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SOCIETY NOTES

the Elks Club. Dr. O. Beverly Campbell, of

St. Joseph, was unanimously chosen as presTRI-STATE (ALABAMA, GEORGIA, TENNES- ident of the society for the ensuing year and SEE) MEDICAL Society. - The eighteenth an.

other officers were elected as follows: Dr. W. nnual meeting of the Tri-State Medical So.

F. Milroy, Omaba, first vice-president; Di. ciety of Alabama, Georgia and Tennessee,

C. 0. Thienhaus, Milwaukee, second vicewill be beld at Chattanooga, October 2-4, president; Dr. Donald Macrae, Council 1906. Reduced rates have been obtained from all points in Alabama, Georgia, Tennessee, Mississippi, Louisiana and Florida, and an unusually large attendance is assured. The preliminary program includes an excellent list of papers from leading medical men of the South. Strong pressure will be brought to bear to ultimately convert this organization into a branch of the Americal Medical Asso. oiation - The Association of tbe Southeastern States, and recommendations will be made at this meeting. Physicians desiring to read papers should send their titles at once to the secretary, Dr. Raymond Wallace, Chattanooga, Tennessee.

MISSISSIPPI VALLEY MEDICAL ASSOCIATION.—The next event of National interest. will be the annual meeting of this association, which will occur on November 6, 7 and 8, at Hot Springs, Ark., under_the presidenoy of Dr. J. H. Carstens, of Detroit. A program of more than usual merit bas been prepared by the efficient secretary, Dr. Tuley, including three orations, by President Car.

0. B. CAMPBELL. M. D., St. Joseph, Mo. stens, and Drs. Frank P. Norbury and Florus President-elect Medical Society of the Missouri Valley. F. Lawrence. Extensive preparations have been made by the profession of Hot Springs

Bluffs, treasurer (re-elected); Dr. Chas. for the entertainment of members, their wives

Wood Fassett, St. Joseph, secretary (reand daughters, and a cordial welcome awaits

elected). The secretary's report showed the them. Reduced rates will be in effect on all prosperous condition in which the society lines of railway, the Missouri Pacific and Iron

finds itself at the close of the year, baving Mountain System offering special service gained furty-four new members and losing

and through trains for the occasion. For

The annual Missouri Valley excur.

but one. full particulars regarding rates, call at city

sion to the A. M. A. was made a subject of ticket office, or write the editor of the Fort. special comment, and the secretary expressed

FORT

the opinion that the next trip to Atlantic City NIGHTLY.

would be even more enjoyable, if possible, MEDICAL SOCIETY OF THE MISSOURI VAL- than the last. Following is a list of members LEY. -The nineteenth annual meeting of tbis admitted at this meeting: Robert R. Hollis. society was held at Council Bluffs, Septem- ter, F. W. Lake, L. B. Bushman, Alfred ber 6 and 7, with an attendance of 125, Dr. Schalek, S. Cole Little, and C.W. Pollard, of Jno. E. Summers presiding.

The program

Omaha; J. H. Gassan, Albert V. Hennessy, included twenty-five papers, and the discus- T. B. Lacy, Jr., John F. Sprink, of Council sions were most interesting and instructive. Bluffs; Halsey M. Lyle, Kansas City; Wil. Among the guests at this meeting, who read liam A. Chapman, Ingleside, Neb.; William papers, were Dr. Emil Reis, of Chicago; Dr. H. Anderson, Dunlap, Ia.; J. N. Medill, L. L. Uhls, superintendent of the State Hos. Persia, la.; J. R. Hollow bush, Rock Island, pital for Insane, Osawatomie, Kas.; Dr. Leo Ill. ; James W. Lehan, Dunlap, Ia. ; C. V. M. Crafts, Minneapolis; Dr. Alfred Schalek, Artz, Hastings, Neb.; H. P. Duffield, MarOmaha; Dr. E. W. Clark, president of the shalltown, Ia.; Charles L. Mullins, Broken Iowa State Medical Society, who responded to Bow, Neb.; W. R. Young, Ausley, Neb.; H. the address of welcome given by Congressman D. Spencer, Oakland, Ia.; W. F. Pierce, Smith of Council Bluffs. The society was Carson, Ia.; L. L. Uhls, Osawatomie, Kas. royally entertained by the local members at The papers and discussions will appear in the the street carnival, and given a reception at Medical Herald, the society's official journal.

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of

REPORTS ON PROGRESS man 53 years old, bad one epileyptiform

seizure and one attack of syncope apparComprising the Regular Contributions of the Fortnightly Department Staff.

ently at the onset of the malady. The pulse

was slow, venous pulsations in the neck were INTERNAL MEDICINE.

absent, slight arterio-sclerosis and hypertro

phy of the heart. A brief sojourn at “Bad O. E, LADEMANN, M. D.

Nanheim" afforded no relief. The patient

died two years after the apparent onset. Blood Pressure and Pigmentation in Addi

During the course of the disease the pulse son's Disease. --Short (The Lancet, Aug. 4,

ranged from 37 to 19. The third patient, a 1906) publishes a case of Addision's disease, woman, 51 years old, suffered from syncopal on which many observations were made on

attacks, slow pulse, venous pulsations in the the bood pressure. He summarizes his paper veins of the neck and cardiac hypertrophy. as follows: The symptoms of Addison's dis- The pulse rate averaged 40 per minute. ease are due to vasomotor paralysis. This is due to absence of adrenalin, the normal es- Spontaneous Rupture of the Heart in a Case citant of the sympathetio nerve endings, from of Senile Dementia — Miller's (Boston Medithe blood. The pigmentation is due to vas- cal and Surgical Jour., Aug. 2, 1906) patient cular relaxation of the skin causing exag- was a man 33 years old, who had a spontanegerated functional activity of the pigment ous rupture of the heart as a result of myocells. The most promising line of treatment, malacia cordis, the acoident being determined on theoretic grounds, is the adninistration by mental and physical excitement. The of vasoconstrictors of prolonged action; digi. rupture occurred at the site of an old infarct talin has given good results in one case. near the top of the left ventriole. The age A Case of Acute Rheumatism, Hypyrexia; tem, were favoring conditions almost invaria

the patient, the condition of the arterial sysRecovery.-Smith (The Lancet, Aug. 4, 1906) bly cited in cases of spontaneous heart ruprecords a unique case of rheumatism with excessive pyrexia in a man 54 years old. On the

ture. The pre-existing myocardial disease,

anemic necrosis, is regarded as a less frequent eighth day of the illness the temperature by mouth registered 107.2 deg. F. with a pulse tive diseases of the niyocardium.

cause of heart rupture than other degenerarate of 128 beats per minute. Just prior to using an ice pack the temperature in the rec- Id.-Palmer describes a remarkable case of tum rose to 109.3 deg. A three-quarters of spontaneous rupture of the heart in a man, 36 an hour application of the pack resulted in years of age. The rupture ocourred in the reducing the temperature to 107 deg. F. The pleural cavity and was probably determined author finds only two cases recorded in Birts by the obliteration of the pericardial cavity ish literature where a recovery followed so through the formation of adhesions which ex. high a temperature in rheumatism, and in isted over the greater surfave of both auricles both of these cold baths had been employed. and ventricles. The patient presented the

physical signs and symptoms of aortic aneurStokes-Adams Disease.- Steiner (Buston Molical and Surgical Jour., Aug. 9, 1906)

ism, accompanied by symptoms of pressure

on the left recurrent laryngeal nerve. The says that Stokes-Adams disease is an affection which presents clinically the following slight enlargement of the descending portion

of the aortic arch present could not have posfeatures: (1) A slow pulse, usually perma- sibly been responsible for this clinical picnent, but sometimes paroxysmal, falling to

ture. The coronary arteries were in an ad40, 20, or even to 6 beats per minute; (2) cerebral attacks which consists in vertigo vessels were normal.

vanced stage of arteritis, while the systemic of transient character, syncope, pseudoapoplectiform attacks or epileptiform seizures; Intermittent Peatosuria and Glycosuria.and (3) visible auricular impulses in the Kaplan (N. Y. Med. Jour., Aug. 4, 1906) di. reins of the neck, the beats varying greatly, vides pentosuria into: (1) Chronio pentosuria, as 2:1 or 3:1 rhythm being the most com- occurring wben the excretion of pentose in mon (Osler). During the last three years the the urine is constant, and when glycosuria author has seen three cases, wbich be details. cannot be induced after the ingestion of The first patient, a man, aged 77, had recur- one hundred grams of glucose. (2) Aliment. rent syncopal attacks in the same month at ary pentosuria occurring in individuals who intervals of a year or more, a slow pulse, cannot oxidize large amounts of pentosans venous pulsation in the neck, arteriosclero. introduced with the food, exerting a portion sis and cardiac hypertrophy. There was a

of the pentosan as pentose; when the articles gradual improvement during the further containing these pentosans are excluded from course of the disease. The second patient, a the dietary the pentose disappears from the

urine.

(3) Intermittent pentosuria, occur. selves, and for some time there had been a ring when the excretion of pentose takes tendency to diarrhea. The hematologio explace at more or less regular intervals unin. amination presented the following: Red blood fluenced by external oonditions and when one corpuscles less than 4,000,000; the hemaglohundred grams of glucose will not give rise bin amounted to 70 per cent; tbe leucocytes to a glycosuria. (4) Intermittent pentosuria were above 10,000. The blood, save tbat of a and glycosuria. When this condition occurs slight secondary anemia, was otherwise norpentose is present in appreciable quantities, mal.

The physical examination was negaand glucose appears in the urine, either inde. tive. A bacteriologic examination of the pendently or after the administration of one blood gave a pure culture of bacillus coil hundred grams of glucose.

communis. The condition, therefore, belongs The Influence of Excessive Meat Diet on

to the group of affections often termed false Growth and Nutrition. - Watson's (Lancet,

cyanosis. July 21, 1906) paper deals with the clinical

Tuberculin in the Treatment of Tuberculoresults obtained by feeding rats on an exclus. sis.--Pogue (Med. Record, Aug. 4, 1906) deive meat diet. His experiments prove that ducts the following conclusions from a study the use of such an excessive meat diet is at- of 167 cases: An early diagnosis is the most tended by a retarded growth, and sterility is important step to the successful treatment of induced if the diet is commenced in early tuberculosis. Tuberculosis may be arrested life. The power of lactation is diminished by proper treatment, with a certainty of a a permanent weakening of the resisting power permanent cure. Tuberculin is a valuable of the animals is induced by the use of excess- adjuvant in the treatment of tuberculosis, as ive flesh diet in early life, the animals suc.

is evidence by the recovery of twenty-eight cumbing to disease at an unusually early age,

out of thirty cases that were treated with and there is a high death rate in the offspring practically nothing but tuberculin while they of animals fed on excessive meat diet. Clin continued to follow their ordinary occupation

. ical experience leads Watson to think that during the treatment. Cases of tuberculosis there is also a close parallel in diseases of the treated witb the addition of tuberculin showa human subject, and especially in that class of much less tendency to recur than similar affeotions commonly included under the terms cases treated without tuberoulin. Tuberculin of gout and goutiness. He mentions that in small doses (0.01 to 0.005) seems to have particular attention should be given to early

a more curative action than when given in dietetio history of patients as far as obtaina. large and increasing doses. No ill effects fol. ble.

low the administration of small doses of

tuberculin. Purely incipient cases improve A Simple Test for Biliary Pigments in the

very rapidly under the use of small doses Urine.-Krokiewicz (Bulletin général de ther- of tuberoulin, both as to the arrest of the apeutique, May 23, 1906) recommends a test disease and the clearing up of the diseased consisting of aqueous solutions of sulpban- area. Tuberculin should never be given ilic acid (1 per cent) and sodium pitrite (1 to a patient who has a fever or who is sufferper cent) as highly sensitive for bile pig. ing from mixed infection. Third stage cases, ments in the urine, and that its application, especially advanced cases, receive little or no is not affected by the presence of other sub. benefit from the use of tuberculin. stances. The test is carried out as follows: Equal quantities of the sulphanilio acid and

The Loss of Patellar-Reflex in Pneumonia. sodium nitrite solution ( cc.) are placed in a

-Barnes (Birmingham Med. Review, April, test tube, to which an equivalent quantity of 1906) like Augblings Jackson, observed a loss urine (1 cc.) is added. The mixture is

of knee and other reflexes in cropuous pnenshaken for ten or fifteen seconds, and if the monia, while in pulmonary consoildations urine contain bile pigment the solution will

due to tuberculosis and septic pneumonias become a ruby red, which upon the addi. the reflexes invariably persisted until death. tion of one or two drops of hydrochloric

He noted an absence of the patellar re. acid changes to a violet amethyst.

flexes in thirty out of thirty-four cases of

crou pous pneumonia. A disappearance of Microbic Cyanosis.—Gibson and Douglas the knee reflex on the first or second day (Lancet, July 1, 1906) relate an interesting generally indicates a severe attack with a bad case of a woman, 36 years of age, who had termination. In those cases which ended been subject to headaches, weakness, attacks fatally, the author was able to demonstrate of dizziness and faintness for some years changes in the third lumbar segment. Barnes The appearance of the skin was of a dis- believes that the absence or presence of the tinctly cyanotic tint. Gastric as well as en- knee retlexes is not only a valuable differenteric disturbances frequently evidenced them- tial sign, but also a guide to the prognosis.

DEPARTMENT OF LEGAL MEDICINE. system of the chest is enormously distended

with bluod, much more so than can be acR. B. H. GRADWOHL, M. D.

counted for on the basis of a post mortem fill. Death from Electricity. Kratter (Veir. ing by gravity; this is not an artefact, but

; teljahrsschrift fuer Ger. Medizin, Band is found in every case of death by asphyxia XXX Heft 2, Proceedings of the German as well as in electric deaths. As Kratter said Association of Legal Medicine) has con- before, “death by electricity is a central restributed several monographs upon the subject piration paralysis, a special kind of internal of death from electricity. He opened the asphyxia." discussion of this subject anew at this con- What changes take place in the central vention by dividing the subject into three nervous system as to lead to death by as. headings, viz. : 1. What is death by electric- phyxia was the sabject of an inquiry by ity? 2. How can the diagnosis of death from Kratter; he made sections of the spinal cords electricity be verified ? 3. Which ourrent can of two subjects, one human and one experikill a man?

wental animal, dying from the electric Knowledge can be gained of the fact that stream. He made out minute hemorrhages. death is caused by the electric current by the Corrado found in the brains of dogs killed many deaths of persons and animals by acoi. with the current decided changes in the gandent and the pathologic-anatomic changes glion cells of the cortex. These changes were found in them; secondly, by experimental in the shape of distortion of the nuclei and researches upon animals with this current. chromatin substance and vacuole formation. Death occurs suddenly in some, sometimes There was a condition of varicose atrophy. with an outcry, sometimes without it, with Kratter is unable to confirm Carrado's lind. only tetanio-like convulsion of the body, with. ings. Neither can Jellinek confirm the same, out leaving any visible traces upon the out- although he has made many sections of ani. side of the body. In other cases death does mals dying from the current. not occur immediately, there is loss of con- In short, Kratter inquires, "Can we accur. sciousness, a soporific effect of the current, ately draw a picture of the pathologio anadeath finally taking place with sterterous tomic findings in a case of electric death and breathing and gradually increasing cyanosis. make a diagnosis thereon ? He replies, that In experimental animals where naturally ob- we cannot and for the following reasons: 1. servation can be more acute, there is remarked The peculiar character of the current and a difficulty in breathing at first, followed by laok of control over the same makes it im. conclusion of the entire muscular system. possible to reason on one case from all cases. The breathing difficulty is either permanent It is a fact tbat much more severe changes (death), or begins after a quarter, a half or than are found in cases of electric death an entire minute, and gradually is restored. are produced in the brains of men who rally Jellinke bas observed other phenomena; at survive. 2. Experiments and clinical cases the moment of contact, there is a spasm of of electric shock show us that reparable effects the entire circulatory system, with an enor- are sometimes produced by the current from mous increase in the blood pressure, this go

wbich the animals recover. ing far to explain the hemorrhaes which have It is a fact that while the anatomio diagbeen described in some cases of electric nosis cannot be distinguished from that of shock. This can be determined by the spby- “shock” in the ordinary expression of the mographio tracings, which show that if the term, as regards the effect upon the internal breathing stops for any long period of time, organs, yet fortunately the effects of the there is a sinking in the blood pressure, with current upon the exterior of the body serves Almost impreceptible movement of the pulse to make a competent diagnosis, i. e., the and very slight palpable beart's action. This effects of burns either from lightning or is the picture of an asphyxiation.

from actual electric sbocks from motors, etc. The anatomic picture found in these The burns produced in industrial accidents cases does not differ either in man or in ani. are characteristic; a long blister usually upon mals. The blood in the body is very fluid, the index finger of the bund receiving the or with very slight clots in the bodies of ani. shock. Other means of diagnosis depend mals, of a dark color, over-filling of the lungs upon the point where the shock was received and heart and great vessels with blood, many in the body, burning and tearing of the ecobymoses visible to the naked eyes in clothing, foot or bead apparel, in lightning places in the body, just as we find them in deaths burning and melting of metallio subdrowned bodies. In one case Kratter found stances like watches, watch.chains, etc., on ecchymoses under the endocardium of the the body, and magnetization of iron subleft heart, as Dietrich has pointed out in stances on the body, such as knife blades, cases of death from sun-stroke.

The venous

keys, etc.

As to the third question, what kind of a urea. Disturbances of the kidney and liver, current can kill, there arises an important Croftan states, often are seen to go band in question, theoretic as well as practical. It band, and he believes this would be found can be accepted as a fact that a current with much more frequently if the liver were exama voltage of 500 is dangerous, and the dan. ined as thoroughly as the kidneys in every ger increases as we go over the 500 mark. case of Bright's disease that comes to au. This rule varies with individuals as a rule. topsy, and if mild functional disorders of the For instance, men have been killed by a cur. liver were as easily recognizable as like disrent of 250 volts and others have survived a orders of the kidney. Even if the kidneys current of over several thousand volts. It is are primarily share the function of eliminat. a well-known fact that currents of 20 milli- ing toxio matters and some of the most imamperes are used for medicinal purposes. A portant of these must pass through the liver current of 100 M. A. is a dangerous. Mois- before being finally eliminated by the kidture of the skin increases the effect of the peys. Even if the kidneys are primarily discurrent, as well as salt solutions and aoid so. eased more work is thrown on the liver, not lutions opon the skin.

only in its disintoxicating function, but also The idiosyncrasy of certain persons to the in making up for the waste caused by a leaky current must not be forgotten. Alcoholics, kidney. The organ consequently becomes patients with heart disease and lymphatic fatigued, its fonction of disintegration of altrouble, as well as youthful people in general bumins is impaired and less ures and more are quite susceptible to the current. Alter- incompletely disassimilated intermediary pronating currents are more dangerous than the duots of albuminous metabolisni are thrown direct.

into the circulation and intoxication results.

Though this may thus follow or accompany GENITO-URINARY.

renal disease, it is still due more to hepatic

than to renal insufficiency. Hence the im. T. A. HOPKINS, M. D.

portance of recognizing early even mild deAn Analytical Study of Uremia.Dr. A.

grees of hepatic insufficiency (particularly C. Croftan, Chicago (Jour. A. M. A.), criti. in renal cases and in pregnant women) and cises the current theories of vremia, showing of safeguarding the patient against any- . that neitber anuria nor the variations of ex. thing that may suddenly impose a strain on crementitious nitrogen output suffice to ex- the fatigued liver. Instead, therefore, of plain the phenomena. Only when we de stimulating the kidneys, the chief object of termine separately the various groups of ni. treatment should be to prevent development trogen bodies that occur in the blood and of uremia by attention to those organs that urine do we find abnormal conditions tbat threaten to fail. Croftan advises first rest may be deemed fairly characteristic. The for the liver, even starvation for a few days, two most important of these are: 1. A rela- and in any case complete elimination from tive increase of the ammonia salts, both of the diet of all substances irritating to the or. the blood and urine as compared to normal gan, and that every effort should be made to average values and as compared to the circu- reduce intestinal putrefaction to a minimum. lating and excrementitious urea. 2. A rela. He would follow this by mild stimulation, tive decrease of the urea, both of blood and the carefully guarded use of salioglates, of urine as compared to normal average values bile acids, possibly of calomel, und such dieand to the total nitrogen of the circulating tetic and physical means as are available, all and excrementitious nitrogenous waste prod- under careful supervision. For the acute uots. There may also be highly toxic albu- uremic attack the most sensible procedure, he minoid cr alkaloid bodies in the blood or says, is blood letting, a lost art that should urine that might have an enormous effect be revived in such cases as these. The injecwithout appreciably changing the amount or tion of a saline to replace the lost fluid can relative proportions of the nitrogeu content. do no barm, especially if some salt is injected As regards the inorganic salts, the most deli. that can stimulate the hepatio function, e.g., cate tests, Croftan states, give little evidence salicylate of soda in normal sult solution, or that uremia is due to salt retention. That a solution of sodium citrate or phosphate in there must be some poisons acting in the proper molecular concentration. Sympto. productions of uremia can not be denied. matically, he has seen good results from the The decreased urea secretion, Croftan is in. use of such infusions. clined to think, is due rather to non-formation than to retention. It is not increased in The Rational Treatment of Urethritis.the blood, as it should be if it were merely N. E. Aronstam M.D., Detroit, Mich. (Jour. not eliminated, and the corresponding in- A.M.A.), condemns the so-called abortive crease of ammonia is normally concerted into plan of the treatment of acute urethritis and

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