Vol. XXV. No. 11.] 
POPULAE SCIENCE NEWS. 
173 
therefore left undescribed. The Saxon translator 
has slavishly copied from his originals, Instead of 
studying Saxon plants in the field, but both the 
Iferbariuin and the Leech book show that the 
Saxon leech was at bottom a herbalist and his 
craft " wort cunning." 
tSpeclally Compiled for Populak Science News.] 
MONTHLY SUMMAEY OF MEDICAL 
PROGRESS. 
BT MAURICE D. CLARKE, M. D. 
The Healing of Tuberculosis. — That pul- 
monary tuberculosis is curable is demonstrated 
clinically by the recovery of patients In whose 
sputa elastic tissue and bacilli had been found, 
writes Dr. William Osier, and anatomically by 
the existence of lesions in all stages of healing. 
Caseous areas may be impregnated with lime 
salts, or the tuberculous masses may be encap- 
sulated by fibrinous tissue, in which case the sub- 
stance remains quiescent, and the disease is not 
cured. Perfect healing does not occur after cavi- 
ties are formed. A cavity may be much reduced 
in size, but is not often closed. I^aennec did much 
good work in this direction. He recognized the 
cicatrices complHes and the cicatrices jistulences, and 
suggested that as tubercle growing in the glands, 
which we call scrofula, often healed, why should 
it not do the same in the lungs. In a large num- 
ber of autopsies healed or quiescent tubercular 
lesions have been found in the lungs. This was 
noticed in 1880 by Palmer Howard, who called 
attention to the great frequency of puckering at 
the apices of the lungs in elderly persons. 
The following is noted of the apices : 
1. Thickening of the pleura, usually the poste- 
rior surface of the apex, with perhaps subjacent 
indication of the lung tissue, for the distance of a 
few millimeters. 
2. Puckered cicatrix at the apex, depressing 
the pleura, which may or may not be here thick- 
ened. On section, there is a fibrous scar much 
pigmented, the bronchioles in the neighborhood 
dilated, but no tubercles or cheesy masses. Such 
structures are extremely common, and may in 
some cases indicate a healed tubercular lesion. 
3. Puckered cicatrices with a cheesy or creta- 
ceous central nodule, and with scattered tubercles 
in the vicinity. 
4. The cicatrices flstnlences of Laennec, in which 
one or more cavities have become quiescent, sur- 
rounded with fibroid tissue and communicating 
with the bronchi. 
At 1,000 autopsies of his over 59 cases, or 5.05 
per cent., were found in which persons dying of 
other diseases presented undoubted tubercular 
lesions in the lungs. Of the 59 cases the causes 
of death were: Cancer of various organs, 12; 
cirrhosis of the liver, 7; accidents and operations, 
8 ; acute fever, 9 ; uraemias, 5 ; diseases of the 
head and arteries, 5; other affections, l.S. Tlie 
ages of those cases : Under lO.years, 4; from 10 
to 20, 2 ; from 20 to 30, 8 ; from 30 to 40, 10 ; from 
40 to 50, 14 ; from 50 to 60, 14 ; from 60 to 70, 5 ; 
above 70, 2. Heitler, of Vienna, found in 16,562 
cases in which the deaths were not directly caused 
by phthisis, there were 780 instances of obsolete 
tubercle, or 4.7 per cent. The simple fibroid indu- 
ration should be excluded. With each decennial 
period up to the sixtieth year the number of cases 
increased. Bollinger found in 27 per cent, in 400 
bodies evidences of tubercular lesions in the 
lungs. Staudacker, in 737 cases, found apex cir- 
rhosis in 202. Massini found evidences of healing 
in 39 per cent, in 223 bodies examined. Harris, of 
Manchester, found in 139 cases 54, or 38.84 per 
cent., in which there were relics of former active 
tuberculosis. The greater number of these were 
in the third, fourth, and fifth decades. In the 
Paris Morgue it is said that 75 per cent, of sui- 
cides and those accidentally killed present evi- 
dences of old tubercular lesions. 
These facts demonstrate, first, the widespread 
prevalence of tuberculosis ; and secondly, the fact, 
as shown by the above figures, that at least one- 
fourtli of all infected persons recover spontane- 
ously. In the great majority of cases the disease 
was very limited and had made no progress, and 
could not have given rise to physical signs. But 
even in cases further advanced, arrest is by no 
means infrequent, and if not cured the condition 
of arrest is consistent with comparatively robust 
health. 
Once infection has occurred, there are three in- 
dications : first, to place the person in surround- 
ings most favorable for tlie maintenance of a 
maximum degree of health; second, to take such 
measures as in a local or general way influence 
the tuberculous process ; and third, to alleviate 
symptoms which are necessarily associated with 
the disease. l"he environment is of the first im- 
portance. Trudeau's experiments with free and 
confined rabbits prove this. A patient confined 
to the house in close, overheated rooms, or in the 
stufTy, ill-ventilated dwellings of the poor, or even 
in hospitals, does not stand the chance with the 
patient in the fresh air and sunshine all day long. 
The home treatment of consumption is important. 
Fresh air and sunshine are all-essential. Altitude 
is a secondary consideration in comparison with 
these. 
Of measures which influence the general condi- 
tion, apart from hygiene and diet, there are four 
which have stood the test of experience — cod liver 
oil, the hypophosphites, arsenic, and- creosote, all 
of which act by improving the nutrition, and ren- 
dering the tissues more resistant, the soil less 
suitable for the growth and development of the 
tubercle bacilli.— Jb«r. Amer. Med. Assn. 
Relapsed Cases of Hernia.— One hundred 
and nineteen cases are reported by Dr.W. T. Bull ; 
in seventy-three the method of operation was 
definitely ascertained. With reference to these 
the writer says : The ages average about the 
same in all the methods, — from thirty-eight to 
forty-four, — sliowing that the extremes of life 
have generally been avoided. The duration of 
treatment, practically wound-healing, in Czerny's 
method, where the pillars of the external ring and 
the integuments are carefully sutured, is almost 
as great as in the open method. This confli-ms 
my own experience in operating, that the wound 
is a difficult one in which to obtain absolute pri- 
mary union, and is an argument in favor of allow- 
ing it to granulate. It is to be especially noted 
that relapses have occurred as late as two years 
and six months and three years and four months, 
and that on an average no method shows immu- 
nity from recurrence for a longer period tlian fif- 
teen months. This warrants the statement that 
future evidence as to the value of different meth- 
ods must cover an experience of more than three 
years, and that patients who have been without 
recurrence for a year have no reason to expect to 
remain so permanently. 
Interesting details are given of the other cases; 
the various methods and their results are criti- 
cised, and the following conclusions are drawn : 
In view of the trifling mortality now attached to 
these operations, in view of their recognized ad- 
vantage in improving the conditions of irreduci- 
ble, uncontrollable, or strangulated hernia, it is 
wise to continue to strive for better methods. 
Surgeons who liave led the way in the past, de- 
vising and perfecting the still unsatisfactory 
methods, may be expected to make further im- 
provements and advances. There cannot be too 
many of these efforts, nor can they be too varied 
so long as life is not endangered. But I hold, 
after the knowledge of these failures and in view 
of the well-established fact tliat after the old 
operations for liernia recurrence has been often 
long delayed, that it is wise to drop the term 
"cure" and to estimate the value of given pro- 
cedures by the relative proportion of relapses. 
That plan will be judged the best which shows 
the smallest number of relapses in course of the 
longest period of observation. And such period 
ought to be at least five years. Furthermore, I 
believe that all procedures should be so devised as 
to insure prompt healing of the wound, and that 
the support of a truss should be insisted on from 
the time the patient leaves his bed. — JV. 1'. Med. 
Jour. 
Children's Pulse and Temperature.— Dr. 
R. W. Shufeldt publishes in the New Yurk Medical 
■Tournal a series of thirty-five hundred compara- 
tive oliservations upon the pulse, respiration, and 
temperature of six children for three months, 
taken in one of the wards of a Washington hos- 
pital. Nothing that would ensure accuracy seems 
to have been omitted, and the series will add its 
value to that of other similar observations, as 
well as bear witness to the painstaking of the 
observer. 
Case of Cocaine IIypeh-esthesia. — Since the 
widespread use of cocaine in operations upon the 
eye, it has often been noted that it does not 
produce anaesthesia in some cases, especially so in 
acute glaucoma and other inflanmiatory states. 
The 13th of March a lady, 74 years old, was 
prepared for the operation for cataract. Both 
lenses were cataractons, the left being most ad- 
vanced, and against Dr. (Jalezowski's usual cus- 
tom both wore to be operated \ipon at the same 
time. The preparation of cocaine was the same 
as had been used before and has been used since 
with success. The cocaine caused some pain, but 
when the conjunctiva was seized with the fixation 
forceps the pain was atrocious. Dr. Galezowski 
having noted this reaction twice before, deter- 
mined to operate upon the right eye without the 
use of cocaine, 'i'he operation upon the left eye 
was completed without accident, though com- 
plaining very much at every touch of the instru- 
ments. But when the right eye was operated 
upon, though there was some pain complained of, 
it was nothing compared to tluit of the other eye. 
Others have noted this hypernesthesia, but not 
having the opportunity of a second operation to 
compai-e with in the same person, and at the 
same time, have concluded that it w as simply a 
failure of the cocaine to control a highly nervous 
person. — Uec. d'Oph. 
The Closing of Trephine Openings by Cel- 
luloid Plates. — A case was presented to the 
Vienna Medical Society by Hinterstoisser ( Wiener 
Med. Fresse) showing the successful result of an 
effort to close a trephine opening by a celluloid 
plate. The patient, some months after recovering 
from a comminuted fracture of the left parietal 
bone, suft'ered from giddiness, weakness, loss of 
power in the right side, and chronic twitchings of 
the right facial region and the corresponding 
upper extremity. Three years later epilepsy de- 
veloped. Examination showed a hypei-tcsthetic 
