GENITO-URINARY DISEASES.—In dis orders of the urethra and vulva supra renal extract. has recently been found of considerable value. Its effects are sim ilar to those produced upon the tissues of the upper respiratory tract. A 1 to 10,000 solution was also found by Fritsch greatly to facilitate cystoscopy and op erative procedures in the bladder.
In chronic urethritis involving the glands and follicles in the anterior urethra the extract of suprarenal gland is of marked therapeutic value. It acts not as an astringent, but as a direct stimulant to the muscular coats of the blood-vessels. Absorption of embryonic tissue is thus brought about, and im provement of the general tone takes place. Three cases are reported in which chronic urethritis was cured by the use of a solution containing the extract. In one case of chronic posterior urethritis local applications through the endo scopic tube of a 10-per-cent. solution, daily are said to have practically cured the disease after fifteen days of this treatment. In the ordinary cases of chronic anterior urethritis the remedy was applied by means of a hand-syringe. Eaton (Occid. Med. Times. March, 1902).
Adrenalin is indicated in cases of mucous or muco-purulent discharge; when the urine shows mucus or flat, scaly shreds and mucous shreds; when endoscopical examination shows gran ular patches or superficial scleroses: when pus-cells, epithelium, mucous gon ococci. or other micro-organisms are present. Series of cases of urethritis which had resisted other drugs. and which were, with few exceptions, bene fited by instillations of adrenalin chlo ride, 1 to 1000. The field of usefulness of this drug in urethral work is limited to the same indications as for mucous membranes in other localities. It is painless to apply. and causes a cessa tion of secretion by contraction of the blood-vessels for a varying time. It will only act, however, on superficial lesions, and will hear watching for untoward action. S. E. thins (Phila. Med. Jour., Dee. 13, 19021.
In two cases of pudendal irritation.
attended with marked prnritus. supra renal extract gave marked relief. In the one, a young woman 1S years of -26 age, violent itching of the vulva and aims had come on ten days before. Not withstanding usual methods of treat ment, there was no relief, and in the meantime the condition had become so severe that she was unable to leave the house. A local examination showed an intensely congested condition of the vulva and the lower part of the vagina, with increased secretion. A strong solu tion of suprarenal extract was applied to the part, which was followed by a rapid blanching of the mucous mem brane. Momentarily the itching was in creased, and then gave way to a slight burning sensation, which passed off in a few minutes. The effect of this appli cation lasted for fourteen hours, when the itching recurred. A second applica tion cured the case. F. S. Meara (Merck's Archives, May, 190-2).
Pituitary Extract.
Lesions of the pituitary body having been found in almost all autopsies in cases of acromegaly, a close connection between this organ and the symptoms of the disease could but be inferred; it also suggested the use of the gland as a remedial agent soon after the animal extracts entered the field of therapeutics.
Physiological Action.—Although Mairet and Bose found that triturated or macerated gland was practically inert in man as well as animals, producing rise of temperature and emaciation, Schafer and Oliver found, to the contrary, that it was quite active, affecting mainly the arterioles and heart-muscle. It is thought to bear some undetermined relation to the nutrition of bone or dermal tissues.
Rapid and great rise of blood-pressure observed, bearing directly upon the arterioles and probably upon the heart muscles. The pituitary body furnishes a secretion to the blood which serves to increase the contractile power of the heart and arteries and to influence the nutrition of certain tissues. Schafer and Oliver (Jour. of Phys., p. 277, '95).