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

XXXU
THE CHARLOTTE MKDICAL JOURNAL.
and stouter, and stain evenly, while in the
jjustule longer forms are seen with very
irregular staining. The author thinks that
it is definitely proved now that in localized
who were under treatment simply for uter-
ine displacements. The serum was derived
from the blood taken with the patient under
scopalimin-morphin anesthesia just prior to
infection, when one innoculates the patient operation.
with appropriate doses of a carefully pre- The writer's results were very gratifying.
pared vaccine derived fron the infecting All the patients were benefited and in some
organism, one obtains a beneficial effect, the hemorrhage ceased entirely after one or
\'ery fretjuetly in treating, a case of acne two days. There was no return of the
with staphylococcus vaccine it is found symptoms in the patients kept under obserthat
there is a definite improvement for a vation and menstruation returned to normal,
time, then the condition remains stationary
in spite of any modification in the do.se or Erysipelas In the New-Born.— Herrgott
character of the styphylococcic vaccine. ( Annales de Gynecologie et d'Obstetrique )
This is exactly what would be expected describes er\sipelas in the new-born infant
from a consideration of the bacteriology, as a very serious and generally fatal disas
it is only in a certain number of cases ease. The fatality depends on the absence
that the staphvlococcus is present, and even of reaction against the germs, due to the
when present it is not responsible for the absence of phagocytosis in the new-born
whole condition. We can, therefore, divide child. After the age of three months the
cases of acne vulgaris for therapeutical pur- prognosis is quite otherwise because here
poses into three classes. The first uill con- i)hagocytosis goes on normally. Starling
sist of those cases in which the comedo is from the solution of continuity at the umthe
dominant feature, with, also, some of bilicus the germs enter the tissues and are
those which have progressed further to the not opposed by the lymphatic glands. They
indurated and postular stages. In this class enter the lymphatics of the subcutaneous
of case the acne bacillus is the offending tissues, where they are found in great numagent
and the staphylococcus if present at bers, as also in the outer coats of the blood
all is playing a subordinate role. This vessels. A rapidly fatal peritonitis closes
class, therefore, may be treated with a vac- the scene. The external redness and swellcine
of acne bacillus alone. The second ing are slight, the symptoms of peritonitis
class consists of a large number of the in- being the first seen. Treatment has no efdurated
and pustular varieties where both feet,
staphylococcus and the acne bacillus ap-
year to be playing an active part in the Oiphtheria.—Mackay and O'Brien ( In-
tercolonial Medical Journal of Australasia )
causationof the inflammatorv process. The
therapeutic requirements of ' this class are
best met with a mixed vaccine of staphyloreports
404 cases. The conclusions arrived
at by the authors from this series of cases
coccus and acne bacillus. The third class are:
consists of those less common cases where Provided no complications are present,
there is more acute inflammation, tending the best control for the administration of
almost toward a furuncular form. Here diphtheria antitoxin in faucial cases is the
microscopical examination will show that patient's temperature. They gave antitoxin
the staphylococcus is the chief offender and in such dosage, repeated at eight to twelve
treatment should be directed at first against hours' interval where necessary, that a fall
this factor, not forgetting, however, that at in temperature to the normal line was prothe
basis of the condition there is an acne duced. Practically none of their charts,
bacillus infection. except those few cases in which complications
existed, show a temperature range
The Treatment of Uterine Hemorrhage above normal after the second dav. Their
with Serum.- Busse (Zentralblatt fur Gy- average dose of antitoxin was high, but
nakologie) reports his results in the treat- their results were most satisfactory, as evinient
of ten cases. All were cases in which dencedbv the comparatively low death-rate,
there was apparently no anatomical cause earlv resolution of the membrane, and low
for hemorrhage, and in which the hemor- percentage of resulting albuminuria,
rliage was not controlled by other meas- Qeiitle swabbing, douching, and gargures
Curettage had not been successful, ling of the throat with simple saline solu-
In all he cases the aiiemia from the hemor- tion, accompanied by mild oral antisepsis,
rhage had become sufficient to have a seri- js more efficient and much less distressing
"''°" ^'^"'"'''^
''atienfs''"''"^
^'^''^^^' °^ ^'^^ ^^^'' vigorous swabbing and gargling witii
'
\^
strong antiseptic solutions, whose tendency
The treatment consisted in the injection is to abrade the mucous membrane, and so
of 10 c.c. of human serum suljcutaueouslv. produce a fresh raw surface for the spread
The serum was taken from healthy subjects of the diphtheric membrane.