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

XXX
THH CHARLOTTE MEDICAL JOURNAL.
Ovarian Gralts With and Without Anas- haemorrhage. The conclusions from this
tomosls of Vessels. series of cases are that the results of treat-
Mauclsire believes that in order that ment of placenta praevia are so disappoint-
ovarian grafts may be successful it is best i"g by the present methods that ;t is incumto
provide a blood supply bv anastomosing bent on us to seek for improved methods of
the ovarian vessels with some others, pref- treatment. He has been looking over the
erablv the epigastric. He has had two records of 34 cases of placenta praevia re
positive cases in women. There is no doubt ceived at the clinic since 1904, in which the
that both beterografts and autografts have date of the first haemorrhage is mentioned,
been successful, both in animals and in '" every instance a warning hemorrhage
women, although not nearly all the grafts ^^^ occurred during the last few days or
have taken, and many have nndergone weeks before the child-birth. The physician
atrophy. The author gives a teview of the summoned merely ordered the patients to
successful cases recorded. Heterografts bed and the haemorrhage stopped with the
and autografts are made for the purpose of bed rest. These warning haemorrhages reavoiding
the nervous svmpl,oms that result curred three or more times before labor
came on, and the physician would have had
from double ovarian ablation, especially
obesity. Heterografts are also made to ample time to send the patient to the clinic
render pregnancy possible. Another indi- i^ the warning of these premonitory haemorcation
is amenorrhea from congenital ova- rhages had been heeded. The obstetrician
rian atrophy. If we are to succeed gener- is able to save the mother with contracted
ally the author believes that we must supplv Pelvis by perforation during delivery in the
nutrition to the graft bv furnishing it with liome, but with placenta praevia both mother
a circulatory supplv. This appears to be and child succumb in 15 to 20 per cent, of
much more important than a continuous tbe deliveries in private houses. Even in
nerve supply.—Archives Generales de Chi- the clmics the mortality is still from 5 to 8
rurgie. P'-''' cent, at the best.—Zentralblatt fur
Gynakologie.
Pathogenesis ol Unilateral Pleuritic Eifusion
In Cardiac Disease.
'
Crypto-Diphthcrias.
Feliziani says the pathogenic factors in Abrand says that cases come into every
this condition are pericarditis, perihepatitis hospital without visible membrane in the
from hepatic congestion, and pulmonary throat, which later prove to have been true
infarctions. Pulmonary hemorrhagic in- diphtheria, the membrane being located in
farctions are the cause in the great majority the larynx, nasopharynx, trachea, or e.soof
cases. These arise from cardiac diseases, phagus. They are discovered late in the
especially of the atrioventricular orifices, disease, when they have been severely pois-
Small coagula being detached and carried oned, perhaps diagnosed only by the sympinto
the lungsto form pulmonary embolisms, toms of diphtheritic paralysis of the palate,
Aortic affections and arteriosclerosis also and have already spread the disease toother
cause embolisms. The upper level of the patients. The symptoms that indicate this
fluid is not above the angle of the scapula, state of things are extreme fatigue, loss of
— II Policlinico. weight, rapid pulse, marked swelling of the
glands of the neck, with or without high
Treatment of Placenta Praevia. fever.—Annales de Medecine et de Chirur-
^ „ ^, .
Dr. B. Kronig summarizes the details of
twenty cases of placenta praevia at the Freiburg
clinic in which the women were under
Genital Tuberculosis in Woman.
the most favorable conditions in regard to C. Lenormant says that genital tubercuthe
medical supervision in a clinic, asepsis, losis is rare and is almost always secondary
etc., from the start. In every instance during
delivery haemorrhage was arrested by
version. He states that control of haemorto
tuberculosis in some other part of the
body, often the lungs. It may result as a
primary condition from coition with a male
rhage by the metreurynter cannot be relied who has genital tuberculosis, but this is exupon
owing to the fact that haemorrhage is ceedingly rare. In three per cent, of lapafrom
the isthmus as a rule and the metre- rotomies for gynecological troubles there is
urynter stretches the isthmus still farther, a tuberculous lesion found. This is usually
Four of the twenty patients bled to death a descending affection conveyed by the
and another succumbed to sepsis, and yet blood-vessels. The vagina is only infected
the conditions were exceptionally favorable when there are lesions of the mucous mem-
, 1 ., r gie Infantiles.
for all. Those who survived suffered long brane. Tuberculosis is rare where there is
from severe anemia. The more advanced pavement epithelium. It is more frequent
the pregnancy the greater the tendency to in the fundus uteri, tubes, and ovary. There