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testis. Thus he speaks of loss of sensibility in the organ, and effusion in the tunica vaginalis.
But this is not all-be also combines with it a description of what has generally been designated under the name of fungus of the testis, this being an affection in which the inflammatory process causes the rupture of the tunica albuginea, and consequently protrusion of the vasa senimiferi; the vegetation which thus takes place externally producing the fungoid growth. So that in his description we find a little of every thing: tuberculosis, syphilitic testis and fungus of the same organ, all of which, certainly tend to obscure the question instead of elucidating the subject matter. Thus it is that in all which has been written on chronic orchitis, there is much confusion, and nothing characteristic of the disease. Nevertheless, I still believe in the existence of this disease, though, it is undoubtedly very rare. In these cases the testicle becomes inflamed, and an exudation of plastic lymph takes place, quite dif ferent from tuberculous degeneration. This infiltration deposit may be absorbed without suppuration, but on the other hand it may continue during a considerable time, as we see in inflammation of the epididymis, and then the whole organ continues in a state of permanent engorgement.
I think that the case under consideration is an example of this kind. The inflammatory action has been kept up in the testicle by the irritation of the urethra, and this state has finally brought on the chronic engorgement of the gland which is cognizable by the touch.
In relation with this subject, a single fact has been observed among those patients who are affected with this disease. The spermatic secretion is sometimes altered in its physical properties; it assumes a reddish or roseate hue, resembling gooseberry jelly. This circumstance being somewhat curious, I have attentively observed some of these patients, in order to see the result of the disease; I have been thereby enabled to ascertain that the change of color in the spermatic secretion may continue during three or four months without preventing sexual intercourse; then it gradually disappears, and the sperm resumes its normal appearance. Nor does this change affect their virile powers, for some patients who did not renounce their marital rights, have begotten children while their seminal fluid presented this abnormal condition. It has been said that children begotten under those circumstances generally present some peculiarities, such as red marks on the skin, etc. But these are idle stories entirely devoid of foundation. I have made some investigation in order to ascertain if this circumstance has been observed by other writers, and I found that Sweidour met with some patients who presented this peculiarity, and they were much friglitened by the circumstance.
What is the treatment to be followed in this case? The first indication is to remove the cause of engorgement, viz: inflamma
tion of the urethra. There does not appear to be any stricture, only a little pain in micturition. The bladder is not much affected, the urine presents no abnormal deposits.
Leeches have been applied to the perineum in order to diminish the local engorgement; we have also given him tepid baths to be repeated daily. After that, the treatment should be continued by revulsive applications, and among these the Tartar Emetic ointment is to be preferred to Cantharides, for the latter might act on the bladder, and produce inflammation of that organ.
We can very confidently expect that this course of treatment will relieve the inflammation of the urethra, and consequently the chronic irritation of the testicle which is dependant upon it.-[New
Orleans Med. News and Gaz.
Upon the Use of Glycerine as a Topical Therapeutical Agent. By M. LUTON. From the Comptes Rendus de la Société de Biologie.
Glycerine is an unctuous liquid not susceptible of evaporation. Although it has the appearance of an oil, it has the physical characteristics of a svrup; it is also soluble in water. By its first two properties, it prevents, as well as cerate and other fatty substances, the dressings from adhering to wounds. By its solubility in water, an extremely important quality, it permits wounds to be kept clean without the necessity of washing them a great deal. Indeed wounds dressed with glycerine, never have those crusts of pus and cerate formed over them, which can only be raised by means of a spatula, and with pain to the patient. It is ascertained, too, by observation that it is seldom necessary to wash the wound, all that is needed is to cleanse it gently by means of a sponge.
We shall see that glycerine evidently modifies the abundance of the suppuration, and again, being a very hygometrical substance, it keeps the parts in a constant state of humidity and prevents the products of exudation from becoming dry and hard. To obtain this it is indispensable to employ the glycerine in abundance, and to saturate the charpie and the perforated linen with it, while in order to avoid the inconvenience arising from the use of the cerate, when the latter is used, the dressings are hardly covered by it.
It is asked if glycerine preserves wounds from the contact of air as well as fatty bodies. The action of fatty bodies in this relation, is very imperfect; they cannot cover a bloody surface. Glycerine, on the contrary, from the quality the reverse of this, comes more directly in contact with the denuded part. It protects it against the air as well as a wet cloth or a cataplasm. It softens the charpie more readily, and is absorbed better, and with it the exuded fluids which it dilutes, and which the cerate under the samo circumstances cannot do, for it rather opposes the absorption of the watery fluids.
Fatty bodies, preventing the evaporation of the humors upon the denuded surfaces, or even upon the skin, keep up a high temperature. Glycerine, from its affinity for water, also arrests evaporation by retaining the exuded liquids, and accomplishes equally well this object. To prove this, it is only necessary to cover the lips cracked by cold, with glycerine; a decided heat is soon felt in them, even when you are in the air, and the pain is greatly relieved.
Glycerine then, from its peculiar physical properties, triumphs over fatty bodies as a dressing of wounds.
But the advantages of glycerine in the dressing of wounds are not thus limited. It possesses, independently of the qualities we have just indicated, a very remarkable topical action, which should seriously interest the surgeon. To show this action, the author points out the different cases in which it has been applied, in the service of M. Demarquay at the St. Louis Hospital, limiting himself simply to announcing generally its salutary effects.
The first effect of the application of glycerine upon a denuded surface is a slight pricking, which sometimes produces an itching sensation, but which soon passes off, and is never complained of by the patient.
In simple ordinary wounds, accidental, or surgical, and exempt from complications, glycerine employed like cerate has no very manifest action. It conducts to a cure quite as rapidly as most of the neutral topical agents, and is only remarkable in its action by the slight suppuration which ensues, which, however, is one of the essential and general qualities of glycerine. Besides it has been observed that it never produces an exuberance of unhealthy granulations.
In the different degrees of burns, glycerine is of extremely easy application, and has also a very efficacious action. We have seen patients upon whom cauterization had been employed for white swelling, sciatica, &c., object to the glycerine dressing because it healed, as they said, too quick, and did not draw enough.
In the diptherite of wounds,-in that bad aspect which wounds sometimes take on in Paris Hospitals during the first few days, dressings with glycerine are of essential service. Instead of assuming and preserving a grayish diptheritic appearance, they look red, and there is no exuberance of granulations.
In Hospital gangrene it proved of most marked benefit in one case following an extensive burn, in which quinine, lemon juice, mono-hydrated nitric acid, and the cautery had failed. It also succeeded in two other cases occurring in the hospital at the same time.
In deep wounds, in sinuous abscesses, glycerine was also used. It was introduced by means of a pledget of lint, or as an injection. The suppuration was diminished and the period of cicatrization shorter. Injections were made into cold abscesses; into abscesses by congestion, and into abscesses in contact with inflained bones, and the happiest results attended its use.
Glycerine also succeeded admirably in the dressing of ulcers; chronic ulcers, varicose, grangrenous, &c., cleaned rapidly under its influence, the unhealthy granulated surface gradually filled up, and cicatrized. Rest is always a powerful and necessary auxiliary. Glycerine has no property antagonistic to the specific nature of chancres, but their surfaces rapidly become clean and take on a good aspect from its use, and although there are no positive data to be given upon the specific action in this class of ulcers, yet there is no dressing so convenient for chancres of the prepuce as lint saturated with glycerine.
This topical agent has also been employed in diseases of the neck of the womb. MM. Trousseau and Aran have tried it, but never with very satisfactory results. M. Demarquay has reaped great advantages from its use in simple or granular ulcerations of the neck. In chronic cases, or where the neck was large and tumefied, the different caustics were used, and among others, the cautery. Then the glycerine employed as a dressing, modified essentially the quantity of the secretions, which ordinarily follow the fall of the eschars.
It has also been employed in vaginitis, but the results are so inconclusive that they are not reported.
From this review of its application, it follows that the topical application of glycerine diminishes the abundance of the suppuration. It possesses a styptic influence, difficult to determine, but which by this virtue changes an impure and complicated wound into a simple wound, and consequently hastens its cure.-[American Med. Monthly.
Case of Late Dentition.
Dr. Deutsch was called in consultation to a man, 34 years of age, who for some weeks past had been the prey of intense pains in the head and face, the origin of which he had at first attributed to several decayed molars, the crowns of which were destroyed. There was very great swelling of the neck and face, abundant discharge of saliva, and difficulty of deglutition. But the most remarkable thing was the appearance of several new teeth. Thus, somewhat in front of the incisors of the upper jaw, four new incisors were found irreg ularly disposed, two in like manner presenting themselves in front of the two middle incisions of the lower jaw. New canine teeth also appeared in the upper jaw, between the incisors and the canines. In the lower jaw the new canines sprung up from below and in front of the old ones. The two bicuspids in each jaw and on both sides were pressed backwards by new bicuspids. With respect to the second molars of the upper and under jaw of the right side, and of the upper jaw of the left side, the new teeth appeared in the midst of the decayed molars without displacing these, and in such a manner that the remains of the old toothwalls formed partial envelops
for the new. No new teeth were found corresponding to the first molars, although the old ones were carious, or to the second molar of the lower jaw of the left side. All the third molars were broken away. All the old teeth were so firmly placed as to be removable only by force. The new teeth were very fine ones. From the time of their appearance the patient's suffering ceased, although the effects of this continued some time to be apparent. A skillful dentist gradually removed all the old teeth, and those of the new which had grown out amidst the old were removed with these latter. Some months afterwards, the new teeth had assumed a very orderly position, the separations between them being very slight. The patient does not remember losing teeth at the usual period of the second dentition. The author adds, that in his own case two molars of the lower jaw, which were extracted in his twenty-fifth year, were in the course of a year replaced by two new, good, and durable teeth.-[Med. Times and Gaz., from Berlin Med. Zeitung.
Treatment of Cancer by Dilute Solutions of the Chloride of Zinc.
The Medical Times and Gazette (April 25, 1857) contains the particulars of some cases in which Mr. Stanley has pursued the plan of treating cancers by much diluted solutions of chloride of zinc. "Their results," says the reporter, "certainly prove that the destruction and enucleation of an ulcerated cancerous tumour may be effected by the use of solutions so weak as to be all but painless, and without necessitating the confinement of the patient to bed for a single day. Without venturing at present to assert that this plan, when persevered in, in a great number of cases in various conditions of health, will be found to be absolutely void of danger, yet most will doubtless admit that the risk attaching to it will prove to be infinitely small, far less than that of excision, and that which attend. ed the use of arsenical pastes. As far as we know, chloride of zinc, when used in its most dilute solutions, never causes deleterious effects from its absorption into the system, nor does its application ever tend to excite erysipelatous inflammation of the part. An operation for the removal of a cancer, involving as it does the exhibition of chloroform, a considerable loss of blood, a period of a week or so in which the patient is feverish and ill, and takes little food, and subsequently a considerable suppuration, must be granted to be likely, even in those cases in which the patients recovered well, not to have exerted any beneficial influence on the subsequent health. And such indeed is but too frequently observed by those who follow up their cases after dismissal. It is not at all uncom mon to find patients who have never regained such health as they had prior to the excision, although their recovery from its immediate effects may have been as satisfactory as usual. Without, therefore, saying anything whatever as to the probability of the return of