The Journal-Lancet, Vol. XXXV, No. 5, March 1, 1915: The Journal of the Minnesota State Medical Association and Official Organ of the North Dakota and South Dakota State Medical AssociationsVarious
Science
The Journal-Lancet, Vol. XXXV, No. 5, March 1, 1915: The Journal of the Minnesota State Medical Association and Official Organ of the North Dakota and South Dakota State Medical Associations
Various
Medicine -- Periodicals
Thus, theoretically, at least, it would appear that, if the conjunctiva
could be subjected to a temperature as near as possible to this
without injury to the tissues, a marked effect should be observed in
the course of the disease, particularly if the heat can be applied
in such a way as to penetrate as deeply into the tissues as does the
gonococcus. This theoretical requirement has, in my opinion, been
perfectly met practically by the local use of steam as practiced in
the Dimmer Clinic since February, 1913, with the apparatus devised by
Lauber and modified by the writer. Goldzieher of Vienna was probably
the first to employ steam in the treatment of the purulent ophthalmias;
and in his first series of cases reported fifteen patients treated
with the application of steam passing through a nozzle held at a
distance of about four centimeters from the eye, the temperature of
the steam striking the tissues being about 45° C. (113° F.). Although
the results indicated that the method was a distinct step in advance
there were still a number of important details to be worked out, in
order to get the best possible results. First of all, experiment
showed that the temperature of the steam at a given distance from the
nozzle was not constant, so that an arbitrary distance could not be
set. This suggested the advisability of providing the apparatus with a
sliding-guard, which could be set at the exact distance from the nozzle
where the steam was shown by the thermometer to be at the desired
temperature. Secondly, it was determined that the tissues would sustain
without injury a considerably higher temperature than that set by
Goldzieher, and that the effect upon the diseased process was markedly
better when the temperature was raised. Steam at from 50° C. to 53° C.
gave the best results; and in one case in which a temperature of 55°
C. was inadvertently reached no injury was done the tissues. Further
experience naturally suggested other changes in the original technic.
In the first place, the lids were held apart by an assistant in the
usual manner; but, even with gloves on, the exposure of the fingers to
the steam was more or less painful, and gauze wound on little sticks
was substituted. The time of exposure was finally set at six minutes;
and since the application of the steam could not be borne for longer
than from forty-five to sixty seconds without severe pain it usually
took twenty minutes or so to complete the six-minute exposure. This was
done once every twenty-four hours, and was combined with half-hourly
irrigations with potassium-permanganate solution. No other treatment
was used. The results attained with this method in 34 cases (7 adults,
2 children and 25 infants) has left nothing to be desired. In no case
has there been any corneal complication; swelling and pain subsided
with unusual promptness; and the course of the disease was notably
shortened, whereas, after the first application of silver nitrate a
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account