Page images

all our pure hypnotics and all our pure and cardiac enervation; concentrated food antipyretics have been known but a few of the most nourishing character, like fresh years, it is much to be doubted if we have beef juice, milk, brandy, etc., to support come to a knowledge within the last the constitution; digitailis to maintain the twenty-five years of a greater number of heart; oxygen by inhalation to relieve the potent curative medicinal agents than were breathing; morphine to produce sleep; iceknown before. It is natural and inevitable cap to the head to diminish restlessness; that the new drugs should figure more and strapping of the chest in case of great prominently than the old ones in periodi. pleuritic pain, are some of the agents cal literature. We would not have it other which will fill most of the remaining indiwise, for that would be a poor literateur cations."-- American Med. Review. that should keep on reiterating well-known facts. There is room for discrimination, Acetanilid in Surgery.-There is no however; it is hardly to be gainsaid that more widely felt want in the surgical occasionally a particular use of an old drug armamentarium than the desire to replace is in danger of being forgotten, and when iodoform with a dressing that shall give as that is the case a distinct service is ren good results and yet be free from odor. dered by whoever calls attention to it so For, after all that has been said against it, pointedly as Dr. Barrows has to the value and in spite of the laboratory demonstraof veratrum viride in combating so fatal tions of its worthlessness as an antiseptic, and frightful a disease as puerperal the profession will cling fondly to the eclampsia. Such a course sets those who vile-smelling yellow powder, for the very may have been forgetful or skeptical to good reason that its useis followed by such making new trials of the agent in question, excellent results that not even the demonsand may lead either to an undeniable con tration that it is an excellent culture firmation or to a wholesome refutation of medium for germs can shake the popular the convictions of our predecessors. It trust in it. Aristol, hydronapthol anii tends to certainty in therapeutics, which is other comparatively odorless powders have the grand aim of medicine. --- New York tried in vain to supplant it--the iodoform Medical Journal.

sprinkling box still forms an indispensable

part of the average surgeon's outfit. Local Application of Cold in Acute In the search the powders available for Pneumonia.-In the Times and Register antiseptic dressings the coal tar products of December 7, Dr. Thomas I. Mays, writes have come in for a trial, and the three leadas follows:

ing antipyretics, namely, phenacetin, anti"The therapeutic indications in the man pyrin and acetanilid, have been thoroughly agement of pneumonia are, therefore, as tested. The result has been decidedly in follows: (1) Suppression and limitation of favor of acetanilid, and this is fortunate, the process of exudation; (2) Support of particularly in the regard that this drug is the nervous system and particularly of the by far cheaper than the others of its class, pulmonary nerve supply; (3) Reduction of a matter of decided consequence, since a fever; and (4) Maintenance of the function powder for surgical dressings has to be of the heart.

used in considerable quantities. Some of “Now, what does cold play in filling the substitutes that have been offered for these indications? It cannot fill them all, iodoform have been barred from general but it covers those of greatest importance. use by the high price, while acetanilid is a First of all it reduces the pyrexia, strength- comparatively cheap drug, and so bulky ens the pulse, tones up the heart, dimin that a little of it by weight may be spread ishes the pain in the chest, alleviates diffi over a considerable surface. culty of breathing, and gives greater gen One of the most extensive trials of eral comfort to the patient.

It is capable, acetanilid as a surgical dressing was made however, of doing a great deal more. In at the Pennsylvania Hospital last year by virtue or its power to stimulate nerve func Dr. Thomas S. K. Morton, who has tions and to contract small blood vessels it reported the results obtained from its use promotes the pulmonary circulation, re in upwards of a thousand surgical cases. lieves stasis, hastens resolution, and dis Dr. Morton was led to try acetanilid from perses the products of exudation. Strych the published statements of Harrell and nine in large doses to sustain respiratory Bodamer of its remarkable power in pre

The gauze

venting the formation of pus. When For tuberculous lesions he thinks acetanilid applied to a granulating surface in full superior to iodoform, and packs tuberstrength it produces extreme dryness, a culous bone cavities with a ten per cent. blue color and the complete stoppage of gauze. Fistulæ also heal up well when the formation of pus. With this may come

washed with acentanilid in solution in a sensation of warmth of the part, followed alcohol or oil, and hemorrhoids and rectal hy a considerable degree of anæsthesia. fissures are much benefited by cocoa butter The powder combines with the wound suppositories containing three grains of the secretions to form an artificial scab, under drug. which, in favorable cases, healing pro Perhaps the best results of all were had gresses rapidly. It may also be used in by Morton from the application of acetanthe form of solutions, ointments or gauze, ilid to chancroids, which he found healed being soluble in five volumes of alcohol, surprisingly soon under a crust of the drug. twenty of ether and two hundred of water. He tried it in a large number of cases in It is also soluble in liquid petroleum to the the out-patient department of the hospital, extent of forty grains to the ounce, and and in only one case did he fail to get heal. this is a good way to use it where constitu ing in from one to seven days. The one tional effects are desired also.

case was of a phagadenic nature, and may be made according to the formula for required cauterization before it would making ten per cent. iodoform gauze, but heal. In fact, Morton's account is so is effective as a packing for wounds in enthusiastic as to cause some incredulity. much weaker form. For injection into the but it is to be hoped that it will nevertheurethra, into sinuses, pus cavities and less lead to an extensive trial of this agent, other situations, a good plan is to make an so that its exact value may be definitely alcoholic solution and precipitate the drug determined. — Northwestern Lancet. from it by adding water, which causes fine crystals to be thrown down.

A New Use for Thyroid Extract.-). A few cases of poisoning have been W. White (University Medical Magasine, recorded, but they followed the use of August), reports the following case. In large quantities of the acetanilid upon March, 1894, a young girl, who was dressextensive raw surfaces. For instance, ing in front of a mirror in a private carMorton tells of one case where he spread riage attached to a train, was thrown viotwo drachms of the powder over a large lently forward, her face striking the mirburn, and another where he packed an ror, which was broken into many pieces. excised hip in a child with ten per cent. A large crescentic wound of the soft parts acetanilid gauze. The symptoms produced of the right cheek was inflicted. The were the same as those that follow the wound was quickly cleansed and the edges ingestion of an overdose, namely, blueness brought carefully into position with interof the skin, small, slow pulse, cold, rupted sutures. Rapid union, entirely by clammy skin, rapid, shallow respirations first intention, followed, and the scar apin fact, the ordinary symptoms of collapse. peared satisfactory. In the following OcAlthough the poisonous cases caused con tober it had become greatly hypertrophied siderable alarm, none of them were fatal. and caused great disfigurement. AbsorbIt is probable that as much as a drachm of ent ointments, pressure by means of plasthe drug could be applied to a raw surface ter, and other means of local treatment without danger, but the possibility of having been tried to no purpose, she was poisoning should be borne in mind, and the (in January, 1895), put upon thyroid exsmallest possible quantity of the powder tract, from two to four tablets of a wellshould be used in all cases.

known preparation"--each tablet containAlmost every kind of wound does well ing 5 grains-being given daily. All local under a dressing of acetanilid, according treatment was discontinued, the scar being to Morton, and particularly satisfactory are only covered with a film of collodion to the results where the wounds are dirty or prevent abrasion or irritation and to keep greasy, as those made by accidents in the up gentle pressure. On several occasions street or by machinery, and also in cases marked elevation of temperature and where the wounds are ragged, sloughing quickening of pulse occurred, once to an and septic, many of these healing up under alarming extent, but in a few weeks a pera coating of acetanilid without drainage. ceptible change was noted, and at the end

In 71.31

of about six weeks the scar had in almost cachectic state, characterized by wasting, its entire extent come down to the level of a waxy tint to the skin, discoloration of the surrounding skin and the dense base the mucous membranes, puffiness of the had disappeared. White does not claim face, and some general edema. In a certhat this was a case of true keloid, but he tain proportion of the cases of edema there points out that the clinical distinction be is albuminuria, and in such cases uremia tween keloid growths and hypertrophied may develop with great rapidity. cicatrices is, after all, based on the size of Borax appears in the urine iu health half the growth and on its course than upon an hour after ingestion, and may continue any more definite differences.

He reports

to be excreted by the kidneys for weeks the case "for the sake of the suggestion to after the suspension of treatment. On the which it leads up of the trial of thyroid ex whole, Fere concludes that borax is more tract in other conditions involving the skin, efficacious than bromides in a small prointractable to operative surgery, and either portion of cases of epilepsy, and that, on the border line of malignancy, like therefore, it should be tried when the brokeloid, or definitely malignant."Times mides fail. It must be regarded, however, and Register.

as a dangerous remedy, owing to its power

of producing or aggravating lesions of the Borax in Epilepsy.-- Fere (Revue de kidneys even when given in small doses. ---Medicine, September, 1895), publishes the University Medical Magazine. results of the treatment of 122

cases of epilepsy by borax. The drug was given in Bromoform in Whooping-Cough. large doses--two grammes, gradually in H. B. Carpenter (Phil. Plyclin.) The creased to twenty grammes a day, and in author has treated a number of cases of some cases for many months.

pertusis with bromoform, and asserts that per cent of the cases the treatment was marked benefit was obtained in the majorwithout effect. In 19.67 per cent. the im- ity of the cases. provement was less than that derived from

He usually began the treatment with 2the use of bromides. In 9.01 per cent. of drop doses every four hours, with children the cases the improvement was marked, of two years, and increased if necessary. although the permanency of the good effect As bromoform is but slightly soluble in could not be stated on account of the short water, he administered it in a hydro-alcoduration of the observations.

holic solution, as follows: disadvantage of borax is the frequency Bromoform.

48 drops with which its continued use in large dose Alcohol


A. dr. is followed by toxic symptoms. The ear Distilled Water.

I A. 02. liest untoward symptoms are usually asso Syrup Tolu.... to make 3 fl. oz. ciated with the digestive tract, and con Teaspoonful, in water, every four hours, sists in nausea, vomiting, anorexia, and The disease, it is stated, was usually inheaviness and burning in the stomach. In fluenced in a very favorable manner, the some cases these symptoms may be dimin paroxysms being greatly reduced both in ished or removed by administering intesti frequency and in intensity. Dr. C. never nal antiseptics, or by giving the borax dis observed bad effects to follow the adminissolved in glycerin instead of water. Ex tration of small doses, and larger ones treme dryness of the skin with suppression rarely produce narcosis, As a rule, broof the fatty secretion, as well as dryness of moform stopped the vomiting within a few the mucous membranes, may also be pro hours; it often relieved children, who were duced by the large dose of borax required rapidly loosing ground on account of their in epilepsy. The hair also becomes dry, inability to retain sufficient food to nourish and sometimes falls out. Various skin them, to such an extent that they promptly eruptions may be induced by borax, nota regained strength. In a few instances it bly psoriasis and seborrheic eczema. Other checked the disease while in the full vigor less common affections of the skin are the of the paroxysmal stage. The duration of appearance of red plaques, which may be the treatment was usually from two to four confluent and very extensive, may resem weeks. ble the rash of measles or scarlet fever, Dr. C. recommends that the drug be not and may be followed by desquamation. stopped too soon, as a relapse might occur.

In some instances the borax produces a About 75 per cent. of his cases recovered

The great


within one to three weeks, and he thinks antiseptic. Under the former indications, the good effect is partly due to the drug act the acid is to be used in chronic inflammaing as a local anesthetic upon the pharyn tions of the stomach, in cancer of that go-laryngeal mucous membrane. --Massa organ, in pyrexias, in pulmonary tuberchusetts Medical Journal.

culosis and in a word in all those condi

tions which diminish the digestive power How Should Hydrochloric Acid of the gastric juice. Two strengths are be Employed in Diseases of the useful, two grams in 500 of water, and Stomach - Huchard (Journal des Prac three grams in 300 of water. The former ticiens, and Therap. Gazette, August 15, can be used in a wineglass dose at the end 1895), considers that this acid is capable of half an hour after meals, the latter a of exercising a double action upon the di- tablespoonful in half a glass of tepid water gestion: (1) an enpeptic action; (2) an at the end of a meal. The acid is conantiseptic action. As an enpeptic it should traindicated in round ulcer in dyspepsias be employed in hypochloric cases, in with hyperæsthesia and neuropathies. It chronic gastritis, in cancer of the stomach should not be used for more than three in pyrexias, in pulmonary tuberculosis; in weeks or a month, and then after omitting a word, in all cases in which the digestive for a fortnight, use again as before. power is diminished and the amount of As an antiseptic, this acid has given gastric juice is lessened. The following is good results in those cases of abnormal the method of administration:

fermentations with pyrosis, due to the R Acid. hydrochlorici..

m xv

formation of organic acids, in dilitation of Aq. dest. .... .f3 viij the stomach, etc.

When used antiseptiSig. A wineglassful toward the end of cally, the acid should be given outside of each meal and one-half hour after.

the periods of digestion, i.e., a few hours Or,

after meals.—Mass. Medical Journal. R Acid. hydrochlorici..

m xlv Aq. dest. ....

.fz ixss

Aconite in Children's Diseases. M. Sig.--A tablespoonfulin half a glass of Prof. Comby, on account of the depressive warm or cold water at the end of each meal. effect of aconite, recommends it (Laniel)

The contra-indications to the employ- in all spasmodic states, as asthma, the ment of this drug are all forms of hyper- asthmatic attacks of enlargement of the chloride acidity, in ulcer (round) of the bronchial glands, in whooping-cough and stomach, in dyspepsias accompanied by similar states, in stridulous laryngitis, palhyperæsthesia. The treatment should not pitation of the heart and convulsions. It be continued for more than three weeks or is contraindicated in all states of prostraa month, to be continued, if necessary, tion where respiration is impeded and the after a remission of fifteen days. As an heart is about to weaken; therefore, one antiseptic it has produced good results, in should not prescribe it in capillary bronwhich fermentation has been produced chitis, in broncho-pneumonia, pneumonia, with pyrosis due to the formation of organic in valvular 'heart affections, in pericarditis acids, in dilation of the stomach, etc. and in the collapse of severe forms of inIt should be given in these cases two or fectious diseases. The alcoholic tincture three hours after the meal. ----College Ev of the root is especially to be used. In Clinical Record.

adults one may employ aconite, yet it is an

alkaloid which must be given with great How

to Prescribe Hydrochloric circumspection, administering it in doses Acid in Affections of the Stomach.-. of a tenth of a miligram, at regular interThe Journal des Practiciens contains an vals. It should not be used in children's able thesis on the above topic. The author diseases. The tincture of the root is to be recalls, that the introduction of acids in given by the drops and never by the gram, the treatment of stomach affections is by and at regular intervals. In a child of two

means new, since their employment years one may give from five to ten drops; was suggested even by Haller and Syden one of five years, twenty drops in twentyham, though Rousseau was the first to four hours, while up to ten years thirty bring out the scientific use of chlorhydic drops is a proper dose. No great benefit acid. This acid, according to the present is to be expected from small doses. --Mediauthor, has two actions-enpeptic and cal and Surgical Reporter.


Strontium Salts in the Treatment will recover, if treated by prolonged rest. of Albuminuria.—The Journal des prati Of twenty cases treated by the author durciens for January 4th contains an article on ing the last four years by rest and immothis subject in which the writer remarks bilization, nineteen are either quite cured that strontium salts induce a notable and or on their way to complete cure, one only often rapid diminution of albumin in the having died in consequence of the rupture urine. They are, besides, indirectly use of a large psoas abscess into the bladder. ful in aiding digestion, especially in cases Operative treatment is contra-indicated in of Bright's disease where the patients Pott's disease by the seat and the extent of suffer from an excess of hydrochloric acid the lesions, by the nature of the tuberin the stomach. Strontium lactate is a culous process, and by all the risk attendgood intestinal antiseptic.

ing surgical interference. It has been According to Coustantin Paul, says the stated that in fifty per cent. of the recorded writer, strontium is useful only in the cases thus treated, death has been due parenchymatous form of nephritis. It has directly to the operation, and there is no action whatever in the interstitial forms, reason to believe that the mortality really in tuberculosis, or in renal syphilis. amounts to between sixty and eighty per Gaucher and Gallois observed that stron cent. The author concludes that the tium acted more readily on albuminuria operative treatment, which is so fatal or than on the various other symptoms of useless in a large majority of cases, does Bright's disease. When the employment not afford in the few successful cases betof the drug was suspended the amount of ter results than those obtained by strictly albumin increased until it reached its orthopedic treatment.University Medical original proportion. It appears, then, Magazine. says the writer, that, in cases of excessive albuminuria, where it is well to modetate

Skin-Graft Incision

to Prevent the loss of albuminoids, strontium is

Sears: The author advises making an especially indicated. Gaucher and Gallois

incision obliquely to the surface with a recommend the following formula:

razor or a scalpel, so that one border of the Strontium lactate...

750 grains.

wound forms a broad strip like a Thiersch's Water ....

II 75 ounces.

curve before the incision is carried down as It is essential that the drug should be

deeply as necessary. In uniting the pure and free from barium oxide.-N. Y.

wound, the graft is carefully spread over Medical Journal.

the surface from which it was taken.

Small incisions are sealed without suture Diuretic Action of Lithium Salts.

with collodium, or treated in the usual way Mendelsohn (Deut. med. Wochenschr.).

of skin-grafting. In large incisions, deep The author has found, as the result of an

catgut sutures may be employed to close experimental investigation, which was con

the wound, the graft being then inserted, firmed by clinical observation, that while

over that and treated as before. Beck, in all of the lithium salts possess diuretic

Journal American Medical Association. properties, the most active in this respect is the citrate, which has the further advantages of great solubility and comparative The Pharmaceutical Journal states that freedom from disagreeable taste.

in England a patient, under medical adThe acetate was found to be second in vice, had for some time been taking tablets activity.

of salol, when intestinal obstruction was The opinion is expressed that chemical set up and an operation became necessary. solvents of uric acid are not of necessity “On opening the body the intestine was useful agents in the treatment of gout or found packed with the salol tablets unalthe uric-acid diathesis. Massachusetts tered. This was probably due to the presMedical Journal.

sure used in forming the tablets. The

finely comminuted and loosely The Operative Treatment of Spinal packed an insoluble or difficulty soluble Caries.--Dr. Calot holds that in the press remedy, the easier it is absorbed by the ent state of science it is unjustifiable to system, and consequently substances like operate in cases of paralysis due to Pott's salol should never be given in tablet disease of the spine, as most of these cases form."


« PreviousContinue »