MEDICAL EXCERPT.

BYT. P. CORBALLY, A. M., M. D.

CHRONIC RHINITIS.-Dr. L. Pelaez recently presented an elaborate communication to the Oto-Rhinological Congress, on chronic rhinitis and the erectile tissue of the nasal mucous membrane, from which "El Siglo Medico," 17th January, gives the following conclusions:

I. There are cases of rhinitis that are caused exclusively by disturbance of the genital organs.

2. Such cases may have their origin in a disease of the sexual organs acquired before or after birth: in the former case, it depends always on some histo-organic anomaly; while in the second case. may be traced to a great variety of causes.

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3. The most frequent anomalies of the genital organs, such as give rise to chronic rhinitis, favored by occasional well determined causes, are what may be called macro-erectilia and micro-erectilia of the organs of copulation, which coincide respectively, according to the author's observations, with the macro-erectile and the micro-erectile, mucous tissues of the nose.

4. There are, probably, reflex centers of the naso-erectile tissues of the bulbar or bulbo-protuberant, the erectile conductive, the 'bulbo-medullary and the medulo-bulbar.

5. The existence of the naso-erectile tissue is in accordance with genesic use which relates to the sense of smell in some animals.

6. Cases of scrofulous rhinitis are very frequent; this frequency depends on the histological constitution of the nasal mucous in lymphatic subjects and in those of a scrofulous constitution.

7. Pre-vertebral, intraparotid and peri-hyoideal cases always depend on scrofulous rhinitis.

8. Independently of the special observations of the oto-rhinolaryngologist, it ought to be the special care of every general practitioner of medicine to employ rhinoscopy in all chronic diseases of the digestive tube, of the respiratory organs and also in all the neuropathic affections, especially if facial evidences of probable degeneration are present.

9. In hypertropic rhinitis of genital organs, the first indication is to institute adequate treatment and regimen for the disease of the sexual organs and the regulation of their functions.

10. If, notwithstanding this treatment, and appropriate regimen, the chronic rhinitis persists, and is hypertropic in character, do not hesitate to practice in the region supplied with naso-erectile tissue, active galvano-cautery and all the different operations on the nose that may be considered necessary.

II. Extensive operations on the organs of generation may be necessary as a means of removing atropic rhinitis that accompanies intractable, progressive disease with macro-erectile conditions of the organs of generation.

12. Such operations may be performed on monkeys.

13. The aim of the rhinologist, however, ought to be to substitute, for castration, the removal of the thyroid gland if indicated, or some other less serious operation.

14. In order to obtain this result it is absolutely necessary to study the anatomo-physiological, and evolutional relations that exist between the thyroid body and the genital organs, or to make a more profound and pathogenic study of rhinitis.

15. The genito-thyroidal and naso-genital relations may be studied in many of the mammiferous animals.

16. Scrofulous rhinitis, accompanied or not with adenapathic conditions, require almost exclusively a proper general therapeutic treatment, and mild local antiseptic remedies.

17. The anatomist has a vast field for study in the polyclinic, and the clinical student must refer constantly to organology, to hystology, to embryology, to tetratology, and experiment to insure his diagnosis, or be exact in his prognosis, and to improve hygienic and therapeutic methods.

Much of the matter, here too briefly described, has been observed, but the extensive relations of the different organs was not so fully analyzed. Deafness, myopia, and skin diseases are often dependent on rhinitis.

THE CHOLERA MICROBE.-The "Anales del Departamento Nacional de Hygiene," Dirigidos porla Oficina Sanitaria Argentina, December, 1896, publishes the following curious observations from a letter of Hankin to the Institute Pasteur, Paris: "I hope to send you soon a summary of my discoveries regarding the property that the water of some rivers of India, as the Jumma and the Ganges, have of destroying the microbe of cholera. This action as a bactericide, seems to me to be produced by certain volatile acids. This discovery is of special interest because it explains why, in India, cholera is never propagated in the valley of the Ganges in the direc

tion of the current of the river, but always comes to us from Bengal. Frequently the bodies of people who have died of cholera are thrown into the rivers, and, as hitherto, no case of contagion has been known to be spread in this way, not even among the people who drink the water of the rivers; the physicians of India. are not willing to admit that cholera has its origin in the water.

"I have discovered, however, that the microbe of cholera multiplies with great activity in the water of the wells in that district. There are only a few rivers that seem to have the wonderful power of purifying themselves. I will cite, as an example, the observations made regarding the water of the river Jumma, which flows by and quite near to Agra. This is a city of 160,000 inhabitants, and all the sewers of the city are emptied into the Jumma. The contamination with bacteria which is thus produced disappears in less than twelve and a half miles below the city; the number of bacteria in the cubic centimeter, which is from 700 to 830 above the city, increases to 16,000 and to 21,000 as it passes before the inhabited parts and is again reduced to 6,200, 5,600, 4,200 in the three or four miles below; 500 or 600 at a distance of five or six miles, and 120 miles further down there is only 125 to 130; a number equal to that found at Dhobus Ghat, five or six miles above Agra. In regard to the cholera bacillus, the water has the same influence as a bactericide, whether taken above or below the city; in the immediate surroundings of a cadaver that has been thrown into the stream, or around a cadaver that has remained a long time in the water, there is no contagion. The water of the Jumma, boiled, like the water of the wells, favors the multiplication of the microbes. Other experiments of a similar kind have given the same results, and cultures in peptones have demonstrated that all the cholera microbes perish really in the water of the Jumma."

RADIOGRAPHY AND RHEUMATISM.-M. Fournier presented to the Academie de Medecine various specimens showing the results of radiography; Gazette Hebdomadaire, 24th January: 1. A fracture of the femur; 2. Fracture of the neck of the femur; 3. The articulations of the hand in chronic gout; 4. Syphilitic Periostitis. The discovery of Rontgen is now found extremely useful in a series of interesting applications.

As a means of diagnosis, it is most useful in affording the possibility of discovering the nature of deep-seated lesions of the bones, of tumors, diseases of the viscera. It also assists in determining their various conditions in the deep cavities of the human body.

We have already shown the resources afforded by radiography in the diagnosis of tuberculosis, pleurisy, of cysts, cancerous tumors, etc. Now we can announce that there is a possibility of making a differential diagnosis between gout and rheumatism.

M. Potain and one of his pupils, M. Serbanesco, have photographed, by means of the X rays, the hands and the feet of gouty subjects, and they have found, at the extremities of the bones that have been deformed, the existence of clear, distinct spots, indicating that the bone at this point has been more permeable to the invisible rays; while at the periphery of the stains there existed a thin, dark border, accompanied with a greater degree of opacity.

On the other hand, in the bones of healthy persons, or of those affected with chronic articular rheumatism, nothing similar is found. It seems, then, that the examination, by means of the radiographic rays, can, in such cases, aid in the differential diagnosis, sometimes so difficult in cases of gout and rheumatism. And, in fact, in cases of lead poisoning, in which deformative polyarthritis is found, supposed at first to be rheumatism, MM. Potain and Serbanesco have observed clear spots, a fact that has enabled them to change the original diagnosis.

This increased permeability of the bones of the epiphyses, seems to be attributable to the presence of deposits of urates of soda. The authors have also found, by direct experiment, that this salt is eight times more permeable to the rays than the salts entering into the normal composition of the bones; phosphate of calcium, chloride of sodium, etc.

DIPHTHERITIC PARALYSIS AND NERVE CHANGES.-"Le Progres Medical:" Experimental researches have been made to determine the nature of the changes that take place in the nervous system. The pathological anatomy of diphtheritic paralysis is still a subject of very diversified opinion. These opinions may be classified in three groups; some authors have found lesions localized in the cells of the anterior coruna of the spinal marrow; others have found it in disturbance of the peripheral nerves; and, finally, some have found both lesions existing in the same patient; a last group is formed by cases in which the most careful examination cannot discover any alteration, either in the trunk of the nerves or in the cells of the anterior coruna.

To elucidate this subject, a series of experiments have been made. Rabbits have been inoculated, some with cultures of the

bacillus of Loeffler, others with the diphtheritic poison. In all these the effort was directed specially to prolong the life of the animals as far as possible.

From all the experiments the following conclusions have been drawn: the diphtheritic poison seems to attack the spinal marrow, the nerves of the medulla, and the inferior parts of the bulb, exclusively. The protuberance and the brain remain intact. In the spinal marrow the poison attacks preferably the nerve cells; lesions of the white substance are exceptional; the affection is specially a subacute myelitis of slow progress. In regard to the nerves, a degeneration very similar to the degeneration of Waller has been observed: this lesion is found especially marked at the anterior roots; the posterior roots are relatively free. The myelitis is the primitive lesion, the nevritis is secondary. In many the diphtheritic poison causes two kinds of paralysis; the first, localized in the mouth, the nose, the eyes, the larynx, the pharynx, arise from a peripheral nevritis; the second, general throughout the whole body, beginning in the lower extremities, arises from a primitive myelitis progressing to a secondary nevritis.

These cases are very variable in character and duration. A few years ago a patient about twenty-three years of age, remained in Saint Peter's hospital about three months before he showed any signs of improvement. During that time all food was conveyed to the stomach through a tube; at the end of four months he was sufficiently improved to leave the hospital; the case was observed for some time longer, when recovery was nearly complete. In his case the paralysis was of the former kind: limited to throat, larynx, and pharynx; eyes not affected.

A CASE OF CHRONIC PLEURISY WITH EFFUSION EFFECTIVELY TREATED WITH PROTONUCLEIN.-Dr. Almon H. Cooke, of Buffalo, N. Y., reports ("New York Medical Journal," Oct. 10, 1896): "On June 2d a lady came into my office in a greatly disturbed state of mind, telling me that she had suffered from an attack of pleurisy since March 1st, and now she had been told that it had turned into an abscess on the lung, and that she must go to the hospital (to her a place of torment) and have a tube put through her ribs,' to say nothing of being 'laid up' for six or eight weeks.

"On examination there were evidences of adhesions at the base of the right lung, also indications of a small amount of fluid which I suspected would be pus. However, the exploring needle proved it