MEDICINAL TREATMENT. — With the idea that aneurism is often due to syph ilis, iodide of potassium has been much employed; its probable action is that of depressing the heart.
The assertion that iodide of potassium has the power of lowering blood-pressure is contradicted by the sphygmomanom eter. Alexander James (Brit. Med. Jour., June 29, '95).
The cases reported in which iodide of potassium has been of benefit do not sustain the credit accorded that drug as a curative agent; still it ought to be tried in cases where there is even but a suspicion of syphilitic taint. Bristow (Brooklyn Ned. Jour., Oet., '95).
[It may further be said that the drug usually seems to promote the comfort of the patient: a factor of considerable im portance in the treatment of a chronic. incurable, and often distressing disease. WHITTIER and VICKERY, Assoc. Ed'.. Annual. '96.] In cases which have a history of syph ilis, iodide of potassium internally and mercury as an inunction recommended. For some weeks afterward the patient is kept in bed and fed chiefly with milk. Over the situation of the aneurism an ice-bag is applied several times a day for hours. The results of this treatment have. on the whole. been so favorable as to warrant the use of mercurial inunc tion in eases without a history of syph ilis. A rapid subsidence of dyspncea and bronchostenosis was obtained, the relief continuing sufficiently long, in some instances, to permit patients re suming their occupation. A. Fraenkel (Deutsche med. Woch., Feb. 4, '97).
Case of non-syphilitic aneurism in which 30 to 60 grains of iodide of potas sium per day, and an ice-bag applied to the tumor, caused the pulsation to di minish, and in five months the patient, a street-singer, was able to resume his occupation. Edouard (Revue de Mad., SNlay 10, '97).
The calcium salts have been recom mended.
Four cases of aneurism in which the amount of calcium salts passed in the urine was much greater than normal; may be useful as an aid to diagnosis. E. Reale (Rivista clinica e terapeutica, Naples, Nov., '91; Brit. Med. Jour., Mar. 26, '92).
Marked improvement from hydrated calcium chloride in doses of 1 drachm daily. Solomon Solis-Cohen (Philadel
phia Polyclinic, July 6, '95).
Acetate of lead has been used to "equalize the circulation," and bromide of potassium is frequently employed against the cough and pain.
Gallic acid, iron sulphate, barium chlo ride, digitalis, veratrum viride, and aco nite have been used, but the majority of clinicians do not look upon these agents with favor.
Coagulating Injections. have been utilized for aneurisms of the ex tremities. Tannin, lead acetate, Monsel's solution of iron, spermaceti (Dobell), and other drugs being used.
Cervical aneurisms should not be treated by these injections, lest an em bolus be carried to the brain.
To prevent emboli carried into the circulation the arteries above and be low the aneurism should be compressed both during the operation and for some time after it. In the opinion of 'Till mum], any treatment by injection is dan gerous.
Gelatin Injections.—Injections of liq uid gelatin have recently been advocated even in desperate cases.
Operative technique of injection of gelatin for treatment of aneurism is as follows: White gelatin in a quantity of from 1 drachm to drachms is dis solved in a 7-per-cent. solution of sodium chloride in measure 1 to 2 quarts. The solution is placed in a flask, which is sealed and then sterilized with its con tents at a temperature of 120° C. For the injection a flask of the capacity of 1 pint is got ready, fitted with a cork and two tubes like a wash-bottle. The long tube is connected with a sterilized needle and the short tube with an India-rubber air-ball. The gelatin is liquefied in a water-bath at a temperature of 95° F. and poured into the flask, which is also kept in a water-bath. The injection is made slowly into the subcutaneous tis sues of the buttock and should take fifteen minutes. It should be repeated every six or eight days until the sac is obliterated. This Method, if carried out with care, gives excellent results in the most desperate cases. Lancereaux (Paris Academy of Med.; Lancet, Nov. 19, '98).