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

4,U THE CHARLOTTE MEDICAI, JOURNAL
iprapubic wound be suppressed the dura- formitj' by osteotomj', than to subject the
if the after-treatment will very prob- patient for years to extension apy^aratus.
ably be shortened. The abdominal wound Tuberculosis of the knee-joint ( 1 10 cases)
is closed or kept open, according to the
nature of the case, and the patient when
was generally treated by conservative meth-
ods: Extension, fixation, iodoform injecable
to take fluids should be treated by re- tions. In cases of obstinate recurring conpealed
doses of some urinary antiseptic tractures resection is to be recommended,
such as urotropin, helmitol or vesipyrin.
The permeability of the catheters must be
with ankylosis in the extended position.
This operation was particularly done in
carefully tested from time to time by the adults. Thirty-seven cases were treated
injection of small quantities of a 4 per cent,
solution of boric acid or a 1 per cent, solution
of nitrate of silver. If, as will be indicated
by the arrest of the flow of urine, and
solely by hyperemia. In tuberculosis of
the ankle joint extensive use was made of
hyperemia (17 cases with 13 cures). Of 11
cases treated with iodoform-glycerin injecby
feelings of discomfort and pain in the tion, all were cured, and of 15 subjected to
region of the corresponding kidney, either resection, 14 were cured. The functional
catheter becomes blocked, this, it is stated, results after hyperemia treatment were parcan
be readily replaced by a fresh one ticularly good. Of tuberculosis of the
guided by a long mandrel, in accordance
with the instruction of Albarran. On the
fourth or fifth day, if no complications
elbow-joint, there were 28 cases, of which 5
were treated with iodoform with 4 cures,
and 9 by resection with 2 recurrences and 2
have occurred, the compresses are removed deaths; in 4 bony ankylosis ensued; in 2
from the bladder and the operation wounds only slight mobility was obtained, while in
closed by sutures. After another interval 2 the joint was freely movable. In 6 cases
of on.e or two days the ureteral catheters in which hyperemia was resorted to 3 had
are removed and the bladder is drained by moderate and 3 excellent mobility. Of
a retained urethral catheter. The author tuberculosis of the wrist, 34 cases were
has had occasion to prolong ureteral cathe- treated— 14 with iodoform injections, with
terism over nine days, but neither in this good results in 8 and subsequent resection
clinical experience nor in experiments on in 6. Of 12 cases of resection 9 were cured,
animals, in which the catheters were re- He is especially predisposed in favor of
tained for 16 days, were any complications Bier's method of hyperemia in the treatobserved.
The practice of continuous ure
teral catheterism may be capable, the
ment of tubercular arthritis, and from his
results concludes that in the knee joint the
author suggests, of giving excellent results percentage of cures of hyperemia is about
in the surgical treatment of vesical and of
fresh vesico-vaginal fistulse.— British Mediequal
to that of the iodoform treatment,
while the functional result is decidedly betcal
Journal. ter. As regards the elbow, ankle and wrist,
Tuberculosis of the Joints.—V o g
all the cases treated by this method were
e 1 cured, and here also the functional results
( Deutsche Zeitschrift fur Chirurgie) upon ^^gre more favorable than from any other
observations in 349 cases of tuberculosis of
the joints, presents some interesting statismethod.
tical data. In the first two decades of life Scopolamin-Morphin in Labor.-Croom i
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the disease involved the hip or knee joint (Journal of Obstetrics and Gynecology of
in the vast majority of instances. Later the British Empire ) reports his experience
this predominance is much less marked, with scopolamin-morphin narcosis in sixty- {
Hereditary predisposition is present in 55 two cases of labor. Various do.ses were \
per cent, of the cases. Regarding treat- used. With onefour-hundredth grain of
ment, tuberculin proved of no value. Good scopolamin and one-sixth morphin, the re-
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results were obtained with iodoform. Great suits were uneven and unsatisfactory, al- a
caution is demanded in the prognosis, since though the pain was diminished. With
even after years of apparent cure a late re- one-two hundredth grain scopolamin and i|
currence may ensue, particularly after a one-sixth morphin he had better results, but J
trauma. The special treatment of the dif- his best results were obtained by using one- :
ferent joints may be summarized as follows: one-hundredth grain scopolamin and one-
In coxitis: Modified extension, followed sixth grain morphin. With this latter the 'j
by fixation, in connection with intra artic- painfulness of the contractions was mark- ;|
uiar injections of iodoform glycerin; in case edly lessened, and in some cases entirely :!
of failure of conservative methods, arthrec- abolished. The patients slept soundly in ,i
tomy or resection is indicated, with preser- the intervals between the pains and in many ''•
vation of the femoral head if possible. It cases for an hour or two after the comple- I"
is preferable to let the joint heal in a patho- tion of labor. In only two cases was a J
logical position, and later remove the de- thorough resuscitation of the child neces- ;
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