장음표시 사용
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out-patienis deparimentis Ianuar 17 h, Suffering rom a varicose ecetem of the whole lest les, and havin an ulcer the siet of a half-penny on the inne fide of the fame les. He had been suffering rom varicos vein forci 0 years and had avaricos ulcer ora month in 1921. The examination Showed, esides the ecetem an ulcer aiunctio ver prominent varicoS Vein o the postero-internat fide of thelestanee in the pright position. O the fame day, Ianuar 17 '', 0 centifram o quinin were injected into the varicos velns. Two injections ere, in Articular, made into the venous hunc of the knee. Dressininwith somenotiti. O leavins, he complained only of omeheaviness in the les. On Ianuar 26 h. ine days later though he had not interrupted his or at the dock the ulce had healed. The vein were hard atth potnisi injection, and the varicoseiuncti of the inne posterior fide of the knee forme an indurate area in hic no fluctuation a apparant. e injecte again, a Mur potnis, it c. c. of the quinin solutio an prescribed an ichthyol oiniment for the e gema. Case . Missi ..., 3 years old, attendedis an out-patient on the lq h Sep
the inne fide of the testane and of the thisti, isti up to the end
of paste with progressive doses of ichthyol. O October l0 h twas much helter But the les remained oedematous and the varicose Vein were Stili prominent.
The 3 c. . of a quinin solution were injected. his quantity was injecte at eight different potnis in the varicose uncti of the nee an alon the tractis the Saphenou Vein. There a no flow of lood. o ain, and the patient returnedhome ithout an difficultY.
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222 HE REAT MENT OF VARICOSE VEINS
The est leu howed in addition a rather dee ulcerntion. The two less, Stightly edematous, eremovere mit varicoseuein whic satheredant one, the internat saphenous, Which was very dilated in paris formin a string of varicoSe tumourS.we injecte halna c.c. of quinin solution in each dilated portiono the strinxi the lef lower lim, hich, this time reate alone. The patient fellieither crampior pain during the injection.we prescribe for the dressin of the ulcer of this es, compresses with Soloni serum, and ktosa powder. e intentionali did notprescribe any active dressing. On November 12 h. the patient complained only that his les as like lead . The varicose dilatations ere chansed in the lest limb the one treatex into a cord hard and Stishilysainfulcio pressure. The ulceration ad a belle aspect and ad ranulated. etouched the bottom,ith silve nitrate. The right les was then realed it si injections of hal a c.c. of Solution. On November 20 h. the les le wasio longer ainful. The right les, more recenti trealed was stili heam. On December h. the varicos ulce had healed, and the e zema was healing. The ein were indurated on both les a the potnts of injection. ma noti that with this patient it was difficult o feel the fluctuations in the varicose dilatations two minutes after the injectionos quinine. An o the ther hand that the patient a commercia traveller. neve interrupte the walkin and travellin whicli his profession
These si cases how that the injectionis a solution o neutral
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hydrochlorate os quinine a recommended by Geneorier, an producethe indurationi varicos Veins, without an appreciable nain to the patients, without crust, and without cessationis their dati occupation.
The only thin thensomelimes felt was a stistit heavines of the limb. How do thes injections orkῖwe cannot as et clearly explain his Geneorier alis them coagulatins injections , and we intensio findiuti experiment onanimal an in vitro, the actioni neutra hydrochlorate os quinineo the walis of the ein and o the blood.we permit urselves for the momento compare the effect onsumcienti trealed vein to that os repeateffligatures and we thin wema say that the modiis the blood circulationis the varicose limbs favourabi enovsh tolera valvabie adjunc to the locat reaimentis
M. igne thought that, clearly quinine a no the ni saltcapable o curins varicos velns He sed fodium carbonate, and the ein far rom resainins iis Suppleness, wayas hard AS a pen-holder. But the quinin injections ere easter o mahe than the carbonate injectionS. M. de Uerne ut, after potntins ut that urser had also sivenbrilliant resulis, ithe by saphenectom o by the operation os Moresqui sal that, unfortunately, relapSe were Ver frequent. M. Mathius observations ere table to ne reat Objection, namely that the were to recent. In a Varicos ulcer the cause wBSno a circulator one only, andae eare a relapse in ali these cases.
M. Oper deali illi the histor of intravaricos injectionS, an save the histor of the rs observation. hic induced Sicarcit trecti Bricos Vein by odium carbonate. Sicard ad reatly beauti fui resulis However, odium carbonat i liable to crust formatio an he eare that quinine, ould do the fame thing.
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224 LOCA ANESTHESIA BY QUIN IN SALI SLOCA ANESTHESIA B QUIN IN SALT AND THECOMMITTEE REPORT
scope, in Whichri fave, experien e wit the quinin salta, and expresse the opinio that the committe of the Sectioni Larynsol-ogy. Otolos and Rhinolos o locat anestheticchad not quite done justice to quinin as a locat anesthetic Phad latet used quinin hydrochlorid. lirat in didram os distilled water Wit entire satisfaction. Shorti aster ard a patient had a listit Slough of the wound and Ιreduce the strensiliis solution to Atrat ina drams since hichtime I have ad n case of sloughins and the anesthesia has been satisfactory Pthen besan the practice of usinu this strensi os quinin hydrochlori for the right tonsillandi. per cent of cocain for thelest yc.c. to secure comparative resulis. In ali cases ither 2 percent. Ocain cocain ud was rs applied toruach tonsit but insmal amount. In each one of the e cases have been privilesedio operate, the patient has expressed himself as belle satisfied withthe operationis the right than of the lest. The healin after quinin
litti more time teni fifteen minutes is required forinnesthesia, and Dis,et to incise the mucous membrane unde the anesthesia homili cocain application and before edema has follo ed the injectionis the quinin.
Iourna of the American edicat Association Chicago. 8a Iut 28 1923. p. 32 l.
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QUININE REATMENT OF CANCER Z 225ON THE UTILITY OF QUININE REATMENTEOR CANCER
SOBRE A UTILIDA DELIRATAMIENTO QUININICO DE CANCER
Professor of the Medicat Clinic physicia of the Model Medicat Clinic
o canceris quinin salts was in vosue Iaboulay held that the cause of this fata diseas was a protozoa parasite, Verysimila to the plasmodium malariae, and as a logical consequence, hethought that quinine ould likewis have a specia actio on this parasite: e there ore advocate iis se and the rs resulis erepromisins. The patient improved thei sufferinidecreased and life was lensthened. Yet it a no long efore therara bach and inefficac of this therapy made themselves eli. a uia advised the se of intramuscula injections containing 0,50iram of thydrochlorate os quinine per cubi centimetre, and this method ave is to various localtroubles hicli are perfecti mel known to those ho have ad
occasion to reat malaria Susserers.
In therars place the injections are exceedingi painful, o painfulthat ome patient cannot stand them. In addition nodule are formedit the potnt of the injection, lastinga long time and hein also painful. Finalty the formationis abscesses an eschar refractor to cicH- trisation has Men observed.
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226 QUIN INE REATMENT OF CANCER
jus the fame though it musti acknowledsed, after lictuin experienced relies of thei pain and prolongationis life . These lalter facts were in themselves a succes and wel deservet be ahen into account Thus it is that A. Hobi in his reat os Therapeutis recommend quinine, hicli, in his te is the onlyuseful reaiment Hai et of LYons in his thesis consider a number of cases of uterine cancer improVed by the fame asent and Casmisene, in 1912 declare himself in favour of iis application in ali cases of
The last mentione writer endeavoured to void loca troubles hicli occurred after the injection by usinina hishly diluted solutionis
centimetres very the day, sivingin alternate day liram of the Same sal per os in two cachet of 0. 50 gram He was an enthusiastic advocate of the method, o pretendin to cure, ut o relieve the
an have been able to conclude that this therapy has it particular indications and is notisela in ali cases. Needies to sanit has no occurre to me to thin or to spea of ures in his connection. et Phold that in cases like these e mustbear in in the aphorism: Is e cannot cure et us attempt toteli e , addin Ρωithout injury .From m observations I have deduce that quin ine reatinent istisesu in the patribu form os cancer, hateve iis localisation. t Soothes the ain admirabi an obviates the use of morphia this is
the secretis it succes and of the improvemenis,hich, at the ouiset. ere recorded in consequence DitS Se. It is ellanown that the ain o cancer is due principali to the occurrencem a proces of cancerous neuritis Thesain exhausis thepatienis deprive them os fleep. mahes it difficult for them to besultabi sed and finalty produces in them a conditionis decline whichis added to the conditio due to the actuat tumour. It follows logicallythat is his ain is ot rixos o relieved the patient mill experien ea sensation o welibein and will by means os restorative res and sufficient nutrition resain much of his tost strensth. Is in orde to secure this result recourse is had to morphia fallure willi inevitabie hecause though the palmis ali ed. this is effected by producin a state os intellectuat an physica torpor. hic isanythins ut conducive to restoration o strensili. Adde to this
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QUIN INE REATMEN OF CANCER 227
there is the toxic actionis the medicamen and the necessit of progressively increasing the dose, is the analgesic action is tote maintained.
do no belleve in the toni effect hic it has been ought to
in his as in ali form o neuritis an neuralsia, o hic analsesic actionethere is addestit toni effect and the persistence of these effecis. wili set ut inarie forina e cases confirmin m SintementS.
age, Arsentine, Sufferins illi chronic ortitis illi insufficienc of the sigmoid valves Hodoson and who was moreove diabetic. applied suitable reaiment for hermorti alimen and ascertained thather diabetes a simple, without denutrition. Pomit ali that relates tothes aliment in orde to wel at omewhat fuller lensi on thepoint relatins to the subjeci unde discussion. This lad had furthermore sufferin Do frequent metrorrhnsin, which ad occurre after the critical se menopause). O beins examined by a distinguished synecologist, uterine fibroma was diagnos-ed an radiotherapy advised As no practica result hateve was obtained by this treaiment and I was attendinther, she, by m advice, consulte Professor Bottam ho thought that a fungous metritis Wasi question, though no discardin the possibilit os an endo-uterine
He advised sursica intervention curettage wit further proposed
The orti lesion and the diabetes Dom hicli the patient assutarins contra-indicated his laiter operation, butd was in agreement it curettaseiein carried out Themnesthesia was produces ithethyl-chloride after alcatinisatio of the patient, hen he had been pu on a fastinidiet for somelay to brin about dissappearance of slucose Curettas resulted straishtway in the extractionis fragmenta o tumour hich, on examinationi Professor Roso were found ob a cylindric epithelioma. The post-operative consequences ere oscilior duration and the patient continue relativet wel for ome time. It was not long however efore the abundant an characteristic fetid o reappeared, whil a the fame timesain were et lese of the median line immediatet above the pubi arch. These ain hecam so intens that the patient a continually
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228 QUI NINE REATMENT OF CANCER
Thenes resolved to have recourse orireaiment,ith quinin in the form advocated by Casmione and whic Phave explaineffabove Thetavourable result was no long in Sho inmitself the patient experienc-edireat relies of the ain afte two injections that is to Say, after days of reaiment. and the ain disappeare completet shortly after ards. he was subjecte to the actionis quinine for twentydays then I suspende the rectiment. The patient continue weli an recovered strensili and couras inspite of the fac that the tumour continuesto progress and was atready palpabie in the hypogaStrium. The improvement laste for two monilis, at the end of hic thepain reappeare jus as intensem previously. The patient asked forquinine the actionis hich shelne inexperience Fres treaimentand resti improvement. Thus his patient continued ithout suffering to any greater eXtent, thanks to this reaiment, hic I administered rom timerio time and not illistandin the progress of the tumour,hich, emerginitio the limit of the uterus, extende to the entire abdomen producin aperitoneat carcinoma it hemorrhasi ascitis hicli Phad to lance
for a cancer of the lest breast. She passed a periodis about fix monthsvery well, at the end of hich she besan to lae intensesain in thearm and nec o the operate fide, hic reducedine to a conditionos positive madnes danand night. An examinatio of the operative cicatrix and the axillar region howe n neoplasmi nodules ruanslioni infarci The vertebrat column was free Domsain and poss- essed good mobili . diagnosed cancerous neuritis and advised quinine reaiment. On iis application alliain disappeared completely sivin the patient a sensationis perfect welibetns. Thils Se. This case proves that quinine oni improves cancer sufferer byritSallayins fictin.
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QUIN INE REATMENT OF CANCER 229
A emale patient who occupied bed No. of ward V of the Clinical Hospital service of Professor Guemes, ad a cancer of the reat curve of the stomach to ard the pilorus, norexi was absolute. Genera condition one os entire decline, illi occasiona vomiting. Quinine treaiment produced no improvement the patient sol orse every da in spite of the quinine. In my practice Phave had many other cases t whicli I have applied this reaiment,ith the relative success hic it is easibi to expectfrom it. I have selected the foresoinifrom amon them meret a B clinica proos of hat Ladvise.
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230 STUD OF QUIN INE ABSCESSES CONTRIBUTION TO THE STUD OF QUIN INE ABSCESSES
CONTRIBUTION A LETUDE DES ABCES QUINIQUES
Late House Surseo of the Civilirench Hospital os unis
HIS stud has brought the author to the folio in conclusions:
l. Quinin abscesses rem frequent and Sometime Grctve com plication os intramuscula injections os concentrate solutionos quinine: 2. In the great majoritros cases these abscesses are conSequentipona Septic inoculatio at the time o injection: 3. Intramuscula injections Appea to Xyos the patient more particularint AbSceSSes, B the require a very minute technique. Furthermore hen the absces does occurrit is deep. and necessitates tensili confinement of the patient tote and somelime a more ortes serious intervention Finalty it occasionali leave behindirave Sequelae: q. The method to e selecte is that o hypodermi injections os dilute solutions thes ensure rapid absorptionis thedrus, aresainlessan harmies or, at the ver most, sive riserio troubles of a perfectlymit form. Requirin ver simple manipulator methods the mcty, wit ali salaly be entrusted oran ASSiSinni.