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

ORIGINAL COMMUNICATION. 373
Iter in every way." More strength, sleep very complete pellagra without eruption,
tter, good appetite. Ordered Bovinine, and one case apparently complete in all its
o teaspoonsful after meals. Former medi- details. My definition of a "pellagrin." lotion
continued. September 28: Gaining day is a person who has been saturated with
pidly in strength, cheerfulness and rest- volatile fatty acids. He or she must ever
Iness, belches sweet gas occasionally, afterward pay the price of eternal dietary,
Another fact present in all these cases after
ginning this method of treatment was a
and intestinal antiseptic vigilance, or suffer
acute, sub-acute, or chronic attacks of vascontinuance
of the use of bicarbonate of rious kinds.
da, of their own free will). Eruption can The criticism has been offered that "ranfelt,
but not seen. Begins again her cid fats" "has been threshed out over sixty
;ht household duties. Seems thoroughly years ago, and nothing was in it." This
nvalescent in three weeks oi care, asout- "re-threshing" has been done unwittingly,
led above. She has slept as satisfactorily and more comfort, relief and curative sucr
the last three nights as ever in her life, cess for the sick has been found than ex-
;tol)er 2'): She seems well except stiffness perts have been able to offer so far as their
muscles of back of neck, and slight ten- recorded experiences show.
^
mess along eleventh and twelftli dorsal
.ervertebral nerves on both
Ectopic GesSallon-Wlth
sides. Eats
Report o! a Case
°* '*•* Abdominal Type.
d sleeps well. Will she continue to im-
to the
Charleston General and McMillan Hospitals.
3Ve'' Time will tell. ^^ John Egerton Cannaday, 51. D Surgeon ,
Referring to late-stage cases, in the hos-
;al, in which I have little experience, I Extra uterine pregnancy is productive of
II only suggest that, in addition to a one of the gravest emergencies the surgeon
ronic treatment, as outlined, with a diet is called on to treat. This abnormality was
lited in fat, tliat the different electric probal/.y first described by Albucasis, an
)dalilies can be used to advantage, and, Arabia.i p'.nsician of the eleventh century.
ioretically, arc' light baths will show value Laie;" d^s^ribed by Riclanus. .Abdominal
assisting the blood to return to the normal section probably first done for this condition
Dporiions. by Nufer in the year fifteen hundred Mau-
Also. 1 would like to suggest the com- riceau in 1669 clearly described the condinsatory
tonic action on the nerve cells, tion. Demeiris in 1836 gave the world a
It have not degenerated, by the llawley classification used today. Lawson Tait
itnal lymph. It ought to accomplish was the first surgeon who had a wide operainders
in such cases. In the typhoidal live experience in this condition and he was
3e, 1 would like to suggest sodoxylin able to set his brothers an example of sucbbott
>, Strych. Arsen., Atropine, Copper cess to follow.
sen. rapidly to effect: as diet—none—un- The frequency of this condition varies
the patient is better, then a fat free diet much with the individual statistics of differbest
suits the case. ent operators. Some claim as many as one
Before closing, I must mention the case out of every hundred cases while others
Mrs. McCi., from Mississippi, who con- have found only one in twenty thousand.
Ited me September 20, 1909. White, mar- In latter years there has been an apparent
d, fifty years of age. Recorded symp- increase in the number of cases. This is
ns were; Roaring in the ears, one year, probably due to several causes, among
first at night, but for the la.st month both which may be mentioned more knowledge
[ht and day, although worse at night, concerning the subject, growing popularity
ontal head pains every day also, for a of operative treatment, probable increase of
ir. Anorexia, caustive, constant pain gonorrhoea, and the commonness of aborder
right scapula, gastric flatulence, tion. There can be no doubt that in former
fer eructations, lumbar pains, brown col- times many cases went unnoticed and that
id spaces on posterior surfaces of fore- even now cases are not infrequently overns,
evidently the remains of an old pella- looked. The true nature of many cases of
iic eruption, which had been present haematosalpinx, haematocele and blood
fre for four years. The same plan of Cyst of the ovary is misunderstood.
atment, as previously outlined, gave Formerly many cases of ectopic pregnancy
ick relief to the symptoms.- In some were considered to be primarily abdominal,
ics, an insufficiency of liver or pancreatic Latterly, since we have come into a more
ion will be shown as they progress, call- exact knowledge of the subject, the second-
: for medication and diet adjusted to such ary form has been considered the rule and
iditions. These notes show that I have the primary form the exception in abnormal
i, in four years, about 300 "rancid fat" pregnancy. Nearly all cases have followed
;es presenting more or less of pellagrous tubal abortions. A few writers on the subnptoms.
Among these were 12 cases of ject have gone so far as to deny that such a