A historical survey of Dextran is given. Requirements of a satisfactory plasma volume expander are stated. The basic physiology and comparison of various substitutes already used, are discussed. The manufacture of Dextran and its essential chemistry is descriptionbed. Comparison is made with plasma and possible electrolyte disturbances are noted. The clinical uses and important effects in restoring adequate circulating plasma volume, increasing venous return and blood pressure, reduction of oedema, and alleviation of pregnancy oedemas are mentioned.
A case of cervical rib is descriptionbed in which all the 3 main groups of symptoms associated with this condition were shown, viz., sensory, motor and vascular. The rib was unusual in that it was complete, and had 2 articulations- one with the 7th cervical vertebra and the other with a projection of bone coming up from the first rib. Following removal of the rib, there was a marked relief of symptoms. A brief review is given of the various theories about the symptoms associated with cervical ribs. Although the sensory and motor changes are undoubtedly due to pressure effects on the brachial plexus as it is nipped between the clavicle and the rib, there is still speculation whether the vascular changes are due to pressure on the sympathetic fibres which run in the lowest trunk of the plexus, or to pressure on the subclavian artery itself.