the drug. In the common forms of mania, it produces at least temporary quiet. According to Seppilli the drug is of most value in periodical mania, and the main indications for its use are sleeplessness, excitement and destructive manifestations. As an antispasmodic it is used in paralysis agitans, epilepsy (especially status epilepticus), chorea, tabes dorsalis, etc., with a sedative but not a curative effect, Hyoscyamin may be called a chemical restraint and useful in many cases in which other narcotics fail or their more powerful action is not desired. Seppilli begins with doses of 0.002 gram and gives subsequently from 0.005 to 0.01 gram subcutaneously once per day. THERAPEUTICS IN DISEASES OF CHILDREN. Resorcin in cholera infantum.-Dr. Totenhöfer has used reliable preparations of the drug in the treatment of this disease. Dr. Soltman recognizes three forms of cholera infantum. The first is an acute or chronic affection of the mucous membrane of the stomach. It calls for attention to diet, and the use of stimulants, astringents, and finally of opium. The second form is due to fermentation of food, notably of milk, in the intestine. It demands anti-fermentative treatment. The third form is due to putrefaction caused by local, unhygienic conditions. Dr. T. has treated with resorcin ninety-one cases, twentyfour under three months of age, fifteen between three and six months, fifteen between six and nine months, thirteen between nine and twelve months, and twenty-four over one year. Of the ninety-one cases seventy-seven recovered and fourteen died. Of the latter all but three were complicated with other diseases. In the total number of cases this gives a mortality of 15.4 per cent., while the mortality from cholera infantum in the same hospital in 1878 was 34.4 per cent., in 1879 30.7 per cent., and under sodium benzoate treatment the mortality was twenty per cent. This is an excellent showing for the resorcin treatment. Resorcin lessens the times of vomiting, does not produce collapse (nor render it more dangerous, when present) lessens the frequency of stools, is not irritating like carbolic acid, nor does it produce toxic symptoms in the doses needed. It was given without corrigerants and was well borne. It seemed also to aid the absorption of food, especially of dilute milk when given in small but repeated doses. In children under one month of age from 0.1 to 0.3 gram of pure resorcin in 60.0 grams of chamomile was given. Collapse was treated with injection of ether, and peritonitis with tincture of opium. Treatment of diphtheria.-Dr. Annuschat has been successful with cyanate of mercury (0.1-0.2-0.4 gram to 100.0 of water and a teaspoonful of this given hourly) in diphtheria. The local trouble is lessened within twenty-four hours, the membrane dissolves, the ulcers become clean, and the general symptoms are improved. The farther the disease had progressed, the less effective was the remedy, and it was valueless when the larynx was involved. Dr. Rothe has also used mercury cyanate in diphtheria and considers it a specific. His formula is as follows: R. Hydrarg. cyanat..... Aquæ destillatæ...... M. S. A teaspoonful hourly. 0 | 02 1 00 60 00 Dr. Gonterman's method of treating diphtheria consists in painting the parts with lime water every half, or at least every hour. During the night the intervals are from two to three hours. On the fourth or fifth day the exudate separates. In cases in which the painting was impossible on account of resistance of the child, milk of lime was used with a spray. The results were brilliant. Dr. Guttman has used pilocarpin internally in diphtheria. This causes increased flow of saliva and with this the diphtheritic membrane separates and at the same time the constitutional symptoms diminish in severity. He has used it in sixty-six cases; of these fifteen were of the worst form, thirtythree were severe and fifteen were light. From his former experience in the treatment of this disease, he expected from thirteen to seventeen out of sixty-six to terminate fatally, but under the use of pilocarpin all recovered. Pilocarpin acts in a similar manner in other inflammatory diseases of the mouth ond throat, as in angina aphthora and tonsilitis. Pilocarpin is also a valuable agent in laryngeal croup. Dr. G. has had the opportunity to use the drug in four cases of laryngeal croup. Of these two died in a few hours after the administration of the first dose, because the asphyxia had already progressed too far. The other cases recovered. Dr. G.'s formula is: After each dose Dr. G. gives children a teaspoonful, and adults a tablespoonful, of strong wine. This medication must be carried through the night. Poisoning with chlorate of potash.-Dr. Hofmeier reports a lady L suffering from angina tonsillaris, who in thirty-six hours took into her mouth, and for the most part swallowed, forty grams of chlorate of potash. The symptoms were: Rapid breathing, frequent pulse, high temperature, deep dark-brown icterus, a cloudy urine, which on being filtered furnished a dark filtrate. The urine contained disintegrated blood corpuscles, and a yellow or brownish sediment. The spectrum of methæmoglobin in the urine was distinct. Blood drawn by puncture was dark, but histologically normal. Death from asphyxia followed in twenty-six hours. Postmortem: Both kidneys were enlarged and of a brownish-red color, and cut surfaces of the organ were brown. The ureters were filled with reddish-brown cylinders, which consisted of fragments of blood corpuscles. The marrow of the bones (thigh) and the spleen also were reddish-brown. Chlorate of potash was first used in croup and diphtheria by Chaussien in 1819. Forty years afterward it was in general use. Isambert first studied the action of the drug and showed that it was eliminated chiefly through the kidney and salivary glands. The method of detecting its presence in the urine is as follows: Acify the urine, then add a little indigo and sulphate of potassium. The chlorate is changed to a chloride and the free oxygen colors the indigo a yellow or green color, and oxidizes the sulphite to a sulphate. If fresh blood be treated with a solution of chlorate of potash, the blood becomes after a few hours dark-brown, syrupy and finally jelly-like. The corpuscles become pale and cremated, and congregate in irregular lumps and can be preserved for weeks without decomposition. By feeding dogs on chlorate of potash the same change in the blood occurs. The hemoglobin is decomposed and dissolved from the corpuscles. Secondarily the lungs, spleen and kidneys are affected. The ureters are filled with the cylinders already referred to. The urine even during life contains large quantities of brown cylinders and granules. The entire process seems to be identical with that of oxidation of hemoglobin as discovered by Hoppe-Seyler. Treatment of croup.-Dr. Faludi treats croup with calomel, from 0.1 to 0.15 gram every half hour for four or five times. He combines this treatment with the inhalation of dilute lime water and, at first, by ice around the neck, and later by warm applications.-Jarhbuch der Kinderheilkunde. SUBCUTANEOUS INJECTION OF ERGOTIN IN PSYCHOSIS. Solivetti supposing that acute mania is due to hyperæmia of the brain and meninges has used ergotin hypodermically. In eleven cases (seven primary and four secondary) complete cure has resulted. For three or four days, six injections are made daily. The solution used consists of one gram of ergotin in six grams of water, and ten minims of this is injected at one time. After the use of two grams marked improvement is noticed. The same treatment has been used with success in two cases of status epilepticus, and in one of acute alcoholic mania, ergotin seemed to have a marked sedative effect. USE OF PEPTONES IN SITOPHOBIA. Lailler digests a kilogram of finely divided beef steak for twelve hours at 45° centigrade, with five litres of acidified water (twenty grams of pure hydrochloric acid) to which pepsin has been added (about six grams of pepsin to two hundred grams of meat). After from two to six hours the mixture becomes clear. The fluid is then filtered, saturated with sodium bicarbonate, and evaporated to a syrup, when it is ready for use. SELECTED ABSTRACTS. ADMINISTRATION OF BELLADONNA TO CHILDREN. Dr. Jules Simon, in a lecture delivered at the Hopital des Enfants-Malades (Gaz. des Hop., January 5 and 10), observes that belladonna is a medicine that is often employed with success in children, who in general bear it very well, just as adults for the most part tolerate it badly. The doses which he recommends are the result of the almost daily use of the drug, either in his hospital or private practice. As examples of its efficacy he alludes to its use in four cases, one of them occurring as far back as 1871, so that the employment of belladonna is no new thing with him. This case occurred in a boy three years and a half old, the subject of intense whooping cough, to whom he gave, on March 7, thirty drops of the tincture of belladonna to be taken in the twenty-four hours. On the 8th he ordered forty drops, and next day sixty, always in the same space of time. This last dose was continued daily until the 19th, not only without any accident but with great improvement in the cough. In two other cases, in boys four and three years old respectively, the dose given varied from fifty to sixty drops in the twentyfour hours; and in a girl thirteen years of age, with bad paroxysms of the cough, beginning with ten drops per diem, he gradually increased the dose to one hundred and twenty, without the slightest accident arising. The powder and extract of belladonna are two preparations that may be very well associated so as to make very small pills, each containing a centigramme of extract and one of powder; and these pills are found very useful in combating the tendency to constipation in chlorosis. The dose of the tincture may be graduated as follows: From two to three years of age, five to ten drops; three years, ten to twenty drops; and above three years thirty to forty drops per diem-always, however, at this last age commencing with ten drops. The dose should in all cases be divided into two portions. Below the age of two the tincture is given only quite exceptionally, and then at a year old in doses of five drops per diem. Of the syrup the daily dose is one or two teaspoonfuls (five to ten grammes) for a child two years old, and two, three, or even four teaspoonfuls for one of three years. To the adult are generally given two tablespoonfuls, or about thirty grammes. When the neutral sulphate of atropia is employed, half a milligramme per diem should be given to a child two years old, gradually increasing the daily dose to two milligrammes. Belladonna may also be employed externally, as in arthritis and coxalgia, when a liniment may be formed of four parts of extract of belladonna and six of extract of henbane with sufficient quantity of oil of henbane. Sometimes also the extract of belladonna is added to mercurial ointment; and an ointment composed of neutral sulphate of atropia twenty to thirty centigrammes and benzoinated lard thirty grammes is very useful in relieving or even removing muscular pains in certain cases. "Belladonna is, then, a very active and in general well-tolerated remedy; and of all the preparations we have referred to, the tincture in medium doses of ten drops for a child two or three years old is the most employed, as also the syrup in doses of one or two teaspoonfuls for a child of the same age. I much prefer these two preparations to the neutral sulphate of atropia." Turning to its physiological properties and therapeutical indications, belladonna may be described as an irritant substance to the parts upon which it is deposited. Taken internally, it induces thirst, dryness of the throat, with bitterness, and a certain acridity. Sometimes it gives rise to a semi-paralysis of the pharynx, and sometimes even to a kind of dyspha In poisonous doses it gives rise to nausea and vomiting, like opium itself. But while the action of this last on the intestinal canal is characterized by constipation, belladonna, on the contrary, produces hypersecretion from the mucous membrane of the canal, and slight painless contractions-that is, diarrhoea. Belladonna has a sedative action on the circulation, producing in a therapeutical dose a diminution of the pulse and calorification; while in a poisonous dose it gives rise to febrile accidents and a notable elevation of temperature. Preparations of belladonna produce on the skin almost a scarlatiniform eruption of uniform redness. Their action on the respiration is to diminish the secretion of the respiratory mucous membrane, the rapidity of respiration, and the play of the thorax, diminishing also the sensibility of the nerves. But when given in large doses, at the same time that these induce vomiting and fever they increase |