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¡1542 Washington Avenue ANURIA FOLLOWING THE INTRAVENOUS ADMIN- of an appendicitis or a pericolitis with bands or perhaps ISTRATION OF SALVARSAN both together. Through a right rectus incision the appendix, which was congested, was removed. The George R. Memphis slightly pericolitic Livermore, M.D., condition was very pronounced and several bands running C. S., white, man, aged 19, had a chancre in May, 1911. transversely over the ascending colon and cecuni, producing Mucous patches appeared in the mouth one month later. He constriction, necessitated division. On further investigation was treated in Birmingham for six months, with protoiodid of the left side of the abdomen proved to be negative, but a very mercury pills, but has had no treatment for the past month, pronounced patch several inches in area of this membrane and no further symptoms. Examination showed no evidence was noted on the peritoneal surface to the left of the of syphilis, except general adenopathy. The heart, eyes, lungs umbilicus. It was non-adherent to the adjacent underlying and kidneys were normal. viscera. An intravenous injection of 0.55 gm. salvarsan was given in a hospital at 9 a. m., July 2, 1912. Temperature was 98.6; A HOME-MADE INFANT INCUBATOR pulse, 60 and respiration 20. At 10 a. m. the patient com- plained of headache and vomited 8 ounces of yellow fluid. He Fred E. Leavitt, M.D., St. Paul slept for one hour; then had large soft bowel movement. Many improvised infant incubators have been devised, but Temperature was 105; pulse, 106 and respiration 34. The tem- for simplicity of construction and uniformity of heat, one perature gradually fell to 101 at 6 p. m. The bowels moved at made by Dr. D. D. Turnacliff of the Midway General Hospital, 6 p m. and again at 12 midnight. The patient voided urine and shown in the accompanying illustration, has proved as a small amount both times, but only at midnight. The bowels satisfactory as any we have moved at (la. m. next but no urine again the day, was passed. used, not excepting the more At 9 a. m. the temperature was 101.4; pulse, 100 and respira- . elaborate and expensive sort in tion .'14. The patient seemed drowsy and said he felt sick all common use. He over. was given 8 ounces of saline per rectum; nitro- A table, a metal stand, rub- glycerin 1/100 grain bypodermatically. and a hot-water ber gas-tubing, a thermometer, bottle was applied over the kidneys; also plenty of hot water a piece of string and two infant by mouth. At 2:30 p, m. temperature was 102; pulse 108 bath-tubs were all the parts and the no and respiration 30, patient had voided urine, lie used, except an gas- and ordinary was given strychnin 1/30 grain nitroglycerin 1/100 grain regulating glass tube and an bypodermatically every four hours, and a hot pack for ten incubator lamp from the lab- of 1 of saline minutes, with hypodermoclysis pint solution. At oratory. The lower tub was 4 p. m. the patient vomited a large amount of dark green partly filled with water in The hot was 0 and fluid. pack repeated at p. m., potassium which rested the upper or bicarbonate (,'i0 grains in one-half glass of water) was given. outer tub with the baby. The At 9 10 ounces of p. m., he vomited greenish Huid. Saline thermostat was regulated to the method was at I) and con- solution by Murphy begun p. m., keep the water at a uniform tinued through the night. At 9 a. m. .Inly 3, calomel one-half temperature of 40 C. (104 F.). sodiunr grain every half hour, for six doses, and theobromin Where neither gas nor the salicylate with essence of pepsin every four hours were given. thermostat are to be had, the Huid at !>:.'!(). a home-made Infant Incubator. Patient vomited 12 ounces of greenish Murphy water may be kept warm by drip was continued, The bowels moved at 11 a. m. and again means of a small kerosene at 12 m. At 2 p. m. the patient was cat lief orized, and it lamp, a night lamp, or even by a tallow candle. ounces of urine were obtained. Murphy drip was continued The apparatus is so simple and so easily extemporized that, through afternoon and night. At 8 p. m., (I ounces of urine its use need not be limited to premature infants, but will were obtained by catheter. The patient vomited several be of service whenever a delicate or feeble child needs artifi- times during the night, and the bowels moved three times, cial heat constantly applied. lioin this time on, he voided urine in sufficient quantity, and made a good recovery. The first urine contained a large amount of albumin, and all kinds of casts. Subsequent speci- A PECULIAR CASE OF COMMON SALT mens have improved till now they contain no albumin and POISONING few hyaline casts. O. H. Campbell, M.D., St, Louis The only explanation for the suppression of urine is an The R. G., was a of 5 idiosyncrasy for arsenic. The technic employed was the one patient, healthy boy years. Parents I were and well. Patient had had at always use. The solutions were made with pure distilled, living mumps 4 years and sterile measles at 3 no other illness. This water, und the patient's urine was normal in every years; summer he had not the respect before salvarsan was given. slept well and mother believed that the child might have worms. On the advice of a friend the mother decided to administer a salt enema. The suggestion had been to in a of NON-ADHERENT MEMBRANOUS PATCH IN use one tablespoonful quart water, but she misunder- PERICOLITIS stood and used one pound of salt in a quart of water. The enema was given at 5 m., 13. In from five Victor F. Marshall, p. July M.D., Appleton, Wis. to ten minutes the child cried, with severe pains in head, is The literature replete with numerous contributions by became intensely thirsty, vomited violently, and soon began various authors concerning membranous pericolitis, Jackson's to purge violently; within thirty minutes he became uncon- membrane and other terms designating the same condition, scious and had one convulsion after another. I saw him at with many theories as to its etiology. I cannot add anything 6:30 p. m. and found him unconscious and unable to swallow, to the present conception of this condition, but wish merely with one clonic spasm quickly following another. The tem- the was to report following with the hope that it may serve to perature 90.2, pulse 150, bowels moving often, passing throw light on the pathology of this rather obscure condition. blood and mucus. At 8 p. m. the temperature was 102.5, Miss M., aged 19 years, was operated on at Theda Clark pulse 170; the eyes were crossed, and all of the symptoms Memorial Hospital, Neenah, Wis., Aug. 17, 1912, for right- seemed worse. At !) p. m. the temperature was 104.(1, pulse sided pain confined to the right hypochondriac and ileocecal about 200. All of the symptoms seemed worse and continued region. The attack was of two days' duration. Temperature to increase in severity until Kl p. m., when the child died. was 90.5 F., pulse 90. Constipation and some anorexia were I was unable to have a post-mortem examination. I have present, but no vomiting. There was rigidity of the right searched the literature carefully but can lind no parallel case. rectus muscle. The urine was normal. A diagnosis was made ¡1542 Washington Avenue. Downloaded From: http://jama.jamanetwork.com/ by a Virginia Tech User on 05/14/2015.
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