New York Medical College - Fleuroscope Yearbook (Valhalla, NY)

Page 188 text:

RECENT ADVANC ES IN MEDICINE By Ioseph F. Tedescop Nicholas A. Knox, Ir. DURING the past few years extensive and remarkable progress has been made in the diagnosis and treatment of various conditions which have hitherto presented obstacles to the medical profession. Since the majority of overworked medical students have neither time nor facilities to keep pace with these incessant changes, this article aims to merely acquaint the reader with a few of these innumerable contributions. ln the field of diagnosis the Frei test has been brought to the fore as a positive sign of lymphogranuloma inguinale. When an antigen made from sterile pus, or aspirated from previously unruptured abscesses, was injected intradermally a positive skin reaction was produced in patients who have had the disease in the past or are actively infected at the time. Satisfactory anti- gens are made at the present time by grinding infected glands and periglandu- lar tissue. Another condition which has presented diagnostic difficulties is Kala-Azar. It was previously thought that splenic puncture, with the demonstration of Leishman donavon bodies, was the only possible method of diagnosis. In the last few years various investigators have advanced the feasibility of precipita- tion of a pathological serum by iron peptonate. It has been definitely shown recently that the Takata test is not infallible in the diagnosis of liver pathology. The Ucko modification of the Takota test has recently gained favor since it has given more accurate results than the original method. I-Iodgkin's disease has presented diagnostic difficulties which may or may not be solved by the Gordon test. This test has not, as yet, been definitely proven to be correct in all cases. The procedure involves the injection of an extract of enlarged nodes twhich microscopically do not show the typical pic- ture of Hodgkins'l intracerebrally into rabbits. An encephalitic syndrome is produced when the nodes are involved by lymphogranulomatous changes. Various dyes have been used to demonstrate definite pathology in the kidneys. A new contribution has been made in the intravenous injection of Trypan Red. If any of the dye appears in the urine within 10 minutes there is an impairment of renal function. After using Trypan Pied, inject indigo car- rnine. Therefore, if the urine shows either an absence of indigo carmine or the presence of Trypan Pied, there is a definite lesion in the kidney. ln roentgenological diagnosis a new preparation, benzedrine sulphate, has been introduced which has been a great aid in facilitating the visualization of the gastro-intestinal tract when a barium meal has been taken. Previously it was practically impossible to obtain a clear picture of the entire tract when spasms, whether due to unpleasant emotion or organic disease of the gastro- One hundred eighty nine

Page 187 text:

. . ANIID SUDDEN DEATH . . tWith Apologies to I. C. Furnasl MANY of you perhaps have read this stirring article by I. C. Furnas. He points out, quite plainly, how one places one's life in jeopardy every time he steps into an automobile. However, were Mr. Furnas aware of the plight of younger brothers of future medicos, I am sure he would be moved to write another blood-chilling article. Until then I'll try to pinch hit for him. Did any of you, when stepping out of a doctor's office, have a feeling that you are already on the road to recovery? Little do you realize that you have just profited by some other person's pain and discomfort tprobably the young- er brother of the doctorl. I don't suppose you realize what a Human Guinea Pig suffers during his brother's four year stay in a medical school. What with pill boxes full of arsenic, mercury, strychnine, et al. what with whole kits full of scalpels, scissors, and other such bric-a-brac, what with microscopes -yes, you never thought that a microscope could be an instrument of torture. Well, anyway, its an accessory to a crime, for it's used to count bloodl Yes blood, human blood, MY bloodl First I'm iabbed or slashed with a sharp razor edged implement and some of my blood Cabout a quartl is put on a glass plate and scrutinized. Something goes wrong and the plate is thrown out, and again I'm required to donate more blood-huh, what's a few quarts of blood to a doctor tespecially if it isn't his ownl. No doubt you've read about ,the aftermath of some of these automobile accidents. People lying about with broken bones, crushed bodies, amputated limbs, and internal injuries: but I still insist that they get off easier than we poor Human Guinea Pigs because they sometimes die, but we're not allowed to die, we're nursed back to health l?l. Each time we're allowed to go a little nearer to death and then nursed back to health again. I sometimes think that they have the same idea that Louis Pasteur had when he developed his rabies treatment. Yes, I do believe that I'm being immunized against dying. After reading Mr. Furnas' article, only the last paragraph holds any terror for me because it pertains to my poor case. ........ Take a look at yourself as the man in the white jacket shakes his head over you, tells the boys with the stretcher not to bother, and turns away to somebody else who isn't quite dead yet. And then take it easy. Please, you future medicos, read that last paragraph again, very care- fully, especially the last five words, and think of us poor Human Guinea pigs. ARNOLD BAGNER From the Memoirs of a Future Doctor's Brother No. 4 Dec. 27, 1936 One hundred eighty-eight

Page 189 text:

intestinal tract or due to a reflex spasm originating in a disease elsewhere, were present. Benzedrine sulphate is a sympathicomimetic drug which diminishes or 'abolishes gastro-intestinal spasms without interfering with normal peristalsis. If the barium meal Cor a barium enema? is not progress- ing as it should, due to a spasm, mild massage of the abdomen should be at- tempted. lf this does not give the desired result 30 mgms of the drug, taken orally, will alleviate the spasm within five to ten minutes. This effect is also useful in that it aids in the differentiation of a functional spasm from an organic one. As yet, only one objection has been forwarded against its' use, and that is the temporary elevation of blood pressure. This elevation varies from 20 to 50 mgmsfl-lg and is a definite contra-indication to the use of the drug in severe cardiac cases. Benzedrine sulphate has also proven of definite value as a therapeutic aid in spastic colitis and pyloric spasm. ' In the field of therapy, one of the most important contributions was intro- duced in the treatment of diabetes. Previously, the use of insulin was not without its faults, since either an overdosage or an underdose would disturb the metabolic equilibrium intensely, with a resultant fluctuation of the blood sugar. A new form of insulin was introduced which more closely approximated the normal continuous secretion of this hormone. Protamine insulinate was pro- claimed as the desired substitute since it is absorbed slowly, maintains the blood sugar at the desired level for twice the length of time that insulin alone does: thus decreasing the possibility of insulin shock. It is stable for a few weeks only, and should not be used after being kept over the specified time. Protamine insulinate does not really supplement insulin but serves as an adjunct to insulin. Both may be used together at different times of the day. Protamine insulinate is especially useful in cases which can not be controlled by insulin alone. ' . Pneumonia has presented numerous problems which have been solved by medical science. But until now, it has proven rather difficult to supply a pati- ent with a consolidated lung with sufficient oxygen. The use of nasal tubes and oxygen tents have been objected to because the alveoli are incapable of absorbing oxygen. Other channels are therefore necessary for the introduc- tion of oxygen. Recently the use of subcutaneous oxygen therapy has been utilized in pneumonia with favorable results. Oxygen introduced in this man- ner is readily absorbed with a relief of dyspnea and cyanosis. The patient's blood pressure soon rises While the viscosity of the blood decreases. Children are given fifty c. c. to 200 c. c. while adults can withstand 200 c. c. to 800 c. c. Recently several favorable reports have been made on the use of a high carbohydrate diet, in combination with insulin, in the treatment of cirrhosis of the liver. Since this condition has been generally recognized as being hope- less, from the medical aspect, these favorable results should be only the spark to stimulate further investigations into the problem. Another condition which has defied medical treatment is migraine which has been justly called the enigma of medicine. The successful treatment of any condition is predicated upon a sound knowledge of its abnormal physio- logy and since practically nothing is known about migraine it is not surprising that its treatment is so devoid of success. Complete relief of a series of cases was recently reported through the utilization of ergotine tartrate. In recent years extensive research has been undertaken in an attempt to limit the occurrence of epidemics of poliomyelitis. The use of convalescent One hundred ninety