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THE BLOOD IN TUBERCULOSIS.
976 ance
of
an
editorial committee of which Mr. J. T.
Humphrey is chairman, and the medical members oí which are Dr. J. H. Burn, Dr. H. H. Dale, and Dr. W. E. Dixon. assured.
The
success
of the
new
publication
is
____
secretes a substance which nourishes and activates the sperm and states that spermatozoa are more active in the tail of the epididymis than they are in the head. Oslund was not able to confirm these observations and believes that the main motive power of the spermatozoa is derived from the pressure of secretion from behind. As far as he could see there is in man very little storage of spermatozoa anywhere in the genital tract. Certainly the vesiculae seminales cannot be regarded as reservoirs and spermatozoa found within them in cadavers must be regarded as invaders rather than as normal inhabitants. As the result of the constant passage of sperm from the testis towards the urethra spermatozoa are found frequently in the urethra and in the urine. During coitus there occurs a speeding up of the movement of the sperm along the vas deferens. This is due to contraction of the muscles of the epididymis and vas deferens including the ampulla which decreases the volume of the tubules and forces spermatic fluid towards the urethra. These contractions are observed after stimulation of the hypogastric nerves;they also occur spontaneously and more especially during coitus when they supply the chief mechanism for the transportation of spermatic fluid.
THE DOG AND CAT IN DERMATOLOGY. So far as we know, the only cutaneous diseases that can be contracted from the dog or cat are scabies and ringworm, but in these days of domestic pets the chances of such infection are by no means remote. Hudelo and Rabutstate that the scabies of dogs, which is caused by an acarus morphologically similar but smaller than that of human scabies, is less common than the feline variety, which is due to the Notaeriris cati, an even smaller parasite. Both infections seem to require prolonged and intimate contact with the offending animal-e.g., in bed-and neither parasite burrows in the human skin, thus rendering diagnosis a matter of doubt and difficulty. The presence of isolated intensely pruriginous papules, capped sometimes by a minute blister, usually on the flexor aspects of one or both forearms, or on the abdomen, or one shoulder, should arouse the suspicions of the practitioner and, in spite of the absence of acarine runs in the finger webs, on the THE BLOOD IN TUBERCULOSIS. breasts, or the penis should suggest an atypical scabietic AFTER a cytological study of the blood in The possibility of animal transmission infection. may make it necessary to examine the animal patients suffering from pulmonary tuberculosis, suspected. In the dog, according to Hudelo and R. S. Cunningham and Edna H. Tomkins1 claim Rabut, scabies is manifested by fine desquamation on that in this disease the white cells undergo very the anterior borders of the ears ; in advanced cases definite changes in number and character, and in there is patchy loss of hair and an eruption of papules particular that the monocytes are always multiplied. and pustules over most of the body. In the cat it may The " supra-vital " technique introduced by Sabin set up a generalised inflammation with greyish crusts was employed in their investigation, as it facilitates spreading from the scalp, which is denuded of its differentiation between the monocytic and lymphohair, as far as the neck, such a condition being often cytic types. So convinced are these observers -of the severe and sometimes even fatal. A characteristic sign importance of this change that they would hesitate is coexistent infection of the paws from violent scratch- to accept a diagnosis of pulmonary tuberculosis if ing of the ears. The treatment of scabies contracted the patient’s blood failed to show an elevation of the from a cat is simple and the infection subsides almost monocyte count. The lymphocytes show a reciprocal as soon as the animal is removed. The canine variety relationship to the monocytes. Thus the latter is not so easily eliminated, and the inunction of increase during infection while the former decrease, sulphur or some antiparasitic ointment is usually the monocyte serving as an index of dissemination A progressive As regards ringworm, the identification and the lymphocyte of resistance. necessary. of the various species will demand a careful cultural decrease of the lymphocyte count suggests a grave technique, which Sabouraud has elaborated in his prognosis. It is possible that some specific toxin of Les Teignes." There are three great tuberculosis acts as a stimulant to the monocytes famous work, classes, the trichophytons, the microsporons, and and a depressant to the lymphocytes, so that the favus.’ They may attack the glabrous skin and the ratio between the two types of cell may thus be used hair both of the scalp and beard, and recently the as an index of the relation of the processes of infection important observation has been made that follicular to those of resistance. Enumeration of the white eruptions on the back and chest of children are cells of the blood may thus, they consider, be useful sometimes attributable to trichophytides. which have in both diagnosis and prognosis. reached this secondary site by way of the blood ____
"
stream. THE STORAGE OF SPERMATOZOA. WE have still much to learn about the physiology of the male reproductive system. Dr. Robert M. Oslund2 tells us that in the course of a series of experiments involving ligation and resection of the vas deferens in animals he became interested in the question of the storage of spermatozoa. He found that in the seminiferous tubules there occurs an accumulation of colloid material derived from the breaking down of spermatocytes and spermatids. This colloidal fluid moves slowly along the tubules, its movement being determined by the vis a tergo rather than by active contraction on the part of the When the fluid enters the seminiferous walls. epididymal canal it comes under the action of the ciliated lining, but in the author’s opinion the influence of this is insignificant in comparison with the force exerted by the accumulation of spermatic material behind it. The motility possessed by the spermatozoa probably does not exercise much influence on the progress of the fluid or of the spermatozoa through the tubules. Benoit has reported that the epididymis 1 Paris Médical, Jan. 21st, p. 56. 2 Jour. Amer. Med. Assoc., March 17th, 1928.
I
THE BEGINNINGS OF LOCAL ANÆSTHESIA. THE inestimable benefit that cocaine has proved to be as a local anaesthetic in eye surgery and the perhaps equal services that its synthetic derivatives now afford for infiltration anaesthesia render the history of the first employment of the drug of considerable interest. It is to Dr. Carl Koller, formerly of Vienna, now of New York, that ophthalmic surgeons owe the discovery of its practical application. In a personal communication he informs us that long before 1884 he had been conducting experiments with such substances as chloral, bromides, and morphia in the hope of obtaining an efficient local anaesthetic for the eye, but without success. The alkaloid cocaine had been isolated from coca leaves brought from Peru so long ago as 1860, and its numbing effects on the nerves of the tongue had been recorded, but lost sight of in view of the overshadowing effects of the drug on the central nervous system. "
When in the course of preparing for these physiological writes Dr. Koller, " I realised that I had in my possession the local anaesthetic which I had been previously striving for, I went at once to Stricker’s laboratory, made a solution of cocaine, and instilled a drop in the
experiments,"
1 American Review of Tuberculosis, March, 1928.
of
an
editorial committee of which Mr. J. T.
Humphrey is chairman, and the medical members oí which are Dr. J. H. Burn, Dr. H. H. Dale, and Dr. W. E. Dixon. assured.
The
success
of the
new
publication
is
____
secretes a substance which nourishes and activates the sperm and states that spermatozoa are more active in the tail of the epididymis than they are in the head. Oslund was not able to confirm these observations and believes that the main motive power of the spermatozoa is derived from the pressure of secretion from behind. As far as he could see there is in man very little storage of spermatozoa anywhere in the genital tract. Certainly the vesiculae seminales cannot be regarded as reservoirs and spermatozoa found within them in cadavers must be regarded as invaders rather than as normal inhabitants. As the result of the constant passage of sperm from the testis towards the urethra spermatozoa are found frequently in the urethra and in the urine. During coitus there occurs a speeding up of the movement of the sperm along the vas deferens. This is due to contraction of the muscles of the epididymis and vas deferens including the ampulla which decreases the volume of the tubules and forces spermatic fluid towards the urethra. These contractions are observed after stimulation of the hypogastric nerves;they also occur spontaneously and more especially during coitus when they supply the chief mechanism for the transportation of spermatic fluid.
THE DOG AND CAT IN DERMATOLOGY. So far as we know, the only cutaneous diseases that can be contracted from the dog or cat are scabies and ringworm, but in these days of domestic pets the chances of such infection are by no means remote. Hudelo and Rabutstate that the scabies of dogs, which is caused by an acarus morphologically similar but smaller than that of human scabies, is less common than the feline variety, which is due to the Notaeriris cati, an even smaller parasite. Both infections seem to require prolonged and intimate contact with the offending animal-e.g., in bed-and neither parasite burrows in the human skin, thus rendering diagnosis a matter of doubt and difficulty. The presence of isolated intensely pruriginous papules, capped sometimes by a minute blister, usually on the flexor aspects of one or both forearms, or on the abdomen, or one shoulder, should arouse the suspicions of the practitioner and, in spite of the absence of acarine runs in the finger webs, on the THE BLOOD IN TUBERCULOSIS. breasts, or the penis should suggest an atypical scabietic AFTER a cytological study of the blood in The possibility of animal transmission infection. may make it necessary to examine the animal patients suffering from pulmonary tuberculosis, suspected. In the dog, according to Hudelo and R. S. Cunningham and Edna H. Tomkins1 claim Rabut, scabies is manifested by fine desquamation on that in this disease the white cells undergo very the anterior borders of the ears ; in advanced cases definite changes in number and character, and in there is patchy loss of hair and an eruption of papules particular that the monocytes are always multiplied. and pustules over most of the body. In the cat it may The " supra-vital " technique introduced by Sabin set up a generalised inflammation with greyish crusts was employed in their investigation, as it facilitates spreading from the scalp, which is denuded of its differentiation between the monocytic and lymphohair, as far as the neck, such a condition being often cytic types. So convinced are these observers -of the severe and sometimes even fatal. A characteristic sign importance of this change that they would hesitate is coexistent infection of the paws from violent scratch- to accept a diagnosis of pulmonary tuberculosis if ing of the ears. The treatment of scabies contracted the patient’s blood failed to show an elevation of the from a cat is simple and the infection subsides almost monocyte count. The lymphocytes show a reciprocal as soon as the animal is removed. The canine variety relationship to the monocytes. Thus the latter is not so easily eliminated, and the inunction of increase during infection while the former decrease, sulphur or some antiparasitic ointment is usually the monocyte serving as an index of dissemination A progressive As regards ringworm, the identification and the lymphocyte of resistance. necessary. of the various species will demand a careful cultural decrease of the lymphocyte count suggests a grave technique, which Sabouraud has elaborated in his prognosis. It is possible that some specific toxin of Les Teignes." There are three great tuberculosis acts as a stimulant to the monocytes famous work, classes, the trichophytons, the microsporons, and and a depressant to the lymphocytes, so that the favus.’ They may attack the glabrous skin and the ratio between the two types of cell may thus be used hair both of the scalp and beard, and recently the as an index of the relation of the processes of infection important observation has been made that follicular to those of resistance. Enumeration of the white eruptions on the back and chest of children are cells of the blood may thus, they consider, be useful sometimes attributable to trichophytides. which have in both diagnosis and prognosis. reached this secondary site by way of the blood ____
"
stream. THE STORAGE OF SPERMATOZOA. WE have still much to learn about the physiology of the male reproductive system. Dr. Robert M. Oslund2 tells us that in the course of a series of experiments involving ligation and resection of the vas deferens in animals he became interested in the question of the storage of spermatozoa. He found that in the seminiferous tubules there occurs an accumulation of colloid material derived from the breaking down of spermatocytes and spermatids. This colloidal fluid moves slowly along the tubules, its movement being determined by the vis a tergo rather than by active contraction on the part of the When the fluid enters the seminiferous walls. epididymal canal it comes under the action of the ciliated lining, but in the author’s opinion the influence of this is insignificant in comparison with the force exerted by the accumulation of spermatic material behind it. The motility possessed by the spermatozoa probably does not exercise much influence on the progress of the fluid or of the spermatozoa through the tubules. Benoit has reported that the epididymis 1 Paris Médical, Jan. 21st, p. 56. 2 Jour. Amer. Med. Assoc., March 17th, 1928.
I
THE BEGINNINGS OF LOCAL ANÆSTHESIA. THE inestimable benefit that cocaine has proved to be as a local anaesthetic in eye surgery and the perhaps equal services that its synthetic derivatives now afford for infiltration anaesthesia render the history of the first employment of the drug of considerable interest. It is to Dr. Carl Koller, formerly of Vienna, now of New York, that ophthalmic surgeons owe the discovery of its practical application. In a personal communication he informs us that long before 1884 he had been conducting experiments with such substances as chloral, bromides, and morphia in the hope of obtaining an efficient local anaesthetic for the eye, but without success. The alkaloid cocaine had been isolated from coca leaves brought from Peru so long ago as 1860, and its numbing effects on the nerves of the tongue had been recorded, but lost sight of in view of the overshadowing effects of the drug on the central nervous system. "
When in the course of preparing for these physiological writes Dr. Koller, " I realised that I had in my possession the local anaesthetic which I had been previously striving for, I went at once to Stricker’s laboratory, made a solution of cocaine, and instilled a drop in the
experiments,"
1 American Review of Tuberculosis, March, 1928.