Upload
lydat
View
220
Download
0
Embed Size (px)
Citation preview
1486
relieved the symptoms for a time. In two weeks the patientcalled again. There were pinkish, small, hard, irregular papil-lary growths of the conjunctiva of the left upper lid, mostmarked at the upper end of the tarsus. In spite of the localapplication of sulphate of copper the growths did not seemto diminish for fourteen days. The arsenic was then dis-continued and, under treatment, the growths grew muchless. The use of arsenic frequently gave rise to conjunctivitis,but there were no cases on record in which papillary growthshad formed.-The PRESIDENT considered it doubtful whetherthe arsenic was the cause of the papillary growths. Had itbeen so, they should have appeared in both eyes.The following cases and card specimens were shown :-Mr. LANG : A case of Cataract with Crystals in the Lens,
with Microscopical Specimens.Mr. H. WORK DODD : (1) A New Pince-nez ; (2) a case of
Congenital Lens Opacity.Dr. BRONNER : (1) Wire Shield for Use after Cataract
Operations ; (2) Benno’s Writing Paper, with Raised Lines,for the Use of the Blind.
Mr. G. LINDSAY JOHNSON: (1) Removal of Lenses in acase of Myopia ; (2) Symmetrical Markings in a case ofLamellar Cataract.Mr. N. C. RIDLEY : A case of Congenital Coloboma in the
Macular Region.Mr. W. J. CANT : Large Sarcomatous Tumour of the Right
Side of the Brain.Mr. DONALD GUNN : Case of Tuberculous Iritis.
HUNTERIAN SOCIETY,
Treatment of Skin -Diseases by Thyroid Extract.AN ordinary meeting of this society was held in the London
Institution on Nov. 28th, Mr. CHARTERS SYMONDS, Pre-sident, being in the chair.
Dr. FRED. J. SMITH showed a patient convalescent fromTyphoid Fever after some weeks’ continuous treatment bybathing.
Dr. ARTHUR DAVIES exhibited a series of lantern slidesrepresenting patients suffering from Myxcedema, Psoriasis,and other Skin Diseases before and after treatment by thyroidextract.
Dr. P. S. ABRAHAM brought forward a patient sufferingfrom Lupus Vulgaris of the Face, who had exhibitedmarked improvement under thyroid feeding. The patient,a girl, had been taking three tabloids a day until quiterecently. She had also until lately been treated withcod-liver oil, and had used an ointment containing oleate ofmercury, salicylic acid, and oxide of zinc. The treatment had
already lasted six months, and it would be continued till thepart was quite healed. This was the third case of lupus treatedin this way by Dr. Abraham; the other two patients showedan improvement which had been maintained. Of 55 cases of
psoriasis in which thyroid gland was administered, some ofthe patients had benefited, but the majority had not, and thegeneral results were disappointing. He had tried the remedy intwo cases of leprosy. One of these patients thought himselfvery much benefited-at any rate, he did not become worse inthe course of twelve months; the other patient was in an ad-vanced stage, and had since died. The late Dr. Rake gave thetabloids to five patients at the Trinidad Leper Asylum. Hisconclusions were not favourable, but his supply of the remedywas insufficient, and the patients who took it had already Ibeen affected for several years. Dr. Abraham knew of a Ifemale suffering from nearly complete alopecia areata, inwhom the administration of thyroid gland had been followedby a very general sprouting of hair on the scalp, eyebrows,and elsewhere.
Mr. E. C. KINGSFORD mentioned that in a female patientunder his care, suffering from Eczema of the Face and Armsof three years’ standing, whom he treated with injectionsof thyroid extract, five minims every third day, no effectwas produced on the eczema, but the patient becamevery ill and thin, and an abscess formed at the placeof the last injection. One of his brothers, who thoughthimself too corpulent, took three tabloids daily. Hesoon lost six pounds in weight, and complained thathe had got the " staggers," but recovered perfectlywhen the tabloids were discontinued.-The PRESIDENT hadseen a female suffering from exophthalmic goitre, whobecame extremely ill in consequence of using thyroid extract,but improved as soon as it was stopped.
Replying after the discussion, Dr. DAVIES said that thethyroid remedies should be regarded as specific il4 myxcedema,and cretinism, the result being nearly always successful. Inhis opinion the disease was at first aggravated, and the treatment should be continued for at least two months after
thyroidism had been established. Neurotic persons were not
good subjects for thyroid treatment and were liable to become-worse. In myxœdema 3 th of a gland had produced toxic.effects. Ninety minims of the extract alluded to equalledsone gland ; one of the tabloids was equivalent to one-sixteenthof a gland.
________
NORTH LONDON MEDICAL ANDCHIRURGICAL SOCIETY.
Bacteriological Diagnosis of Diphtheria.A MEETING of this society was held at the Great Northern
Central Hospital on Dec. 13tb, the President, Dr. J. G-.GLOVER, being in the chair.
Dr. JAMES GALLOWAY read a paper on the BacteriologicalDiagnosis of Membranous Inflammations of the Throat. Thespeaker based his remarks on a series of eighty cases recentlyexamined by him. Commencing with a consideration of thedifficulties lying in the way of making accurate clinical dia-gnoses in cases of diphtheritic affections, a criticism was madeof the various terms made use of to designate these affections.The conflict of opinions held by members of the profes-sion in reference to the virulence of diphtheritic diseaseof the throat and larynx, the extraordinary difference in,the death-rate of the disease in different epidemics, and’especially the difference of view as to the efficacy ofvarious remedies were quoted as facts showing the varietyin membranous affections of this region, and also that,no accurate means had been available to allow of correctclassification of these diseases up to the present time.The question of the symptoms of experimental diphtheria,and what might now be called pure diphtheria, in the humahsubject was then discussed, and the symptoms of these com-pared with other membranous diseases of the throat andlarynx. It was stated that none of the signs or symptomsobserved could be regarded as of absolute diagnostic value indifferentiating true diphtheria from similar affections, withthe exception of the characteristic diphtheritic paralysis-a.symptom too serious to be permitted to supervene if it mightbe prevented, and occurring too late to be of value in earlyand efficient diagnosis. The characters of the exudation
having been considered, the speaker went on to saythat it was only by a recognition of the organism or organismscausing the disease that a trustworthy basis for diagnosisand for the classification of these diseases could be obtained..Various pathogenic organisms discovered in diphtheriticaffections were mentioned and described. The following werethose specially noted : (1) bacillus diphtheriæ (Klebs-Lofller),(2) streptococcus pyogenes, (3) staphylococcus pyogenes.aureus, (4) staphylococcus pyogenes albus, (5) dtplococct’(described by different observers), (6) micrococcus of Talamcn-Fraenkel, (7) pneumococcas (Friedlander), and other
organisms. The characters of these were demonstrated, theirpathogenic properties were described, and mention was madeof their probable r6le in diphtheritic affections. In thisconnexion the subject of mixed infections of the throatwas alluded to and the possible increased virulence pro-duced by some of the associated micro-organisms mentioned.Easily adopted methods for the purpose of distinguishing themicro-organisms having been shown, the speaker stated thatearly accurate diagnosis was possible only by bacterio-
logical examination, and that this test would also supplytrustworthy methods for the formation of a new classifica-tion of the diseases under consideration. In view of newmethods of treatment now under trial the importance ofaccurate bacteriological examination was especially insistedon, and attention was drawn to the unreliable character ofmany of the cases and statistics now being published forwant of this precaution. The paper was illustrated through-out by means of the lantern and by typical pure and mixedcultures of the organisms obtained from cases of suspecteddiphtheria.
Mr. LENNOX BROWNE spoke of the importance of reco-gnising, not only the true bacillus diphthehse, but also asso-ciated micro-organisms, and mentioned the views heldespecially as to the association of the streptococcus pyogenes.
Dr. GAYTON referred to his experience of the diseasefrom the clinical aspect during his association with the