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For Specific Iritis - The following is recommended to be given intern ally in cases of syphilitic iritis:

R Hydrarg. biniodidi...
Potass. iodidi...

Aq. destil...

Syr. aurantii, q. s. ad..

gr. vi

3iss

3ss

3iij

M. Sig. One teaspoonful three times a day after meals.

Frost Bite.-Protect the hands, feet, and ears, especially in children. When frostbitten, rub parts with camphorized alcohol and apply:

Starch.....

Salicylate of bismuth.

Glycerine...

Tinct. iod.

9 parts

1 part

Apply tincture of iodine pure, or paint on each night:

To calm itching at night, apply :

Glycerini...

Aquae rosae.

Tannin..

20

10

COMBY.

50

50

0.10

-C. BESNIER.

5

30

-Journal de Medecine.

When ulceration has occurred, apply morning and night:

Borax....

Vaseline.

Treatment of Laryngismus Stridulus.-The following is recommended by Merck's Archives in treatment of laryngismus stridulus occurring in children two years of age or older:

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M. Sig. One teaspoonful every hour until difficult inspiration is relieved.

Quinin as a Styptic and Antiseptic.-Occasionally the general practitioner is called upon to check hemorrhages which are stubborn to treatment. Marx, as noted in Med. News, states that iodoform and its derivatives have so many objections that he has been induced to search for other substitutes. Among these he has tried quinin with great satisfaction. He employs the following combination:

B Quininae hydrochloratis.
Alcoholis....

Aq. destil. q. s. ad..

gr. X-XX

3ss

3ii

M. Sig. Saturate the gauze and apply to bleeding surface.

OUR MONTHLY QUIZ.

Prizes Open to Fortnightly Subscribers.

TOPIC FOR FEBRUARY.

1. How do you treat the pernicious vomiting of pregnancy (medical and hygienic treatment) ?

TOPIC FOR MARCH.

2. How do you treat the rheumatic affections, viz.: Rheumatic fever, sub-acute and chronic rheumatism?

Answers should reach this office not later than the 15th of the month.
Questions for discussion in this department are announced once a

month.

For the best and most practical answer to any one of these questions we will give a prize of $5.00. To the second best a subscription to the FORTNIGHTLY for the year. The answers must be short, no one answer to contain more than four hundred words. We shall publish the substance of such of the answers as seem most likely to prove interesting to our readers.

Only subscribers to the FORTNIGHTLY will be recognized as competing (although we shall be pleased to hear from others who have ideas to suggest), and all persons known to be engaged in medical journalism are disqualified. Prizes will not be awarded to the same person more than once each year. Every answer must be accompanied by the writer's full name and address.

The Treatment of the Pernicious Vomiting of Pregnancy.

BY

BY EVERETT J. BROWN, M. D.,

DECATUR, ILL.

Y pernicious vomiting of pregnancy I understand, the persistent, uncontrollable vomiting occurring usually in the first half of pregnancy, in which practically nothing is retained by the stomach, and which if allowed to continue, often ends fatally; the patient becomes bedridden, emaciated, the pulse becomes rapid, more or less fever may develop, and a typhoid state ensues.

The remedies suggested for this condition are legion, hence none are of much value. In true pernicious vomiting nothing is retained by the mouth; if medicine or food is retained at all, the vomiting is not pernicious and does not require the extreme treatment which I advise.

The treatment which I have found successful in six out of seven cases which I have seen in the last eleven years has been the hypodermatic injec

tion of morphine and atropine in doses of one-fourth and one one-hundred and fiftieth of a grain respectively; this dose to be given two, three, or even four times in the twenty-four hours. In no case has the morphine habit been produced, but on the contrary, after three to six weeks treatment, when the uterus has lifted itself out of the pelvis and into the abdomen, the morphine was gradually discontinued without protest from the patient.

CASE I.-Single girl aet 18. Had been treated for three weeks for ulcer of stomach; she was much emaciated and lay in a typhoid state with fever, and sordes on gums; nothing, not even a teaspoonful of water was retained; a vaginal examination revealed pregnancy, and a hypodermic of morphine gave her the first rest for several nights; the dose was increased to half a grain daily, and and when under its influence she would retain milk and broths; her condition gradually improved, and at end of five weeks the morphine was discontinued, and she gained rapidly in flesh.

CASE II. Mrs. F. Twice have I conducted this woman through a most pernicious form of vomiting; besides rejecting everything she suffered great pain beneath the sternum; a quarter grain morphine tablet four times in twenty-four hours for a period of six weeks in first, and four weeks in second pregnancy, carried her safely through.

The other three cases were similar and required same treatment; one had had abortion performed twice for this condition.

The seventh case seemed to have an idiosyncrasy against morphine and was not successful; abortion was necessary to save her life.

This treatment I recommend not for the ordinary, or even the moderately severe forms of vomiting, but only for the bed-ridden and greatly weakened patients who otherwise might pass on to a fatal termination, or require an abortion to save life.

Hygienic and Medicinal Treatment of the Pernicious Vomiting of Pregnancy.

BY ARTHUR H. FLICKWIR, M. D.,

DETROIT, MICH.

HE first thing to be considered in the treatment of the pernicious vomiting of pregnancy, is the regulation of diet, and the patient's mode of life. All sexual intercourse should be prohibited. Strict attention to the condition of her gastro-intestinal tract. A light breakfast should be taken in bed, before the patient arises in the morning. After breakfast she should rest for an hour or so, by doing this the nausea and vomiting caused by the ingestion of light food may be avoided. Tea and toast or milk is sufficient for the morning meal. In the worst cases rectal alimentation is often indicated. Liquid peptonoids, peptonized beef-tea, and pancreatized milk are quite satisfactory, as the enemata should not

contain anything irritating. Three to seven ounces may be given three or four times a day. The rectum should be kept clean, and injections of normal salt solution will relieve the distressing thirst, which is a usual symptom. It must not be forgotten that the vomiting of pregnancy is a neurosis, therefore a strong nervous and moral impression upon the patient will help admirably.

MEDICINAL TREATMENT.

Cocaine is an excellent remedy given in gr. 1-12 doses, or may be used as a spray to the fauces. Small doses of calomel gr. 1-20. Oxalate of cerium, subnitrate of bismuth are all efficient. Iodine gtt. i-ii in water gives good results. Sodium bromide, potassium bromide and chloral are the best nerve sedatives to use. Sod. brom. gr. x and aq. camph. f3 iv four times a day is very good. The bromides may be given by enemata when the stomach will not retain them. Patient should be kept quiet and in bed.

CONSOLIDATION AGAIN. The union of the Cleveland Journal of Medicine and the Cleveland Medical Gazette, which was recently announced, is one of the most important of consolidations yet recorded in journals of this class. Both journals occupied an enviable position among medical journals, and the new journal, which is to be known as the Cleveland Medical Journal, must needs be one of great strength and usefulness.

A MILLON PRISONERS.-Russian prison statistics lately published reveal some startling facts. Four years ago the number of prisoners in Russia was 764,373; now it has risen to 842,729. If the inmates of the military prisons, the peasants in the houses of correction and the prisoners in Transcaspian jails were counted, it would be found that a million of the subjects of the Czar are incarcerated, not including the Siberian exiles, who number 77,160.

A MONUMENT TO HIS MEMORY.-By the will of the late J. Alfred Kay, of Philadelphia, many hospitals are the subjects of substantial bequests. Among these are $5,000 each to the Pennsylvania, Germantown, University, Jefferson, Orthopedic and Polyclinic Hospitals. The codicil also gives $1,000 each to St. Agnes', St. Joseph's, Jewish, Hahnemann, Presbyterian, German, Children's, Howard, Medico-Chirurgical and Gynecean Hospitals and to a number of homes for the blind. etc.

ISOLATION PAVILION FOR CONSUMPTIVES, BLACKWELL'S ISLAND. -On the last day of January, the tuberculosis pavilion at the Metropolitan Hospital on Blackwell's Island was opened for the reception of patients. It contains 120 beds which will be filled as soon as the weather moderates so that the transfer from other hospitals can be made without danger to the patients. Five buildings, recently occupied by insane patients, have been converted to the use of the consumptives. It is expected that an extra appropriation will be obtained from the Charities Department to pay for the refitting of the four other buildings.

PAPERS for the Original Department should be in hand one month in advance, and contributed to THE MEDICAL FORTNIGHTLY exclusively. A liberal number of extra copies will be furnished authors, and reprints may be obtained at reasonable rates, if request accompanies the manuscript. Engravings from photographs furnished free. Contributions, and books for review, should be sent to the Editors, 312 Century Building, St. Louis.

COLLABORATORS.

ALBERT ABRAMS, M. D., San Francisco.
LEWIS H. ADLER, Jr., M. D., Philadelphia.

M. V. BALL, M. D., Warren, Pa.

J. K. BAUDUY, M. D., St. Louis.

A. V. L. BROKAW, M. D., St. Louis.
DILLON BROWN, M. D., New York.
CHARLES W. BURR, M. D., Philadelphia.
HENRY T. BYFORD, M. D., Chicago.
W. T. CORLETT, M. D., Cleveland.
ARCHIBALD CHURCH, M. D., Chicago.
N. S. DAVIS, Jr., M. D., Chicago.
FRANK R. FRY, M. D., St. Louis.

Mr. REGINALD HARRISON, London, Eng.
RICHARD T. HEWLETT, M. D., London, Eng.

J. N. HALL, M. D., Denver.

HOBART A. HARE, M. D., Philadelphia.
CHARLES JEWETT, M. D., Brooklyn.
THOMAS LINN, M. D., Nice, France.

F. J. LUTZ, M. D., St. Louis.
FRANKLIN H. MARTIN, M. D., Chicago.
J. M. MATHEWS, M. D., Louisville.

E. E. MONTGOMERY, M. D., Philadelphia.
NICHOLAS SENN, M. D., Chicago.
FERD. C. VALENTINE, M. D., New York.
EDWIN WALKER, M. D., Evansville.
REYNOLD W. WILCOX, M. D., New York.
W. E. WIRT, M. D., Cleveland.

H. M. WHELPLEY, M. D., St. Louis.

Vaccination.

BY JOHN WHITLOCK HAIRGROVE, M. D.,

JACKSONVILLE, ILL.

Read before the Morgan County Medical Society, January 7, 1902.

ACCINE disease; vaccinia; cow-pox is an infectious disease characterized by general and local symptoms. When this disease is successfully conveyed to the human body it produces an immunity from smallpox. Its introduction into the blood of man is by direct infection and is called

vaccination.

Vaccination when successful produces a vesicle to the point of introduction, and the contents of this vesicle when re-inoculated into a healthy person not previously vaccinated, or having had the smallpox will again produce the same disease.

Tyson says it is pre-eminently characteristic of vaccaine disease that it can be communicated only when directly introduced into the blood. Quoting further from the same author:

"Nature of Vaccinia.-Two views as to the true nature of vaccinia are held the English, that it is smallpox modified by transmission through the cow; the second, or French view, that it is a separate disease distinct from smallpox. Each side claims that its own view is sustained by experiment. The former view is probably correct-that vaccinia is smallpox modified by passing through the cow.

96

Lymph in Use.-At the present time it is almost the universal practice to use animal lymph or the lymph directly from the cow, although humanized lymph, that from another person having vaccine disease, can also be successfully used. The chief reason for using animal lymph is that all dan

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