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He states that he is thoroughly satisfied same time less toxic, such as the aromatic that it does not proJuce bad habits, even compounds, the naphthols, etc. in highly sensitive narcotics, and that it As evidence of the efficacy of intestinal acts with little energy upon the digestive antisepsis, Bouchard and others refer to tract and the heart. As a somnifacient, the deodorization of the stools in patients he says, morphine has been nearly driven who had taken stated doses of bismuth salout of use by the products of the modern icylate, naphthol beta, and other remedies chemist, and it should be discarded also in of the same class given to disinfect the aliother fields. As a cardiac stimulant, mor mentary canal, also to the lowering of the phine acts quickly and energetically, but maximum of toxicity of the intestinal conthe after-depression which always comes tents and the diminution of the toxicity of after its use may be avoided by using the urine. Bardet affirms that these are strychnine, nitroglycerin, caffeine, digit not sufficient proofs of intestinal antisepsis. alis, or even atrophin, in the proper dose. The deodorization of the fecal matters is To use opium or morphine for a condition not necessarily an indication of antifermenof nervous excitation and exalted reflexes tative action, nor is the fetid odor of the is, in many cases, like stunning a refrac feces a sure sign of the existence of putrid tory patient with a club. Valerian, hyo fermentation being almost peculiar to scyamus, and the bromides will generally biliary retention. The deodorization of give better therapeutic results of greater the feces is quite relative, and due simply permanence, and with less risk.
to the fact that the aromatic substances, It is in those diseases of the digestive themselves odorous, mask the odor of the tract which are commonest in summer, feces. The proof of this is that the says Dr. Barr, that opium is the medium aromatic compounds are powerless to atof the most harm. Close observatiou, he tenuate the special odor of fecal matters says, must drive the physician to the con which have undergone the putrid fermenclusion that very rarely indeed is opium tation, and that, moreover, this deodorizaindicated in the treatment of diarrhæa. tion cannot be obtained by powerful antiThis affection usually needs some drug septics not of the aromatic series, such as which increases the excretory functions,
the salts of mercury. and thus drives out of the body something Backiewicz says that he has observed a which, by its presence, is producing the very notable diminution of the microAux from the bowel. Opium temporarily organisms of the intestine as a result of relieves the chief symptom at once, and intestinal antisepsis; Bouchard has said when its influence has subsided and the the same thing. Bardet affirms that these disease still persists, the condition is called researches do not agree with his own. The a relapse or a new attack.
sowing on glass plates or in test-tubes of It is certainly true, says the author, that fecal matters, previously much diluted, opium has a real value therapeutically in taken from four patients before and after certain inflammations, in great pain, in rare the prolonged administration of doses of forms of diarrhæa, as a splint for the intes benzo-napthol amounting to four grammes tines, and in some other directions.-N.Y. a day, has always resulted in an equal Medical Journal.
number of microbian colonies in all the samples; certainly the sowing was as fruit
ful after as before the administration of On Antisepsis of the Gastro-Intes the antiseptics. tinal Canal.- Bardet, long associated The urinary toxicity cannot itself enable with the late Dujardin-Beumetz in experi us to gauge with certainty the role of inmental therapetics, has, in a recent com testinal antisepsis, for this toxicity does munication to the Société de Théreutique, not result from intestinal fermentations combated the doctrines of that writer and alone, but also from the waste of cells in of Bouchard relative to the benefits of all parts of the organism. medicinal antisepsis of the digestive tube. Bardet says that his observations and
Among the antiseptics most in use, the his experiments lead him to think that the most active have been set aside as being local or general antisepsis of the gastrodangerous. Thus the salts of mercury, intestinal tract by means of medicaments with the exception of calomel, have given of the aromatic series (benzo-napthol, place to substances less active, but at the naphthol, naphthalin, salol) is in reality
impossible. These substances do not rather limited in extent. The drug is necessarily break up in the alimentary regarded as a serviceable heart tonic and canal, but they may accumulate or be elim a diuretic, and also as efficacious in the inated without undergoing any decomposi relief of certain forms of migraine, but tion. Their diffusion through the intesti this is about the limit of its application. nal tract may be very limited, and there According to Dr. E. M. Skerritt, however are cases where their absorption is nil. (The Practitioner, Vol. liv., No. 4), caffeine
It is true that favorable results have is possessed of considerable virtue in been reported from intestinal antisepsis in respiratory affections, especially in those typhoid fever. Dr. Bardet alludes to these where the element of spasm is prominent. facts, and says that their explanation may It is in asthma especially that Dr. Skerritt not yet be possible. It may be said, how has obtained good results with caffeine, ever, that we do not know all the circum and he believes that the drug is deserving stances that bring about restoration in any of much wider recognition than it has hithgiven case of typhoid fever and it is quite erto obtained in the management of this possible to attribute amelioration to the intractable and erratic complaint. Sucwrong causes. Moreover, excellent clini.
cess does not always attend its use, he cians, in private practice and in hospitals, says, but its failures are perhaps fewer have made rigorous trial of the antiseptic than those of any other remedy; and he method of treatment in typhoid fever, and has often remarked that when drug after have been disappointed; the results have drug and specific after specific have proved not been better than by other methods of unavailing, caffeine has afforded relief. treatment,
The action of the remedy in any individBardet also affirms that gastro-intestinal ual case cannot be predicated, although antisepsis cannot yet be considered a mat as a rule the writer found more certain ter of choice in the treatment of dyspepsias, effects in adults than in children. The and the value attributed thereto is rather a results were more uniform also in those matter of theory than of actual scientific cases in which there were no evident demonstration.
sources of peripheral irritation, such as It is worthy of mention in this connec dyspepsia or nasal polypi. The drug was tion that Dr. P. Dignat, in a late number given in five-grain doses, repeated every of the Journal de Medecine de Paris, in a four hours during the paroxysm until relief timely article, writes of the dangers which was afforded, and then at longer intervals. may possibly accrue from the internal ad But it is not in asthma that the writer ministration of antiseptic remedies. He above mentioned has observed good effects describes in detail two cases in which the from the administration of caffeine, for ingestion, respectively, of salol and guaia they are exerted, he says, in any morbid col,in comparatively feeble doses, produced condition in which muscular contraction a series of outward symptoms.
After a of the bronchial tubes is a factor, and they careful observation and study, these symp are proportionate to the amount of such toms could only be ascribed to the action spasm which is present in any given case. of the remedies alluded to. He believes Thus, in acute bronchitis, when the existthat antiseptic internal medication renders ence of dry rales points to a narrowing of some service but insists that the fact that the tubes from contraction of the muscular such medication is apt to do more harm fibres in their walls, as well as to inflamthan good in many instances should not be matory swelling of the lining membrane, lost sight of in modern therapeutics. Un caffeine will tend to cause relaxation of prejudiced experience will lead most thera the spasm, and consequently relieve dyspeutists, we believe, to regard this as a pnæa in so far as it is due to this element, judicious sentiment. -Boston Medical and but there will be no change in the physical Surgical Journal.
signs indicating tumefaction of the mucous
membrane or the presence of secretion in Bull, et mem. Soc. de Ther., November 27, 1895.
the bronchial tubes. There is often an
element of true spasm in chronic bronCaffeine in Diseases of the Respira chitis and emphysema; and upon this, Dr. tory Organs. - Although esteemed by Skerritt says, caffeine will be found to some as of great value in certain cases, the exercise a beneficial influence, allowing employment of caffeine has always been greater freedom in the passage of air, thus
relieving the dyspnæ and adding much to feet became cyanotic in color. Death took the comfort of the patient.
place, and the post-mortem exanination Caffeine has occasionally been found of confirmed the diagnosis of specticemia, service in acute respiratory affections where together with universal methemoglobinuria. heart failure threatens, as in pneumonia Spleen and liver presented pronounced and capillary bronchitis; and has been brownish discoloration. The kidneys were especially praised by various observers of enlarged and discolored and the seat of the treatment of the former disease. It is hemorrhage. The lower lobe of each lung also well spoken of in telectatic and was pneumonic. The gastric mucous memhypostatic conditions of the lung. "It is brane close to the pylorus was the seat of obvious that its action as a heart tonic, as an irregular ulcer.- Medical Neros. well as a relaxer of bronchial
spasm makes it doubly useful in many morbid conditions
The Importance of Precision in the of the respiratory organs; and it undoubt Technic of Hydrotherapy.-In another edly gains additional value by its influence column we present an abstract of the imas a general stimulant to nerve centres portant paper read by Dr. S. Baruch, of in cerebrum, in cord, and in medulla.” New York, before the Philadelphia County New York Medical Record.
Medical Society. The subject is one of
great interest to every practical physician. Fatal Poisoning with Phenacetin. Almost from time immemorial water has -Kronig (Berliner klinische Ilochenschrift, been used as a therapeutic agent, both inNo. 46, p. 998), has reported the case of a ternally and externally; but, unfortunately, boy, seventeen years old, who looked ill its systematic and scientific use has in and depressed, and complained of pain, re modern times been confined to a few phyferred to the occiput and also to the right sicians, the majority having allowed hydrohypochondrium. The face and body pre therapy, like electrotherapy and pneumosented a dirty-yellow or ashy-gray color; therapy, either to be altogether neglected the conjunctivæ were also yellowish, and or to fall into the hands of charlatans. One the lips were cyanotic. The temperature obstacle to the penetration of knowledge was slightly elevated and pulse and res hydrotherapeutic methods among piration accelerated. The liver was a lit English speaking and English-reading tle enlarged and of increased consistency: physicians has been the lack of a compenthe spleen considerably enlarged and of dious exposition of the technic, the indicanormal consistency. There was a purulent tions, and the power of the various prodischarge from the right ear, with perfora cedures brought under this head. Dr. tion of the tympanic membrane. A diag. Baruch has done much, and others have nosis of septicemia of undetermined origin done something toward remedying this had been made, but the peculiar aspect of state of affairs. Not the least in merit of the patient suggested some form of intoxi recent contributions upon this subject is cation attended with blood-destruction. the one which has given title to this article. Examination of the blood disclosed, in ad The thought embodied in that title is really dition to an increased number of white the keynote of the situation. “A hot bath," corpuscles (mononuclear equally with “a cold bath," "a shower bath,” “a polynuclear), destructive changes in the douche,"etc., are indefinite and unscientific red cells-a true erythrolysis.
terms, and convey no adequate idea of the further inquiry it was now learned that the procedure intended. “Immersion of the patient had received for the relief of oc patient for ten minutes in water at a temcipital pain five powders of phenacetin of perature of 65 F., with friction to the 15 grains each, of which he was to take one surface of the body," is definite statement; during the attack, but not more than two “a shower for two minutes with water at in twenty-four hours. After taking the 90 F., and a pressure of thirty pounds to fifth powder, at the end of three weeks, the the square inch," is also a definite statepatient was seized with vomiting, and a ment; but to be made “precise” requires bluish-gray color of the face and lips was specification of the size of the shower-plate, observed. The bowels became loose and the number and caliber of the openings, the urine assumed the color of chocolate. and the height from which the shower falls. Finally the skin generally presented a yel Whatever may be the temperature, the lowish hue, while the lips, ears, hands and pressure, and duration desired should be
specified equally with exact description of "shock" of cold water peripherally applied the form of application. Indeed it some is a stimulant to the heart's action, and times becomes necessary to specify the that the dread of "a weak heart" should no form of application in even more precise longer be permitted to deprive patients of terms than immersion, or douche, this powerful aid toward recovery. shower, and the like. It is true that Yet, the main object of the paper must among those familiar with the subject, once more be repeated. It is not so much certain technical terms conveying definite that cold water is a good application in ideas are in use; but patients are not cases of typhoid fever and pneumonia, or familiar with these terms, and one must that hot water properly applied will benefit frequently describe the intended procedure cases of neurasthenia or tuberculosis, but in a paragraph, rather than in a term, a that whatever application be resorted to, phrase, or a sentence. Applied with pre its method be precise, and that a definite cision for the effectuation of definite ends, physiologic result be held in view. In this as one uses the electric current or the agents way one is able to learn whether or not the of materia medica, water is capable of application which he is making is the best doing great service in the treatment of both for the particular case under treatment, acute and chronic diseases. Its ready and is able then to intelligently modify and availability, its capability of wide variation combine hydrotherapeutic procedures as he in temperature and pressure, as well as in modifies and combines the methods of elecmode of application, and the nicety with tric, pneumatic or drug treatment. — Phila. which its physiologic effects can sometimes Polyclinic. be regulated, render it a potent instrument in the hands of one whose aim in the treat Antipyrine and Tannic Acid as a ment of disease is to aid nature, favoring Styptic.—The following is from an artithe natural processes of recovery, and cle by Dr. Roswell Park, of Buffalo, which minimizing the danger attendant upon the appears in the Medical News for November complete evolution of pathologic processes. 16th: “In the Medical News of December The most common mistake among Ameri 15 and 22, 1894, I rehearsed some of my can physicians to-day is to think that hydro experiences with antipyrine as a styptic in therapeutic measures are restricted to the surgical practice, stating that I had for use of cold water; on the centrary, water at years used a five per cent. solution as a all temperatures has usefulness, and almost spray, sterilizing the water before making each degree of temperature has its own field the solution. This I had no hesitation in of application; not even with cold water is spraying upon any surface, peritoneal, the sole therapeutic indication the reduction cerebral, or other, from which parenchymaof temperature. We have at last learned tous oozing was taking place to an extent to regard fever as a natural effort toward complicating the operation or jeopardizing recovery and to avoid undue interference the success of an ideal dressing. This with it. Even in typhoid fever, in which therapeutic note attracted at least sufficient the method of cold bathing, as taught by attention to lead to its pretty general use Brand, has recently won such universal by surgeons in various parts of the country, recognition among teachers in this country, from many of whom I have heard comthe object of the bathing is not to reduce mendatory remarks, and from none of temperature, but to stimulate the nervous whom I have ever heard of disappointment system, and thus improve the circulation,
in its use.
The present note is to corthe respiration, the secretion, and the ex roborate the favorable esteem in which I cretion. The most significant fact, in this have long held this procedure, and to state connection, is the increased urotoxic coeffi that I have since resorted to it more widely cient in cases of enteric fever submitted to and more generally for styptic purposes. the Brand process, clearly pointing to the Thus, I have no hesitalion in using it in greatly increased elimination of poisons, the urethra, or even in the bladder, in which, under other forms of treatment, are cases of hæmaturia proceeding from either retained in the system, depressing the pa of .these locations. Even in the eye it tient, and often leading to delirium, coma may be used without fear, preceding its vigil, and death. Another point, clearly rise by that of a weak solution of cocaine, brought out by Dr. Baruch, in the discus through in this location the antipyrine sion upon his paper, is the fact that the solutions need not be made so strong. On
the other hand, it may be used in much use may be made to result in benefit and larger percentage when the five per cent. satisfaction. There is but one attendant solution fails to accomplish the purpose; difficulty, that it is so remarkably cohesive even when small vessels spurt, compres that when the time comes for detachment sion for a few moments with iodoform or separation of the tampon it is difficult gauze of acetanilid gauze sopped in this to remove it. It may be even necessary to solution will often be effective.
wait for sufficient time for the formation of “As every physician will realize, there granulations and separation by natural occur cases of bleeding—for instance, from
processes. the nasal cavity or from divided bone-in "I strongly commend to surgeons exwhich even these solutions will be ineffec perimentations with these solutions, and tive. My present object is to call atten their own determination as to the strength tion to the combination of antipyrine and in which it may be best to use them. tannic acid, in solution, by which there is N. Y. Medical Journal. precipitated an intensely agglutinative and cohesive substance, of to me unknown The Treatment of Puerperal Conchemical composition, which offers the vulsions with Veratrum Viride. — It most ideal styptic for certain purposes was an interesting and profitable discussion that I ever dreamed of. This combination that followed Dr. Charles Clifford BarI hit upon by accident, and first resorted rows' recent accounts of two cases of puerto in a case of apparently intractable peral convulsions in the treatment of which hæmorrhage from removal of adenoid tissue the use of veratrum viride had played an in the vault of the pharnyx, in which I was important part. It took place at a meetcalled in consultation by my colleague, ing of the Society of Alumni of Bellevue Dr. Hinkel. He happened to have at Hospital held on October 2d, and a report hand a bottle of alcoholic solution of tan of it is presented in this number of the nin, while I was provided with antipyrine Journal. Dr. Barrows properly laid stress in powder. The case being emergent, I upon the use of veratrum viride in the suggested the combination of the two treatment of puerperal convulsions-not styptics, and added the dry powder to the that he fancied it was new, but rather, we solution. To our surprise,
presume, that it seemed in danger of being formed at once
a gummy mass, at first forgotten, for, he says, except for its enflocculent, which quickly cohered, the thusiastic advocacy by the late Dr. Fordyce result being a combination the stickiness Barker, he had not noticed that it was genand adhesivenesss of which quite aston erally appreciated except in the Southern ished us.
A small sponge dipped into the States. The discussion shows at least that Auid containing this material in suspension the gentlemen who took part in it had not was inserted into the postnasal space, and ignored the title of the remedy to be ranked hæmorrhage instantly was checked, not high among the means of controlling the to again recur.
convulsive disorder under consideration. "I have since experimented with these Dr. Edgar's declaration that he did not materials, and have found that they may believe there was any drug, with the posbe united in almost any proportion sible exception of chloroform, that was of with the formation of the gummy mass, much value veratrum viride in and would suggest that the substances be eclampsia, coupled with Dr. Chandler's mixed in proportion to the emergency of testimony to its efficiency, goes far to show the case, and to the desire for little or that experienced obstetricians in general much of the resulting compound. It is are less forgetful of the virtues of veratrum possible by adding strong solutions, or than its comparative inconspicuousness in by pouring the powder of one into the current literature might lead one to supsolution of the other, to precipitate so pose was the case. It is very sure that an much of the agglutinative composition as overwhelming preponderance of our therato make a gum that they may be placed peutical resources does not reside in the about the margin of the bleeding bone novelties that have been introduced so profor instance, in operations upon the cran fusely within the last few years—perhaps ium; or a small piece of sponge or cotton no preponderance at all. Although, not sopped in this material may be forced into to mention the wholly novel medication to a tooth-socket, or in various other ways its which bacteriological study has given rise,