X-Rays in Pseudoleukemia.—Senn Reports Two Cases in Which, in View of the Hopeless Condition, He Suggested the Use of the Rays, in Addition to Giving Arsenic and Iron

X-Rays in Pseudoleukemia.—Senn Reports Two Cases in Which, in View of the Hopeless Condition, He Suggested the Use of the Rays, in Addition to Giving Arsenic and Iron

Current Medical Literature. abscess, fistula, fissure of the anus, ulcer, pruritus, constipation and fecal impaction. Cancer and stricture can hardly be on in the office when in the lower rectum, AMERICAN. operated excepting but in most cases the local treatment and topical applications, Titles marked with an asterisk (*) are abstracted below. etc., can do much toAvard improving the condition. New Medical York Journal. 4. derived from in¬ April 18. The Diazo Reaction.—The conclusions this method in the of the New York •The Therapeutic Value of the Roentgen Ray in the Treatment vestigations by laboratory of Pseudo-Leukemia. N. Senn. Department of Health are Billings as folloAvs: *A Plea for the Office given by Non-Hospital or Treatment of Diseases 1. The of the urine in cases Rectum and Anus. G. examination of suspected typhoid of the Samuel Gant. fever is of value, provided that its limitations are recognized. The Practical Uses of Hypnotic Suggestion. William L. 2. While of Howard. not so absolutely pathognomonic typhoid fever, yet the diazo reaction Is even more constantly present in that disease than the AA'idal reaction. So that its absence at a period when it should be present, if the case is one of typhoid fever, is of consid¬ erable value in making a negative diagnosis. 3. In a majority of instances the diazo reaction is present in the urine at least forty-eight hours earlier than the Widal reaction in the blood. 4. It disappears much earlier than the Widal reaction, however, and negative results obtained later than the second week are of lit¬ tle or no value. 5. "Doubtful reactions" have slight significance. 5. Typhoid Fever Complications.—The complications of typhoid discussed here by Erdmann are liver abscess, perfora¬ tion of the gall bladder, cholecystitis and intestinal perforation. The operative treatment of each is discussed. For liver abscess, opening, either by rib excision or otherwise, is advised Avith sub¬ sequent drainage. He does not believe in delaying pus evacua- Dr. George L. Richards, Fall River, Mass., Chairman of the Section on Laryngology and Otology. 4 *The Work Performed by the Diagnosis Laboratory of the Department of Health in Connection with Ehrlich's Diazo Reaction During 1902. J. S. Billings, Jr. 5 'The Treatment of Some of the Surgical Complications of Typhoid Fever. John F. Erdmann. 6 *Is the Cognomen, "Chemical Physiology," Scientific? A Study of Vital Processes. Joseph Clements. 7 The Management of Occipitoposterior Positions of the Pre¬ senting Head. (Concluded.) Walter J. Cavanagh. 1. X-Rays in Pseudoleukemia.—Senn reports two cases in which, in view of the hopeless condition, he suggested the use of the rays, in addition to giving arsenic and iron. The benefit was great, both patients noAV considering themselves in perfect health. He says in his remarks that there is no doubt that the constitutional disturbances which folloAV the prolonged use of the œ-ray, and Avhich set in simultaneously with the progressive diminution in the size of the glands, were due to toxemia caused by absorption of the degenerative products of Dr. J. F. Barnhill, Indianapolis, Secretary of the Section on pseudoleukemia. This Avas also undoubtedly the cause of the in¬ Laryngology and Otology. creased enlargement of the spleen, which was noted after the tions at the expense of the patient's vitality. In cases of second series of applications in the second case. The constitu¬ perforation of the gall bladder there is one treatment, he tional disturbances were decided and only annoying itching, burning, says, cholecystectomy, though the condition of the patient pigmentation, etc. He says the success attained in these tAvo must weigh with us somewhat in the consideration, and cases the use of the leaves no doubt as to the curative by ¡ -ray must be done in certain cases. effect of the in the treatment of cholecystotomy Repair by rays pseudoleukemia. suture is umvarranted. Operative interference in cholecystitis 2. Rectal and Anal Disease.—The forms of trouble Avhich depends largely on the symptoms presenting. If marked rigid¬ Cant Avould treat in the office or away from the hospital are ity of the upper rectus segment continues for thirty-six to external and internal hemorrhoids, in the latter of which he uses forty-eight hours without any diminution, and septic conditions Avell as injections as the ligature, polypi in the rectum, anorectal are indicated by the temperature and pulse, or rupture of the bladder threatens, then cholecystotomy should be performed 9. Eye-Strain in Youth.—Ranney discusses this disorder and if the condition is bad or is patient's cholangitis present; other¬ insists on its importance. His conclusions are: all eases wise cholecystectomy. In the abdomen may be closed 1. Eye-strain can not be recognized too early in youth. 2. Its without drainage unless Ave leave the cystic duct open for drain¬ scientific investigation by modern methods and its radical correction may favorably modify both physical and mental develop¬ age of the hepatic fluid. The statistics of the operation for ment. 3. intestinal perforation are noted and the principal question The neglect of an existing eye-strain may in time allow it to exhaust the reserve nerve capital of the sufferer and produce untold seems to be whether Ave should Avait six to tAvelye hours for ills both of body and mind. subsidence of shock. He is inclined to answer this in the 4. No child should ever be allowed to begin education until it is known that its eyes are properly fitted the work. from his of the statistics. The suture be for negative study to 5. Legislative enactment should, and surely will in time, compel employed is either the Lembert or the circular purse-string an eye examination of every child before it enters the public schools. 6. Teachers should also be instructed in the rudimentary steps of vision testing. 7. Tests for mal-adjustment of eye-muscles should be made on every child as thoroughly and intelligently as tests for errors of refraction are made prior to its education. 8. A knowledge of the possible effects of eye-strain on mental and physical development can not be too widely disseminated among parents and teachers. 9. The direct causal relationship between "eye-strain" and nerv¬ ous diseases is too well established to-day to require further proof, or even to justify further discussion. 10. The modern methods of testing for anomalies of adjustment of eye-muscles are the only ones that can furnish us with scientific and accurate information. The time has happily passed when any oculist can instruct a pa¬ tient to simply follow with the eyes some object held before the eyes, and then on that test alone give a final decision as to whether mal-adjustment of the eye-muscles exists or does not exist. 11. The cure of disease to-day is intelligently based on the search for its cemse rather than on an indiscriminate use of drugs ; and the prevention of diseases is rapidly becoming more important to the medical mind, and also to the laity, than its cure. S. Solis Cohen, Philadelphia, Chairman of the Section on Materia Medica, Pharmacy and Therapeutics. Avhen inversion is possible. The question of drainage can be settled only by experience. He believes that Avith a fairly clean toilet, no drainage should be used. 6. Vital Processes.—Clements' article is an argument in favor of the vitalistic point of view in physiology. Medical Record, New York. April 18. 8 *A Report of Final Results in Two Cases of Polyarthritis in Children of the Type First Described by Still, together with Remarks on Rheumatoid Arthritis. Royal AA'hitman. 9 *"Eye-strain" in Youth and Its Modern Treatment. Ambrose L. Ranney. 10 Tuberculous (Basilar) Cerebrospinal Meningitis and Delu¬ sional Insanity Complicating Pulmonary and Laryngeal Tuberculosis. Henry Levien. 11 'Resection of Intestine, with Report of Three Interesting Cases. A. E. Isaacs. 8. Polyarthritis of the Still Type in Children.—The two cases reported by Whitman are, as he says, undoubtedly samples of the disease described Still in in by 1897, consisting general Dr. C. S. N. chronic of the with Hallberg, Chicago, Secretary of the Section on Materia progressive enlargement joints, general en¬ Medica, Pharmacy and Therapeutics. largement of the glands and spleen. The cases are elaborately 12. The of in is an Avith illustrations and One of detection "eye-strain" youth important step reported, radiograph. them re¬ in preventive medicine, and the arrest of a nervous leak may save covered, which is apparently decidedly different from the usual many a child from a permanent break-down when an adult. 13. The of and course of the disease. in this was study facial expression head posture is destined Recovery case apparently to become an important aid in diagnosis. completed by an attack of acute disease, scarlatina, after which 14. The governing boards of institutions for the feeble-minded, the his former health. The author remarks in the epileptic, and the insane will sooner or later be compelled to in¬ patient regained vestigate more carefully and earnestly than in the past the eye regard to the nature of rheumatoid arthritis, and seems to conditions of their inmates. the infectious nature of the disorder as doubt well as other 11. Intestinal Resection.—Three cases of interest are reported theories that have been advanced. by Isaacs. The first tAVO shoAV hoAv uncertain the diagnosis of acute appendicitis may be, even if the symptoms are apparently 17 Pernicious Anemia following Thyroid Enlargement. V. S. Merritt. clear. The first case is also of interest on account of the length 12. and of the gangrenous gut, tAventy-three inches, included in the Tabes Paresis.—Leredde holds to the syphilitic intestinal strangulation.

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