LARYNGOLOGY AND RHINOLOGY. Under the Charge of WM. E. HOPKINS, M. D., Professor of Laryngology in the Post-Graduate Department (San Francisco Polyclinic) of the University of California; Oculist to St. Mary's Hospital and Hospital for Children. Rupture of the Membrana Tympani from Violence.The following case which has recently been under my care is worthy of being placed on record. F. H. W., age 29, a native of Dublin, Ireland, presented himself at 4 P. M., September 1st, and made the following statement: At 11 o'clock the same day while at work on a vessel in the bay he became greatly overheated and brought relief by repeatedly plunging his head into a large vessel filled with cold water. Realizing that his left ear was filled with water, he rubbed and struck it with some violence. While doing this he felt a very sharp, agonizing pain shooting through the ear up over the temple and down the neck. This, after lasting some fifteen minutes, abated very much. At the end of two hours there was a noticeable discharge of serum that so alarmed the patient that he sought advice. He was very restless and complained of a continuous dull pain behind and below the ear. Hearing was greatly reduced, the watch being very faintly heard at five inches. On examination the following interesting picture was observed. The circumference of the membrane was intensely congested, while near the center for a space covered by a radius of two lines there was complete blanching of the membrane. In the center of this white spot and just behind the tip of the manubrium of the malleus was a round, ragged opening with fine dark lines radiating from the border. Realizing that intense reaction was setting in leaches were ordered and a mild antiseptic lotion applied. The following morning there was no pain, the opening was smaller, the border swollen and it was apparently closing up. At this date, one week later, the opening has closed, symptoms have all disappeared and the watch is heard at thirty inches. Death from Convulsions six hours after scraping post-nasal adenoids under cocaine. The operation was a simple one performed at ten o'clock. At 3:30 a severe general convulsion occurred, from which the patient recovered, but this was followed after about a quarter of an hour by violent general convulsion, and death from asphyxia in a few minutes. He con sidered the first convulsion to be reflex, and that during this basal hemorrhage took place, causing the second fatal attack. The cocaine probably caused increased nervous excitability He believed that this was the first recorded case of the kind.— Dr. Arthur SANDFORD in J. Laryng., Rhin. and Otol. Removal of Button three-quarters of an inch in diameter from posterior nares, which had been in situ for about eight years, causing fœtid discharge, nasal occlusion, and asthmatic attacks of dyspnoea, in a patient aged thirteen years, who had no recollection of how the foreign body entered the posterior nares. -DR. ARTHUR SANDFORD in Jl. Laryng., Rhin. and Otol. Cicatrix from a Tubercular Arytenoiditis.-The cicatricial tissue is composed of adult connective tissue fibers, mixed with very rare normal fasciculi, without hypertrophy aud without tendency to proliferation. We do not find any fibrous nodules of concentric fibers, and nothing which would lead one to diagnose a cured tubercular lesion, if we make only one examination of several sections. The glands are destroyed, although in their place we can observe very small regenerated acini, forming groups elongated and parallel to the direction of the fibers. None of the nervous filaments present lesions, either of perineuritis or of segmentary neuritis; the pathological fibers of Remak, so numerous and clear in sections of pseudo neuroma, are, on the contrary, absent in all sections.-DR. MICHEL DANSAC, J. Laryng., Rhin. and Otol. GENERAL DEMOGRAPHY AND CLIMATOLOGY. Under Charge of P. C. REMONDINO, M. D., Member of the American Public Health Association, of the American Medical Association, of the State Board of Health of California, and of the Board of Health of the City of San Diego. Gout. The habitual eater of meat in liberal quantities has a healthier and a less "gouty" urine than the subject of regime that limits the proteids. Let practitioners give their patients plenty of red meat, which is the staple of the food eaten by animals which do not produce uric acid. Keep up their energy with dry champagne or some other wine that contains a minimum of alcohol with a maximum of nerve-stimulating property; and for remedies fall back on iodine, combined with diffusive nerve tonics and stimulants, such as musk (Cullen's sheet an chor), camphor and the other tried remedies of the older and too much neglected type.-GRANVILLE, Med. Record. Psychic Effects of Weather.-J. S. Lemon (American Jour nal of Psychology, January) notices the very great influence of weather on the health and temperament, and through them on the customs and habits of men of all ages. This is reflected in the salutations of all nations, in their religious ideas, particularly in their conceptions of the future life, and a thousand petty details of everyday existence. It affects even crime. Suicide is known to depend largely upon the weather, and it has been calculated that in India 48 per cent of certain crimes disappear when hot weather gives place to cold. The health of idiots and those afflicted with acute mania is especially dependent upon weather, and its effect on the nervous system is such that many persons can anticipate weather changes from their own feelings. Accidents in factories are said to be much more frequent in bad weather than in good, and physiological phe nomena like knee-jerk seem to be dependent on it in some measure. Its effect on the appetite is well known, and teatasters, who have cultivated the sense of taste till it has become almost abnormal, say that in good weather this sense is more delicate than in bad weather. No systematic study of all these facts and relations has yet been made, but such a study would doubtless well repay the investigator. Vaccination for the Grippe.—I have found in the blood of persons attacked with the grippe a microbe like that described by Mr. Pfeiffer, the peculiar characteristic of which is that it cannot be cultivated except in a certain quantity of blood. I have ascertained by a series of experiments that the blood serum of animals which have been vaccinated with cultures of the bacillus of influenza, possesses the power, even when administered in small doses, of conferring on other animals immunity against infection as well as against being poisoned by the influenza. In fact, in these cultures of the specific bacillus there is a toxicant to which the hare is very sensitive. In addition, the same serum has, I have ascertained, very marked curative properties. Even in feeble doses, it is capable of curing an animal of an infection which would kill it in five or six days, and that even when the therapeutic injections have not been begun until forty-eight hours after the inoculation. As to the quantity of serum sufficient to vaccinate with before infection, it is less, and one forty-sec ond part of a gramme will suffice to render a hare safe from all danger of infection.—MR. BRUSCHETTINI in Archivii per le Scienze Mediche, Rome. Bodily Temperature.-The Kansas Med. Journal has the following to say concerning the temperature of the body: "It is remarkable what slight variation there is in the temperature of the healthy human body. The normal temperature is 96.6, and it is a fraction less than this one or two hours after midnight; while the maximum temperature occurs from one to two hours after the noon hour. The ingestion of food, fasting, exercise, all are factors in slightly ranging the temperature. The great peculiarity about the temperature in men is its evenness under all conditions. Heat or cold causes but slight variation, and in man less than in any other animal. In extremes that would be fatal to many animals, man can endure and enjoy good health under those circumstances. We read of Arctic voyagers enduring a temperature ranging from 80° to 90° and even 102° below zero, while on the other hand, in the tropics, during the greater part of the year, the temperature ranges from 106° to 110° above, and yet men enjoy health in such varying temperature. We are told that the workmen of Sir F. Chantrey were accustomed to enter a furnace in which his molds were dried whilst the floor was red hot and a thermometer in the air stood at 250° F. And Chabert, the fire king, was in the habit of entering an oven the temperature of which was from 400° to 600° F. Such heats are dry, and should the atmosphere be moist and evaporation from the body thus prevented, such intolerable heat could not be endured.” MATERIA MEDICA AND MEDICAL CHEMISTRY. Under the Charge of A. L. LENGFELD, M. D., Professor of Materia Medica and Medical Chemistry, University of California, And DAVID M. FLETCHER, Ph. G. Jambul in Diabetes.-Dr. Leoni (Gazzetta Degli Ospitali) has tested the extract of syzygium jambolanum (jambul) seeds in four cases of diabetes mellitus, and reports that the drug contains an active principle which, while not specific, is yet capable of neutralizing the diabetic process in individual cases. Test for Albumen in Urine.-M. Boymand states that the best re-agent for the detection of albumen in the urine, is trichloracetic acid. It is said to be more reliable than nitric or metaphosphoric acid, and it also has the power of precipitating that peculiar form of albumen which is thrown down by heat, but redissolved on the addition of acetic acid. Trichloracetic acid is obtained by the action of chlorine gas upon acetic acid. The test may be used in a solid form or in solution. If the solid be employed, a small fragment is placed in a test tube containing the urine; it sinks to the bottom and is dissolved, producing a cloudiness, or with very clear liquids, a zone of cloud. The solution can be used either saturated or fairly concentrated. When poured upon the urine to be examined, it forms a ring which is characteristic—like that obtained by means of nitric acid, but without producing any coloration. If the urine contains much urate of soda, it is better to dilute it with distilled water.-Doctor and Druggist. Strophanthus in Dipsomania.-It would seem to judge by some of Dr. Skvottzow's (Sem Med., 1894, xiv, p. 14) observations, that tincture of strophanthus may arrest an attack of dipsomania very quickly. This curious effect of the medicament in question was discovered accidentally by the author in a corpulent man of 63 years, who drank large quantities of brandy. As he exhibited feebleness and intermittence of pulse, the author considered it necessary, to relieve the embarrassed cardiac action, to prescribe a dose of seven drops of tincture of strophanthus three times a day. The patient was seized, after the first dose, with nausea, and experienced such a disgust for alcohol that he abandoned its use abruptly and definitely. The same effect is reported by the author in two other instances. Strophanthus always provoked a nauseous condition, soon followed by abundant perspiration-an effect not ordinarily observed in non-alcoholic persons. The abrupt suppression of alcohol is said not to have produced any delirium, which is contrary to the usual experience with drunkards. HANDSHAKING.-Kissing, at least in public, was long ago considered a misdemeanor in Boston, which was punishable by a fine, imprisonment or both, but it remained for Baku, Russia, to establish a society for the suppression of handshaking, as it is considered possible to communicate diseases by this means. |