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

nig of the spongy layer. This occurs after
each pain, until at last, when both membranes
and placenta are thus separated, the
uterus, gathering itself up, as it were, expels
the placenta according to Schultze's
or Duncan's mechanism, which are really
mechanisms of expulsion but not of separation.
As regards the bearing of this
theory upon management of the third stage,
hesaysthat the latter may be conducted in
two waj-s. Ill the first method the attendant
graps the uterus firmly, brings on pain
by friction if he thinks the uterus sluggish,
and reinforce each pain by pressure. This
is the active method introduced by Crede.
In this way the third stage may be shortened,
but the practitioner will find that he
has hemorrhage, and occasional retention
of membranes with all their unpleasant
sec|uel?e. If the upper edge of the placenta
is at the Fallopian tube angle, he may perhaps
expel the placenta and membranes,
w//;//^.f a piece of the placenta the size of
the tip of the finger, and this piece may
become septic. The second method is to
keep the hand permanently on tlie uterus,
wait for pains, and not to compress the
uterus unless there are indications for it,
the UKiin one being hemorrhage. The size
of the uterus should be noted, and only
when its bulk markedly diminishes, indicating
separation, should gentle exi>ression
of the uterus or pressure in the suprapubic
region, according as the ])laceiita is
in the lower uterine segment or in the vagina,
be employed. This method goes on
the theory tliat the placenta is separated
after the pain, that hand pressure will not
separate it safely at the time, and that the
safe lime to use hand grapiiig is after the
placenta has separated.
/V\isccllcincous-
Oatmeal In Diabetes Mellitus
Pari (Cazz. degli Osped. ) says that, in
spite of its relative richness in hydro-carbons,
oatmeal is often not only well borne
by diabetics, but exercises a curative effect.
V. Noorden first drew attention to this fact
in 19(12. It is not possible to continue for
long on a diet of oatmeal alone, as nausea,
diarrhea and edema may occur, so that it is
well to alternate with other diabetic diets
for example, one or two days of strict dieting
(flesh, ham, greens, butter," cheese), then
three or four days of oatmeal, followed by
one or two days of greens, and so on in a
cycle. At first, after the oatmeal diet,
there is a slight increase in the glycosuria,
but this soon disappears and conies down
to the level, or even below, that obtained
by the strictest dieting. Seeing that we
—
ABSTRACTS. 269
know so little about the actual chemical
composition of the various starches, the
author thinks it not impossible that the
starch of oatmeal may have a specific action
on diabetes. He records a case of diabetes
in a young man aged 22, where the oatmeal
had a decidedly good effec*, and in a very
short time (a few days) brought about the
disappearance of the sugar, the oxybutyric
acid, and very much reduced the acetone,
whilst the body weight increased.— British
Medical Journal.
Regulin In Constipation.
In most cases of chronic constipation there
is an excessive absorption of water, so that
the intestinal bacteria cannot form certain
products necessary for a normal defecation.
II. F. Hoffmann, therefore, expresses the
opinion that perhaps the most valuable preparation
recommended for chronic constipation
is regulin, a pure agar-agar, containing
about 20 per cent, of an aqueous extract of
cascara. It is marketed as scales or tablets;
the dose of the former is one to two tablespoonfuls
in apple sauce or mashed potatoes,
and of the latter, three tablets twice daily,
after the chief meals Most other cathartics
lose their strength in time, the defecation
is often painful, and hemorrhoids are
likely to appear. Oil injections are usually
effectual, but are troublesome and disagreeable
to take, while diet alone only rarely
helps for any length of time. Only few patients
have the lime and means to resort to
massage and systematic exercise. With
regulin, the author claims that the intestines
will soon fuctionate properly, and it is even
possible to diminish the dose gradualh'.
In the beginning of treatment, it may be
necessary to resort to mild laxatives or to
glycerin per rectum. Hoffmann has tried
regulin in a large number of cases, including
intestinal vertigo and gynecological
cases, and reports the best results.—Therap'
Monatshefte.
Treatment of Diabetes With Leucofermanlin.
By means of a special method, Marcus
could demonstrate that in diabetes there is
quite regularly a diminution of th e antitrypsin
in the blood, provided no other
severe lesions, such as nephritis, psoriasis,
or advanced cachexia, are present. This
low amount of antitrypsin was not due to
the polyuria, since the urine never possessed
antitryptie properties. It was thought also
possible that a certain amount of trypsin
might be carried away with the urine, but
all tests in this direction were negative.
Several cases could be observed for as long
a period as six to eight weeks, and in every