Page images

It may be interesting to add that the very same condition was produced in the same patient four days later by the application of one plaster only, and the removal of which resulted in the removal of the trouble.

The points of interest in this report appear to be these: (1) The remarkable suspectibility of this woman to the influence of belladonna. (2) The minimum amount of the drug which produced the symptoms of poisoning. (3) The possibility of mistaking that condition for acute insanity when it occurred in the puerperium. (4) The caution to be observed in prescribing belladonna plaster or ointment-an old warning, but one that can bear repetition.

Journal American Medical Association.

THE PREVENTION OF TUBERCULOSIS.-We are glad to see that the Daily Telegraph is lending its powerful support to the movement recently started by Sir Wm. Broadbent, Mr. Malcolm Morris, and a considerable number of leading members of the medical profession in London to take steps to check the continued prevalence of tuberculous disease in this country. The question is eminently one upon which an enlightened public opinion ought to be formed. The public mind must be aroused to the fact that consumption and other forms of tubercle are preventable diseases. "If preventable, why not prevented?" as the Prince of Wales said on a memorable occasion. We understand that His Royal Highness has already shown a warm interest in the movement, and has promised to preside over a public meeting which will be held after the autumn holidays, probably early in October. At this meeting the formation of an Association for the Prevention of Tuberculosis on lines similar to those of the associations which are doing such good work in France and Belgium will be proposed, and other means will be concerted for placing sufferers from pulmonary consumption in its early stages under the most favorable conditions for recovery.-British Medical Journal.

TARDY ABSCESS OF THE LIVER FOLLOWING DYSENTERY IN A TEMPERATE CLIMATE.-At the Fourth French Congress of Internal Medicine (Gazette hebdomadaire de medecine et de chirurgie, April 24) Boinet, of Marseilles, reported four new cases in which, within a few months or a year after a mild attack of dysentery, a large abscess had formed in the liver. In such abscesses occurring in temperate regions, he says, adhesions are exceptional, although they are frequent in the tropics.- New York Medical Journal

ATHEROMATA ON THE FLEXOR TENDONS OF THE FINGERS.—Trnka, of Prague (Centralblatt fur Chirurgie, 1898, No. 6; Wiener klinische Wochenschrift, May 12th), reports that he has observed six cases in which globular atheromata as large as a hazelnut and of cartilaginous hardness were situated between the skin and the flexor tendons of the fingers. Although firmly attached to the sheath of a tendon, they could always be smoothly dissected away without injury to the sheath.-Ibid.


Vol. 28.

OCTOBER 1, 1898.

No. 7.

H. A. COTTELL, M. D., Editor.

A Journal of Medicine and Surgery, published on the first and fifteenth of each

month. Price, $2 per year, postage paid.

This journal is devoted solely to the advancement of medical science and the promotion of the interests of the whole profession. Essays, reports of cases, and correspondence upon subjects of professional interest are solicited. The editor is not responsible for the views of contributors.

Books for review, and all communications relating to the columns of the journal, should be addressed to the Editor of THE AMERICAN PRACTITIONER AND News, Louisville, Ky.

Subscriptions and advertisements received, specimen copies and bound volumes for sale by the undersigned, to whom remittances may be sent by postal money order, bank check, or registered letter. Address

JOHN P. MORTON & COMPANY, Louisville, Ky.


The increase in the number of opium habitues from year to year is a menace to the body politic, and must soon become appalling if the medical profession can not devise some effective method of holding it in check. So far all drugs which have been used against it have proved vain; the “cure," if effected at all, being the result of gentle restraint, and moral suasion on the part of the physician, and the exercise of extracrdinary will-power on the part of the patient. This and nothing more is what is done in the numberless sanitariums for the relief of drug addiction, and we fear that time will add no new resource to the measures in vogue.

The results are too well known to call for statement, and are melancholy indeed. The victim of the insane appetite returns to common life, and, being set free from the healthful restraint of the sanitarium, is too weak to withstand temptation, and, like the “dog” and the "sow” of the Scripture, turns again to the “vomit” and the “wallowing in the mire."

Now, if the unfortunate could be put and kept for a season upon a drug not itself enslaving until the cravings for opium had died out of his system, the problem of the cure of opium addiction might be solved to the relief of a multitude of helpless and hopeless wretches, and the unburdening of society of a load that may become insupportable. If

the problem is ever solved, it must be worked out upon some such line as the following interesting case-report suggests. Dr. C. H. Humphreys, of Dayton, Ohio, writes thus in the New York Medical Record, 24th ult.:

I was asked recently to see a physician who had unfortunately acquired the morphine habit, and who, after many ineffectual efforts to stop the use of the drug by “tapering off,” saw an account by Dr. MacLeod, in the British Medical Journal, of the cure of the morphine habit by bromism, and determined to give it a trial. He had taken about three ounces of the salt when his family grew alarmed at the mental disturbances produced, and requested me to see him. I found him deeply under the influence of the bromide, and, learning the true state of affairs, had him removed to the hospital, the better to conduct the treatment. Not being satisfied with his statement that he had been taking on an average twelve grains of morphine a day, I cut the injection down to half a grain three or four times a day, and then gradually reduced it to one fourth of a grain twice daily, until on the fifteenth day of his hospital treatment he, of his own accord, refused further injections of the morphine, although it entailed considerable suffering. The cessation of the drug was followed by the usual digestive and nervous disturbances for several days. At the end of the third week the patient returned to his practice, freed from all desire for morphine, he firmly declares.

As a result of the bromism and the withdrawal of the morphine there were great muscular relaxation and general lassitude, which were relieved by hypodermic injections of strychnine.

The patient is of the opinion that the morphine should have been entirely withdrawn while he was under the full effect of the bromide, as the continuance of it, even in small doses, after the effect of the bromide had passed off, only fed the old flame and in a measure converted the treatment into the gradual-withdrawal plan, with its attendant suffering.

Notes and Queries.

URTICARIA OF Mucous MEMBRANES.-The eruption of urticaria does not affect the skin only, but may extend to the mucous membranes. On some patients it can be observed; on others its existence is to be inferred from the symptoms. Affection of the stomach usually shows itself by vomiting, but in a few rare instances hematemesis has occurred. In the British Journal of Dermatology, May, 1898, Dr. T. H. Chittenden has published the following case: An unmarried woman, aged thirty-eight years, became subject to attacks of urticaria. They increased in severity ; the tongue and lips became very swollen, there was sore throat with dysphagia and dyspnea lasting three or four hours, and the mucous membrane of the nose was much swollen and congested. These attacks usually lasted about a week. Later they were accompanied by nausea and by vomiting of large quantities of blood, which was followed by relief and the disappearance of the rash. There appeared to be some relation between the catamenia and the hematemesis; the latter came on about the first day of the former. Menstruation for the most part was regular but very profuse. No cause for the disease could be traced; there was no family history of gout, asthma, or hemophilia, and the strictest rules of diet had no effect. In the Transactions of the Clinical Society of London, 1885, Dr. Pringle recorded an exactly similar case in a man; he concluded that the hematemesis was the result of capillary hemorrhage from an urticarial gastric mucous membrane. In urticaria of the skin analogous hemorrhage may take place into the wheals (urticaria hemorrhagica). The mucous membrane of the bronchi may be affected, and a typical attack of asthma may accompany the skin disease. Of this a marked example was published in the Lancet of May 22, 1886, by Mr. T. Davies Pryce. Indeed, apart from such cases of concurrence, urticaria and asthma show many analogies. Idiosyncrasy plays the same prominent part in their causation. These facts lend support to the theory of the late Sir Andrew Clark that asthma is a neurovascular affection of the bronchial mucous membrane.-Lancet.

TRI-STATE MEDICAL SOCIETY.—The tenth annual meeting of the TriState Medical Society of Alabama, Georgia, and Tennessee will be held at Birmingham, Ala., Tuesday, Wednesday, and Thursday, October 25th, 26th, and 27th, 1898.

The following are some of the papers promised:

President's Address, J. A. Goggans, Alexander City, Ala.; Early Diagnosis of Cancer of the Uterus, Thos. E. Cullen, Baltimore, Md. ; Acute Anterior Poliomyelitis, E. D. Bondurant, Mobile, Ala.; A Case of Com

plete Obstruction of the Common Bile Duct by Floating Gall-Stone, W. H. Hudson, Lafayette, Ala.; A Simple Operation for Hemorrhoids without Injections, Ligature, Clamp, Cautery or Crushing, R. R. Kime, Atlanta, Ga.; Total Amputation of the Penis so that the Patient Can Urinate Normally, H. M. Hunter, Union Springs, Ala.; Impotence, W. H. Mangum, Georgiana, Ala.; Extirpation of the Pancreas, H. Berlin, Chattanooga; Two Cases of Surgery, S. W. Purifoy, Lowndesboro, Ala.; Fracture of the Spine: Presentation of Two Cases, B. G. Copeland, Birmingham; The Treatment of Intestinal Obstruction and Constipation by Electric Injections, E. P. Johnson, Oak Park, Ill. ; Conservative Gynecology per Rational Medication, R. H. Hayes, Union Springs, Ala.; Ectopic Gestation, W. E. B. Davis, Birmingham; Modern Treatment of Corneal Opacities, with Report of Cases, M. L. Heffelfinger, Huntsville, Ala.; Keratitis, A. A. Greene, Anniston, Ala.; Purulent Ophthalmia: New Method of Treatment, Frank Trester Smith, Chattanooga; Fevers of Alabama, Charles McAlpine Watson, Florence, Ala.; Some Fevers of St. Clair County, Ala., Eugene P. Cason, Ragland, Ala. ; Continued Malarial Fever in Southeastern Alabama, William R. Belcher, Daleville, Ala.; Typhoid fever, H. Eugene Mitchell, Oneonta, Ala.; Typhoid fever, E. A. Mathews, Clanton, Ala.; Typhoid Fever, J. D. Gibson, Birmingham, Ala.; Typhoid Fever, Report of Cases, C. L. Guice, Harris, Ala.; Some Suggestions in the Treatment of Typhoid Fever, J. C. LeGrand, Birmingham ; Diphtheria, H. L. Appleton, Cedar Bluff, Ala. ; Chorea, S. W. Fain, Chattanooga; Suggestion in the Healing Art, E. T. Camp, Gadsden, Ala.


BEWARE OF THE MANCHINEAL Tree.—The following circular, prepared by Dr. J. T. Rothrock, Commissioner of Forestry, Department of Agriculture of the Commonwealth of Pennsylvania, has been published and distributed by direction of Hon. Daniel H. Hastings, Governor of the Commonwealth:


BEWARE OF THE MANCHINEAL TREE!! It grows along the seashore in Cuba and the West India Islands generally.

It is from forty to fifty feet high, has oval, pointed, toothed, shining leaves, which are from three to four inches long.

When the fresh leaves are pulled off a drop of milky juice comes from the leaf stem.

The fruit is a yellowish green, fragant, and somewhat resembles an apple in shape.

If bitten into it makes the mouth very sore for a time and may produce serious results.

After handling any part of the tree-root, leaves or fruit-rubbing the eyes may cause them to become seriously inflamed.

Mucous membranes (such as the red margin of the lips or eyes or anus are particularly subject to its poisonous effect.

« PreviousContinue »