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EDINBURGH OBSTETRICAL SOCIETY.
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improvement having followed manipulation it was decided Seventh, Eighth, Ninth, Tenth, and Eleventh Cranial l in a woman, aged 32 years, who six years ago conto open the joint. On August 5th a free incision was made Nerves 1 On opening the joint the tracted across the front of the joint. syphilis. The present symptoms had come on anterior crucial ligament was seen to be torn away from the
619 third monstrosity with the mother out of six
or seven pregFoetus with Anencephaly ; and (3) Photographs of Historical Teratological Phenomena. Dr. KEPPIE PATERSON showed a Myxomatous Mole. Dr. MACVIE read a paper on a case of Eclampsia having a Peculiar Puerperal History, with Observations on Coma. The patient was a woman of neurotic disposition and anticipated her labour with helpless timidity and dread. Her first labour was easy with a slow recovery. Her second labour was easy and she did well till the end of the first week when a gradual stupor set in, which deepened and became profound in the next few days. The pulse was slow and soft, the breathing was quiet and shallow with intermittent sighs, and the temperature was normal. The bowels acted fairly well with drugs. The urine was scanty and deposited urates, but was otherwise normal. The treatment was mainly nutritive and designed to keep the heart going. When death seemed imminent consciousness gradually returned and in a week the patient was well except for debility. She regained her strength but slowly. Her third labour was favourable, but on the seventh day she became listless and apathetic, her look became vacant, aDd stupor gradually intervened, though not so profound as in the previous puerperium. At her fourth confinement . she was found to have oedema of the ankles and the urine on boiling deposited about one-half albumin. The presentation was by the face. The membranes were ruptured and the child was easily delivered by forceps under chloroform. Six hours afterwards a fit occurred, followed rapidly by eight or nine others, and in two hours she had becameunconscious with stertorous and laboured breathing. was performed and about nine ounces of blood were withdrawn. Improvement in the breathing and colour of the patient was almost immediate and deglutition power returned. Hot water was given freely. Consciousness soon returned and steady progress occurred during the next few days. The urine then only contained a trace of albumin. She continued well for three or four days when apathy began, which gradually deepened into a profound stupor. From this she never rallied and death occurred on the tenth day of the puerperium. In discussing the case and the treatment of eclampsia Dr. Macvie advocated chloroform in the stage of convulsions to narcotise the brain centres and to allay peripheral irritation. He believed that the state of coma was mostly induced by the venous congestion of the brain during the tonic spasm of the chest in the convulsion. This stage was therefore best met by inhalation of oxygen and venesection. Elimination of the poison causing the fit was helped mainly by the administration of warm fluids, either by the mouth, subcutaneously, or by the rectum.-Professor SlnzrsoN, Dr. F. W. N. HAULTAIN. and Dr. FREELAND BARBOUR made remarks on the paper. Professor A. R. SIMPSOX read a paper on Basilysis. He said that improvements in the construction of the forceps and a better appreciation of the conditions under which turning, Cæsarean section, and symphysiotomy could be safely carried out had in recent years greatly restricted the group of cases in which the obstetrician felt called upon to deliver by cephalic embryotomy. There was still, however, a not inconsiderable field for the employment of embryotomy procedures, as might be gathered from the papers written on the subject. The basilyst was used first for perforating the cranial vault and it was then bored into the cranial base and broke it up. The chief drawback to the cranioclast was that in some cases it did not fracture enough of the base of the skull to allow of the perfectly easy extraction of the head. The point of the basilyst was conical, with a double-threaded screw thread on it. This was applied to the vault and by twisting the handle it was easily screwed through the bone ; by pressing the blades of the handle a segment of the point was opened out and the perforation was enlarged in all directions. After washing out the brain the screw-point was applied to the base of the cranium, the sella turcica, or ethmoid, and these bones were broken up. The head then collapsed very readily. A fenestrated blade for application outside the skull could be locked on to the basilyst and extraction was thus made easier in difficult cases. The whole instrument had been recently improved and made much lighter. An illustrative case was given and the head was shown.-Dr. BALLAXTYNE, Dr. BARBOUR, Dr. HAIG FERGUSON, Dr. FORDYCE, and Dr. HAULTAIN made remarks on the paper. Professor SIMPSON read some Notes on the Use of Levurine. Levurine was a dried extract of beer yeast (devures de biere) which was prepared by Dr. Aragon and
nancies ; (2)
Vexresection
a
M. Couturieux of Paris. They were stimulated to the preparation of this drug by a paper on the use of barm in diabetes mellitus Levurine had also been found to be of value in furunculosis. It was therefore not a new drug, but was the yeast of beer so prepared that it was concentrated in powder form. It was always fresh, constant in its action, and was prepared in an easily administrable form. It might be taken in beer or in aerated water, or in cachet form. The dose was a tea-spoonful three times daily until the desired effect-viz., arrest of suppuration or reduction of temperature-was attained. Dr. Aragon and M. Couturieux suggest that its effect was produced by counteracting a latent glycsemia. or by acting as a germicide to streptococci and staphylococci or as an antagonist to their toxins. Professor Simpson reported a case of appendicitis where each time the temperature rose to 100° F. a dose of levurine brought it down to about normal. It also gave good results in a case of tuberculous ulceration and the drug was administered to a septic puerperal patient with evident advantage. It had also been stated to have been beneficial in furunculosis, tonsillitis, and pneumonia.
ROYAL ACADEMY OF MEDICINE IN IRELAND. SECTION OF ANATOMY AND PHYSIOLOGY. Protamines and. their Cleavage Products.-Model of liscera. -Mucons Glands. --Epiphyses of Iluman Bones.-Form and Position of the Stomach.- Viscera of the Gibbon. A MEETING of this section was held on Feb. 2nd, Professor W. H. THOMPSON, the President, being in the chair. The PRESIDENT read a paper on Protamines and their Cleavage Products. Protamines, hitherto obtained only from the ripe milt of various species of fishes, are believed by Kossel to be the simplest proteids. On hydrolytic cleavage they yield mainly hexone bases-viz., arginine, with histidin and lysine in some cases. These bases have recently been shown to exist largely in antipeptone. It appeared desirable, therefore, that their physiological properties, as well as those of the protamines, should be examined. The experiments were performed on anaesthetised dogs in the Physiological Institute, Marburg, and yielded the following results. The protamines were found to be very poisonous, the maximum non-lethal dose being one-fifth of a gramme. Their effects in many ways resembled those of the albumoses ; blood-pressure was rapidly and profoundly lowered, but with a moderate dose returned to normal in half an hour. Coagulation was greatly retarded and the number of leucocytes in circulation were largely reduced. These effects were also temporary. Respiration was peculiarly influenced; the movements were at first greatly accelerated and exaggerated ; then came a gradual decline, ending in complete cessation. After a few seconds diaphragmatic respiration returned and gradually became deeper and deeper, the movements of the thoracic walls during this period being wholly passive. Subsequently (after the lapse of an hour or more) active thoracic respiratory movements reappeared and the function gradually became normal. Other muscles-viz., those of the trunk and limbs-were also temporarily paralysed. None of the cleavage products showed these effects, nor did a trace of residue, which splits off in addition to the hexone bases, during the process of hydrolysis. Histon, a substance obtained from lymphoid organs, which had considerable chemical resemblance to the protamines, produced almost identical physiological effects. Anttpeptone had very little effect on blood-pressure and blood coagulation. It raised blood-pressure slightly and hastened coagulation. Arginine hastened blood coagulation, while its effect upon blood-pressure was practically nil—i.e., its effects coincided with those of antipeptone. These substances reduced enormously the number of leucocytes in the circulation, but the leucocytes reappeared in about three-quarters of an hour; they could not, therefore, have been destroyed nor have wandered out of the blood-vessels.-Professor COFFEY, Dr. WALTER SMITH, and Dr. DAWSON discussed the paper. Dr. C. J. PATTEN, in the unavoidable absence of Professor Cunningham, exhibited for him a model of the Thoracic and Abdominal Viscera from behind which had been prepared primarily to exhibit the form and relations of the spleen. Professor COFFEY showed sections which illustrated the Formation and Manner of Development of the small RaceThe specimens were mose Glands of Mucous Membranes.
improvement having followed manipulation it was decided Seventh, Eighth, Ninth, Tenth, and Eleventh Cranial l in a woman, aged 32 years, who six years ago conto open the joint. On August 5th a free incision was made Nerves 1 On opening the joint the tracted across the front of the joint. syphilis. The present symptoms had come on anterior crucial ligament was seen to be torn away from the
619 third monstrosity with the mother out of six
or seven pregFoetus with Anencephaly ; and (3) Photographs of Historical Teratological Phenomena. Dr. KEPPIE PATERSON showed a Myxomatous Mole. Dr. MACVIE read a paper on a case of Eclampsia having a Peculiar Puerperal History, with Observations on Coma. The patient was a woman of neurotic disposition and anticipated her labour with helpless timidity and dread. Her first labour was easy with a slow recovery. Her second labour was easy and she did well till the end of the first week when a gradual stupor set in, which deepened and became profound in the next few days. The pulse was slow and soft, the breathing was quiet and shallow with intermittent sighs, and the temperature was normal. The bowels acted fairly well with drugs. The urine was scanty and deposited urates, but was otherwise normal. The treatment was mainly nutritive and designed to keep the heart going. When death seemed imminent consciousness gradually returned and in a week the patient was well except for debility. She regained her strength but slowly. Her third labour was favourable, but on the seventh day she became listless and apathetic, her look became vacant, aDd stupor gradually intervened, though not so profound as in the previous puerperium. At her fourth confinement . she was found to have oedema of the ankles and the urine on boiling deposited about one-half albumin. The presentation was by the face. The membranes were ruptured and the child was easily delivered by forceps under chloroform. Six hours afterwards a fit occurred, followed rapidly by eight or nine others, and in two hours she had becameunconscious with stertorous and laboured breathing. was performed and about nine ounces of blood were withdrawn. Improvement in the breathing and colour of the patient was almost immediate and deglutition power returned. Hot water was given freely. Consciousness soon returned and steady progress occurred during the next few days. The urine then only contained a trace of albumin. She continued well for three or four days when apathy began, which gradually deepened into a profound stupor. From this she never rallied and death occurred on the tenth day of the puerperium. In discussing the case and the treatment of eclampsia Dr. Macvie advocated chloroform in the stage of convulsions to narcotise the brain centres and to allay peripheral irritation. He believed that the state of coma was mostly induced by the venous congestion of the brain during the tonic spasm of the chest in the convulsion. This stage was therefore best met by inhalation of oxygen and venesection. Elimination of the poison causing the fit was helped mainly by the administration of warm fluids, either by the mouth, subcutaneously, or by the rectum.-Professor SlnzrsoN, Dr. F. W. N. HAULTAIN. and Dr. FREELAND BARBOUR made remarks on the paper. Professor A. R. SIMPSOX read a paper on Basilysis. He said that improvements in the construction of the forceps and a better appreciation of the conditions under which turning, Cæsarean section, and symphysiotomy could be safely carried out had in recent years greatly restricted the group of cases in which the obstetrician felt called upon to deliver by cephalic embryotomy. There was still, however, a not inconsiderable field for the employment of embryotomy procedures, as might be gathered from the papers written on the subject. The basilyst was used first for perforating the cranial vault and it was then bored into the cranial base and broke it up. The chief drawback to the cranioclast was that in some cases it did not fracture enough of the base of the skull to allow of the perfectly easy extraction of the head. The point of the basilyst was conical, with a double-threaded screw thread on it. This was applied to the vault and by twisting the handle it was easily screwed through the bone ; by pressing the blades of the handle a segment of the point was opened out and the perforation was enlarged in all directions. After washing out the brain the screw-point was applied to the base of the cranium, the sella turcica, or ethmoid, and these bones were broken up. The head then collapsed very readily. A fenestrated blade for application outside the skull could be locked on to the basilyst and extraction was thus made easier in difficult cases. The whole instrument had been recently improved and made much lighter. An illustrative case was given and the head was shown.-Dr. BALLAXTYNE, Dr. BARBOUR, Dr. HAIG FERGUSON, Dr. FORDYCE, and Dr. HAULTAIN made remarks on the paper. Professor SIMPSON read some Notes on the Use of Levurine. Levurine was a dried extract of beer yeast (devures de biere) which was prepared by Dr. Aragon and
nancies ; (2)
Vexresection
a
M. Couturieux of Paris. They were stimulated to the preparation of this drug by a paper on the use of barm in diabetes mellitus Levurine had also been found to be of value in furunculosis. It was therefore not a new drug, but was the yeast of beer so prepared that it was concentrated in powder form. It was always fresh, constant in its action, and was prepared in an easily administrable form. It might be taken in beer or in aerated water, or in cachet form. The dose was a tea-spoonful three times daily until the desired effect-viz., arrest of suppuration or reduction of temperature-was attained. Dr. Aragon and M. Couturieux suggest that its effect was produced by counteracting a latent glycsemia. or by acting as a germicide to streptococci and staphylococci or as an antagonist to their toxins. Professor Simpson reported a case of appendicitis where each time the temperature rose to 100° F. a dose of levurine brought it down to about normal. It also gave good results in a case of tuberculous ulceration and the drug was administered to a septic puerperal patient with evident advantage. It had also been stated to have been beneficial in furunculosis, tonsillitis, and pneumonia.
ROYAL ACADEMY OF MEDICINE IN IRELAND. SECTION OF ANATOMY AND PHYSIOLOGY. Protamines and. their Cleavage Products.-Model of liscera. -Mucons Glands. --Epiphyses of Iluman Bones.-Form and Position of the Stomach.- Viscera of the Gibbon. A MEETING of this section was held on Feb. 2nd, Professor W. H. THOMPSON, the President, being in the chair. The PRESIDENT read a paper on Protamines and their Cleavage Products. Protamines, hitherto obtained only from the ripe milt of various species of fishes, are believed by Kossel to be the simplest proteids. On hydrolytic cleavage they yield mainly hexone bases-viz., arginine, with histidin and lysine in some cases. These bases have recently been shown to exist largely in antipeptone. It appeared desirable, therefore, that their physiological properties, as well as those of the protamines, should be examined. The experiments were performed on anaesthetised dogs in the Physiological Institute, Marburg, and yielded the following results. The protamines were found to be very poisonous, the maximum non-lethal dose being one-fifth of a gramme. Their effects in many ways resembled those of the albumoses ; blood-pressure was rapidly and profoundly lowered, but with a moderate dose returned to normal in half an hour. Coagulation was greatly retarded and the number of leucocytes in circulation were largely reduced. These effects were also temporary. Respiration was peculiarly influenced; the movements were at first greatly accelerated and exaggerated ; then came a gradual decline, ending in complete cessation. After a few seconds diaphragmatic respiration returned and gradually became deeper and deeper, the movements of the thoracic walls during this period being wholly passive. Subsequently (after the lapse of an hour or more) active thoracic respiratory movements reappeared and the function gradually became normal. Other muscles-viz., those of the trunk and limbs-were also temporarily paralysed. None of the cleavage products showed these effects, nor did a trace of residue, which splits off in addition to the hexone bases, during the process of hydrolysis. Histon, a substance obtained from lymphoid organs, which had considerable chemical resemblance to the protamines, produced almost identical physiological effects. Anttpeptone had very little effect on blood-pressure and blood coagulation. It raised blood-pressure slightly and hastened coagulation. Arginine hastened blood coagulation, while its effect upon blood-pressure was practically nil—i.e., its effects coincided with those of antipeptone. These substances reduced enormously the number of leucocytes in the circulation, but the leucocytes reappeared in about three-quarters of an hour; they could not, therefore, have been destroyed nor have wandered out of the blood-vessels.-Professor COFFEY, Dr. WALTER SMITH, and Dr. DAWSON discussed the paper. Dr. C. J. PATTEN, in the unavoidable absence of Professor Cunningham, exhibited for him a model of the Thoracic and Abdominal Viscera from behind which had been prepared primarily to exhibit the form and relations of the spleen. Professor COFFEY showed sections which illustrated the Formation and Manner of Development of the small RaceThe specimens were mose Glands of Mucous Membranes.