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

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ORIGINAL COMMUNICATION. 373<br />

Iter in every way." More strength, sleep very complete pellagra without eruption,<br />

tter, good appetite. Ordered Bovinine, and one case apparently complete in all its<br />

o teaspoonsful after meals. Former medi- details. My definition <strong>of</strong> a "pellagrin." lotion<br />

continued. September 28: Gaining day is a person who has been s<strong>at</strong>ur<strong>at</strong>ed with<br />

pidly in strength, cheerfulness and rest- vol<strong>at</strong>ile f<strong>at</strong>ty acids. He or she must ever<br />

Iness, belches sweet gas occasionally, afterward pay the price <strong>of</strong> eternal dietary,<br />

Another fact present in all these cases after<br />

ginning this method <strong>of</strong> tre<strong>at</strong>ment was a<br />

and intestinal antiseptic vigilance, or suffer<br />

acute, sub-acute, or chronic <strong>at</strong>tacks <strong>of</strong> vascontinuance<br />

<strong>of</strong> the use <strong>of</strong> bicarbon<strong>at</strong>e <strong>of</strong> rious kinds.<br />

da, <strong>of</strong> their own free will). Eruption can The criticism has been <strong>of</strong>fered th<strong>at</strong> "ranfelt,<br />

but not seen. Begins again her cid f<strong>at</strong>s" "has been threshed out over sixty<br />

;ht household duties. Seems thoroughly years ago, and nothing was in it." This<br />

nvalescent in three weeks oi care, asout- "re-threshing" has been done unwittingly,<br />

led above. She has slept as s<strong>at</strong>isfactorily and more comfort, relief and cur<strong>at</strong>ive sucr<br />

the last three nights as ever in her life, cess for the sick has been found than ex-<br />

;tol)er 2'): She seems well except stiffness perts have been able to <strong>of</strong>fer so far as their<br />

muscles <strong>of</strong> back <strong>of</strong> neck, and slight ten- recorded experiences show.<br />

^<br />

mess along eleventh and twelftli dorsal<br />

.ervertebral nerves on both<br />

Ectopic GesSallon-Wlth<br />

sides. E<strong>at</strong>s<br />

Report o! a Case<br />

°* '*•* Abdominal Type.<br />

d sleeps well. Will she continue to im-<br />

to the<br />

Charleston General and McMillan Hospitals.<br />

3Ve'' Time will tell. ^^ John Egerton Cannaday, 51. D Surgeon ,<br />

Referring to l<strong>at</strong>e-stage cases, in the hos-<br />

;al, in which I have little experience, I Extra uterine pregnancy is productive <strong>of</strong><br />

II only suggest th<strong>at</strong>, in addition to a one <strong>of</strong> the gravest emergencies the surgeon<br />

ronic tre<strong>at</strong>ment, as outlined, with a diet is called on to tre<strong>at</strong>. This abnormality was<br />

lited in f<strong>at</strong>, tli<strong>at</strong> the different electric probal/.y first described by Albucasis, an<br />

)dalilies can be used to advantage, and, Arabia.i p'.nsician <strong>of</strong> the eleventh century.<br />

ioretically, arc' light b<strong>at</strong>hs will show value Laie;" d^s^ribed by Riclanus. .Abdominal<br />

assisting the blood to return to the normal section probably first done for this condition<br />

Dporiions. by Nufer in the year fifteen hundred Mau-<br />

Also. 1 would like to suggest the com- riceau in 1669 clearly described the condins<strong>at</strong>ory<br />

tonic action on the nerve cells, tion. Demeiris in 1836 gave the world a<br />

It have not degener<strong>at</strong>ed, by the llawley classific<strong>at</strong>ion used today. Lawson Tait<br />

itnal lymph. It ought to accomplish was the first surgeon who had a wide operainders<br />

in such cases. In the typhoidal live experience in this condition and he was<br />

3e, 1 would like to suggest sodoxylin able to set his brothers an example <strong>of</strong> sucbbott<br />

>, Strych. Arsen., Atropine, Copper cess to follow.<br />

sen. rapidly to effect: as diet—none—un- The frequency <strong>of</strong> this condition varies<br />

the p<strong>at</strong>ient is better, then a f<strong>at</strong> free diet much with the individual st<strong>at</strong>istics <strong>of</strong> differbest<br />

suits the case. ent oper<strong>at</strong>ors. Some claim as many as one<br />

Before closing, I must mention the case out <strong>of</strong> every hundred cases while others<br />

Mrs. McCi., from Mississippi, who con- have found only one in twenty thousand.<br />

Ited me September 20, <strong>1909</strong>. White, mar- In l<strong>at</strong>ter years there has been an apparent<br />

d, fifty years <strong>of</strong> age. Recorded symp- increase in the number <strong>of</strong> cases. This is<br />

ns were; Roaring in the ears, one year, probably due to several causes, among<br />

first <strong>at</strong> night, but for the la.st month both which may be mentioned more knowledge<br />

[ht and day, although worse <strong>at</strong> night, concerning the subject, growing popularity<br />

ontal head pains every day also, for a <strong>of</strong> oper<strong>at</strong>ive tre<strong>at</strong>ment, probable increase <strong>of</strong><br />

ir. Anorexia, caustive, constant pain gonorrhoea, and the commonness <strong>of</strong> aborder<br />

right scapula, gastric fl<strong>at</strong>ulence, tion. There can be no doubt th<strong>at</strong> in former<br />

fer eruct<strong>at</strong>ions, lumbar pains, brown col- times many cases went unnoticed and th<strong>at</strong><br />

id spaces on posterior surfaces <strong>of</strong> fore- even now cases are not infrequently overns,<br />

evidently the remains <strong>of</strong> an old pella- looked. The true n<strong>at</strong>ure <strong>of</strong> many cases <strong>of</strong><br />

iic eruption, which had been present haem<strong>at</strong>osalpinx, haem<strong>at</strong>ocele and blood<br />

fre for four years. The same plan <strong>of</strong> Cyst <strong>of</strong> the ovary is misunderstood.<br />

<strong>at</strong>ment, as previously outlined, gave Formerly many cases <strong>of</strong> ectopic pregnancy<br />

ick relief to the symptoms.- In some were considered to be primarily abdominal,<br />

ics, an insufficiency <strong>of</strong> liver or pancre<strong>at</strong>ic L<strong>at</strong>terly, since we have come into a more<br />

ion will be shown as they progress, call- exact knowledge <strong>of</strong> the subject, the second-<br />

: for medic<strong>at</strong>ion and diet adjusted to such ary form has been considered the rule and<br />

iditions. These notes show th<strong>at</strong> I have the primary form the exception in abnormal<br />

i, in four years, about 300 "rancid f<strong>at</strong>" pregnancy. Nearly all cases have followed<br />

;es presenting more or less <strong>of</strong> pellagrous tubal abortions. A few writers on the subnptoms.<br />

Among these were 12 cases <strong>of</strong> ject have gone so far as to deny th<strong>at</strong> such a

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