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

408 THE CHARLOTTE MEDICAL JOURNA; .
contained albumin and occasionally a trace follows: 1. In stenosis due to ulcers, as
of blood and casts. The abdomen was ten- well as cases of ulcer persisting- in spite of
der in the epigastric and right iliac regions, prolonged internal treatment posterior relroaud
there was occasional vomiting. The colic gastroenterostomy, with a circular
child was treated with two injections of double row of sutures, is the procedure of
horse serum without any improvement, but choice. In cases of relaxed and dilated
recovered and was discharged with the stomach, a prophplactic enteroanastomosis
urine still albuminous. Case 2 was a boy, after the method of Braun is indicated. 2.
aged 6 years, suffering from abdominal pain Following operation in cases of open ulcer
and vomiting. There were purpuric spots the administration of acid reducing remeall
over the extensor aspects of the limbs, dies, later combined with irrigation, as well
The abdomen was not tender. The urine as the careful selection of foods, is of imcontained
albumin and occasionally blood, portance. ,3. Resection is to be considered
In hospital he was suddenly attacked with whenever there is a suspicion of the maligabdominal
pain, and the abdomen was ten- nant character of a gastric tumor as well as
der in the left lumbar region. The pain for severe callous ulcers, especially when
continued on and off fornearly two months, neighboring organs (liver and pancreas)
occurring in crises every two days. Blood have been eroded. According to the con- ',
was found in the srools during most of this ditions present in each case, either the raditime.
Later the face became puffy, espe- cal operation of resection or the less dangercially
the lips and the eyelids, but the child ous gastroenterostomy is performed. Rebegan
slowly to improve. .The treatment section should be done after the manner of ,
was at first calcium chloride, and, later; Riede! (circular). 4. In nervous affections
three injection.s of horse-serum. Two fresh of the stnmach operatton iscontraindicated,
groups of purpuric spots appeared while the excejit an exploratory laparotomy, to de- J
child was taking calcium. The third case, termine whether an ulcer is present or not. }
under the care of Dr. C. Bolton, was a boy Among the one hundred and twenty four k
aged 6 years, who came into hospital with cases reported there were ten circular and i
severe pain and passing blood in the stools, segmentary resections and one hundred and (j
with a measly, non purpuric rash and cory- four gastroenterostomies. Of the former jj
za. The next day he passed blood and cases, two died, while the mortality in {|
mucus by the rectum. The abdomen be- ninety-six gastroenterostomies was nine
came distended, audit was thought that in- deaths. Of the seventy six cases of ulcer
tussuscejjiion might be present, and the ab- examined a year after operation, sixty-five
douien was opened, but none found. There were completely cured, eight had slight
were flecks of lymph in the peritoneum with gastric disturbanees and in two cancer had
some evidence of general peritonitis. He developed. In twelve cases of resection the
died next day. At the necropsy there was end-result was good, although two required
a general peritonitis, and on the small int°s- another operation for stenosis. In sixtytine
were about 1,3 hemorrhagic extravasa- one of sixty-fonr gastroenterostomies the
tious about the size of peas and projecting end- result was satisfactory. _„ ,
on both outer and inner surfaces of the in- '•
testine. About a foot from the ilo-ccecal Ttic Elficacy of the Anti-Gonorrlteic 1;
valve there was a collection of much larger Arhovin.—N a ge 1 (Zeitschrift f. neuere ij
heemorrhages. The small intestine wasdis- physik. Medizin) s^ys he has used arhovin -ft
tended with gas, and the larger intestine as for three years, with generally favorable |
far as the splenic fissure where for about six results, and considers it indicated in gonorinchesit
was quite dark from diffuse haenior- iheal diseases of the genital organs and
rhage, thickened and looked almost gan- urinary passages in the dose of two capgrenous.
The diagnosis lay between measles sules thrice daily. He also employed it in
and Henoch's purpura, the suspicion of in- the form of vaginal globules and bougies.
tussusceptioH not being verified. Dr. Park- Untoward effects from its use never occurred,
inson thought it was a case of purpura, but The duration of the arhovin treatment is, i
the absence of blood and albumin in the on the average, between two and six weeks, i
urine was unusual. The case supported a In acute gonorrhea he considers it especisuggestion
of Mr. H. Lett, made in the ally important to have the patient taking
"Reports of the Society for the Study of arhovin observe the dietetic and hygienic
Diseases in Children," that it is advisable requirements. His most recent observa-.
not to operate for intussusception in a case tions have certainly confirmed his earlier
of Henoch's purpura unless an abdominal conclusions. The chief effects of arliovi;"
tumor could be felt. are secretion lim.iting and analgesic; th
Surgical Treatment of Benign Gastric discharge becomes less and the pain
Affections— Busch (Archiv. f. Klin. Chir. ) urination disappears. The urine, at fir
from an analysis of 124 cases concludes as cloudy, becomes clear.