The Saint Paul globe. (St. Paul, Minn.) 1896-1905, 1896-09-17

ton is best treated among the rich,
frequently indeed a permanent cure is
effected in this class OF cases; so for
evident reasons those who are, poor
should be given especial attention.
Patients who have been cured must
not be allowed to return to their form
er environment. Redevelopment is in
consistent with clinical experience.
Change of air and outdoor exercise
and labor hardens and refreshes- the
tissues and the respiratory Impurities
are no longer present. Reinfection
may be prevented by, first, through
disinfection of the patient and sur,
roundings; second. destruction of the
sputum. This protects the patient
against himself"
The paper was discussed by Drs.
Love, Mathews, Coulter and Babcock.
LOCOMOTOR ATAXIA. ~
Dr. Hugh IT. Patrick, of Chicago, read
a paper on Trunk Anaesthesis in Lo-
comotor Ataxia." In substance he
said, in nearly all cases of tables DOR
sails there is a band of anaesthesia
about the trunk at the level of the nip
pie. 1t Is early in the disease, very
narrow or even incomplete, or may be
represented by a zone in which the To-
caliZation of touches is not normally
accurate The sensory bunting on the
lcSs So lTSQuSHL III IdUSS, Is GENERALLY
an analgeSia. The trunk anaeStheSia is
essentially tactile and the pain sense
may be quite normal. The band of an
aestheSia does not correspond to the cut
aneouS distribution of the intercOStal
nerves, but to the nerve fiberS arising
from adjoining segmenIs of the spinal
cord. In some cases there are two dis
tinct zones of anaesthesia, indicating
simultaneous involvment of spinal seq
ments at some distance from each
other. The borders are inconstant, or
dinariIy retract on continued testing
and vary in position with the method
Of examination. The same band of an
aesthesia may occur in syphil-
tito pseudotabes, as shown by
known the only one on rec
ord. The patient presented nearly all
the symptoms of locomotor ataxia, in
Guiding a wide band of trunk anaes-
thesia, but a diagnosis of syphilis of
the cord was made and on active spe-
eific treatment he made an almost per-
feet recovery. The principal character
istlcS of the symptoms were Illustrated
by numerous diagrams and photo
graphs.
DIR. Hughes in discussing the paper
said: 1T is not surprising that these
peculiar areas of anaesthesia should be
round IN locomotor ataxia; considering
that the entire symptom, complex of
the disease, is due to disturbance of the
sensory mechanism. L have asked the
doctor whether any of his patients were
women, and if so, how many for
have long taught that organic disease
may give expression to a latent hys-
terra, causing combination of the two
diseases In locomotor ataxia we may
have not only anaesthesia and anal
gesla, but also hyperesthesia and hy-
peralgesia.''
OPERATION IN SURGERY.
DR.. ]. Frank, Chicago, discussed "a
New Method of Fastening the Round
Ligament in Alexander's Operation.
With Little Disturbance Of the Anat-
omical Relations" He said in part:
An incision an inch long is made
midway between the anterior superior
spine of the ileum and the spine of the
pubes, a trif1e above Poupart's llga-
ment. The tranSversalis muscle is
pushed back and the ligament lifted
out with blunt hook, such as I here
show you. Draw it out until the
uterus is in the correct position. No
great difference is experienced If the
peritoneal cavity is open Usually
three Sutures are required to close the
wound; the first one being taken as
low as possible through one flap of the
per1toneum, then through the round
ligament itself Instead of drawing
the ligament through the fascia as
formerly practieed, it is replaced in it's
anatomical position beneath the trans
versails muscle. By this method a
slough of the ligament is prevented
rms operation is the simplest of all vet
proposed. AS Sutufe material kan
CARGO tendon has proven most salts
factory in my experience A pessary
should be lifted in before the operation,
and worn as long as necessary after
wards" The paper was briefly dis
cussed by Dr. Ochsner
DIR. [. A. Abt, Chicago, read his ma
per. The Clinical Significance of the
Child's Frontanelle.'' s'In health tha
frontanelle does not sink below or rise
above its bony frame said the doe
tor. 1t has both respiratory and pull
satory movements. With increased in
tercranial pressure the normal br1lif
may quite disappear An early ossi
hcation interferes with brain develop
ment and produces braehycephaIic
skull In rachitis the inyolution of
the frontanelle is delayed. Marked
Dulging is caused by the collection of,
fluid within.
The abnormal reaction of the fronta-
nellie always Indicates a condition of
lnanlt1on. 1t may be temporary: if
chronic, it is a serious condition A.
deeply sunken frontanelle is ALWAYS a
danger signal in any case. InyoIu-
ton occurs normally at fifteen to
eighteen months. Protuberance and ten
sion indicate meningitis"
Dr. Mayo, Rochester, Mimi, on 1.-THE
Surgical Treatment of Pyloric Obstr11c-
lions" said: This subject has not re-
ceived the attention it demands from
American surgeons. The differential
diagnosis of serious pyioric disease is
often matter of the greatest diff
Guilty. / have found the free exhibition
OF strychnia for several days previous
to the operation of great value in pre-
venting shock. The stomach should al
ways be thoroughly washed out few
Eours before the operation and nothing
eaten afterwards. For combating the
shock, besides strychnia and dry heat
an enema of pint of hot coffee should
be given. Nourishment by the stomach
afterWard should not too long be with
held. Fer twenty-four hours rectal ali
mentatiOn should be used; in thirty
six hours some champagne, later but
termilk and a gradually increasing
diet"
This paper melted a lively discussion,
lin which DR.. Oehsner called attention
to the prognosis when malignancy was
present, and advised the use of the
largest size appropriate when insert
ing the Murphy button. He believed
much Of the success in the use of the
button depended on the skillful tech
nique in using it.
DIR. House opposed the use of the
button, as his experience had been un-
favorable Il think the less foreign
matter you have In the bowel the bet
ter. With the Murphy button the bow
ell sometimes sloughs, not so with the
suture.''
DR.. Lawrence agreed with the author
and considered the Murphy button the
method par-excellence
DR.. Manley, New York, read paper