Of special theoretical and practical interest has been the treatment of traumatic conditions, especially those following surgical procedures. The recognition of the role of fatty acids acting at different levels of the organization and inducing several different manifestations, has led to the concomitant use of various agents proper to the levels. From the various agents studied, heptanol was thus chosen as acting at the cellular level, glycerol, polyunsaturated alcohols and alkaline amino acids and butanol at the tissular level, glycerophosphoric and organic acids at the systemic level.

The various preparations, obtained by combining or mixing these agents, were administered by intravenous infusions together with glucose and saline or glucose and sodium lactate, in the more severe cases, and intramuscularly or orally in the milder cases. The results obtained with these preparations in hundreds of subjects have been highly satisfactory.

The administration of n Butanol after prostatectomy markedly reduces pain

Fig. 298. The administration of n Butanol after prostatectomy markedly reduces pain. (J. Urol. 62: 629, 1949.).

Chapter 14, Note 5. Dr. B. Welt's Conclusions On Hearing

In his studies on hearing, Welt arrives at the following conclusions, communicated at the Brooklyn Eye and Ear Society.

"1) The ideas, methods and substances devised by Revici have been applied to the problem of impaired hearing, and have shown significant results in improving that function.

2) The study has confirmed the dualistic concept about pathological foci, namely that a pathological focus may exist in two states of metabolic imbalance, leading either to a local alkaline or acid change.

3) The substances utilized in this study have been effective in influencing the symptom of impaired hearing, and it is reasonable to believe that the pathological structure has also been influenced to some degree.

4) Revici's ideas of the fatty acid sterol imbalance have been confirmed by showing that other instances having similar biologic activities, act in the same manner. Their clinical application confirms this.

5) This study shows that both air conduction and bone conduction may be benefited. No method has been found to improve bone conduction up to the present time.

6) From the biochemical and chemotherapeutic point of view, this study indicates that the vestibular labyrinth and the cochlea should be viewed as one organ. Phylogenetic, histological, and this clinical study all tend to support this idea.

7) The study indicates that people up to 60 years of age may obtain normal audiometric hearing if treated early enough. Children and the younger age groups were those that had the highest incidence of good results.

8) Finally, this study has indicated a dual therapeutic attack on a hitherto insoluble problem. It can help us in this otologic problem at any age in life, the formative years, when hearing is vital to the education of the children.

9) It should not be construed or inferred, from this communication, that a cure for hearing is implied. The only conclusion to be drawn is that the author has beneficially influenced the impaired hearing function, or induced a remission for varying periods of time at an improved or normal functional level."

Chapter 14, Note 6. Butanol In Plastic Surgery

Following our indications. S. Sher has utilized butanol in post operative cases. One of the most disagreeable complications seen in plastic surgery of the nose is seventh day bleeding, which while usually not severe, has been known to endanger the lives of several patients. Use of antibiotics has reduced remarkably both incidence and severity of the hemorrhage. However, the prevention of seventh day bleeding has remained a problem for the plastic surgeon. S. Sher has applied our treatment with butanol in almost 2,000 cases. Immediately following surgery, 10 cc. of a 6.5% solution of butanol is injected intramuscularly, the injection being repeated every six hours for the first day. After 24 to 48 hours, the butanol is administered orally in doses of one tablespoonful every four to six hours, and this is continued until after the eighth day following the operation. With this treatment, no severe bleeding has been seen. In several cases when the patient failed to follow instructions and did not continue taking butanol, hemorrhage resulted. In two cases, bleeding was relatively severe, the hemorrhage was brought under control by the intravenous injection of 10 to 20 cc. of the butanol solution. Administration of butanol afterward prevented subsequent bleeding. The value of butanol as a preventive of seventh day hemorrhage thus has been confirmed. (189)