Macdonald (Journal of Tropical Medicine and
Hygiene, June 15, 1920) note that the present ten-
dency is to look upon all forms of erythema multi-
forme, inckiding herpes iris, as being due to ana-
phylaxis caused by the absorption of some chemical
product from the intestine or other passages, or
from a diseased organ. The success of treatment by
intestinal antiseptic therapy in certain cases ofTers
some support to this theory. The essential features
of herpes iris are the central vesicle or bulla, the
surrounding rirtg of vesicles, the affection of the
lips and mouth, the formation of several rings of
vesicles outside the first ; the slight constitutional
disturbance, and the tendencies to recur if not
properly treated. It is differentiated from its near-
est ally, erythema iris, by the fact that in the former
there is a vesicle surrounded by an erythematous
blush. The first aim in the treatment should be to
find the site from which some form of chemical
absorption is taking place. In one of the author's
cases the intestinal tract appeared to be the only
possible source of trouble; the patient was placed in
bed on restricted diet and given purgatives and
salicin, with immediate and excellent results.
New Method of Preventing Anaphylactic
Manifestations. — Kopaczevvski ( Pressc medicale.
June 16, 1920) has shown experimentally that
anaphylactic manifestations can be obviated in ani-
mals by injecting chloroform or ether in amounts
insufficient to produce anesthesia. The widely ac-
cepted theory of the important role played by the
nervous system in anaphylactic shock is thought to
be weakened by these observations. Since general
and local anesthetics possess to a marked degree
the property of reducing the surface tension of the
blood, and since this property is also known to be
the powerful factor preventing precipitation of col-
loids — and therefore precipitation of the blood—
the author is led to consider anaphylaxis simply as
a precipitation of the colloids of the blood. The
jirecipitate formed blocks the capillaries and thus
causes sudden and grave asphyxia. Widal's labors
have shown that many disorders are associated with
anaphylactic manifestations, e. g.. asthma, hemo-
globinuria, urticaria, the diathetic and dyscrasic
affections, eclampsia, and serum disease.
Diagnosis and Treatment of the Hemorrhagic
Diseases. — Ralph C. Larrabee ( I-ioston Medical and
Surgical Journal, August 5, 1920) says, concern-
ing the treatment of these disea.ses, that local appli-
cations are not satisfactory. The older ^astringents
and styptics, such as ferric chloride and alum, do
little but make a nasty mess. Epinephrine solu-
tions will often control slight bleeding from the
mucous membranes, but their action is quite fleet-
ing. Cephaline, coagulen, coagulose and other tis-
sue extracts are of somewhat greater value locally,
both in platelet cases and in hemophilia, but appear
to be ineffectual when used intramuscularly or in-
travenously, while the possibility of producing em-
boli would seem to make the intravenous use inad-
visable. Calcium salts are of value only where the
hemorrhagic tendency is the result of calcium de-
ficiency. In such cases, when an operation is con-
templated, calcium lactate should be given in large
doses by mouth for several days, and operation
should be deferred until coagulation time is nor-
mal. Fresh animal serum contains prothrombin,
which is absent in hemophilia and hemorrhagic dis-
ease of the newborn, but this disappears in a few
hours and old serum is worse than useless. ■ Fresh
serum does not contain platelets, so can be of no
value in hemorrhagic ]3urpura and other diseases
where the bleeding is due to platelet deficiency. The
value of diphtheria antitoxin rests wholly on em-
pirical grounds. Theoretically and experimentally
serum is of little value. The intravenous adminis-
tration of whole blood comes nearer to being a
universal panacea in this grotip of diseases than
any other procedure. It is the method of prefer-
ence except in chronic obstructive jaimdice, where
calcium is better. Either the citrate or the paraf-
fined tube method may be used. He prefers the
latter because the citrate method causes more reac-
tion and Buy Sildalis introduces fewer platelets. When facili-
ties for intravenous transfusion are lacking, rapid
intramuscular injection of small amounts of human
lilood may be used, preferably in tissues near the
bleeding area ; especially good results have been
reported in purpura hemorrhagica.
Proceedings of National and Local Societies
MKDICAL SOCIETY OF THE STATE OF
NEW YORK
One Hundred and Fourteenth An7iital Meeting,
Held in New York, March 23 to 25, 1920
The President, Dr. Claude C. Lytle, of Geneva, in the
• Chair.
{Continued from page 652)
The Role of the Colon Bacillus in Infections of
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