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pendicitis, by Dr. L. J. D.\NDUR.\NT. of St. Joseph. Missouri ; and An Unusual Case of Dilated Capil- laries, by Dr. W'illiam Frick. of Kansas City, Missouri. PHILADELPHIA COUNTY MEDICAL SOCIETY. Mfefit'p of Wednesday. November 3^. iqto. The President. Dr. Hknry Leffmann, in the Chair. The Pathological Chemistry of Diabetes Mel- litus. — Dr. .A. G. : The paper presented was a nummary of the literature, the points re- viewed being that the hyperglycjemia and glycosuria of diabetes mellitus are due either to overproduc- tion of glucose by the liver or to an underconsump- tion by the tissues, the former possibly the chief of the two. This perversion of metabolism appeared to be due either to the failure of substance pro- duced normally by the pancreas, m.uscles, and pos- sibly other tissues, or to an affection of the central nervous system. The acidosis of diabetes was due to the abnormal metabolism of fats and possibly proteins as carried on in the absence of sufficient carbohydrates. Determination of acetonuria ap- peared to be the most satisfactory clinical method of estimating the degree iif acidosis. The Functions of the Stomach in Six Cases of Diabetes Mellitus. — Dr. John J. Gilbride: A study of the six cases formed the basis of this paper. A seventh was also studied, but sufficient gastric contents for a complete analysis were not obtained, as the patient refused further examina- tion. Of these seven cases, only one complained of indigestion, and she had marked gastroptosis. One case had catarrhal gastritis ; one catarrhal gastritis with dilatation of the stomach and intermittent gas- tric retention. Twenty-two test meals were given, and it was frequently found necessary to aspirate mermaid queen casino the stomach in thirty or even twenty minutes after an Ewald test breakfast, and in two and a half hours after a full dinner (dietetic) in order to ob- tain any contents. Pepsin digestion was tested by the Mett method, and found vigorous in one, re- duced m four, absent in one, and only a slight trace in one. Pepsin was absent on five examinations in one case and present on the sixth mermaid queen slots review analysis. It was also absent on two examinations in one other case, and a trace was present on three other examina- tions. The total acidity and free hydrochloric con- tents were each high in four. Free hydrochloric acid was absent in three. These cases confirm the finding that the motility of the stomach is usually increased, and the gastric secretion frequently di- minished in patients with diabetes mellitus. They also show that pepsin secretion is frequently re- duced, sometimes absent, and occasionally reap- pears intermittently. Two cases out of seven had a marked catarrhal gastritis, and did not com of stomach symptoms. The Cold Cautery. — mermaid queen online Dr. L. D. Frescoln said making profound impressions of cold, we had a rapid method in the use of carbondioxide snow what he called the "cold cautery." This was collected in chamois from an iron tank where the gas was held under pressure. With varying degrees of exposure and imder regulated amounts of pressure it caused hardening, bleaching, vesication (like extreme frost bite) and finally crusting and at times a plia- ble scar. This CO„ was used also in the freezing microtome by means of which we could diagnosti- cate or exclude malignancy from a specimen during operation. It mermaid queen slot machine had been used for local annesthesia instead of ethyl chloride. This paper, however, treated of the therapeutical snow, particularly in re- lation to dermatology-. It was used successfully in treating moles, nrevi. warts, senile keratosis, lupus erythematosus, lupus vulgaris, trachoma, and some forms of epithelioma of the skin. It was first used extensively bv Pusev. of Chicago, (see description in Journal of American Medical Association). It was to be applied from lO to 40 seconds, often w-ith April 15. i9>i] PROCEEDINGS OF SOCIETIES. considerable pressure. It was well for the operator to protect his own fingers during the application. We should not treat a large area at one sitting, particularly on the cellular tissue about the eye. The temperature of the solid stick was — 79° C. and this might be reduced by dipping in ether. He quoted ten recent cases cured or markedly improved under one or more treatments. Cases of keratosis senilis, thought by the patients to be malignant and lasting many years, had disappeared completely in from one to three treatments, and this sometime- when X rays had made little improvement. The proper cases should be chosen for this particular form of treatment or for this form combined with other suitable forms. He had not yet had much ex- perience with n3?vi and forms of lupus. It should be tried in the future on keloids. Its advantages are : cheapness (a large tank refilled costs two dol- lars, enough for, he supposed, fifty treatments) ; it was easy to control ; prompt in action. Portable tubes wei'e used for office practice. A summary of its action might be stated as (i) stimulating; (2) destructive; (3) immediately destructive. Further study was needed on this form of treatment to reach its possibilities. Dr. Henry Kennedy G.askii.l said they had had experience with the cold mermaid queen slots free cautery of fifty or sixty pa- tients in the past three years at the Jeff^erson Hos- pital with most gratifying results. Included in this series were cases of lupus erythematosus, pigmented moles, capillary nsevi, small epithelioma, and tattoo marks. In many cases of njevi, the electric needle was supplemented, for small areas left between ap- plications were difficult to treat otherwise. When the trouble was deeply seated, the exposures must be from one minute to one minute, twenty seconds, and they had found that if given in application of 20 seconds and two days afterward another appli- cation of 30 seconds the resulting scar would be less, though the pam was more. In small pigmented moles the electric needle was still preferable, as often the pigments would be disseminated in a ring- around the area. Dr. Stelwagon asked him to show the society a little apparatus which he had adopted, consisting of a small metal tube filled with carbon dioxide and a rubber tube with stop cock, originally intended to be sold mermaid queen games for the inflation of automobile tires. This tube was about 12 inches long, having a copper cap which had to be punctured to allow the escape of gas which was collected in a piece of kid firmly bound down with adhesive strips. The snow could be readily moulded by hand and with a knife cut in any desired size or could be pressed into an ear speculum. It was wise to measure the area to be treated in order that the surrounding skin might not be involved while the snow was melting under pressure. The larger tubes, used in drug stores, were unsightly as well as awkward to handle, and there was a slight amount of risk of their exploding. This little tube was neat, readily handled, and could be carried to the patient's house if desired. The initial cost was $2.50 for the entire apparatus and twenty cents for refilling each tube. Dr. A. B. lIiRSH wished to ask whether there was pain from the application of the snow. Dr. B. A. TnoMA.s said they had been using for two years, in the Surgical Dispensary of the Uni-

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