Page images
PDF
EPUB

men have signified their intention to be present and read papers, and an excellent scientific programme is assured. The indications all point to a large and successful meeting.

Convenient and ample accommodations have been secured for the General Sessions, Section work, Registration, and Exhibits.

The entertainment of members and their families is being planned on an elaborate scale, and the Committee promises all who may come a most enjoyable time.

Denver is an interesting city, and the State offers many and varied attractions to visitors.

Local excursions are being arranged, to take place after the meeting, that all may have ample opportunity of visiting various points of interest in the State and seeing the best scenery of the Rocky Mountains.

The Committee confidently expects to obtain a one-half rate and thirtyday limit for the round trip on roads west of Chicago and St. Louis, and reduced rates on Eastern roads. The rates will be announced in the Journal of the Association as soon as definitely determined.

“Pure” DIPHTHERIA.-At a recent meeting of the Societe Medicale des Hopitaux Dr. Barbier communicated the results of his important and laborious researches on the clinical and bacteriological forms of diphtheria. He showed that cases of pure diphtheria due to infection with the bacillus only were clearly distinguishable from cases of modified diphtheria in which the additional infection of other microbes--streptococci, staphylococci, etc. -played a part. As a result he presented a clinical description of diphtheria much simpler and more definite than the existing one which confounds all forms. This pure diphtheria may be observed experimentally in animals in which the bacillus causes simple vaso-constriction and necrosis but never inflammation. But when diphtheria occurs in man it is usually in the modified form, for being but feebly contagious a pre-existing morbid condition of the affected surfaces is generally necessary to enable the disease to install itself. The diphtherias secondary to scarlet fever and measles are examples of this. In only 54 out of 221 cases examined bacteriologically was the diphtheria pure. Pure diphtheria is to be recognized clinically not by the appearance of the membrane but by the state of the throat especially; the mucous membrane is not inflamed, but, on the contrary, rather pale mucous or purulent secretion is absent, and adenopathy is absent or triling. The temperature is but little elevated; it is at most a little over 100° or 101° F., and this only temporarily. The pulse is always small and rapid. There is little or no albuminuria. However benign may be the appearance of the throat the patients look ill and have a pale, leaden complexion, because they are under the influence of the diphtheria toxin. No matter what may be the extent of the membranes or the multiplicity of the localities attacked, recovery under the influence of antitoxin manifests itself on the day following injection and is completed in two or three days, rarely later. The prog

nosis is therefore very good. All Dr. Barbier's 54 cases, which included 13 laryngeal cases in which intubation had to be performed, recovered. There is only one danger in this form-extension of the disease to bronchi, which may lead to suffocation. Dr. Barbier never observed paralysis in any of his cases—a remarkable fact. In modified diphtheria of the throat the mucous membrane is always red, sometimes it bleeds, and the tonsils are always swollen. The inflammation may be limited to the neighborhood of the false membranes, confined to a part of the mucous membrane--for example, the uvula-or generalized. In the pharynx is seen muco-purulent matter, secreted there or coming from the nose or larynx. In almost all cases the lymphatic glands are enlarged. Though the appearance of the membranes is not characteristic, in most cases, and especially when there is staphylococcic infection, they are rather thick and extensive, and often the odor of the breath indicates decomposition which is caused by saprophytes. The nose is almost always attacked, and whether membrane exists or not there is a discharge, serous, purulent, or hemorrhagic, containing numerous septic microbes. The temperature is higher than in the purer form—101.3° to 104°. Complications such as broncho-pneumonia, otitis and impetigo frequently occur, and in the worst cases septicemia.-London Lancet.

GonoCOCCI IN THE BLOOD.-Dr. Ahman has described in the Archiv fur Dermatologie und Syphilis (vol. xxxix, part 3) a case in which gonococci existed in the blood. The patient, who suffered from urethral gonorrhea complicated with multiple arthritis, tenosynovitis, epididymitis, and nephritis, was liable to feverish attacks, during one of which a Pravaz syringeful of blood was taken from a vein in the arm, and this blood when spread over four ascites-fluid agar plates yielded pure cultures of the gonococcus. Dr. Ahman considers that this is the first instance in which general gonorrheal infection of the system (blennorrhoische allgemeininfection) has been directly proved, all previous attempts to cultivate gonococci from blood having failed, perhaps because an insufficient quantity of blood was employed. Ibid.

"OLE DOCTEUR FISET,” WHO HAS “GOT NINETY YEARS OR SO."

But Docteur Fiset, not moche fonne he get,

Drivin' all over de whole contree;
If de road she's bad, if de road she's good,
When ev'ryt'ing's drown on de Spring-tam food,

An' working for not’ing half time mebbe !

Let her rain or snow, all he want to know

Is jus' if anywan's feelin' sick,
For Docteur Fiset 's de ole-fashion kin',
Doin' good was de only t'ing on hees min',
So he got no use for de politique.

- British Medical Journal,

Special Notices.

A NEW METHOD OF LOCAL ANESTHESIA.—Since the discovery of the anesthetic properties of cocaine, its sphere of usefulness has constantly broadened, and it has become one of the most serviceable drugs in the everyday practice of the physician. Recently attention has been directed to a new method of employing cocaine, the aim of which is to facilitate its use and render it more safe and efficient. In devising this method three objects have been kept in view: (1) To secure an absolutely pure grade of cocaine, free from all by-products; (2) To do away with ready-made solutions which are liable to decomposition and then lose their potency and become irritating; (3) To dispense the cocaine in such a form that fresh solutions of any desired strength can be prepared at a moment's notice. To accomplish these objects, it has been found advantageous to employ the cocaine in the form of the discoids, each of which contains a definite quantity of the drug without any excipient whatever. The amount of cocaine hydrochlorate in each discoid is accurately determined by weight, and in consequence of their ready solubility the discoids dissolve in a few drops of water. The physician, therefore, always has at hand the material for preparing fresh cocaine solutions of any percentage strength desired. Thus, for instance, if he wishes to make use of a few drops of a 4-per-cent solution, all that is required is to dissolve a one-fifth-grain discoid in five minims of water, while larger quantities can be prepared in the same way. By proceeding in this manner the physician is always informed as to the amount of the drug he is using in any given case, and unpleasant or serious effects are thus reduced to a minimum. For the induction of local anesthesia in minor surgery, dentistry, diseases of the eye, ear, nose, and throat, in short, wherever there is any indication for the use of cocaine, the cocaine discoids will be found the most eligible method of securing the beneficial effects of this remedy. These discoids are prepared by Schieffelin & Co., who were the first to make cocaine in this country, and, as is well known, their name has long been identified with the manufacture of high-class pharmaceutical products. Every means is taken by them to produce absolutely pure cocaine, and to secure uniformity and accuracy of weight in the preparation of the discoids.

A PRE-ANTITOXIN MORTALITY OF 40 PER CENT REDUCED TO 3.6 PER CENT.-Prior to the introduction of anti-diphtheritic serum, the mortality from diphtheria at the Harper Hospital, Detroit, averaged for a number of years 40 per cent. According to the thirty-fourth annual report of the hospital authorities, as published in the February number of the Harper Hospital Bulletin, page 73, one hundred and forty-one cases were treated at the hospital during 1897, with the following results:

[merged small][merged small][merged small][merged small][merged small][ocr errors][subsumed]

139 5 Mortality under antitoxin treatment,

3.6 per cent The antitoxin employed exclusively in Harper Hospital during 1897 was the antidiphtheritic serum of Parke, Davis & Co.'s Biological Department, and the remarkable reduction displayed in the death-rate reflects the highest credit on the efficacy of this matchless product.

CLEANLINESS IN CATARRHAL AFFECTIONS.—One of the fundamental principles in the treatment of catarrhal troubles of the nose and throat may be summed up in a single word, “cleanliness.” To permit secretions to remain on the surface of the in

flamed mucous membranes is to increase the existing irritation and delay the healing process. The retained mucus and crusts form a fertile soil for the growth of microbes, and, after undergoing decomposition, act as severe irritants. It follows, therefore, that means should be taken to remove these inflammatory products and keep the mucous membrane as clean as possible. All rough manipulations should be avoidedthe object is not to scrub off the mucus and crusts, which are often quite firmly adherent, but to dissolve them and wash them away. For this purpose an alkaline antiseptic solution such as Bensolyptus (Schieffelin) is especially indicated. Experience has shown that an alkaline fluid is not only the best solvent for mucus, but also exerts a soothing effect upon inflamed mucous membranes. In Bensolyptus these beneficial effects of the alkaline ingredients are supplemented by its antiseptic and anticatarrhal properties, in consequence of which it arrests all growth of microbes and facilitates the process of healing. In the various forms of rhinitis, pharyngitis, and tonsillitis, Bensolyptus has proved an important auxiliary in the treatment by promoting cleanliness, allaying irritation, and preventing bacterial infection. Bensolyptus is the outcome of careful experiments made in the laboratory of Schieffelin & Co. to produce an ideal alkaline antiseptic fluid, and the high reputation enjoyed by the products of this firm for over a century renders any further comment unnecessary.

MR. J. B. DANIEL: Sometime since I wrote for sample of Passiflora Incarnata which you kindly furnished me and for which I very sincerely thank you. I used the article above named in one of the most obstinate cases of Insomnia I have ever met with, and after the use of almost every remedy recommended with indifferent success and lost courage. I fortunately read of ur Passiflora, and as soon as received put him on its use, and to my astonishment (for I was very dubious of so positive effects), he reported he had slept well, better than for two years. After a week's use of the medicine he slept well—a dose every few nights being all that was necessary, and now reports he has not taken a dose for two weeks and is well. It has acted very nicely in a case of hysteria in a young married lady-says it does better than (as she expresses it) all things. I shall certainly make much use of it in the future. Will report often further trials of Passiflora, though so far it has proven to be of great service in delicate nervous females. Again thanking you for your kind favor,

I am very truly, Wardsville, Mo.

DR. W. S. GLOVER. The old gentleman above referred to says “it's worth its weight in gold."

CHRONIC GOUT, while not a fatal disease per se, is a dangerous affection on account of atheroma and involvement of the kidneys, depending as it does upon an increase of urate of soda in the blood depositing itself in certain joints and internal organs. These deposits consist of sodium urate, sodium chloride, and calcium phosphate. The entire arterial system is apt to become atheromatous, causing hypertrophy of the left ventricle of the heart. The treatment therefore is plain. Active exercise; bowels must be kept open daily. Hot baths are of service. Alcoholics should be interdicted. Among drugs besides alkalines colchicum and iodine are the best; salicylate of sodium is very useful. A preparation containing colchicine, decandrine, solanine, iodic acid, and sodium salicylate, in cordial, known to the profession as Henry's Tri-Iodides, meets not only all indications, but has clinically proved itself the most useful combination eyer offered.

SANMETTO IN INCONTINENCE OF URINE.-I used Sanmetto in a case of a lady, forty years of age, who could not retain her urine more than one hour for years. She had been under treatment before, without any remarkable result. I put her on teaspoonful doses of Sanmetto four times daily, and her improvement was very marked, and she is now practically cured. I desire to keep Sanmetto on hand, as there is nothing better to fill its place in such cases.

FRED A. GOEDECKE, M. D. Milwaukee, Wis.

[blocks in formation]

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

MEDICAL VAGARIES.

The Doctorate Address of the Medical Department of the University of Louisville.

Session of 1897-98.

BY H. M. GOODMAN, A. B., M. D.
Professor of Medical Chemistry in the University.

Man in the primitive state was, from the nature of his environment, a creature whose mind was filled with superstitious beliefs. To supply his meager wants and to furnish him with sustenance did not require that his intellectual faculties should be developed much above those of the brute. Accordingly, when phenomena presented themselves for which he could not give an explanation, he attributed them to supernatural causes. Hence arose the idea of various spirits for good or evil; and traditions from father to son, relating the achievements of extraordinary persons, led to the association of the names of these heroes with the names of deities presiding over and controlling human affairs. I am unable to state which of these founded medicine, for the mutilated accounts of the more important events transpiring in these early times, such as the rise and fall of empires, are uncertain, and necessarily the history of a complex science like that of medicine could hardly be expected to be handed down to us in a more perfect condition.

Our earliest authentic records of medicine are, in all probability, those of the ancient Egyptians; and, however much we may have reason to believe that there was a civilization which preceded that of the Egyptians, the records of this are utterly lost in the lapse of time.

« PreviousContinue »