^^-^^^^ and went to sleep; the tembymvxedema
the surgeon should always
^^.e rapidly fell, followed bv a rise some
consider carefully the question whether or
^-^j^^ j^^j^j. but the patient seemed better and
not in these cases the normal thyroid in the
^^^ ^^^^ stronger. The production of a
neck is sufficiently developed to carry on
^^^^^^ satisfacton^ anti-meniiigococcal se-
itself the thyroid function m the body. In ^.^^^31^0^1^ „ot be long delayed, and to this
case of absence or small size of the cervical ^^ ^^^^ j^ok as being the most rational,
thyroid, one would hesitate to operate ex- ^^^ ^^^ ^^^^^ method of combating this discept
when the size of the lingual deposit ^^^^ jochman produced a serum for which
should prove dangerous to life Enough ^^ claims distinct therapeutic properties;
of the lingual deposit should be left to carry ^.^j^ .^ ^^ ^^.^^ ^^j^ ^^ confer immunitv to
on the thyroid function (m case of cervical ^.^^ a-ainst six times the ordinary lethal
absence) even at the risk of subsequent re- ^^^^ ^^ ^^^ ^^^^. p^^ humans, doses of
currence. He advises the splitting of the ^^ ^ ^ ^^^ required either iutraspinally or
tongue from tip to base, thus permitting g^bcutaneously. Of seventeen patients
thorough eradication. The writer prefers ^^.^^^^j j^^ jj ^^^y 5 qj. 09.4 per cent. died,
this method to that of subhyoid Pliaryng- j^^ pg gerum' he tried on three patients
otomy, for while the latter is admirably ^^^^^^^^ success. Recently Flexner's serum
adapted for the removal of growths at the ^ ^o be giving verv satisfactory reentrance
to the larynx, it has for the re- ^^^^^ ^^^^^ ^^^^^^ ^^^^^ ^^ l^^^.g brought
moval of growths at the base of^the tongue ^^^^;^ ^^^ mortality considerably,
the great disadvantage of opening a communication
between the septic cavity and pyopcricardium in Children.—Poynton
the large cervical wound. Moreover, if the jj^ -j-j^g British Medical Journal says in an
transverse incision is carried any distance analysis of 100 fatal cases of this affection
beyond the hyoid bone, the superior nerve tai-en from the Great Ormond Street Hosmay
be cut, and the larynx is rendered in- pj^-^j ^^^^ other records, notes that S3 per
sensitive, permitting food and discharge to ^^^^^ occurred before the fourth year of life
enter the cavity and expose the patient to ^^^^g completed and two-thirds between t'he
the danger of foreign body pneumonia, ^^^gg ^f one and three years, making it, in
The procedure to be followed after expos- j^^t, almost a disease of infancy. Primary
ure of the growth depends on its size. In- pyopericardium is excessively rare. About
cision with curetting and cauterization may (^q p^j. (,g„t ^.gre associated with empyema,
suffice in some instances, but the author a^j about 40 per cent, were associated with
contends that it is a very much better plan acute pulmonary tuberculosis. ,\bout 20
to extend the operation to an excision of pgj. ^gnt. of the cases ran an acute course
the capsule which, he says, consists of the lasting about four weeks. Fifty per cent,
dilated remains of the thyrolingual duct. ^^^^ subacute, lasting four weeks to six
Cerebrospinal Fevcr.-Larkins, in The months; 17 percent, were chronic, with in-
London Practitioner, mentions the sera used sidious onset lasting from six months to
in the cerebrospinal fever. The use of anti- over a year. In acute cases the symptoms
diphtheritic serum was suggested by Wolf, were abrupt and pneumonic in type. In
of Hartford, Connecticut, to whom it oc- the subacute and chronic cases, cough,