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

270 THE CHARLOTTE MEDICAL JOURNAL.
instance the amount of antitrypsin in the
blood was in inverse proportion to the degree
of gl3'cosuria.
An attempt was then made to increase
the amount of anti ferment in the blood by
giving the patients pancreatin in large doses,
with the result that the sugar increased and
the antiferment diminished still more.
Much better results were seen when the antiferment
itself was given. The best preparation
to use is the leucofermanin (Merck),
since it contains more than twice as much
antiferment as the blood of a normal individual.
On succeeding days 1, 2, and3Cc.
were injected, so that 6 Cc. in all were
given. The antitrypsin in the blood increased
rapidly, the subjective symptoms
disappeared, and the amount of sugar excreted
was reduced, \n one case from 2 .5 to
0.3 per cent., though the diet remained the
same and no other drugs were given. The
leucofermantin also contains other ferments
besides the antitrypsin. After two to four
days a more or less pronounced erythema
will usually develop at the site of injection.
—Zeitsch f. experiment. Path. u. Therap.
The Incompatibility oi Iodide with Pagenstecher's
Ointment and Calomel.
It is well known, but constantly forgot-
ten, that if yellow oxide of mercury ointment
or calomel be placed in the eye of a
patient who is taking iodine in any form,
violent irritation is produced, and the morbid
process instead of being arrested is
accentuated. It is very easy to make this
error when treating a "strumous" child suffering
from phlyctenulee with yellow oxide
ointment locally, and with cod-liver oil and
syrup of iodide of iron internally. Ne.Kt
day the child returns, with all the symptoms
aggravated. Yvert ( Rec. d'Ophtal., August,
1908,) in a lecture at Dijon treated of this
subject. He tokl his hearers that the iodide
acted upon the mercury compound, and
Ijroduced a mercurous iodide which in the
presence of an excess of iodine rapidly decomposed
into free mercury and the extremely
caustic mercuricriodide. The same unl)leasant
experiences occurred when oxycyanide
of mercury was used locally to wash
out the bladder of a patient taking iodide.
Hollander ( Berlin Society of Medicine, May
16, 1906) pointed out that this double decomposition
with the formation of nascent
mercuric iodide could be utilized therapeutically
in cases of tubercle of mucous membranes,
buccal, laryngeal, and cystic. He
found that, especially in tubercle of the
bladder, excellent results were obtained.
The patient is given a teaspoon ful of a fiveper-cent
solution of iodide of potassium a
quarter of an hour before the local treat-
ment, which consists of the insufflation of
calomel or its injection in oily emulsion.
Yvert concluded by warning his hearers
never to put calomel or yellow ointment into
an eye until they had ascertained that the
patient had not taken iodine, either from a
medical man's prescription or in one of the
patent medicines which often contain it.
British Medical Journal.
Diagnosis oi Lead Poisoning.
The presence of basophile granules in the
red cells is an early and extremely valuable
sign of lead poisoning. A. Trautmann
finds that these granules occur in anemia as
well as in perfect health, but more than one
hundred granular cells to the million is certainly
rare. Twelve cases of undoubted
lead poisoning were examined, and each
showed over one hundred granular cells to
the million. The actual percentage is subject
to slight changes, hence it is often advisable
to make two or more examinations of
the same case. It would be most desirable
to make regular examinations of all individuals
coming into contact with lead, as
intoxication could thus be prevented.
Muench. Med. Woch.
—
Evolution and Treatment oS Tuberculosis
Among Syptailitics.
Emile Sergent tells us that syphilis and
tuberculosis are frequently associated in the
same subject. Syphilis constitutes a prime
factor in causing tuberculosis both directly
and indirectly. Directly a tuberculosis may
be engrafted on a syphilitic laryngitis or
tracheitis; indirectly, syphilis causes a condition
of the system which predisposes the
subject to the reception of the tubercle
bacillus. This occurrence of tuberculosis
in the syphilitic may take place in the early
primary or in the secondary stage. There
may be association of the two lesions in the
same location, as when we have a hybrid
lupus. Generally the soil is such that both
conditions are engrafted on it at the same
time. We may have local tuberculosis in
syphilitics, or pulmonary tuberculosis in
syphilitics, and either condition may be the
primary one. The author believes that the
contraction of syphilis by a tuberculous subject
is not as serious as has been thought.
Provided that the tuberculous subject is in
a fair general condition, he may not be very
severely affected by the syphilis. In all
probability syphilis is a cause of many cases
of fibrous or sclerotic pulmonary tuberculosis.
Tuberculosis also occurs in heredosyphilis
in young subjects. In all cases
except very late ones or very acute ones of
tuberculosis, anti-syphilitic treatment benefits
both the syphilis and the tuberculosis.