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ALIMENTARY GLYCOSURIA.—Krehl (Centralbl. f. inn. Med., October 9, 1897,) has studied alimentary glycosuria occurring after beer-drinking. Kratschmer has also made some similar observations. Krehl examined for this purpose some one hundred students. He was able to vary the kind and amount of the beer taken, as well as the time of drinking and the diet. The urines of four young brewers who had drunk large quantities of beer in the fasting state or at breakfast time were also examined, and in one case sugar was found. The exact composition of the beer, especially in regard to sugar, was not ascertained. The students examined mostly drank one half to two liters and a half of beer in the morning. Of fifty-seven drinking a lager beer, the sugar reaction was positive in four cases, or seven per cent. In the case of an export beer, five out of fourteen, or thirty-six per cent, had glycosuria. In twenty-five students drinking one half to one and a half liters of Rosen beer, no glycosuria was observed. Out of nineteen cases drinking large quantities of an Ehringsdorf beer in the evening, one, or five per cent, had glycosuria. Of eleven other students drinking largely of all sorts of beer, only one had glycosuria. It was often impossible to repeat the examination in these cases. The predisposition of the individual is always important in these cases, for those who drink the most are not always those who have the glycosuria. The more marked presence of the glycosuria in the morning was due to the more rapid absorption. Both Strumpell and Strauss showed that alcohol favored the appearance of an alimentary glycosuria. Perhaps the sugar in the urine in these cases was due to the action of the alcohol, but other substances in the beer may be responsible. The author thinks that at the present moment there is no satisfactory explanation of the alimentary glycosuria following upon beer-drinking.-British Medical Journal.
COLD IN THE ETIOLOGY OF DISEASES.—Chelmonski, in the Deutsches Archiv für klinische Medicin, 1897, page 140, reaches the following conclusions (Gazette hebdomadaire de médecine et de chirurgie, December 19th):
1. Taking cold, in the ordinary acceptation of the term, does not exist. 2. The etiological rôle of cold is very subordinate; in inflammatory affections it does not figure, except as a predisposing cause. 3. Chilling is dependent upon the action of thermic agents that are ordinarily difficult to avoid. 4. The mode of reaction of the skin against the thermic excitation produced indicates whether the individual may, in certain conditions, contract a cold. 5. The degree of tendency to colds is not a constant property of the individual. 6. Old persons, those attacked with intermittent fever, and individuals suffering from renal affections seem to be more subject to taking cold. 7. There does not exist any relation between the tendency to colds, on the one hand, and the condition of nutrition and the thermic sensibility, on the other. 8. Individuals may be protected from diseases caused by cold by developing, with appropriate means, the power of reaction against the thermic influences.—New York Medical Journal.
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JODOTHYRINE IN THE TREATMENT OF OBESITY.
The treatment of obesity has ever been and we fear will ever be an insoluble problem in therapeutics. And the reason for this is that the chemistry of the production of fat from carbohydrates, and probably from proteids is not understood; nor can any interpreter of nature's thaumaturgy tell us why one man, who rides the bicycle miles daily, walks inordinately, and religiously restricts his diet to albuminous food and the minimum of carbo-hydrates and hydro-carbons, should nevertheless steadily advance to Falstaffian proportions, while another who cultivates laziness as a fine art, and luxuriates in starches, fats, and sugars, should preserve unaltered and against hope the gauntness, angularity, and skin-shriveled characteristics of “the lean and hungry Cassius.” Nevertheless, the experience of every practitioner presents cases illustrative of both extremes.
Since fat when taken in excess of physiological needs (and the personal physiological co-efficient of fat can never be stated) will be stored up in the areolar tissues of the body, and since starches and sugars seem ready on the least encouragement to go into fat, and since according to some authorities proteids have a carbo-hydrate radicle and are fond of the same transmutation, the fat man who looks to dietetics for relief will find that he must steer his craft between the Scylla of starvation
and the Charybdis of enhanced accumulation. And the doctor who by drugs attempts to reach the case will ere long realize the truth of Hippocrates' first aphorism, and end by allowing the sufferer to go it alone. With such gruesome items of experience in the retrospective we turn but with faint hopes to the followivg refreshing items translated from the Journal de Medecine de Paris by our friend the Medical Fortnightly:
Dr. A. Lutaud, of Paris, France, says (Jour. de Med. de Paris): “The active principle of the thyroid gland has been used for several years with undeviating success in the treatment of myxedema. This therapeutic procedure, although momentarily discouraged by a few unfortunate accidents easily explained by the inexperience of the early experimenters, is at the present day universally accepted.
" Its general application and especially its extension to other morbid conditions has only been clearly shown since the introduction of iodothyrine. This substance, which was first called thyroiodine, may be considered as the true active principle of the thyroid gland. It is prescribed in the form of a white powder, free from disagreeable taste, and is taken in doses which average one gram daily.
“We know that at the present time this substance is prescribed in parenchymatous goitre, in myxedema, in metrorrhagias, and in certain persistent cutaneous affections associated with a diathesis (psoriasis, obstinate acne, etc.).
“ The modifications of structure and the cellular atrophy obtained in parenchymatous goitre could not fail to lead practitioners to experiment with iodothyrine in the treatment of obesity.
“We have already called attention to the use of this substance in an article on “The Medical and Dietetic Treatment of Obesity in Women," Journal de Medecine de Paris, November, 1896; but the experiments which we made during the early part of 1896 did not seem sufficiently conclusive, because iodothyrine was employed in conjunction with other established methods of treatment.
“During the past three months we have repeated these experiments, using almost exclusively medication by iodothyrine, and we believe that we are able to give a more exact account of its action.
“The cases in which it has been used may be divided into three groups: simple obesity, without visceral lesions; obese subjects, with cardiac, pulmonary or hepatic complications; and lately, cases of fibroid tumor with or without obesity."
Notes and Queries.
Dr. Joseph O'Dwyer.-Dr. Joseph O'Dwyer, the inventor of intubation, was born at Cleveland, Ohio, October 12, 1841, and died at New York, January 7, 1898.
His boyhood was spent in Canada, near London, in which city he attended school. His first studies in medicine were with his preceptor, Dr. Anderson, of London, Canada, about 1863. He came to New York and entered the College of Physicians and Surgeons in 1864, and was graduated in 1866. Immediately after graduation he became an interne in the Charity Hospital of New York City, under the then new arrangement by which this institution had its own interne staff, entirely separate from Bellevue. Among his associates forming the new staff were Drs. Leroy M. Yale, F. A. Castle, and P. A. Callan. The visiting staff comprised among its numbers Drs. J. Lewis Smith, Loomis, Flint, Van Buren, and Sayre.
During his service at the Charity Hospital there appeared in New York an epidemic of cholera, the hospital for which was located on Blackwell's Island. Dr. O'Dwyer was placed in charge of this institution—it is generally supposed he volunteered for this service, and it is accurately known that upon him, in his isolated quarantine, the commissioners most confidently relied. During his service typhus fever also appeared as an epidemic. This disease Dr. O'Dwyer contracted. His case was a rather severe one, but after a long illness he recovered without permanent injury to his constitution. He was fond of saying he knew the very hour of his infection. It occurred during an early morning visit, when he was called before breakfast to see a man in a small cell in the penitentiary who had been taken sick during the night. The room was close, and he spent some time examining the patient. Promptly on the day the incubation period expired Dr. O'Dwyer became ill with the disease.
During 1868-9 he became examining physician for the hospitals under the Commissioners of Charities and Corrections. His duties were the distribution of applicants to the various hospitals, to Bellevue and to Charity. During this service classes in physical diagnosis were permitted, and he often, in later life, referred with pleasure to this work. In this year (1868) Dr. O'Dwyer opened his office, on Second Avenue, near Fifty-fifth Street, with Dr. Schoonover. During 1872 he moved to Lexington Avenue, near Sixty-fifth Street, and began the part of his life which brought him into connection with the New York Foundling Asylum (1873) and to the study of intubation.
It was in 1880 that Dr. O'Dwyer “began to think" on the subject of intubation. Tracheotomy was in such bad repute at the Foundling Hospital with a record of one hundred per cent of deaths, that the physicians as well as Sisters of Charity saw no excuse for further torturing the children.
The first fruit of his "intubation thinking " was a wire spring, which quickly gave way to a spring bivalve speculum. Then came the changes to a “tube of plain oval form,” tubes with collar and constriction to receive the vocal cords, and tubes with retaining swell, a tilting back of the upper portion of the tube, thickening and blunting of the lower end, etc., recently detailed by the inventor in an article, entitled “The Evolution of Intubation."
After five or possibly six years of work, thinking and trying, Dr. O’Dwyer reluctantly consented to operate upon patients in private practice. His fourth case was in a prominent family in the practice of the writer. This occurred during the first week of January, 1886. It will be remembered that he began “thinking” on intubation in 1880. Dr. O'Dwyer has occupied in recent years many positions of honor and responsibility, viz., Consulting Physican to Willard Parker Hospital, Lecturer on Intubation at the Post-Graduate Medical School and Hospital, and later at Bellevue Hospital Medical College, Attending Physician to St. Vincent's Hospital and to the New York Foundling Hospital (during twenty-five years), President of the American Pediatric Society, Member of the Council of the Society for Relief of Widows and Orphans of Medical Men, and a member of the Physicians' Mutual Aid Association, Consulting Physician to Seton Hospital, besides many medical societiest, and the New York Academy of Medicine.
Intubation is O'Dwyer's monument. It is equally true that it killed him.-W. P. Northrup, M. D., in the Medical News.
The following from the Oklahoma Medical Journal is worthy of attention:
AN APPEAL TO EVERY REGISTERED PHYSICIAN AND LICENSED MIDWIFE IN THE UNITED STATES FOR INFORMATION CONCERNING
CRIMINAL ABORTION. Dear Doctor : I most earnestly appeal professionally to each of you, regardless of your school of practice, your prominence in the medical profession, or your location, to answer the questions given below. In replying please designate each question by its number. Answers can be made in numerals, and if you do not elect to respond by letter a postal card will do as well. The face of such a card will present only an aggregation of meaningless figures to all who handle it except ourselves.
However, I will highly appreciate whatever you may impart in relation to criminal abortion otherwise than may be contained in your answers to my questions. I trust your visiting list, your cash and account books, and other data in your possession will enable you to give definite or approximate answers without consuming too much of your time. If the 115,000 to 120,000 physicians in the United States will kindly give the information I ask, I will return to them through the medical press, some time during 1898, a summary of the results of my investigation.