TUFFNELL'S METnon.—The best known method in this connection is that of Tuffnell, which, though usually em ployed for internal aneurisms, has also been advantageously used for aneurisms of the extremities.
The object of Tuffnell's treatment is to reduce the watery elements of the blood and to increase the solid elements.
The patient is kept in the recumbent position for at least three months; this causes the rate of pulsation to diminish greatly. In one case it fell in a few days from 96 to 66: a reduction of 30 beats a minute, 1S00 beats an hour, and 43,200 beats a day. No drug can cause such a diminution without danger to the patient. The recumbent position, according to Tuffnell, acts upon the cir culation in internal aneurism as does mechanical compression in external aneu rism. The food is diminished, amount ing to but 10 ounces of solid and 6 ounces of fluid in the twenty-four hours.
TuffneWs food consists of 2 ounces of bread and butter and 2 ounces of milk for breakfast; 2 or 3 ounces of meat and 3 or 4 ounces of milk or claret for dinner; 2 ounces of bread and 2 ounces of milk for supper.
Rest and restriction of liquids are the most important parts of the treatment.
Tuffnell published his first observa tions in 1S75. Of ten cases treated seven were cured and three died during the treatment. One ease of popliteal aneu rism made a recovery in twelve days.
To induce sleep lactucarium is recom mended, and, with the view of dimin ishing the liquid portion of the blood, the patient is purged from time to lime with compound powder of jalap.
Results of study of effect upon the blood of Tuffnell method of treatment, combined with calcium salts, in manage ment of two eases of aortic aneurism. Restriction of fluids caused decrease in elimination of calcium salts, while in crease of fluids caused marked increase in their elimination. Water should be given in abundance, if it is desired to saturate the body with calcium salts. Personal cases absorbed much more cal chilli while taking large quantities of water. Ingestion of calcium seemed to increase the quantity in the circulating blood. Specific gravity of blood was not distinctly affected by the treatment. The plasma-nitrogen, plasma-albumin, and the quantity of albumin in the plasma of 100 cubic centimetres of blood, were constant in the two cases, except at one estimation. The fibrin-nitrogen was not increased. The time of coagula tion was reduced in one case, but was not affected by the ingestion of calcium. In the other case the time varied, lint was not shortened on the average. Influence of the treatment upon the blood seemed, therefore, entirely negative, although both patients showed distinct improve ment in their physical signs. A. E. Tay lor (Jour. Exper. Med., May, '98).