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

340 THE CHARLOTTE MEDICAL JOURNAL.
diet; the proteid contents of the vegetarian costal element on the anterior limb of the
diet are sufficiently great. Probably no transverse process of the seventh cervical
specific difference exists between the use that is, on the interior root of the transverse
made by the body of vegetable or animal
proteid material. On the other hand, too
process we get an independent centre of
ossification, which may develop and assume
high proteid contents in the diet probably the importance of a cervical rib. As regards
is injurious to the health; the uric acid the aetiology of this condition, opinion is
forming bodies which are present in specially
large amounts in meat are most probdivided.
According to Planet, all animals
possessed at one time as many ribs as verably
injurious. It is not necessary alto- tebrae, but in course of time these have
getiier to avoid mpat, but it is well to con- dwindled down to the number of twelve in
siderably limit the amount taken. The man with only rudiments in the cervical
vegetable-milk diet is much cheaper than region. Some writers accordingly class the
the preponderatingly meat diet, but its ab- condition as a species of atavism. Others
sorption by the intestine is less complete, have laid stress on the frequency with which
The change to a vegetable-milk diet can several members of the same family are
only be gradually effected. Careful prepar- affected. For instance, Israel is of the
ation and cooking renders the vegetarian opinion that heredity plays some part, and
diet digestible and easy of absorption. that there is sometimes a history of degneracy
in some member of the family. Occa-
Suprapubic Pros.ateclomy Without gj^,,^,,^, ^,g^ jj^^ condition is associated in
Opening ttic Bladder.-Y an Stockum, ac-
^^^ ^^^^^ ^^^ ^^-^^ some other congenital
cording to 1 he Hospital, London, described
n^alformation. Formerly the condition was
two cases oi suprapubic prostatectomy sue-
^^^^^^ ^^ ^^.^^ but with the advent of
cessfully pertormed ^y.thout opening tire
Rontgen rays and greater precision in diagbladder
The author's method is as fol-
^^gj^ ^^^ condition has now come to be relows:
After making an incision above the
cognized as comparatively common. The
pubes and cutting down on to the anterior
^.^jority of cases probablv pass unrecogwall
of the bladder, this latter IS carefully
^j^^^ during life because no svmptoms
separated from the posterior surface of the
nianifest themselves. Of those which cause
pubic symphysis. I his having been done,
symptoms, the majority appear to be found
the retropubic tissues are stripped off the
i„ , females, the reason for this being
anterior surface of the prostate, and each
undetermined. The age at which svmplobe
ot the organ enucleated separately
toms are noticed is generally between twelve
after opening up the capsule by a vertical ^^^ ^^^^^^,^ ^^,- robablv to the activity
mcision a little to one side of the middle
^f the skeletal growth between these ages,
line. Whilst enucleation is proceeding, an
j^ ^1^^^^ ^^^^^ ^^^-^^ do not cause svmpassistant,
by means of a finger m the rec-
^^^^ ^^^ supernumerary rib probably is not
turn, pushes the organ well forward A large enough to project into the posterior
cathether is next passed into the b adder
1,^^,,^^^ ^nd there cause svmptoms due to
and tied into position. A gauze plug is
pressure or deformity. Cases which do
then put into the prostatic cavity, and a
„t symptoms, however, are very fredrainage
tube inserted into the suprapubic
^j diagnosticated wrongly, because
wound. The author IS of opinion, however,
jj^^ ^^^^ -^^^^^ examined for a possible
that the drainage tube is really unneces-
^^^^^ ^-^ ^^ account, for example, for the
sary, and proposes for the future to sew up symptoms of a neuritis in the arm. Hence,
the wound leaving only a small opening
before the introduction of radiographv, the
through which the end of the gauze plug is
condition was frequently discovered only
brought to tire surface. The catheter ,s
accidentally, or, if attention was bv any
left ,11 for about a fortnight. He claims
chance directed to the neck, the condition!
hat this operation causes less damage to
^^^ ^^ ^fj^.j mistaken for something else,
the tissues than that of Freyer, and reduces ^he condition is now more often recognized,
hemorrhage to a mmimum. ^^^ -^ becomes possible to relieve pain and
Double Cervical Rib —Donaldson, ac- to obviate further complications such as'
cording to the British Medical Journal, says possible aneurysm of the subclavian, °
that more or less well developed ribs are grene, or paralysis of the muscles of the
liable to be met with in connexion with the hand.
seventh cervical or with the first lumbar Hypertrophy of the Female Mamma.
vertebra. Turner and Gruber say "cervi- Batson (Edinburgh Medical Journal) recal
ribs may be either the unusually devel- ports one case of this rather rare lesion,
oped rudiments of the anterior traiisvere The hypertrophy began at puberty and was
process or rib of the seventh vertebra, or associated with pain and discomfort in the
merely unusually developed epiphysis." breast. At the age of 19, the patient men-
There is au independent development of the struated twice, but only very slightly; since
—