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

ABSTRACTS. 185
been removed by lithotrity and the patient vocates the giving of tuberculin by the
restored to health in a week, whereas he is mouth in normal saline solution or in fresh
now condemned to pass through au unnec- horse serum. He says that it should be
essarily severe ordeal. In skilful hands given when the stomach is empty and in
the x-rays will nearly always eliminate the morning. He shows by the effects on
such errors, even when the sound has failed the opsonic index that it really acts when
to reveal the true cause. Prostatectomy so used, but the dose required is about doushould
be deferred until after treatment by ble the hypodermic one. He asserts that
catheter has been tried. The patient may benefit is derived from tuberculin even in
recover his power, or he may decide, when very acute stages of phthisis, but this is not
he knows exactly what to expect, to con- altogether confirmed by Dr. Mackenzie,
tinue treatment. No harm can come of a The point of interest is the fact that fresh
delay of a month or more, and in septic horse serum given alone always raised the
cases much good will result, for the patient opsonic index to tubercle without any prewill
improve and be in a better condition to ceding negative phase, and should, therebear
the operation. Afterward, if the ca- fore, be a most useful addition to the treattheter
fails or is found too irksome, recourse ment of acute phthisis. When tuberculin
can be had to operation. When the patient is given in any form, the patient should be
is comparatively young, in good health, kept in bed for at least twenty-four hours,
and has many years of life before him, and the temperature taken every four hours,
operation is ver>' rightly advocated as soon preferably in the rectum, in order to guard
as it is proved that catheter treatment will against ill effects during the negative phase,
not cure. The same may be said of those He considers that Marmorek's serum is
who, owing to their position in life, calling, horse serum containing an unknown amount
or lack of funds, are unable to carry out of tuberculin. This serum was tried some
the few simple details necessary in sterile time ago but did not give such results as to
catheterization. Prostatectomy undoubt- make its use permanetit. Dr. Maguire's
edly is the best treatment when the prostate, method of injecting intravenously every
by its mere size, has largely encroached day 50 c.c. of 1 in 2.000 formic aldehyde in
upon the bladder space, and there is no normal saline solution is difficult, but does
residuum. The urine is clear and free from good in some cases. Cinnamate or hetol
all signs of sepsis, yet the patient has con- injections increase the number of leucocytes
slant and urgent calls to pass water both by in the blood, and thus probably aid the
day night. Pinally, the operation may be phagocytic power,
necessary in certain cases where the prostate
is constantly bleeding and filling the Radloactlvlly and Carcinoma.— Barbladder
with clot which interferes with in- low, in The British Medical Journal, prestrumentation
and endangers the patient's sents his views on radioactivity and carcilife.
noma. The writer shows that certain of
the tissues of the human body show skoto-
PWhlsIs.— Broadbent (London Practi- graphic action (liver, kidney), while certioner)
in speaking of the treatment says tain do not (spleen, lung); that a larger
that in giving tuberculin, the best results amount of this property resides in female
will be obtained, if the opsonic index is tissues that possess it than in male of the
taken a few times first, and the new tuber- same kind; that the amount present in the
culin T. K. injected when the index begins liver increases from infancy to the age of
to fall. After the injection, there will be a fifty-five years, with an unexplained drop
negative phase of a falling opsonic index in both sexes during the age period thirtyfor
about twenty-four hours, followed by a five to forty-five, and that after fifty-five
rise to above the former line. A new injec- while it increases still further in the case of
tion is indicated when the index again be- males, in females it undergoes a sharp
gins to fall, which is usually in seven to diminution. The author demonstrates that
ten days. Headache, rise of temperature, carcinomatous material possesses skotoor
a prolonged negative phase would show graphic power, whether it is primary or
that too large a dose had been given, and secondary, and that female carcinomatous
a feeble opsonic response that the dose was tissue has a higher skotographic value than
toosmall. It is safest to begin with 0.00002 male; and that the existence of a mass of
of a milligramme, slowly increased to 0.0001 carcinoma in a tissue ^modifies its normal
or 0.0002. It is possible to give tuberculin skotographic value. Barlow has found that
without using the opsonic index, if the tem- certain substances commonly supposed to
perature and clinical symptoms of the pa- be causally related to carcinoma possess
tient are very carefully watched, and the the skotographic power to a high degree
quantity injected is very slowly increased (cholesterin, gallstone), while others are
at intervals of ten days. Dr. Latham ad- devoid of it (clay pipe, paraffin). The