Fig. 6.-PHASE OF CIRCULATION AT PARTURITION AND PUERPERIUM. Death occurred three hours after labor by invagination of the uterus immediately following parturition due to atrophy of the fundus by reason of the dragging of a large powerful omental and peritoneal band in consequence of a ventral hysteropexy, performed four years previously. The oligamic uterine zones--central longitudinal (A, B, and X), bilaterally cervical, and fundal-have changed appearance; blood-vessels have become apparent in them. The few blood-vessels and little blood of the oligamic uterine zones of the resting uterus have become pouting full. The utero-ovarian artery (except the ovarian segment) has lost its prominent spirality. The mighty, expanding uterus forced the spirality into extension. vical, and fundal-are definitely marked to the maximum in contour and degree (see Fig. 6). PUERPERIUM. The puerperal phase is the periodic uterine involution, when the elastic and muscular bundles, like living ligatures, contract, decreasing the dimensions and de SENESCENCE. In the senescent state the tractus genitalis gradually atrophies, the utero-ovarian. artery decreases in diameter and length, and the arterial walls are reduced in muscular and increased in connective tissue. The functions of the tractus genitalis (ovulation, secretion, absorption, peristalsis, Fig. 7.-PHASE OF CIRCULATION IN SENESCENCE MAINTAINED BY OVARIAN CYSTS. (AN X-RAY.) Multipara about fifty years of age with bilateral ovarian cysts as large as cocoanuts. 1, 2, 3, and 4, pelvic floor segment; 4, 5, and 6, uterine segment; and 6, 7, 8, and 9, oviducal segment of uteroovarian artery; 22 and 22, rami laterales cervicis; 23 and 23, rami laterales corporis; 24 and 24, rami laterales fundi; 25 and 25, arteria vaginalis; 27, arteria vesicæ; 13, 14, and 15, arteria ligamenti teretis; 19 and 19, ureter, distal orifices. The rami corporis are atrophied, while the rami fundi are strong and large, maintained by the large ovarian cysts. A, B, and C, longitudinal oligæmic zone. The oligamic uterine zones-central longitudinal (A, B, and C), fundal, and bilaterally cervical-are at fifty years of age (senescence) well marked and distinct. The utero-ovarian artery still maintains marked spirality. PHASE OF CIRCULATION IN DISEASE. The circulation of the uterus may be maintained in normal or abnormal activity beyond the climacterium by means of irritation caused by uterine or ovarian tumors. Figs. 7 and 8 are excellent and common and elastic tissue, which, like living ligatures, control the vessels; hence insufficiens uteri occurs (see Figs. 7 and 8). The circulation of an organ quotes its value in the animal economy. It rates its function. Fig. 8.-PHASE OF CIRCULATION IN SENESCENCE MAINTAINED BY MYOMATA. (A PHOTOGRAPHIC X-RAY.) Represents a subject, fifty-three years of age, with multinodular myomata in the uterine wall. The specimen was injected after removal from the body with red lead and starch. It was x-rayed and a bromide illustration was produced. Dr. Scholer, the artist, strengthened some of the weaker and repaired some of the defective shadows of vessels. The fact to observe is that, although this subject is 53 years of age, the presence of uterine myomata has so stimulated the arteria uterina that it is actually larger than is usual at thirty-five years of age. For size of vessels it resembles a pregnant uterus at five months. Note the loops of the uterine segment (4, 5, and 6) and the distinct pelvic floor segment (1, 2, 3, and 4). The ureters are marked by a wire (black line), which passed through them. The fact that the presence of uterine myomata stimulates the utero-ovarian artery to large size resembling that of gestation accounts for the continued and excessive hæmorrhages of subjects possessing them. The cervical loop is very long and large on each side. The oviducal and ovarian segment are not so prominent as the pelvic floor and uterine segments. Observe that the smaller, finer rami laterales uteri usually noted in active sexual life are not present, especially in the cervix. Also observe that rami laterales uteri on the left (4) and on the right (5) are very prominent, large, and strong; these supply directly the large uterine myomata. This specimen resembles that containing the sarcoma of the endometrium in which the utero-ovarian artery was stimulated to the dimensions noted at the end of a three months' gestation. In gestation the utero-ovarian artery rapidly increases in length and volume; however, on account of the expanding uterus, the arterial coils become unfolded-extended. In uterine myomata the uterus has similar irritation as in gestation, but the uterus remains small; and hence when the artery increases in volume and length it is compelled to coil in various directions, as noted in this beautiful x-ray half-tone of the pathological condition mentioned. TRANSFUSION (ELECTRICAL): A AGENTS THROUGH BY JAMES J. EDMONDSON, M.D., Formerly Captain and Assistant Surgeon, United States Army Volunteers. NEW YORK, N. Y. THE THEORY. ELECTROSTATIC currents while passing through the body can be made to carry along medicinal or antiseptic substances. It is entirely in accord with known phenomena that certain solutions contained in a receptacle at the positive electrode are. carried along by the electrostatic currents when the same are in the path of the said current. The porosity of metals to a fluid under direct mechanical pressure was demonstrated as early as 1661 by the Florentine Academy, by forcing water through metal sheets. The conditions are analogous to those in the experiments of the Florentine Academy with the difference that in the present case a powerful flow of electricity at a high pressure serves as a vehicle or means for drawing along the solution in molecular form through the metal, whereas in the early experiment a direct mechanical pressure upon the fluid was employed. The current in this manner serves to convey the agent through the metal of the electrode and through the tissues of the body to the seat of the disease. The joint action of static electric currents of high tension with an agent which is transferred by the action of the currents produces a permeation of all the tissues in the path of the current. In electrolytic processes not only chemical changes are brought about, but there is also a wandering of molecules. In decom posing dilute sulphuric acid by a current of 1 ampère the cell in which this experiment is made contains a membranous diaphragm. After several hours the concentration of the acid on one side of the membrane shows the transference of acid by the electric current. This wandering of molecules is easily explained in accordance with the well known theory of electric osmosis. By this the fact. is established that electric currents cause a transference of the molecules of chemical substances. The human tissues may be considered as acting like the membrane in the above experiment. An antiseptic is transferred in an analogous manner to the seat of disease. A chemical decomposition of the antiseptic does not take place because the quantity of the current is so small in electrostatic currents of high tension that electrolytic work cannot be accomplished thereby. The high tension currents merely act as a vehicle or means for conveying or producing a flow of the agent to the seat of disease. When the silent static discharges pass from the electrode through the air to the skin, the air through which the discharge passes is slightly rarefied, and the molecules of the air arranged in the direction of the silent discharge so that a slightly rarefied passage is established for the agent in the direction of the discharge from the electrode to the skin. The therapeutical effect is reached by the joint action of the curative agent and the static currents of high tension. The process is of great scientific value. and utility, and it is in harmony with physical and electrostatic phenomena accepted by the scientific world. This principle is used in the arts. In Germany there is a large factory for making wood proof against the attacks of the marine teredo by driving a preservative into it by means of the electric current. The theory is based upon: 1. STATIC ELECTRICITY, sufficiently accumulated to kill as by lightning all microbes, without any danger whatever to the patient. 2. THE UTILIZATION OF STATIC CURRENTS at the same moment to carry the antiseptic and deposit it upon the very seat of the disease, thus neutralizing the toxin. 3. THE EMPLOYMENT OF METALS which, carried in the same manner, and combining favorably with the medicines, become valuable auxiliaries to the cure some as reconstituents, others as antiseptics. The transmission of antiseptic remedies to the very seat of the disease rests upon a scientific basis. The introduction into the organism of medical substances by means of static electric currents of high and medium tension is a fact of the greatest importance. PHYSIOLOGICAL EXPERIMENTS. For the purpose of determining positively that electrostatic currents can be used to carry agents through the tissues of the body, a large, powerful, specially constructed static machine was used. Preparations of iodine, mercury, and formaldehyde, which had been made after a great deal of experimentation, were employed in these physiological experiments. 1. A guinea pig was shaved on the surface of the abdomen, and made fast to a board and laid on the insulated table of the static machine. The negative pole was connected by means of a chain with the back of the animal, and a sponge saturated with the iodine preparation was fastened on the movable positive electrode. The sponge was brought in contact with the abdomen of the guinea pig, held there for a few minutes and then raised a few inches; next sparks were allowed to pass from the sponge to the body. The animal was then chloroformed, and an autopsy immediately made. The organs, including the intestines, were tested with an acidulated starch solution, and a characteristic blue reaction was found, thus proving the presence of iodine, and also that it had been transfused through the tissues of the body by means of static currents of electricity of high tension. 2. Another guinea pig was shaved on the surface of the abdomen and painted with a preparation of mercuric bichloride and subjected immediately to the same treatment for about one minute. The animal was killed after two hours' time, when the lungs, salivary glands, and bladder with its contents were removed for examination. Tests for mercury in these organs showed its presence in appreciable quantities. 3. A third guinea pig was treated in a similar manner, using formaldehyde. Examination of the lungs after they had been removed, and kept in a bottle without alcohol or other preservative for four days, showed a marked preservation; not the slightest evidence of putrefaction was found; this preserved condition is presumptive evidence of the presence of formaldehyde. The lungs were extracted with distilled water, the extract was distilled; the distillate was treated with a drop of dilute phenol, and the same poured over strong sulphuric acid. At the point of contact of the two fluids a faint pinkish coloration was seen, showing the presence of formaldehyde. 4. A fourth guinea pig was treated with formaldehyde, but in this case the head was covered with a thick cloth to keep the animal from inhaling any of the agent to be transfused; the transfusion was kept up for five minutes, the animal was then chloroformed, and an autopsy immediately made. A small portion of the lungs was treated as in Case 3 (Henner's test for formaldehyde). A faint rose-violet ring was obtained, proving the presence of formaldehyde. It is worthy of mention that none of the animals exhibited any discomfort after the application of the electrical transmission. They were rather more lively and quite eager to eat. The guinea pig subjected to the treatment with the strong solution of mercuric bichloride was not killed for more than two hours after, yet it did not show the least indisposition. |