COTO BARK.

Dr. Rohrer, of Zurich (Schweiz Corr.-Bl.), reports one hundred and eighty cases in which he has used coto bark or its preparations. Of these, one hundred and sixty-two were cases of diarrhoea, fifteen of typhoid fever, and three of hyperhidrosis. Dr. R. is especially enthusiastic in his praise of coto in diarrhoea in children. Of the tincture of coto bark he orders for children from four to ten, and for adults from fifteen to thirty drops, hourly given in sweetened water. Of the powder he orders for children from ten to thirty, and for adults from fifty to sixty, centigrammes, to be divided into ten powders; one powder hourly. The dose of cotoin for children is from five to fifteen, for adults, thirty centigrammes daily. In cholera infantum he combines the cotoin generally with powdered musk; in adults with colicky pains with the simple or camphorated tincture of opium in the proportion of from one to two grammes to thirty grammes, of which one teaspoonful in water is to be taken four times per day.

Dr. R. thinks coto especially valuable in infantile diseases on account of the absence of any narcotic effect. The cases of typhoid fever treated with coto did well. In two of the cases of hyperhidrosis the effect seemed to be good, in the other, only moderate.

A CASE OF SO-CALLED IDIOPATHIC ASCITES.

Dr. Debroise (Jahrb. f. Kinderheilk.) saw a girl, aged thirteen, who was very anæmic, but whose lungs he pronounced sound, with marked ascites. The girl had no discoverable disease of the liver, spleen or heart. The urine was free from albumen. Diuretic treatment had no effect upon the dropsy, and finally on account of dangerous dyspnoea, punctio abdominis was resorted to, and ten liters of serum escaped. After the puncture, the ascites returned to some extent, but gradually disappeared as the child gained strength. Two years later the girl was entirely well.

PERFORATION OF THE COMMON CAROTID FROM A RETROPHARYNGEAL ABSCESS.

Dr. Szekeres (Pester Med. Chir. Presse) reports a case of this accident from the Budapest Charity hospital. A boy, aged four, was taken with pneumonia, died on the sixth day after admission, after having thrown up, and passed at stool, a large amount of blood. Section showed perforation of the left common carotid from a retropharyngeal abscess. From this abscess there was a pus cavity as large as a crow quill to an abscess in the tonsil.

SALICYLATE OF SODIUM IN NERVOUS HEADACHES.

Dr. Oehlschläger (Allg. Med. Centr. Ztg.) reports two cases of long-standing nervous headache relieved by this drug. The first was that of an old lady who had suffered for years. The second was that of an old man who had fallen on the back of his head in his sixteenth year, and who had been almost a constant sufferer since. Quinine, arsenic, caffein, valerianate of zinc, etc., had been tried in this case without any benefit. Potassium bromide brought temporary relief, but the salicylate seemed to produce a permanent cure. Dr. O. uses the drug in the form of natrum salicylicum dialysatum, and in doses of one gram. It is without value in the nervous headache due to anæmia.

HOT BATHS IN PUERPERAL CONVULSIONS.

Dr. Brieus (Arch. f. Gynäkol.) reports the following cases: (1) A primipara, aged thirty-four, after having had sixteen. convulsions in one day, was brought to the clinic. During one of the convulsions, she threw herself from the bed and dislocated her right shoulder. After the convulsions she was totally unconscious. Edema was general, but especially marked on the inferior extremities and the face. The urine contained a large amount of albumen. Pregnancy had advanced to the ninth month. The foetus was still alive. Within five hours after admission to the hospital and after four more convulsions, two grams of chloral was given by the rectum. On the next day, the patient was unconscious, but had no convulsions. The dislocation was reduced. Some days later consciousness returned, and the convulsions reappeared. On the whole, her condition was unchanged. On the fourth day, the patient was given a hot bath and then surrounded with warm packing. There was abundant perspiration followed by sleep, and the oedema. and albuminuria rapidly disappeared. A hot bath was given daily, and after the fourth the oedema had wholly disappeared and the amount of albumen in the urine had greatly diminished. After ten days the patient was dismissed from the hospital. There was no return of the convulsions, and after four weeks the woman was delivered of a healthy child.

(2) A lady, thirty-one years of age, in the sixth month of pregnancy, showed marked oedema of the face and the whole body, especially of the genitals. The urine was small in amount and highly albuminous. On the second day after admission, she had convulsions followed by loss of consciousness. She was given three grams of chloral by the rectum and a hot bath (35° Reaumur) of half-hour duration, then surrounded with warm packing. On the following days the baths were repeated. The oedema rapidly subsided and wholly disappeared after the

fourth day. The urine became less albuminous, and after six weeks the woman was delivered of a living child.

(3) A primipara, aged nineteen, at the time of delivery, had marked ædema, albuminuria and two convulsions, followed by stupor. Three grams of chloral was given. After four hours there was another convulsion. Birth was effected by instruments. In an hour there was another convulsion. Two grams of chloral were now given, and the woman placed in a hot bath, followed by warm packing. There was no further accident. Four baths in all were given. The oedema and albuminuria disappeared, and the puerperal period passed without disturbance.

(4) A primipara, twenty-seven years of age, with marked oedema and albuminuria, had a violent convulsion as the head was born. Two grams of chloral was given without effect. There was a second convulsion, when the hot bath was used. Afterwards there was no accident. On the next day two baths were given. The oedema disappeared, and on the ninth day the urine was free from albumen. There was slight puerperal endometritis, and tardy involution of the uterus.

(5) A primipara, aged twenty-seven, was brought to the hospital in a deep stupor after repeated convulsions. Delivery was effected under narcosis. Then a hot bath was given, but a paroxysm followed. The patient remained in a stupor, and despite hot baths and chloral, died the next day. Section showed Bright's disease in the second stage, with the kidneys doubled in size. There was marked oedema of the brain, and slight of the lungs. There was some cirrhosis of the liver. The uterus had contracted normally.

(6) A primipara, aged twenty, had a delivery without accident, October 11. Afterwards parametritis developed, and November 1 she complained of pain in the eyes and head. The lower extremities became oedematous and amaurosis appeared. The urine was highly albuminous. On November 3 she had a convulsion. She was now given a hot bath, followed by warm packing. The baths were repeated, and by November 28 she had wholly recovered.

ABDOMINAL TYPHUS IN CHILDREN.

Dr. Röth (Arch. f. Kinderheilk.) reports his observations on eighty-two cases of this disease in children under fifteen years of age, twenty-nine of these were in the children's hospital, and fifty-three at the poly-clinic at Heidelberg. Under one year of age, there was one child, nine from two to five years, thirty from six to ten, and forty-two from eleven to fifteen. Of the eighty-two cases, eight ended fatally, and two others died from relapses. In a minority of the cases, the disease was ushered in by a chill, after which the temperature rapidly increased. In the majority the incubation stage lasted from three to seven

days, then followed, as a rule, febris continua remittens, which lasted from six to twenty-five days, with evening rise of temperature to from 39.5° to 40°. Finally there was febris intermittens, lasting from four to five days. The spleen was enlarged in sixty-two cases, but there was no enlargement discoverable in some of the most severe cases. The roseola appeared between the sixth and eleventh day and was tolerably constant. In some it was very slight and transient continuing scarcely a day. In others it failed wholly. In fortythree cases its presence was doubtful; in thirty-seven it was unmistakably present. In forty-six, bronchial catarrh was a complication; in seven, bronchitis and broncho-pneumonia. There were eight relapses, five slight, and three severe, of the latter, two died.

CHANGES IN THE BRAIN IN FEBRILE DISEASES.

Dr. Blaschko (Virchow's Archiv.) has examined, with nega tive results, the brains of women dying of puerperal fever, and of animals in whom septicemia had been produced. Only in one instance did he find emboli in the veins and capillaries of the brain. He expresses a doubt as to the exclusively parasitic nature of septicemia.

EFFECT OF CHRONIC LEAD POISONING ON THE OFFSPRING.

-Dr. Rennert (Arch. f. Gynæl.) has examined seventy-nine children from eleven families, in all of which the father, and in several the mother also, has suffered from chronic lead poisoning.

First Family-Father and mother both severely poisoned; eight children, of these two (aged three months and three years) have died of colic. These two had large and angular heads. Of the six living children all have large, angular skulls, with especially marked parietal and frontal protuberances. All, save the youngest, aged three months, have suffered with colic. One is quite stupid. Postmortem examination of one, who had died, showed a large amount of serum in the softened cortex of the brain. Brain was very large, heavy and hard. The cavities were filled with serum, but were not abnormally enlarged.

Second Family.-Both parents poisoned with lead; ten births, one pair of twins; of these one has died. The ten living children are all macrocephalic, and frequently suffer from crampy pains.

Third Family.-The father seriously, and the mother only slightly poisoned; five children, all with large heads; three have died, one from colic and two at birth. The two living have rickets, and one has suffered from lead poisoning.

Fourth Family.-Father seriously, and mother slightly, affected; ten children; seven have died with colic. The three living ones are aged nineteen, fourteen and eleven years, and

all are macrocephalic and suffer from colic. The oldest son has atrophic lameness of the left arm.

Fifth Family.-Both parents poisoned; eleven children, all dead, and all, save one which was born dead, died with colicky pains. All had large, angular heads.

Sixth Family-Father, a drunkard, and chronic lead poisoning; the mother, sound. two, who were macrocephalic, died from colic. ing suffers from colic.

suffering from Four children; One of the liv

Seventh Family.-Father seriously, and mother slightly, poisoned. Four children; two dead, one of which was macrocephalic. The two living frequently suffer with colic.

Eighth Family-Father poisoned with lead; mother, sound. Eight children; three, all macrocephalic, died with cramps. Of the five living, only one has a normal head.

Ninth Family-Father, poisoned; mother, sound. Three children. The oldest is living, but has a large head. The others, who had normal heads, are dead.

Tenth Family-Father, slightly poisoned; mother, sound. Eight children, only one macrocephalic.

Eleventh Family.-Seven children from two marriages; four born dead, two from each wife. One died of apoplexy, and one of the living is macrocephalic.

From two families, in which both father and mother were seriously affected, there were nineteen children; of these seventeen suffered with cramping, and thirteen died; seventeen had large heads; one, macrocephalic, is living, and one, with normal head, was born dead.

In four families, in which the father was seriously and the mother slightly affected, there were twenty-seven children; seventeen, macrocephalic; eight suffered from cramping, and of these two died; nine were not troubled with cramping.

In five families, in which the mother was sound, there were thirty-three children, ten macrocephalic, seventeen suffered from cramping; twelve died.

RESINA COPAIBE.

An apothecary, Paquet, has prepared capsules of the pure resin of copaiba to be used in gonorrhoea in the place of balsam of copaiba. In this way the unpleasant effects of the balsam, as the fœtid breath and various cutaneous eruptions, are avoided. The remedy is to be used only in those cases in which there are no symptoms of acute inflammation. Each capsule contains an amount of the resin equivalent to from 0.90 to 1.00 gram of the balsam. From ten to twelve capsules may be given daily. It is best, as a rule, to begin with a small dose and gradually increase the amount, and to continue its use for some time after all symptoms of the disease have disappeared.

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