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Gas bacillus embolus after abortion
New Series Vol. I, No. 2
American Journal of Surgery
PROGRESS IN SURGERY Selections Jrom Recenl Literature HALOGEN SOLUTION IN WOUND TREATMENT.
(Eine Halogenlibsung zur Wundbebandlung). PauI AIbrecht, Vienna. Wiener kIiniscbe Wocbenscbrift, July I, I926. The author calls attention to the fact t h a t in the war while the Allies used a chIorine soIution in the treatment of wounds, the CentraI Powers empIoyed an iodide solution with the same purpose and almost equivalent results. The chlorine soIution has the advantage of rapid effect; the iodide soIution, however, gives a more proIonged though not as powerful antiseptic resuIt. The effort of the author was therefore directed toward combining the desirabIe effects of both these soIutions. This he has accompIished in what is calIed solution X. It is a composition of chIorine, iodine and fluorine. It is a yeIIowish, watery, hypertonic Sotution with a hydrogen-ion concentration of 6.o. It decolorizes after Iong exposure to the air and sunIight. It is not irritating to the Skin. The soIution has been used in the treatment of grossIy contaminated wounds as weII as in cIean wounds. It appears to be non-irritating to serosaI as weII as to mucosaI surfaces. WhiIe the exact modus operandi of the haIogen solutions has not been definitely determined, it is believed that their antiseptic properties are due to the increased hydrogenion concentration. This Ieads to a IocaI acidosis as weII as to a swelIing of the tissue colloids and a consequent increase in adsorption power. The work on this soIution is not as yet compIeted. It can at present be obtained from onIy one chemicaI firm in Vienna, the addr.ess of which is given. STREPTOCOCCIC SEROTHERAPY AND TIlE BLOOD
PICTURE. (Streptokokkenserotberapie und BIutbild). Hans LehfeIdt, CharIottenburg. ZentraIblatt fi;r @niikologie No. 24, 1926. In cases of puerperaI and surgieaI streptococcic sepsis successfuIIy treated with antistreptococcus serum, the author noticed a reIative Iymphocytosis, a reappearance of eosinophiIes and a shifting backward toward the right in the 'Arneth blood picture. Experimental intraperitoneaI injections of streptococci caIIed forth the same reaction in the white mouse as in the human being. The
changes in tile blood picture are simiIar to those found in human streptococcus infection. FolIowing injection of antistreptococeus serum, there is a definite change in the blood picture corresponding with t h a t mentioned above as occurring in the human being. MiIdIy infected mice recovered more quickIy than those to whom no serum has been given. Severely infected mice Iived longer after serum treatment than those without serum. Untreated or insufticientIy treated severe infections Iead to death within 24 hours. The author calls attention to the fact that the data here presented may be of some value prognostically and therapeuticaIIy. By means of the definite change in the bIood picture, it shouId be possibIe to determine whether there is any tendency toward improvement and whether that is due to the use of the serum or is mereIy coincidentaI. GAS
BACILLUS
EMBOLUS
AFTER
ABORTION.
(Gasbrandembolie nacb Abort.) Strassmann Erwin, BerIin. Zentralblatt fi~r Gyniikologie, I926, No. 22. The author reports an .interesting case in which gas bacilIus sepsis developed after the performance of a criminaI abortion. Gas bacillus infection is apparentIy more frequent now than before the war. In infections of the uterus, it may appear in two forms, the emphysematous, in which gas deveIops within the uterine cavity, or the interstitiaI, in which the infection is confined to the uterine waII. It is this Iatter form which Ieads to the subsequent deveIopment of general sepsis or gas bacillus peritonitis. In the case here presented, a generaI sepsis deveIoped as the resuIt of a septic embolus to the lung. The clinieaI picture as welI as the pathologic findings, both g, oss and microscopic, are described in great detail. There is appended a bibliography of the more important contributions on this subject. N E W MEDICAL AND SURGICAL APPLICATIONS O F ANTI-GANGRENOUS SEROTHERAPY. H.
Vincent, VaI-de-Grace. International Clinics; Jurle, 1926. Professor Vincent, who has deveIoped in his Iaboratory at VaI-de-Grace a poIyvaIent toxin for gas gangrene infections, urges that it shouId also be used prophylacticaIIy in aII injuries for which one wouId use tetanus antitoxin and, therapeutically, in various phlegmonous conditions produced by anaerobic I09
American Journal of Surgery
PROGRESS IN SURGERY Selections Jrom Recenl Literature HALOGEN SOLUTION IN WOUND TREATMENT.
(Eine Halogenlibsung zur Wundbebandlung). PauI AIbrecht, Vienna. Wiener kIiniscbe Wocbenscbrift, July I, I926. The author calls attention to the fact t h a t in the war while the Allies used a chIorine soIution in the treatment of wounds, the CentraI Powers empIoyed an iodide solution with the same purpose and almost equivalent results. The chlorine soIution has the advantage of rapid effect; the iodide soIution, however, gives a more proIonged though not as powerful antiseptic resuIt. The effort of the author was therefore directed toward combining the desirabIe effects of both these soIutions. This he has accompIished in what is calIed solution X. It is a composition of chIorine, iodine and fluorine. It is a yeIIowish, watery, hypertonic Sotution with a hydrogen-ion concentration of 6.o. It decolorizes after Iong exposure to the air and sunIight. It is not irritating to the Skin. The soIution has been used in the treatment of grossIy contaminated wounds as weII as in cIean wounds. It appears to be non-irritating to serosaI as weII as to mucosaI surfaces. WhiIe the exact modus operandi of the haIogen solutions has not been definitely determined, it is believed that their antiseptic properties are due to the increased hydrogenion concentration. This Ieads to a IocaI acidosis as weII as to a swelIing of the tissue colloids and a consequent increase in adsorption power. The work on this soIution is not as yet compIeted. It can at present be obtained from onIy one chemicaI firm in Vienna, the addr.ess of which is given. STREPTOCOCCIC SEROTHERAPY AND TIlE BLOOD
PICTURE. (Streptokokkenserotberapie und BIutbild). Hans LehfeIdt, CharIottenburg. ZentraIblatt fi;r @niikologie No. 24, 1926. In cases of puerperaI and surgieaI streptococcic sepsis successfuIIy treated with antistreptococcus serum, the author noticed a reIative Iymphocytosis, a reappearance of eosinophiIes and a shifting backward toward the right in the 'Arneth blood picture. Experimental intraperitoneaI injections of streptococci caIIed forth the same reaction in the white mouse as in the human being. The
changes in tile blood picture are simiIar to those found in human streptococcus infection. FolIowing injection of antistreptococeus serum, there is a definite change in the blood picture corresponding with t h a t mentioned above as occurring in the human being. MiIdIy infected mice recovered more quickIy than those to whom no serum has been given. Severely infected mice Iived longer after serum treatment than those without serum. Untreated or insufticientIy treated severe infections Iead to death within 24 hours. The author calls attention to the fact that the data here presented may be of some value prognostically and therapeuticaIIy. By means of the definite change in the bIood picture, it shouId be possibIe to determine whether there is any tendency toward improvement and whether that is due to the use of the serum or is mereIy coincidentaI. GAS
BACILLUS
EMBOLUS
AFTER
ABORTION.
(Gasbrandembolie nacb Abort.) Strassmann Erwin, BerIin. Zentralblatt fi~r Gyniikologie, I926, No. 22. The author reports an .interesting case in which gas bacilIus sepsis developed after the performance of a criminaI abortion. Gas bacillus infection is apparentIy more frequent now than before the war. In infections of the uterus, it may appear in two forms, the emphysematous, in which gas deveIops within the uterine cavity, or the interstitiaI, in which the infection is confined to the uterine waII. It is this Iatter form which Ieads to the subsequent deveIopment of general sepsis or gas bacillus peritonitis. In the case here presented, a generaI sepsis deveIoped as the resuIt of a septic embolus to the lung. The clinieaI picture as welI as the pathologic findings, both g, oss and microscopic, are described in great detail. There is appended a bibliography of the more important contributions on this subject. N E W MEDICAL AND SURGICAL APPLICATIONS O F ANTI-GANGRENOUS SEROTHERAPY. H.
Vincent, VaI-de-Grace. International Clinics; Jurle, 1926. Professor Vincent, who has deveIoped in his Iaboratory at VaI-de-Grace a poIyvaIent toxin for gas gangrene infections, urges that it shouId also be used prophylacticaIIy in aII injuries for which one wouId use tetanus antitoxin and, therapeutically, in various phlegmonous conditions produced by anaerobic I09