Portal de Periódicos da CAPES

Cases of Cholecystotomy

1900; Massachusetts Medical Society; Volume: 142; Issue: 5 Linguagem: Inglês

10.1056/nejm190002011420502

2331-4710

Edgar Garceau,

Minimally Invasive Surgical Techniques

either event exerts an antiseptic influence at the seat of inflammation.Bovee says0 the presence of sodium chloride in the blood favors osmosis and retards coagulation.These of course are desirable effects in the first stage of pneu- monia, but be also warns us that the salt if present in excess gives rise to pulmonary edema, dyspnea, head- ache, vertigo, mental excitement or delirium and se- vere pain in tin; left side..The paiicreatin is added in the hope that it may as- sist in the digestion of tin; pulmonary exúdate, and in the conversion of any primary or secondary proteoses that may be present into peptones.These proteoses result not only from imperfect proteid digestion in the alimentary tract, but from the action of bacterial enzymes on the necrosed tissues of the infected part.Doth proteoses and peptones are toxic if free in the circulation, but the dilfusibility of the latter is much greater than the former and hence it happens that peptones will leave the blood in the urine, while pro- teoses remain behind.Lolu and Emmerich have shown '" that the en- zymes of certain diseases kill not only their par- ent germs, but also those of cholera, typhoid fever, anthrax, diphtheria, black plague, stuphylococci and, probably, gonococci.The bacillus of tuberculosis seems incapable of producing an enzyme that is fatal to itself.This is also true of black plague, and Eor this reason, say these investigators, the antitoxin of black plague has failed to cure.This hint should not be lost, and it is earnestly to be, desired that experiments should be instituted as to the effect of pan- creatin on the growth of the bacillus tuberculosis.Fresh air and the cure of intestinal indigestion will do much to improve the condition of those suffering from pulmonary tuberculosis, and, if begun early enough, a curt!muy be looked for in a certain propor- tion of cases.The use of normal salt, solution is also to be recommended.The writer can never forget the extraordinary im- provement which once followed his use of a sodiumchloride solution in a case of this kind.The patient was far gone in consumption and had been under ob- servation for many months.One morning the word came that he was dying, and on arrival at the bedside it seemed indeed as if dissolution were at hand.There was great dyspnea, the face was pale and bathed in a cold sweat, the pupils were dilated, the pulse fluttering and almost imperceptible and the temperature 101°F.About three grains of sodium chloride were dissolved in a teaspoonful of boiled water and this was injected under the skin.In a few moments it seemed as if the breathing were easier.