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

Of the patients three were spinsters, three
multiparas, and fifteen primiparas. Ages
varied from 28 to 45. Of the operations
done, three were enucleations and seventeen
h^-sterectomies, two of the latter being
total, as the fibroids were in the cervix.
The writer has seen the red change occur
in all thirty-two times. The author says
that he has no opinion as to its cause. The
presence of micro-organisms in the degenerated
tissue is in all probability exceptional.
The thrombus and infarction theories
which have been advanced require
more proof than has thus far been brought
forward. The condition is prone to occur
during pregnancy. Fibroids so changed
are a serious menace to the pregnant state.
lodipin In Syphilis.— Freshwater, in The
British Medical Journal, mentions the advantages
and disadvantages of iodipin. It
is often necessary to give a long course of
iodine to patients who are unwilling to lake
iodide either from its lowering effects or
that they are the subjects of iodism. All
the iodipin injected is used up and must
exert its specific action; an exact dosage is
therefore possible. Injections are painless,
and there is no fear of sepsis if proper precautions
have been taken. Subcutiineously
it does not produce iodism. Patients who
have an idiosyncrasy to potassium iodide
can take it quite well. Patients remain
much longer under the influence of iodine
than when iodine is given in other forms.
After a short course of injections the system
can he kept for a period of four to six
months under the influence of iodine. The
body is under a slow, continuous regular
action of iodine, which is of prophylactic
value. In nearly all cases, after a prolonged
course of potassium iodide, there
are stomach and bowel troubles. This does
not occur with iodipin. It has a specific
action in tertiary syphilis and arterial degeneration.
The disadvantages to the use
of iodipin may be briefly summarized as
follows: In cases of syphilis, when a rapid
therapeutic efifect of iodine is required, iodipin
is of little use, as the absorption of iodipin
is extremely slow, two to ten days elapsing
before the iodine can be definitely demonstrated
in the urine, so that in cases in
which there is a threatened perforation of
the palate, cerebral gumma, etc. .potassium
iodide should be given. lodipin is not a
substitute for potassium iodide when active
lesions are in progress. A further disadvantage
is that only a small amount of iodipin
can be absort)ed per diem, about onethird
what would be given in the ordinary
way by the mouth. This can, however, be
turned to account in various ways. For
example, in tertiary syphilis, after potas-
ABSTRACTS. 189
sium iodide has been administered somewhat
vigorously, a course of iodipin injections
may be given, and the patient may
then be left without medicine for some
months, during which time the physician
knows that iodine is daily passing through
his tissues.
Typboid Bacilli in tlie Blood of Patients
Not SIcl{ witli Typlioid.— Busse
(Muencb. Med. Wchschr.) says that the
difficulty experienced in the early diagnosis
of typhoid fever led many clinicians to endeavor
to discover new methods and new
symptoms which should be pathognomonic
iu the early stages of typhoid fe\er, and
distinguish it from similar infectious diseases,
especially from miliary tuberculosis.
Xo reaction and no symptom has as yet
been discovered which would absolutely be
proof for or against the diagnosis of typhoid.
The receut demonstratioti of typhoid germs
in the blood of typhoid fever patients in the
early days of the disease caused many investigators
to believe that this method had
but one meaning—the diagnosis of typhoid
fever. This would be the case if the Eberth
bacilli could only be found in the blood of
typhoid fever patients. The author reports
the clinical history of four patients. Two
of these had miliary tuberculosis, another
phthisis, with intestinal affection, and one
case of typical lobar pneumonia with diarrhoea.
In all four cases typhoid bacilli
were demonstrated in the blood in the Hygienic
Institute of Posen. In the first two
cases typhoid was suspected, but the autopsy
revealed no typhoid lesions. The third case,
with pulmonary tuberculosis, was under
medical treatment for months without typhoid
symptoms. The autopsy revealed
no typhoid changes. The typical course of
pneumonia in the fourth case excluded t^'phoid
entirely. The cases indicate that the
finding of typhoid bacilli in the blood of
patients does not necessarily mean that the
I)atient is sick with typhoid, on the contrary,
it demonstrates that typhoid bacilli
present in the intestines of patients sick
with some other serious malady and with
intestinal affections, may pass from the intestines
into the blood without causing
typhoid fever. As these four cases occurred
in the course of a year without having systematically
made examinations for typhoid
bacilli, it has the appearance as if it were
not an infrequent occurrence. In making
the diagnosis, this fact must be taken in
consideration. Typhoid bacilli in the blood
of suspected typhoid patients- do not absolutely
mean that typhoid fever is present.
Complications oi Suppuration in Air
Sinuses.—Turner (Edinburgh Med. Jour.)
iu speaking of the treatment, says that we