Chapter III: Part 3

Taking into account all of the circumstances attending the circulation of the blood through the abdominal organs, especially the rate of flow, and remembering the great increase in the number of leucocytes contained in the blood during the several hours attending digestive proteolysis, it is plain that a comparatively large amount of proteid matter must be transferred from the intestine to the blood in the bodies of the white corpuscles so abundantly produced in the lymph glands, etc., during proteid digestion. Indeed, Pohl calculates, on the basis of his own and the observations of others, that in the case of an animal weighing 5 kilograms, and fed with 100 grams of fresh beef, containing 20 grams of proteid matter, the entire amount of albumin required to supply the loss incidental to the normal physiological processes of the body could be absorbed into the circulation from the intestine in the form of leucocytes, assuming a digestive period of six hours. Moreover, the evidence acquired from Pohl’s experiments of the enormous production of new cells in the intestinal walls during the height of digestion renders such a theory of the transference of proteid matter from the alimentary tract to the tissues and fluids of the body quite plausible. At the end of twenty-four hours the leucocytes have fallen back to their normal number, having presumably been broken down in the blood-plasma or dissolved in the tissues and organs, thus giving up the proteid matter, of which they are composed, for the general nourishment of the body. Obviously, we can not admit that all the proteid matter of the food is absorbed in the form of leucocytes, for, as we know, some at least of the proteid food ingested is carried beyond the peptone stage, either through the action of trypsin, or through the action of the organized germs in the intestine, but we can certainly accept the views so admirably worked out by Pohl, in so far as they indicate one way in which proteid matter may pass from the intestine into the blood, after having undergone a preliminary transformation in the alimentary tract into primary albumoses and peptone. Again, if Pohl’s views are correct, we see that the proteid foods are quickly transformed into organized material in the body of the lymph cell prior to their absorption into the blood, a view which is in harmony with the long-known fact that peptone and other products of digestion can not be detected, in any quantity, at least, in the blood of the portal vein, even after the ingestion of a diet rich in proteids. As has been frequently stated in the past, the products of proteolytic action are transformed in the very act of absorption, presumably through the activity of the epithelial cells of the villi, and we may now assume, in the light of Pohl’s results, that this transformation may be due in part, at least, to the upbuilding of the ordinary products of digestion into the living protoplasm of the white corpuscles in the intestinal walls, and in this form as organized albumin circulated through the body.

Editorial in Dietetic and Hygienic Gazette, November, 1893.

Book Notices.

AN AMERICAN TEXT-BOOK OF GYNECOLOGY, MEDICAL AND SURGICAL, FOR THE USE
OF STUDENTS AND PRACTITIONERS. Edited by J. M. BALDY, M. D.,
assisted by a corps of Nine Contributors. Cloth, 8 vo., pp. 713. 360
illustrations and 37 colored and half tone plates. Philadelphia: W.
B. SAUNDERS, 1894. (Sold by Subscriptions only; Price, $6.00).

The magnificent work described above has just been received from the publisher, and inasmuch as it is at once the most modern and most complete of all works of this class prepared exclusively by American authors, it will naturally receive a warm welcome. A somewhat cursory examination shows that it is what it claims to be, namely, a practical work, written by practical men, who are, themselves well qualified by experience, and thoroughly equipped for teaching, all being teachers in high repute in different medical schools. Owing to this special feature, it is entitled to more than usual attention at the hands of American physicians; but this characteristic will give it standing abroad, and doubtless will be the means of advancing the cause of scientific treatment in the class of cases with which it has to deal. Theory and speculation have been set aside, and in their place we find reliable data not alone for the operator, but also for the general practitioner, and we bespeak for the work a favorable reception. The following extract from the prospectus will give in brief the main objects kept in view in its preparation:

In this volume all anatomical descriptions excepting what is essential to a clear understanding of the text have been omitted, illustrations being largely depended upon to elucidate this point. It will be found thoroughly practical in its teachings, and is intended, as its title implies, to be a working text-book for physicians and students. A clear line of treatment has been laid down in every case, and, although no attempt has been made to discuss mooted points, still the most important of these have been noted and explained; and the operations recommended are fully illustrated, so that the reader may have a picture of the procedure described in the text under his eye, and cannot fail to grasp the idea.

It is to be regretted that the authors’ names do not appear in connection with their respective contributions, and this is about the only feature that will detract from the completeness of the work. For example, we should like to know which one of the ten is responsible for the statement found on page 90, to the effect that “_All salts of potassium in full doses are cardiac depressants._” This is true only in part, as it is a well-recognized fact that when eliminatives are required, iodides are valuable, in fact, are demanded, and when given in what is known as medicinal doses, potassium iodide is an efficient cardiac stimulant. It is not, however, a cardiac stimulant in the sense that digitalis, strychnine and arsenic are cardiac stimulants, through their influence upon the cardiac mechanism; but rather, because potassium iodide increases protoplasmic activity, promoting the discharge of waste products, and thus lessens materially the work devolving upon the heart muscle itself. Statements of this character should always be made with caution, since they are too sweeping, and calculated to mislead those unfamiliar with the true physiological action of drugs. The book is well printed, handsomely illustrated, and reflects credit alike upon the authors and publisher.

SYLLABUS OF LECTURES ON THE PRACTICE OF SURGERY. Arranged in
conformity with the American Text-book of Surgery. By N. SENN, M.
D., Ph. D., L. L. D. Cloth, 12mo., pp. 221. Philadelphia. W. B.
SAUNDERS. 1894. (Price, $2.00.)

Like all Prof. Senn’s work, this is an excellent compilation, and no doubt will be highly appreciated by teachers in this department, although it will prove most acceptable to the general practitioner who desires to refresh his memory from time to time in regard to surgical affections. By reference to the list of contents, arranged alphabetically, any subject can readily be located, and all the more important points gained in the course of a few minutes. Those who do not possess the original work will be prompted to purchase it when they have an opportunity of examining this convenient arrangement.

FUNNY BONE.—A Book of Mirth, for Doctors, Druggists, Dentists, Medical
Students and Others. Containing Funny Sayings, Jokes, Good Stories,
Dialogues, Conundrums, Ludicrous Things, Ditties, etc., from a great
many sources, with _Over 150 New and Original Comic Illustrations_
by Dr. L. Crusius, all of which pertain to the Medical and
Pharmaceutical Professions. The FUNNY BONE PUBLISHING CO., 1421
Market St., St. Louis, Mo. (Price, 50 cents).

Read the preceding title and description carefully: It tells all about the nature of the book. Then take our word for it that the book is really very funny; the illustrations are unique, odd, totally unlike anything ever supplied by a comic artist, wholly original; and if you want something odd and unique, to read and to show to professional and lay friends as a curiosity, send 50 cents to the publishers and get a copy by return mail. You’ll get more than 50 cents’ worth of fun out of the book.

* * * * *

The Antikamnia Visiting List is a neat and practical account book,
of convenient size, and fitted into a durable leather cover. We have
received one of these lists from the Antikamnia Chemical Co., St.
Louis, Mo., and have no doubt that any physician who will write to
the firm can obtain the same—and make good use of it.

BOOK NOTES.

The Funk & Wagnalls Co. (18 and 20 Astor Place, New York) announce that Vol. I of their new “Standard Dictionary” was issued in December, but the first edition was not large enough to fill all orders booked before publication. A new edition is in press, and will be ready shortly. The second volume of the work will be ready in a month or two, and simultaneously the single volume edition of the entire work will be ready. Write for a prospectus: this Standard Dictionary is a wonderful book, and if you make yourself familiar with its features—as comprehensively shown in the prospectus—you are bound to secure a copy for your library. Write to the publishers at once.

E. B. Treat (5 Cooper Union, New York) has just issued two new volumes: Landis “How to Use the Forceps”, revised and enlarged by Chas. H. Bushong, M. D. (price, $1.75); and Beard’s standard work on “Nervous Exhaustion” (price, $2.75). Both books are issued in the familiar style of the publisher, and form necessary additions to available reference books on important specialties.

E. B. Treat also announces the early publication of his “International Medical Annual” for 1894 (the 14th year of publication). From the prospectus we note that the staff of editors and collaborators remains at the same high standard as heretofore, and hence the usual excellent annual review of medical progress in all branches is ensured. Write for prospectus; the book is sold at $2.75, and is cheap and indispensable.

Lea Bros. & Co. (Philada) announce the publication of the new _National Dispensatory_ on January 25th. The J. B. Lippincott Co. had advertised the appearance of their new _U. S. Dispensatory_ for January 15th, but some delay has apparently been caused, and the book will not appear until the middle of February. There will be greater rivalry than ever before between these two books; but each has its special features, and both are valuable—so that the careful student will do well to procure both volumes. The information in one will often amplify the other, and neither volume alone contains all the knowledge we possess—and ought to have at command—regarding drugs and materia medica.

PUBLICATIONS RECEIVED.

The Present Condition of Otology in Europe. By LAWRENCE TURNBULL, M. D., of Philadelphia. Reprint, 1893.

The Relief of Chronic Deafness, Tinnitus Aurium and Tympanic Vertigo, by Removal of the Incus and Stapes. By CHARLES H. BURNETT, M. D., of Philadelphia. Reprint, 1893.

Some Observations on Treating Cases of Diphtheria. By G. BENSON DUNMIRE, A. M., M. D., of Philadelphia. Reprint, 1893.

A Case of Tumor of the Optic Thalamus. By WHARTON SINKLER, M. D., of Philadelphia. Reprint, 1893.

Pathology and Treatment of Paralysis from Pott’s Disease. By WHARTON SINKLER, M. D., of Philadelphia. Reprint, 1893.

Syringo Myelia. By WHARTON SINKLER, M. D., of Philadelphia. Reprint, 1893.

Hysterectomy: Indications and Technique. By J. M. BALDY, M. D., of Philadelphia. Reprint, 1893.

Removal of the Uterus and Its Appendages for Pelvic Inflammatory Disease. By J. M. BALDY, M. D., of Philadelphia. Reprint, 1893.

A Few Thoughts About Ophthalmometry, as to What the Javal Instrument Will Do, and What It Will Not Do. By LOUIS J. LAUTENBACH, A. M., M. D., of Philadelphia. Reprint, 1893.

Epiphora or Watery Eye. By L. WEBSTER FOX, M. D., of Philadelphia. Reprint, 1893.

Phlyctenular Conjunctivitis, with Special Reference to the Pathology and Prophylaxis of the Disease. By LOUIS J. LAUTENBACH, A. M., M. D., of Philadelphia. Reprint, 1893.

Phthisis: A New Method of Treatment. By HENRY S. MORRIS, M. D., of New York. Reprint. 1893.

Extract of Malt and Its Combinations. By J. J. MULHERON, M. D., of Detroit, Mich. Reprint, 1893.

The Measured Effects of Certain Therapeutic Agents, etc. By D. D. Stewart, M. D., of Philada. Reprint, 1893.

The Successful Treatment of Anæmia, with Effect Shown by Increase of Red Corpuscles and Haemoglobin. By H. P. Loomis, M. D., of New York. Reprint, 1893.

Miscellany.

METRIC EQUIVALENTS.—The metric nomenclature is coming into such common use, especially in scientific articles, that the following formulas will be found valuable:

WEIGHT EQUIVALENTS.
To convert grains into grammes multiply by 0.065
To convert grammes into grains multiply by 15.5
To convert drachms into grammes multiply by 3.9
To convert ounces (avoir.) into grammes multiply by 28.4
To convert pounds (avoir.) into grammes multiply by 453.6

MEASURE EQUIVALENTS.
To convert cubic centimeters into grains multiply by 15.5
To convert cubic centimeters into drachms multiply by 0.26
To convert cubic centimeters into ounces (avoir.) multiply by 0.036
To convert pints into cubic centimeters multiply by 473
To convert liters into ounces (avoir.) multiply by 35.3
To convert gallons into liters multiply by 3.8

FLUIDS WITH MEALS.—The arguments presented by many writers seem to prove that the moderate taking of fluids with the food at meals is not without benefit. But the importance of the thorough mastication of food before it is presented to the stomach must never be overlooked. If this is interfered with in any way by the use of liquids we must promptly prohibit their indulgence.

Fluids may be taken ad libitum during meals by those whose digestive powers will allow it; but such persons should keep in mind that the strongest stomach may be abused too far, while those whose stomachs are already unequal to a severe strain should be especially careful as to the quantity of fluid imbibed with the food.

The saliva is the best lubricator for the food while it is in the mouth, both because of its starch-digesting powers, and because its alkalinity serves to stimulate a copious flow of the acid secretion of the stomach.

Any habit, therefore, which permits the entrance of food into the stomach before it is thoroughly incorporated with saliva must be pronounced pernicious in the extreme.

If we cannot afford the time necessary for masticating our food properly and incorporating it thoroughly with saliva, it would be better to take nothing but broths and similar foods. The use of water and other liquids as lubricators is not to be tolerated.

On the other hand, if we bear in mind the whole mechanism of digestion, it will readily be seen that, in cases of weakness or want of tone on the part of the muscles of the stomach, when every part of the food cannot be properly presented to the action of the digestive juices, the introduction into the stomach of a moderate amount of water may be of no slight benefit. The mass of food will become more pliable, and so more easily operated upon by the weakened muscles.—_Youth’s Companion._

MALAKIN is a salicylated derivative of phenacetin, which occurs in small, palish-yellow crystals, insoluble in water but quite soluble in warm alcohol. The mineral acids decompose it into salicylic aldehyde and phenacetin. This also occurs in the stomach, and salicylic acid is found in the urine. Jaquet of Basle has (_Jour. de Med. de Paris_) found it of value in rheumatics in whom salicylic acid produces untoward effects. According to him, it has a mild, efficient action similar to that of nascent salicylic acid. No untoward effects were observed, but the results were prompt. It is given in 15-grain doses four or six times daily. As an anti-neuralgic and antipyretic it is inferior to phenacetin.—_Med. Standard._

PROTECTION AGAINST DIPHTHERIA.—The Board of Health has announced a new measure looking to the control and diminution of diphtheria, and circulars were sent to practising physicians giving the grounds for the step decided upon, and the reasons why it was deemed expedient.

The proposition is to supplement the primary bacteriological examination now made at the beginning of any individual case of the disease, by other cultures repeated during its course and during convalescence. It is hoped in this way to make sure that apparent recovery, and the disappearance of all false membrane is followed by the extermination of all the Loeffler bacilli from the throat. The circular is written by Dr. Hermann M. Biggs, chief inspector of pathology, bacteriology, and disinfection, and is signed by President Wilson with the approval of the board. It is explained that 405 cases of true diphtheria have been subjected to repeated examinations at intervals of three or four days during illness and until the disappearance of the bacilli. It was found that in 160 cases the bacilli persisted after the complete separation of the false membrane, or, in other words, after the individual had recovered. Of these 160 cases, 103 showed the germ for seven days, thirty-four for twelve days, sixteen for fifteen days, four for three weeks, and in three for five weeks, after the exudation had completely disappeared from the upper air-passages. The circular infers, thence, that “these results show that in a considerable proportion of cases persons who have had diphtheria continue to carry the germs of the disease in their throats for many days after all signs and symptoms of the disease have disappeared.”

These experiments have led the Health Department to adopt the rule that no person who has suffered from diphtheria shall be considered free from contagion until it has been shown by bacteriological examination, made after the disappearance of the membrane from the throat, that the throat secretions no longer contain the diphtheria bacilli, and that until such examinations have shown such absence all cases in boarding-houses, hotels, and tenement-houses must remain isolated and under observation. Disinfection of the premises, therefore, will not be performed by the department until examination has shown the absence of the organisms.

Secondary cultures, as in the case of primary cultures, may be made by the attending physician, if he so desires; otherwise they will be made by the inspector of the district in which the case occurs. This applies only to cases occurring in boarding-houses, hotels, and tenement-houses—not to those in private houses.—_N. Y. Evening Post_, January 8, 1894.

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Footnote 1:

The source is not quite so accurately known; hippuric acid is
eliminated with the urine in human subjects as well—after the
administration of benzoic acid. For an interesting compilation on this
point, see Wood’s Therapeutics, page 642.

Footnote 2:

Archiv für Experimentelle Pathol. und Pharm., Band 25, p. 31.

------------------------------------------------------------------------

TRANSCRIBER’S NOTES

1. Silently corrected typographical errors and variations in spelling. 2. Retained anachronistic, non-standard, and uncertain spellings as printed. 3. Footnotes have been re-indexed using numbers and collected together at the end of the last chapter. 4. Enclosed italics font in _underscores_.