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DEVON AND EXETER MEDICOCHIRURGICAL SOCIETY.
545
through the splanchnic nerves. He then referred to estimations of blood-sugar and laid stress on the importance of carrying out a glucose-tolerance test, with estimations every half hour for at least two hours, according to the method described by H. Maclean, and the plotting out of the results as a arithmetically. Prof. MARNOCH and Mr. SMITH contributed to the curve. A single estimation of blood-sugar taken at discussion, and some remarks from the statistical any time without relation to meals was of little value. He showed curves of estimations he had carried out point of view were made by Dr. J. F. TocHER. in normal persons, renal diabetes, the " lag " curve, a and cases of true diabetes. He then attempted to NORTH OF ENGLAND OBSTETRICAL AND give a definition of acidosis and advised the following tests in such a condition : 1. The tests for acetone GYNÆCOLOGICAL SOCIETY. bodies in the urine. 2. The ammonia coefficient in the urine. 3. Estimation of the C02 in alveolar air. A MEETING of tills Society was held in the Liverpool 4. Estimation of the sodium bicarbonate content of Medical Institution on Feb. 16th, Prof. W. BLAIR BELL the blood plasma. in the chair. Dr. F. A. RopBR emphasised the value of bloodAveling’s Repositor. sugar curve estimations as a guide not only in lesser Dr. MILES H. PHILLIPS recorded a case of chronic or occasional forms of glycosuria, but in severer inversion of the uterus to emphasise the value of forms of true diabetes, where they are a gauge of Aveling’s repositor. A complete inversion of uterus the results obtained by dietetic treatment. He also and cervix was discovered four months after confine- showed charts illustrating the altered ammonia ment. After the necessary attention to the local coefficient and the importance of accurate- knowledge toilet, the repositor was introduced and completed of the degree of acidosis present. Protein and fat He had had two small restriction had to be as carefully considered as its work within 12 hours. holes bored through the head to relieve the difficulty carbohydrate restriction in successful dietetic treatpreviously experienced in removing a repositor with ment. Different methods of arriving at a standard diet after abolition of the glycosuria by fasting were a solid head, owing to suction between it and the uterus. This has been completely satisfactory. He described, though as long as effective treatment further emphasised the slight pressure required. remained as at present simply dietetic many disIt was furnished by two rubber " paper bands." appointments in results must always be inevitable. Miss F. IVENS said that as a house surgeon she had Administration of alkalies appears to be of very used the repositor ; the patient had had to be kept limited value whether in acidosis or in coma. The PRESIDENT commented on the fallacies which under morphia owing to severe pain ; the suction between the head of the repositor and the uterus so frequently arose through the Fehling reduction test. Dr. W. GORDON compared the hopeless condition had caused difficulty in removal. Dr. A. DONALD had found the repositor successful of the young diabetic of earlier days-with rapid in four cases. progression towards the stage of coma-with the Dr. J. H. WILLBTT had had no difficulty in applying effects now observed under the Allan and* other the repositor on one occasion, but it had entirely enlightened treatment. There were often, however, failed after 48 hours. In this case the inversion had cases where we found ourselves between the alternaonly been discovered some time after confinernent, tives of starvation and coma. He had seen a recent and involution was complete. At operation the young case where glycosuria, obviously related to a peritoneal surfaces were found adherent to one continuous surfeit of loafsugar, had cleared up another, evidently owing to infection ; this was altogether. He had also seen good results from supported by the occurrence of phlegmasia alba dolens salicylate of soda in the glycosuria of the young. The after the operation. insulin treatment must yet be considered with Dr. FLETCHER SHAW agreed that the peritoneum in reserveand he deprecated the publicity given to it in the daily press. some cases might be damaged and adhesions develop. Dr. B. COHEN raised a question as to the dieting He cited an acute inversion he had seen : primary treatment to relieve the shock, and 24 hours later of a diabetic affected with pulmonary tuberculosis. Mr. A. L. CANDLER quoted a striking case of reduction of the inversion under ether. A fortnight later the abdomen had to be opened for intestinal septicaemia arising from a wound in the foot where the obstruction—coils of intestine were found adherent glycosuria and acetonæmia had tended todisappear after amputation of the limb. to the uterus. Dr. P. D. WARBURTON said that acidosis becameDr. PHILLIPS, in reply, agreed that the repositor would probably fail in cases where adhesions were negativeon the advent of diabetic coma. Dr. H. JONAS mentioned the importance of glucose present; so far he had found it uniformly successful. Dr. LEITH MURRAY, Dr. MEREDITH LITTLF.R, Dr. injections as a prophylactic against the toxæmia and RUTH NICHOLSON, Dr. PICKERING JONES, Dr. WILLETT, jaundice arising from salvarsan injections. Dr. D. DOUGAL, Prof. H. BRIGGS, Miss IVENS, and Dr. FLETCHER SHAW showed cases and specimens.
suffer primary appears in a gangrenous case the risk rises from about 2-4 per cent. to 8-8 per cent. and in some third day cases to double this, the risk rising geometrically as the time increases all cases requiring urgent operation will appendicectomy ; and (3) when pus
acting
I
ROYAL
DEVON AND EXETER MEDICOCHIRURGICAL SOCIETY. A MEETING of this
MEDICO-CUIRURGICAL OF GLASGOW.
SOCIETY
A MEETING of this Society was held on Feb. 16th, when Dr. J. FERGUSON SMITH made a communication
held at the Royal on Feb. 22nd, Dr. G. P. Some Points in the Ætiology of Eczema. HAWKER, the President, being in the chair. The conclusions arrived at were : 1. The skin of Dr. R. V. SOLLY read a paper on eczema patients is not abnormally sensitive to "all Some Laboratory Tests in Diabetes. irritants. 2. The skin of a patient, or an experimental He began by reviewing the modern theories of animal, sensitised to a. protein, is not more sensitive diabetes, particularly with regard to the experiments to a non-specific irritation than that of a normal of Allan and others with reference to depancreatised person or animal. The sensitiveness is specific. dogs and the influence of the hormone from the 3. Attention was drawn to an important class *’of islands of Langerhans on the metabolism of sugar, case in which eczema appears to be due to sensitiveand he touched on the mechanism regulating the ness to skin bacteria. Dr. IvY MACKENZIE made a communication on blood-sugar in relation to the endocrine glands generally and also the special centre in the brain Psychotherapy and the Orthopaedic Problem.
Devon and Exeter
Society
was
Hospital on
through the splanchnic nerves. He then referred to estimations of blood-sugar and laid stress on the importance of carrying out a glucose-tolerance test, with estimations every half hour for at least two hours, according to the method described by H. Maclean, and the plotting out of the results as a arithmetically. Prof. MARNOCH and Mr. SMITH contributed to the curve. A single estimation of blood-sugar taken at discussion, and some remarks from the statistical any time without relation to meals was of little value. He showed curves of estimations he had carried out point of view were made by Dr. J. F. TocHER. in normal persons, renal diabetes, the " lag " curve, a and cases of true diabetes. He then attempted to NORTH OF ENGLAND OBSTETRICAL AND give a definition of acidosis and advised the following tests in such a condition : 1. The tests for acetone GYNÆCOLOGICAL SOCIETY. bodies in the urine. 2. The ammonia coefficient in the urine. 3. Estimation of the C02 in alveolar air. A MEETING of tills Society was held in the Liverpool 4. Estimation of the sodium bicarbonate content of Medical Institution on Feb. 16th, Prof. W. BLAIR BELL the blood plasma. in the chair. Dr. F. A. RopBR emphasised the value of bloodAveling’s Repositor. sugar curve estimations as a guide not only in lesser Dr. MILES H. PHILLIPS recorded a case of chronic or occasional forms of glycosuria, but in severer inversion of the uterus to emphasise the value of forms of true diabetes, where they are a gauge of Aveling’s repositor. A complete inversion of uterus the results obtained by dietetic treatment. He also and cervix was discovered four months after confine- showed charts illustrating the altered ammonia ment. After the necessary attention to the local coefficient and the importance of accurate- knowledge toilet, the repositor was introduced and completed of the degree of acidosis present. Protein and fat He had had two small restriction had to be as carefully considered as its work within 12 hours. holes bored through the head to relieve the difficulty carbohydrate restriction in successful dietetic treatpreviously experienced in removing a repositor with ment. Different methods of arriving at a standard diet after abolition of the glycosuria by fasting were a solid head, owing to suction between it and the uterus. This has been completely satisfactory. He described, though as long as effective treatment further emphasised the slight pressure required. remained as at present simply dietetic many disIt was furnished by two rubber " paper bands." appointments in results must always be inevitable. Miss F. IVENS said that as a house surgeon she had Administration of alkalies appears to be of very used the repositor ; the patient had had to be kept limited value whether in acidosis or in coma. The PRESIDENT commented on the fallacies which under morphia owing to severe pain ; the suction between the head of the repositor and the uterus so frequently arose through the Fehling reduction test. Dr. W. GORDON compared the hopeless condition had caused difficulty in removal. Dr. A. DONALD had found the repositor successful of the young diabetic of earlier days-with rapid in four cases. progression towards the stage of coma-with the Dr. J. H. WILLBTT had had no difficulty in applying effects now observed under the Allan and* other the repositor on one occasion, but it had entirely enlightened treatment. There were often, however, failed after 48 hours. In this case the inversion had cases where we found ourselves between the alternaonly been discovered some time after confinernent, tives of starvation and coma. He had seen a recent and involution was complete. At operation the young case where glycosuria, obviously related to a peritoneal surfaces were found adherent to one continuous surfeit of loafsugar, had cleared up another, evidently owing to infection ; this was altogether. He had also seen good results from supported by the occurrence of phlegmasia alba dolens salicylate of soda in the glycosuria of the young. The after the operation. insulin treatment must yet be considered with Dr. FLETCHER SHAW agreed that the peritoneum in reserveand he deprecated the publicity given to it in the daily press. some cases might be damaged and adhesions develop. Dr. B. COHEN raised a question as to the dieting He cited an acute inversion he had seen : primary treatment to relieve the shock, and 24 hours later of a diabetic affected with pulmonary tuberculosis. Mr. A. L. CANDLER quoted a striking case of reduction of the inversion under ether. A fortnight later the abdomen had to be opened for intestinal septicaemia arising from a wound in the foot where the obstruction—coils of intestine were found adherent glycosuria and acetonæmia had tended todisappear after amputation of the limb. to the uterus. Dr. P. D. WARBURTON said that acidosis becameDr. PHILLIPS, in reply, agreed that the repositor would probably fail in cases where adhesions were negativeon the advent of diabetic coma. Dr. H. JONAS mentioned the importance of glucose present; so far he had found it uniformly successful. Dr. LEITH MURRAY, Dr. MEREDITH LITTLF.R, Dr. injections as a prophylactic against the toxæmia and RUTH NICHOLSON, Dr. PICKERING JONES, Dr. WILLETT, jaundice arising from salvarsan injections. Dr. D. DOUGAL, Prof. H. BRIGGS, Miss IVENS, and Dr. FLETCHER SHAW showed cases and specimens.
suffer primary appears in a gangrenous case the risk rises from about 2-4 per cent. to 8-8 per cent. and in some third day cases to double this, the risk rising geometrically as the time increases all cases requiring urgent operation will appendicectomy ; and (3) when pus
acting
I
ROYAL
DEVON AND EXETER MEDICOCHIRURGICAL SOCIETY. A MEETING of this
MEDICO-CUIRURGICAL OF GLASGOW.
SOCIETY
A MEETING of this Society was held on Feb. 16th, when Dr. J. FERGUSON SMITH made a communication
held at the Royal on Feb. 22nd, Dr. G. P. Some Points in the Ætiology of Eczema. HAWKER, the President, being in the chair. The conclusions arrived at were : 1. The skin of Dr. R. V. SOLLY read a paper on eczema patients is not abnormally sensitive to "all Some Laboratory Tests in Diabetes. irritants. 2. The skin of a patient, or an experimental He began by reviewing the modern theories of animal, sensitised to a. protein, is not more sensitive diabetes, particularly with regard to the experiments to a non-specific irritation than that of a normal of Allan and others with reference to depancreatised person or animal. The sensitiveness is specific. dogs and the influence of the hormone from the 3. Attention was drawn to an important class *’of islands of Langerhans on the metabolism of sugar, case in which eczema appears to be due to sensitiveand he touched on the mechanism regulating the ness to skin bacteria. Dr. IvY MACKENZIE made a communication on blood-sugar in relation to the endocrine glands generally and also the special centre in the brain Psychotherapy and the Orthopaedic Problem.
Devon and Exeter
Society
was
Hospital on