North Carolina Medical Journal. Vol. 3. No. 4. April, 1879Various
Science
North Carolina Medical Journal. Vol. 3. No. 4. April, 1879
Various
Medicine -- North Carolina -- Periodicals; Medicine -- Periodicals
M. Humboldt would not yield to the desire of the Commission, to try
solely the inoculation and the syrup of guaco. The conclusions of the
report were absolutely unfavorable to the experimentalist. The epidemic
of yellow fever continuing its course, the proportion of mortality was
the same among the inoculated, as among other subjects, and if the
statistical tables, presented by M. Humboldt, disagree with the
conclusions of the Commission, it is because he had among the
inoculated, not only a great number of acclimated persons, but of
individuals who had already had the disease. These ideas of inoculation,
inspiring a false security, might produce the saddest results. I think,
however, that this interesting question might deserve to be studied
anew.
I here terminate my effort. I have proposed to make yellow fever known,
as I have observed it at Havana for some twenty years. The reflections,
which I have presented on the nature and the causes of this terrible
disease, the details into which I have entered, in order that all that
relates to its symptoms, its progress, and its treatment, may be clearly
estimated, make this work a monograph, the utility and opportuneness of
which, will, I hope, be appreciated by those medical men, who are called
to practice in tropical regions.
* * * * *
_The Elastic Bandage in the Treatment of Aneurisms._—It seems likely
that Esmarch’s bandage will add very greatly to our means of treating
aneurism. Dr. Weir has collected twenty-one cases of iliofemoral,
femoral, and popliteal aneurisms, mostly the latter, treated in this
way. Twelve of these were successful, while the others failed, owing
chiefly to the fact that obstruction to the arterial current was not
kept up after the removal of the elastic bandage. Upon this point Dr.
Weir lays great stress, and states that in it is the gist of the
treatment.
In connection with the study of this matter, the question of how
long a limb can be kept desanguinated is of importance. In the lower
animals the time is six or eight hours. In man the time is longer
than has been heretofore supposed. Ischæmia has been enforced for
four, five, and in one case fourteen hours without injury. During
the compression it is important to remember that the arterial
tension elsewhere is increased.
Autopsies have made it probable that coägulation begins in the tumor
and extends up several inches into the artery. The arterial clot
then becomes organized into fibrous tissue, and for this
organization a healthy state of the wall is necessary. Aneurisms
with large mouths are perhaps more easily cured by Esmarch’s
bandage.
Public-domain text, read in full here on John Shaqi.
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