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VARIETIES OF INSENSIBILITY.

Prepared by Louis Lewis, M.D., M.R.CS.
CAUSES.
SYMPTOMS.

TREATMENT.
Predisposing:-Heredity, corpulence, sen-
ile decay, valvular disease, Bright's disease.

Pupils dilated (in danger contracted), eyes
Apoplexy.

Horizontal posture, with head raised; cold to head, hot
Exciting.Pressure on brain, abuse of staring, flushed, distorted face, teeth closed, slow, bottles to feet, sinapisms to legs; turpentine enema ;
eating, drinking or narcotics; cerebralcon.

full pulse, incoherent speech, stertorous breathing leeches to anus, temples or nostrils; dry cupping to nuchæ; (Effusion of blood or serum

(usually), epistaxis, partial paralysis of face, croton oil (m ij in mucilage), calomel, tincture of aconite, within the cranium.)

eating, mental overstrain, extreme muscugestion, cold, bathing after intemperate body, palate or sphincters; high temperature, or of veratrum (me v), or ergotine (gr. 4) subcutane

ously; bleeding (when the pulse is bounding).

Horizontal position, with head raised (except in embo-
Sewer-air, choke-damp or other noxious

lism); cold affusion, frictions upwards, rythmical pressure
gases; drowning, hanging, lightning, ob- Pupils dilated, eyes projecting and injected,

over abdomen, artificial respiration, sinapisms over heart
Asphyxia.

structions in air-passages, chloroform. faintness, vertigo, lividity of face, cyanosis of and ankles; ammonia and whiskey subcutaneously; gal

poisoning, mechanical pressure on chest lips, frothy mucus, clammy skin, gasping or im- vanism, removal of obstructions from air passages; inverted
(Suspended animation from or spine, pulmonary collapse, tetanus, em- perceptible respiration, loss of motion and sen- suspension, especially in chloroform-poisoning, tracheotomy,

sation, flickering pulse, clenched hands, cold etc.; bleeding, transfusion.
imperfect aeration in the lungs.) bolism, pleuritic effusion, extreme cold.
In children, spasm and edema of glot- extending upwards; low temperature.

In asphyxia of new-born, slapping with wet cloths; hot
tis, diphtheria.

and ice-cold water, alternately; artificial respiration, gal.
vanism, catheterization of trachea, laryngo-tracheotomy;
non-interference with cord until pulsation has ceased.

may smell of liquor. lar efforts, suppression of menses.

organs, hemor

Horizontal posture, with head rather low; hot bottles to

Pupils dilated, features shrunken, pallor, clammy Collapse. General injuries, gunshot wounds,

skin, impaired vision, sighing respiration, feeble feet and legs, warmth to epigastrium; frictions, nitro-glycer-
burns, rupture of internal

pulse, hiccough, nausea, vomiting, rigors, con- ine (gr. Ito), ammonia to nostrils; beef tea and brandy; gal-
nervous system.)

tensive urinary extravasation, (Sudden shock to general rhage, mental emoion, excessive cold, ex- vulsions, partial or complete loss of conscious- vanism; ether (3 j) or quinine (gr. vj) or morphia and atro

ness, sphincters relaxed, low temperature. pia (q. s.) or tincture of digitalis cm xij) subcutaneously.

Predisposing:-Albuminuria ; diabetes.

Horizontal posture, with head raised; cold affusion, sina. Exciting:- Apoplexy, epilepsy, hyste

pisms, stimulant enema, stomach-pump (if poison susComa.

ria, paralysis, uremia, typhus fever, jaun- Pupils dilated (except in extreme danger or pected), artificial respiration, galvanism, warmth to extremi

dice, injury or diseases of the brain or in opium poisoning), stupor, loss of motion, sen- ties,catheterization,flying blisters, bleeding; crolon oil (M1).
(Total unconsciousness in- skull, retrocedent erysipelas, opium, alco-sation and perception; flaccidity of limbs, decu. In suspected subcranial hemorrhage, with paralysis of one
volving respiration and circu- hol or prussic acid poisoning; embolism bitus, more or less general paralysis, sphincters side, exploratory operation on opposite side of cranium.
lation.)
or thrombosis, noxious inhalations, chlo- relaxed.

In opium poisoning, strong coffee, flaggelation, artificial
roform. In children, scarlet fever.

respiration.
One or both pupils contracted at first, then

Horizontal posture, with head raised; ice to shaved
Compression.

bullet, blood, tumor, pus or serum, result- faccid limbs, complete insensibility, stertorous

Pressure on brain by fractured bone, much dilated. "Eyes staring and insensitive, head, turpentine enema, croton oil (m'ij) in mucilage, (Cerebral irritation, with or ing from falls, blows, gunshot or other breathing, full

, slow pulse, hot, moist skin, catheterization, trephining, aspiration or perforation it ab

scess is diagnosed; removal of tumors or other pressure. injuries, causing intra-cranial inflamma- sphincters relaxed, paralysis of side of face or without external pressure.)

In children, avoidance of operation if no brain symptoms tion.

body, blood or serum from nose, ears or mouth, indicating injury to base of skull.

present.

[graphic]
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fallor, coldness and numbne or surface, feeble

pulse, shallow respiration, deafness, loss of mo Concussion.

Horizontal posture, with head raised; hot blankets, and

tion, vomiting, partial unconsciousness, rigors, hot bottles to feet legs and sides; frictions, blisters to (Sudden succussion of brain spinean by Thulwa sorbenem injuries, or semperature. Symptoms immediately follow the enema, enema of sal volatile in solutions

Blows or falls on the head, jars of the epileptiform seizures, sphincters relaxed, low nuchæ, ice to head, bleeding, mercury, beef tea and brandy or spinal cord, interfering with falls on the buttocks or back.

accident.

In protracted cases, setons to nuchæ.

In concussion of the spine, hiccough (if phre- In concussion of spine, prone position; counter irritation; their circulation.)

nic nerve is irritated), dyspnea (if vagus nerve ice, or dry cupping over spine; chloral bromide of is irritated), vomiting, paralysis of sphincters, potassium. and perhaps of one or both arms, or paraplegia.

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Predisposing:—Heredity, scrofula, syph-
ilitic tumors of brain, cranial malformation.

Pupils dilated and oscillating, eyes rolling,
Exciting.-Injury to head, intra-cranial conjunctiva insensible, face distorted, sudden Horizontal posture, with head raised; gag between

unconsciousness, head turned aside, bitten tongue, teeth, sinapisms to nuchæ and calves of legs, removal of
Epilepsy.

pressure, brain disease, polypus or suppu frothy mucus, sinking at epigastrium, subjective spicula or pressing, bone by trephin pressure over caro

ration in ear, tumors, tape or other worms, sensations in limbs, clenched hands, violent mus- tids, nitrite of amyl inhalations, nitro-glycerin, antipyrin,
(Nervous disturbance either suppressed excretions, over-eating, sun. cular jerkings, bounding pulse, vomiting, sharp bromides, puncture of cerebral abscess

.
centric or eccentric.)
stroke, extreme excitement, cold, some
outcry, profuse perspiration, cold extremities.

In children's convulsion, hot baths, cold to head, spinal
fevers, prolor.ged waltzing.

In mild attacks only transient bewilderment. ice-bag; bromide of ammonium (about gr. iij every ten
In children, dentition, phymosis, worms,

minutes).
In children attacks occur mostly at night.
falls, injuries at birth, rickets.

Cerebral irritation from extreme emo-
tion, sexual degrangements, change of sphincter muscle of orbit, increased flow of tears

Pupils dilated, photophobia, twitching of
Hysteria

and urine, emotional display, chronic convulsive

Horizontal posture; cold affusion, abdominal pressure,

compression of ovaries; nitrite of amyl or chloroform in. (Perversion of nervous func

life, concussion of spine, puberty, suppres movements, incomplete insensibility, agitation halations, tincture of musk or valerian. tions.)

sed emotions, malposition of the uterus, and palpitation. Gradual onset, “Globus hys. digestive disturbance.

tericus."

Pupils contracted at first, afterwards dilated; Horizontal posture, with head raised; cold affusion, zinc
Predisposing:-Heredity.
Inebriation.

helplessness, partial or complete insensibility, or mustard emetics, stomach-pump, turpentine or salt and
Exciting. --Abuse of liquors, alcohol or Aushed face (usually), soft, quick pulse; cold water enema, strong coffee, vinegar, solution of acetate of
(Poisoning of nervous centres its substitutes (tusel oil, etc.) in adulter- surface, temporary paralysis, often involuntary ammonia, pilocarpine (gr. %), or strychnia (gr. st), or
by alcohol.)
ated liquors.

micturition, odor of liquor, low temperature. caffeine (gr. iij), subcutaneously.

Pupils dilated, pallor, cold, clammy perspira- Horizontal posture, with head low; cold affusion, stimu-
Syncope.
Exhaustion, hunger, hemorrhage, fear,

tion; vertigo, shallow respiration, almost imper. lating enema, frictions, ammonia to nostrils, snuffs, sina

ceptible pulse, partial or total insensibility, sud- pisms, turpentine stupes over heart, nitro-glycerin (gr. 1do), (Deficiency of blood to brain

extreme heat or pain, surgical operations, den in outset,' short of duration; cold extremi- galvanism, tinc ture of sumbul (mv), or hydrobromate of

ties, flaccid limbs, vomiting.

quinine (gr. iv in hot water), subcutaneously; artificial In hysterical syncope, pulse natural.

respiration. In extreme cases, transfusion.

Horizontal posture, with head raised; cold affusion (ex-
Sunstroke.
Direct solar heat, diffused heat com- nausea, hurried respiration (sometimes stetorous), cold drinks, cold baths, turpentine enema, dry cupping or

Pupils contracted, eyes congested, vertigo, cept when skin is cold), ice to head, spine or in rectum;
(Nervous exhaustion from

bined with fatigue, hunger or intemper- arrest of perspiration, hot, stinging skin.: fre; blisters to nuchæ, chloroform, bromide of ammonium enenia, hyperpyrexia.)

temperature. quent micturition, pulse rapid, often full; high (gr. xx), antipyrin (= j), or quinine (gr. vj), subcutane

ously; nitro-glycerin (gr. Ito) every ten minutes; digitalis. Accumulation of urea, ammonia or other

nitrogenized debris in the blood from reUremia.

Horizontal posture, with head raised; cold to head, sinaPupils dilated, amaurosis, urinous or ammonianal disease or derangement; scarlatinal cal breath and perspiration, dyspnea, headache, pisms to loins, va por baths, diaphoretics and purgatives, hot

blankets, bleeding, catheterization, chloroform, jaborandi, (Blood-poisoning by constit. albuminuria

, obstruction of uterus

, im- dropsy, delirium, epileptiform convulsions, coma, nitro-glycerine, strophanthus, elaterium, oxygen inhalations, uents of urine.) pacted stone, impassable stricture, extra- vomiting, low temperature.

poultices of digitalis leaves to abdomen, transfusion. yasation of urine, suppression.

THE MEDICAL WORLD

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heart disease. from heart failure.)

ance,

55

An Important Subject.

Biniodide of Murcury as an Antiseptic. Physic need not necessarily be nasty to make Dr. Rogée Saint Jean-d'Angely states that it efficacious. The influence of the mind over biniodide of mercury is not irritant to wounds, the body is such that the whims and fastidious- and a more powerful antiseptic than carbolic ness of patients in respect of nauseous medicines acid. It has no odor, and an alcoholic soluhave to be taken into account. Moreover many tion 1-300 is solůble in all proportions in persons surreptitiously hide or throw away medi- warm water. Lister's dressing is expensive and cines that offend their taste, even in serious not adapted for use in armies. Since 1885 the emergencies; and if they derive no benefit, or author has employed exclusively the biniodide die, the doctor or the druggist gets the blame. with dressings of cotton and gauze, and in 108 Hence, palatability and convenient dosage are operations (32 major) had only one death. – to-day subjects of supreme importance.

Translated irom Lemaine Medical.

a

Injuries to the brain are liable to be attended

A Disinfectant of Air. by plastic effusion, causing adhesions or anchor. age of the brain to its membranes, and of the

According to M. Keldyche, who has just membranes to the skull, so that the free play published the results of a series of experiments of the organ is impeded in the same way that

on the air drawn from his hospital wards, air the movements of the lungs are hampered by

which has been saturated with eucalyptol will adhesions to the pleura. This may also happen

no longer give rise to colonies of bacilli in gel. to the brain during the formation of cicatrix.

atine. The spores of fungi are able to pass un. Under these conditions, the least movement of harmed, but as their action on the higher anithe brain pulls on its membranes, and vertigo, mals is probably limited, it is not a matter of epilepsy, convulsiuns or inflammation ensue.

much importance. If confirmed by independ.

ent observation, this valuable quality renders Pruritus vulvæ is relieved by the application the drug worthy of wide-spread employment,

for no other disinfectant is known which can of a menihelene.

be relied upon to effect its purpose without renAll wines, spirits, alcohols, ethers, fat-acids, dering the air irrespirable, besides acting very aldehydes, turpenes, benzines, paraffins, chloro injuriously on furniture, clothing, etc.- Medi form, iodoform, oils, fats, starches and sugars

cal Press. are carbo-hydrates.

A Hair-Restorer. In Japan, the art of massage is entirely rele

Make a pommade with three ounces of lanolin gated to the blind, who practice it as a means

and five drachms of lard, and a little essence of of obtaining a livelihood.

roses. Shake up seventy-five grains of subniBacteria are said to be brought to the sur

trate of bismuth, and forty-five grains of citric

acid in three and a half drachms of glycerine, face of cemeteries by earthworms, who carry

and add the mixture to the pommade. This is them up from the decomposing bodies of the

stated to restore white or gray hair to its prisdead ; thus the poisons of scarlet fever, small

tine brown color. pox, diphtheria, malignant cholera, etc., are supposed to be returned among the living, for they are undoubtedly transmissible through the

CLASS-ROOM NOTES. body by more than one mode. It must be

From The College and Clinical Record.. remembered however that earthworms are not

Ordinarily, one woman in eight is sterile; found in the earth more than a few inches be

but in women who have fibroids, one in three low its surface.

is sterile. (Parvin.) Bleeding from the ear after a blow does not -In facial erysipelas, where you cannot of necessity mean fracture at the base of the conveniently apply ordinary means, paint the skull; it may arise from laceration of the meatus i part with a ten per cent. iodoform collodion. or pinna, or from rupture of the membrana (Prof. Gross.) tympani. Bleeding due to cranial fracture is

- For a case of trifacial neuralgia, Prof. Da nearly always followed by the escape of clear watery Auid from the subarachnoid space.

Costa ordered five drops of tinct. of gelseminum t. d., increased until double vision results;

also a full diet. Dr. R. D. Ramey, of Dayton, Cass Co., Mo., wishes our readers to send him “A good pre- -In posterior displacements of the uterus scription for dissolving gall-stones.

always replace the organ before introducing a

a

.gr. iv

a

·gr. XV

pessary; the frequent failure of its use is generally due to this cause. (Parvin.)

- Where there is a collection of foreign matter, or pus, in the antrum of Highmore, extract the first molar tooth (or more, if necessary), and drain the cavity in this way. (Sajous.)

-For universal eczema in a child, Dr. Rex ordered bran baths and R Acid salicylic.... Vaseline..

A. oz. j M. Sig.-L'se locally three times a day. -For alopecia Prof. Bartholow recommends : R Extract. pilocarpi fluid..

fl. oz. j
Tinct. cantharidis.

..A. 02. ss
Liniment saponis.

... fl. oz, iiss M. Sig.-Rub in the scalp daily.

- The following are the means of arresting hemorrhage, arranged in their order of usefulness : ligature, torsion; acupressure; compression, forced flexion of a limb; styptics ; and the actual cautery. (Prof. Gross.)

-For specific vaginitis, Prof. Parvin ordered mucilaginous injections and warm hip baths in the acute stage, followed by injections of i to 1000 corrosive solution and tampons of boracic acid and glycerine.

--For fractures of the forearm in the middle third or lower down, Prof. Forbes uses two straight splints extending beyond the finger ends, thus keeping the fragments from being displaced by movements of the fingers, which is liable to occur if a short splint, like Bond's,

11. oz. j

-Prof. Da Costa recommends for the sore throat of scarlet fever : & Thymol..

Glycerini,

Aquæ destillatæ..... ... āā.. A. oz. j M. Sig.-L'se as a wash (dilute further, if necessary)

-As an external application to enlarged lymphatic glands in the neck of children the following is efficient : R Potassii iodidi.

...dr.j Vaseline ...

...07. ) M. Sig.-Rub in thoroughly 3 or 4 times a day.

(Dr. O. P. Rex.) -For the constipation of children where the stools are clay colored and hard, for a child of one year old, Dr. Rex recommends: R Podophyllin

gr. Spirit. vini rectificat..

m xx Syrup M. Sig.-A. dr. j ter die.

- The proper thing to do for a case of sunstroke or heat exhaustion is to remove or loosen clothing about the neck; do not move unless hospital is near; throw buckets of water upon patient, or, what is better, rub down with ice. Get the bowels open; turpentine injections or croton oil if not too much exhausted, or inject cold water, or one-half drachm of glycerine, into rectum. For the stroke, draw blood if pulse is full and strong. Antipyrin is of great value, not only the immediate but subsequent result good. When he commences to recover, allow a bland diet. As one attack predisposes to another, patient should be careful in hot weather ; go to the mountains, if possible; keep the bowels open. To control convulsions, use morphine hypodermically, or inhalation of small amount of chloroform. -For a

case of quinsy seen in the first twenty-four hours the treatment is simple. Add one drachm of ammoniated tincture of guaiac to a teaspoonful of milk; gargle and swallow every three hours; after the third or fourth dose the swelling of tonsils subsides and patient is much relieved; most likely he will have a diarrhea; this is the time to reduce the tincture to onehalf drachm. When the case goes thirty-six hours without interference the treatment is different and difficult. Allow small pieces of ice in the mouth, while internally, twenty grains of bromide of potassium combined with fifteen drops of wine of ergot, or six drops.of tincture of belladonna every three hours, although the latter frequently causes headache; if tonsil has a tendency to go to abscess do not let it rupture spontaneously; find tender spot with finger; take a curved bistory and open, not cutting deeply; bind with cloth. (Sajous.)

is used.

--Prof. Da Costa prefers the use of the bismuth test for sugar in the urine. Take equal parts of urine and liquor potassæ, add a pinch of bismuth subnitrate, boil thoroughly. If sugar is present, the powder turns brown or black.

-For ptyalism, Prof. Gross advises thirty grains of potassii chloras every four hours, and & Liquor, plumbi subacet..... ..A. dr. j Aquæ destillat.......

. A. oz. viij M. Sig.-Use as a mouth wash.

-For diabetes mellitus in a man aged 44 years, in addition to the usual regulation of diet, Prof. Da Costa directed saccharine as a substitute for sugar to sweeten coffee, etc. Also half a grain of codeia morning and evening.

-As a substitute for iodoform, iodol or subiodide of bismuth, which are worthless as germicides, Prof. Gross directs the use of hy. dronaphthol to wounds which require it, as lacerated wounds, where there is danger of sloughing.

Help! Help! Here's a man in a fit,”—

in directions at right angles to each other. As I trudge my professional round,

Consequently spherical glasses are quite un“ His eye-balls are rolling, his tongue it seems bit, And he's wriggling about on the ground.”

suitable. They have to be cylindrical.
I quickly attend him, and hasten to lend him
Whatever of skill I possess;

What Prohibition Does.
I glance at his face, and examine the case,
While loos'ning a part of his dress.

A gentleman who has spent several months His pupils dilated, his breathing abated,

in Kansas says: “Kansas boys ten years old All consciousness gone from his brain;

and under never saw a saloon since they can His fingers clenched tightly, his aspect unsightly, Though utterly heedless of pain.

remember. They never saw a man under the The people all tell that he suddenly fell,

influence of liquor. On arriving at man's es. And a man must indeed be a skeptic,

tate, they will have no more desire for drink Who would not agree in his verdict with me, than they will have for opium or hasheesh.” That this was a fit EPILEPTIC.

This is very true, for we believe that, in very Wild animals, such as rabbits, pigeons, squir- many cases, the habit of drinking liquor has

found its origin in the imitative propensities of rels, are found to frequently “throw back in their breed, or revert to their original form or

humanity; and where the example is not set, color. A white cross has been known to sud

the habit will not be acquired.-Annals of denly show itself in pigeon-breeding after years

Hygiene. of the most careful breeding: The same has occurred in other wild animals, and is termed

Sulphide of Calcium in Chronic Discharges. albinism. We also find white-haired, white

Dr. Mortimer Wilson lately called attention skinned, pink-eyed people occasionally among

to the beneficial action of sulphide of calcium ourselves, usually as the denizens of a Dime in leucorrhea, (" Therap. Gazette") and quotes Museum ; and these people assert that, as far over a hundred cases which have been either back as they know, their parents and progeni- cured or much ameliorated by this agent, given tors have been like other people. Can it be internally, without any local application whatthat we were all originally " albinos ?”

ever.

We would recall attention to Dr. Louis Lewis' Disinfection and Cleansing of Sponges.

statement in these columns some years ago, that Make a 2 per cent. solution of

the same treatment was useful and frequently

permanganate of potash, and a 2 per cent. solutlon of oxalic

curative in urethritis ahd chronic gonorrhea. acid (adding a few drops of sulphuric acid.)

Notes of Some New Remedies. Immerse your soiled or discolored sponges in the former for about ten minutes, then dip them

CHLORALCYANHYDRATE. in the latter. They will come out a brilliant

Formed by the action of hydrocyanic acid on canary-like color, and uninjured.

chloral, and proposed as a substitute for hydro

cyanic acid, of which it contains 1572 per cent. Why Not?

CANTHARIDIN. Some journals speak of the proposition that physicians wear a badge or other distinctive The active blister-producing principle of the mark as a matter of absurdity. We don't see Lytta vesicataria (cantharides) colorless, rhomit. There seems to be a growing fondness for bic, light refracting tablets, nearly insoluble badges of every description; and, if it be a in water or alcohol, more soluble in chloroform, matter of importance for Masons, Odd Fellows, ether or the fatty oils. Mollusks, G. A. R. members and numberless

ARBUTIN. others to wear a distinctive badge, which can benefit themselves, why not let the doctors be A glucoside in white acicular crystals, from as easily recognizable? - Phila. Med. Times. the leaves of Uva Ursi, soluble in water, odor

less and slightly bitter. Diuretic, useful in * The Medical World Visiting List and Ledger of catarrh of the urinary organs, urethritis, etc. Monthly Balances.

Dose, 15 to 20 grains three times a day. *. This visiting list, among other things, has the advantage of being printed and bound in many thin and

EPHEDRINE HYDROCHLORATE. easily-carried booklets, which can be inserted in and removed from the handsome Russia leather case. It is

A new mydriatic alkaloid obtained from not, for this reason, so cumberous as most visting lists

Ephedra vulgaris by M. Kinnossuke Minra. It

has to be employed in a solution, ten times ASTIGMATISM is caused by irregularity in the more concentrated than homatropine, but it curvature of the cornea. It is not as it should is much less costly. It does not paralyze the be—symmetrical, but has different curvatures accommodation for near vision.

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