SÉANCE DU 19 OCTOBRE 907 



succumb to the damage inflicted. Analysis of the cases that died indi- 

 cates that he latter alternative is probably the correct one, and that we 

 hâve erred upon the side of including, rather than upon the side of 

 exclQding cases. Thus, of the cases that died, N° 198, beside being a 

 " cardiac " case, had so much abdomioal hemorrhage that it might well 

 hâve been thrown out on that basis; N° 201 had an unusually had an 

 unusually large bloody action on the table, had considérable oozing 

 from the wounds, both before and after treatment, and had some 

 abdominal hemorrhage; and N° 203 had some extensive chronic hepatic 

 disease, and a pleura that was at least half full of a bloody exudate, 

 the origin of which could not be determined. If thus appears that of 

 the cases that died within one day, pure shock was the sole cause of 

 dealh of one only (N° 197). 



We attribute the advantage the combined injection of acacia and 

 glucose has over their successive injection, as has been indicated, to 

 the élimination of the deleterious action which concentrated acacia 

 solutions seem to hâve. Otherwise we believe the two procédures 

 produce their effects byidentical actions. 



We hâve seen no bad effects from the injection of the acacia-glucose 

 mixture. It markedly expands the blood volume, aud may, through 

 that action, presumably, cause the puise to become large and slow. 



Apparently a rate of injection considerably more rapid than the one 

 we hâve employed does not harm, even in weakened cases. We cite 

 the following case by way of example. After removing the clamp from 

 the cava, the arterial pressure mounted in the course of 33 minutes fo 

 100 millim. Hg. It has began to fall, and by the close of the two-hours 

 observation period was down to 70 millim. Hg. Now the mixture 

 was given, and at twice the usual rate. The pressure continued to fall 

 for some 9 minutes to 70 millim. Hg., and then rose steadily reaching 

 90 millim. Hg. 7 minutes after the conclusion of the injection, when 

 the last reading was made. The animal was found dead the next 

 morning. As was pointed out in the fîrst and second reports, concen- 

 trated acacia solutions rapidly injected may injure the heart. It would 

 b9 bètter, therefore, in practice to err upon the side of safety, and 

 always administer the mixture slowly. 



None of the cases developed a hemorrhagic tendency, directly attri- 

 butable to the acacia-glucose mixture. Oozing from the wound has 

 been seen, but in every instance this had begun before inaugurating 

 treatment, and it was not increased subséquent to the injection beyond 

 what could be attributed to the rise arterial pressure that resulted. 



We hâve not yel encountered any case in which treatment has 

 accomplished lasting benefît when administered in instances in which, 

 two hours after removing the clamp from the cava, the arterial pressure 

 was consistently falling. The example cited above is a case in point. 



