2020 Arch St., Philadelphia.
Current Literature.
_NATURE’S CURE OF PHTHISIS._
Dr. Henry P. Loomis states (_Med. Rec._) that he has found quite a
number of cases of recovery from phthisis. His summary is as follows:
1. Out of 763 persons dying of a non-tubercular disease seventy-one, or
over nine per cent., at some time in their life had phthisis, from which
they had recovered.
2. The new fibrous tissue by which the advance of the disease was
apparently checked and the cure effected, developed principally by
round-cell infiltration of the interlobular connective tissue, which in
some instances had increased to an enormous extent. Some of the new
fibrous tissue was formed later by round-cell infiltration in the
alveolar walls and around the blood-vessels and bronchi. Pleuritic
fibrosis appears to be secondary to tubercular processes in the lung
substance. The interlobular connective tissue is the primary and
principal source of the fibrosis.
3. Tubercle bacilli were present in the healed areas in three out of
twelve of the lungs examined. These healed areas did not differ in their
gross or microscopical appearances from those in which they were not
found.
4. Thirty-six per cent. of all cases where the lungs were free from
disease showed localized or general adhesions of the two surfaces of the
pleura.
_VENTRO-FIXATION OF THE UTERUS._
Dr. Spaeth, of Hamburg, according to the _Lancet_, has now published
reports of twenty-five cases in which he has performed the operation
known as ‘ventro-fixation of the uterus.’ None of the cases proved
fatal. In seventeen permanent anteflexion was obtained; in fourteen
there was, besides the retroflexion, a diseased condition of the uterine
appendages necessitating their removal. Of the cases that were not so
complicated all except one were successful. Dr. Spaeth rarely fastens
the stump of the broad ligament into the abdominal wound, usually
stitching the fundus uteri directly to the parietal peritoneum. In the
later cases he adopted Schede’s method—that is to say, silver sutures
were drawn through the whole thickness of the abdominal walls at
intervals of about an inch and a half, but they were not at first tied.
In the intervals finer silver sutures were inserted through the sheaths
of the recti, the peritoneum and the fundus uteri, and tightened,
twisted, and cut short, the whole of course being beneath the skin; the
thicker sutures were then tightened and twisted and the lips of the
wound brought together with superficial catgut sutures. The subcutaneous
silver sutures remained, but never gave any trouble. Dr. Schede and Dr.
Spaeth are both of opinion that this method is the best for preventing
any hernia, and that when it has been employed abdominal binders are
unnecessary. Dr. Spaeth does not perform or recommend ventro-fixation in
cases of retroflexion unless there is either disease of the appendages
or chronic peritonitis.
_PNEUMONIA._
Croupous pneumonia has during recent times been defined as “an
infectious disease characterized by inflammation of the lungs and
constitutional disturbance of varying intensity.”
The recognition of an infection as a cause of this disease necessarily
implies the existence of a specific germ, and as corollary we may state
that this germ, like all germs, has a limited existence.
During the cause of the inflammation three stages have been
recognized—congestion, red hepatization, and gray hepatization. Now, on
a physician being called to a case of this kind, the query is, what is
the best thing to do in the way of medical treatment?
If one consults some of his associates he will find remedies recommended
_ad nauseam_. One declares the fever does no harm, while another is not
satisfied unless one of the chemical antipyretics keeps the temperature
near the normal standard.
Varying results, of course, follow these different treatments.
Having for a long time accepted and practised the doctrine that many
diseases can be modified and conducted to a safe issue by giving a
remedy that will attack the diseased cell-function, I have treated my
cases of pneumonia in this way. The three remedies that I employ are
aconite, bryonia and iodine. If I am called to see a patient during the
first stage I give aconite and iodide of potassium, and on the
development of the second stage I continue the iodide and also give
bryonia. The aconite is given with a view of relieving the vaso-motor
tension, and thereby equalizing the circulation; this, if doing nothing
more, produces a measure of comfort. The last two remedies are given for
their local effect. Now, as to a dose: in a half goblet of water I put
ten drops of tincture of aconite, and in another goblet containing same
quantity of water I put five grains of iodide of potassium, and give a
teaspoonful alternately every hour. As soon as the second stage comes on
I substitute five drops of tincture of bryonia for the aconite and
continue to give in alternation with the iodide. If the heart becomes
weak give one-fourth of a grain of extract of nux vomica every three or
four hours. If the patient has much pain, hot applications are used.
This with suitable food constitutes a treatment that bears excellent
results. The physician who believes in giving large doses of quinine,
ammonia, etc., will sneer at these small doses and hotly declare that
nature cures independently of the drugs. In view of this declaration
there is a compliment paid to _vis medicatrix naturæ_ that the writer
recognizes, and to have such an ally is certainly a desirable help.
Those who have faith in heroic dosage are not always mindful of this
fact, nor yet of the condition which obtains under their hands, and that
is a state of drug disturbance plus the disease. Nature here is
hindered, not assisted.