11th. That it it is frequently companied by pyrexia. ac-tity of blood passing through the kidneys. This flushing of the surface was 12th. That ascites or icterus, and a constant result, except in a few cases. frequently both together, are of com- On respiration spartein produces an mon occurrence in the atrophic and hy- initial quickening, followed by a slowpertrophic forms. ing, reaching or approaching to the 13th. That the group of symptoms normal rate, at the same time the respirwhich have been referred to cholæmia atory movements are of greater depth. or to cholesteræmia or to acholia, and even sometimes to uræmia, frequently ushers in the fatal issue of hepatic cirrhosis in children. THE PREVENTION AND TREATMENT OF PUERPERAL FEVER.--At the recent meeting of the Ninth International Medical Congress, Dr. T. More Madden, of Dublin, read a paper on the above subject before the Section on Obstetrics. He recommended the following pretionary measures: 1. The most scrupulous attention to puerperal hygiene. portance. ON THE THERAPEUTIC ACTION OF THE SULPHATE OF SPARTEIN.-Dr. J. Mitchell Clarke, of Bristol, records, in The American Journal of the Medical Sciences for October, a clinical study of the therapeutic action of spartein. He finds that it raises the arterial tension, 2. The preparatory treatment of the and regulates the pulse. The first effect, patient-suitable nourishment, fresh air, coming on about thirty minutes after and appropriate tonics-of primary imthe exhibition of the dose, consists in a strengthening of the force of the heart- The author ordered a mixture of pobeats, with a slowing and regulation of tassium chlorate, iron, and quinine, to be the pulse in cases where this is abnormal- taken during the last couple of months ly rapid. Closely following on this, at of gestation, and he has never seen puerabout forty-five minutes or one hour peral septicemia in a patient who had after the dose, the arterial tension is been thus treated before her confineraised, and shortly before this rise of ment. tension, or at the same time the surface 3. From the first day after delivery of the skin becomes red, flushed and moist until convalescence has taken place, the with, in some instances, free perspiration. uterine cavity as well as the vagina During the next two or three hours, for the should be daily thouroughly washed out first part of the time, the surface of the with water, as hot as may be well tolbody remains flushed and warm, the ar- erated, to each pint of which may be terial tension continues to rise, or to re- added an equal quantity of sanital, main at a higher level than before the which, from its absence of color, as well dose, and the rate of the pulse to be as its aseptic properties and agreeable slowed until it reaches or approaches odor, seems specially suitable for the the normal, while from the first the purpose. Carbolic acid and rectified heart beats with increased force, the spirit of turpentine are good, while corpatient, meanwhile, experiences a mark-rosive sublimate is unreliable aud ed sense of well-being and of comfort- dangerous. able warmth, with, if it existed, loss of 4. He does not use a siphone syringe, præcordial distress, irregular cardiac but employs More Madden's irrigator. action and dyspnoea. 5. As a general rule liquor creasota Spartein also causes a variable in- (B. P.) should be administered two or crease in the amount of the urinary se- three times daily in full doses. This cretions, with increased excretion of may be advantageously combined with area, in correspondence with the increase the tincture of the chloride of iron. of water, and this diuretic action we 6. The prevailing type of puerperal should anticipate as a consequence of fever is of a distinctly remittent typhoid the strengthened vis a tergo, the rise of character, and should be primarily blood pressure, and the increased quan- treated by appropriate general stimu lants and nutriments, as well as most important and peculiar features of by attention to the removal of all the disease. Chorea is rarely a fatal septic matter from the uterus, in the disease in children, and hundreds of way already pointed out. Turpen- cases may be treated without a death. tine, iron, quinine, ergot, and opium, By far the most serious fact in the cliniare the only medicines that decal history of the disease is the occur serve consideration. Turpentine, the rence of endocarditis; but here the most important, may be exhibited per danger is remote, not immediate, and os, or per rectum, or by the skin. Tur- lies in the changes which an acute valpentine is stimulating, depurating, in- vulitis may initiate. A satisfactory creasing the elimination by the skin and study of the cardiac relations of chorea kidneys, and arrests the development of embrace the condition during the attack, microorganisms. and the subsequent heart history after a period of years. The first question has and in the October number of The engaged the attention of many workers, Medical THE AVOIDANCE OF OVERPRESSURE IN SCHOOLS.-The Committee of French Academy of Medicine reported as fol-American Journal of the Sciences, Dr. William Osler, of Philalows on this question: "The Academy of Medicine calls the attention of the delphia, works out the second on a scale public authorities to the necessity of not hitherto attempted. He has caremodifying, in conformity with the laws of fully reexamined 110 of the choreic hygiene and the necessities of the physical development of children and young people, the present arrangements of our scholastic establishments. It thinks that to cases treated at the Infirmary for Nerv 1885, the examination in every case having been made more than two years subsequent to the attack of chorea. In 43 cases the heart was normal, in 54 there were signs of organic disease, and in 13 there was functional disturbance. of the colleges and lycées for boarders should be removed to the country; that wide, open spaces should be set apart for games; and that the class-rooms should A study of these cases, Dr. Osler be improved as regards lighting and ventilation. Without dealing with the thinks, justifies the following conclusions: course of study-which it desires to see cases of chorea-much larger than has 1. That in a considerable proportion of simplified-the Academy calls special hitherto been supposed---the complicating attention to the following points: In- endocarditis lays the foundation crease of the time for sleep, as regards organic heart disease. young children; for all the pupils a diminution of the time devoted 2. In a majority of cases the cardiac study and classes-that is to say, to and cannot be regarded as in any way affection is dependent on rheumatism, sedentary occupations and a propor-associated with it; unless, indeed, we tional increase of the time for hold with Bouillaud, that the disease amusement and exercise; the absolute "chez les jeunes sujets, le cœur se necessity of submitting all the pupils to comporte comme une articulation." daily exercise in physical training, pro- 3. As the presence of an apex systolic portioned to their age-namely, walking, running, jumping, formations, evo- tion of the existence of mitral valvulitis, murmur in chorea is usually an indicalutions, regulated and prescribed move- as much care should be exercised in this ments, gymnastics with apparatus, fenc- condition as in the acute endocaring of every kind, games of strength, ditis of rheumatism. Rest, avoidance etc."-British Medical Journal, Aug. of excitement, and care in convales13, 1887. THE CARDIAC RELATION OF COREA.The heart symptoms of chorea demand special consideration as among the cence, may do much to limit a valvulitis, and obviate, possibly, the liability to those chronic nutritional changes in the valvee wherein lies, after all, the main danger. HEREDITARY TREMORS.-Dr. C. L. tion, and no muscular weakness. It is Dana, of New York, in the October associated with other neuroses or psynumber of The American Journal of choses, such as insanity, inebriety, and the Medical Sciences, calls attention to epilepsy, and also with examples of una peculiar hereditary motor disorder usual talent or intellectual vigor. which has not heretofore been systematically described, but which he has seen, PHOSPHATE OF COPPER IN THE TREATand studied in three families, and in all MENT OF PHTHISIS PULMONALIS.-The it produced a general clinical resem- following formulæ have been employed blance. by Luton, of Reims, and are reported The affection consists of a fine tre- by him in the Revue Générale de mor, controlled for a brief time, affecting Clinique et de Thérapeutique of Sepnearly all the voluntary muscles, chron- tember 8, 1887: ic, beginning in very early life, not accompanied with paralysis or any other disturbances of the nervous function. It resembles to some extent the tremor of paralysis agitans, still more a simple neurasthenic tremor. A most striking clinical feature is its marked hereditary or family type, and its transmission along with other nervous diseases. gr. R.-Cupri acetat. neut. For each pill. Al30, āā q. s.—M. B-Cupri acetat. neutral gr. §. Sig.-Dose, a teaspoonful as indicated. 1 part. B.-Cupri phosphat. (newly āā 2 parts. To be mixed at the moment of ad It begins in infancy or childhood, sometimes being brought out by an infectious fever. It continues without progressing in severity during a lifetime, which it does not shorten. The family history will reveal neuroses or psychoses. The upper extremities are most noticeably affected, but it may involve the head, neck, eye, laryngeal, or, in fine, any of the muscles. It ceases during sleep, and can be inhibited temporarily by the will. Everything that produces excitement or nervousness increases the tremor. It may be barely noticeable, ministration.-Medical News. except under some excitement, or the influence of alcohol or tobacco. It does HOUSE-FLIES AS CARRIERS OF TUBERnot interfere with delicate coördination. CULOUS CONTAGION. Spillman and It neither stops nor increases on ordinary Haushalter have recently reported to voluntary movements, in this respect the Academy of Sciences (Paris, Sesdiffering from the tremors of paralysis sion August 16th) their investigations as agitans, or multiple sclerosis. There to the possibility of "contagion" (bacilmay be with it slight contractures of lus) of tuberculosis being carried by the fingers, also developed early and house-flies, and the results make it exnon-progressive, but there are none of the forced movements, rigidity, paresis, subjective sensations, or vasomotor dis turbances of paralysis agitans, while the head and neck are not so much affected, These investigations included repeatas in senile tremor. The tendon-reflexes ed examinations made of the excremay or may not be exaggerated. The ments and intestines of flies that had fed tremor is most nearly like that occurring on the contents of the spit-cups of conin neurasthenic states, or from poisons, sumptive patients. In both, they found only there is no general nerve exhaus- abundance of tubercle bacilli. They also tremely probable that these pests of our dwelling-houses and hospital wards may have much to do with the propagation and disseminations of such contagion. found the same bacilli in the dried ex- plication of the remedy to a very large crements of flies scraped from the win- number of diseased conditions associated dows and walls of rooms occupied by with pain. Among these we may menphthisical patients. The experiments tion both acute and chronic articular show how easily such germs may be rheumatism and the acute paroxymal disseminated by the dried excrements, pains of gout, lumbago, sciatica, and or even by the dessicated and pulveru- the neuritis of ataxics. lent remains of the bodies of these insects; how easily the air of respiration, or the food and drink, may be thus polluted and infected. It is known that the germs of the tubercle bacillus have great tenacity of life. These observations also indirectly strengthen the belief that the suitable soil is quite as es- he speaks of its efficacy in the pain of sential to the development of tuberculosis as the suitable, otherwise the disease would inevitably be far more common than it is. In the second division of his paper, Sée records his use of this drug in painful conditions associated with disorders of the viscera, chiefly abdominal. Chief among these are renal and hepatic colic, colic of a gastro-intestinal type, and that associated with the uterus. Passing on, angina pectoris, and of anæmic heart. Finally, he compares it with antifebrin, and gives no small amount of praise to the drug of which he writes. In the Spillman and Haushalter, as a prac- Centralblatt für klinische Medicin, No. tical deduction from these investigations, 35, is a paper by Dr. Seifert, of Würzinsist on the importance of thorough burg, on the same subject, in which he disinfection of the spit-cups of tuber- speaks of the value of antipyrin in hemiculuous patients, by means of strong crania, angina pectoris, and chorea. solutions of phenic acid or corrosive This writer also speaks very favorably sublimate.-Boston Med. and Surgical of the drug as used in these conditions. Journal. In view of the results so uniformly attained, by observers on the other side of the water, it is a little surprising that reports of its use by American practitioners should be so few and meagre.— Med. News. ODONTALGIA OR SALICYLATES. The possible evil results of long course of salicylic acid or salicylates, formed the subject of an interesting discussion before the French Academy of Medicine, leading to the condemnation by that body of these NEURALGIA?-The agents as preservatives in articles of great difficulty occasionally experienced food. The evidence adduced was cer- in diagnosticating whether neuralgic tainly suggestive of possible renal dis- pain of the fifth nerve is due to periease and arterial sclerosis as a result of pheral irritation from disease of the cumulative irritation from long-con- teeth or to some affection of the nerve tinued use of the drug, even in very trunk, made Prof. Victor Horsley's pasmall amounts.-Boston Medical and per on this subject at the Odontological Surgical Journal Society of considerable interest, especi ally to dental surgeons. The principal DIVERSE APPLICATIONS OF ANTIPYRIN points of distinction may be summed up IN THERAPEUTICS.In the Medical under the following heads: 1. Trophic News of May 28, 1887, we called atten- changes, such as muscular wasting in tion to the results obtained by Germain the parts to which the pain is referred, Sée in the treatment of certain painful chronic congestion, or alternating dilaneuroses by antipyrin, his original obser- tion and constriction of the blood vessels, vations being recorded in L'Union point to mischief in the trunk of the Médicale of April 26, 1887. Since nerve. 2. Alterations in sensation, that time Professor Sée has not been anesthesia or hyperesthesia of the content with so limited a use of the drug, skin, especially when gently touching and in the same journal of September 10 the skin causes extreme pain, while and 13, 1887, we find records of the ap-firm pressure causes no pain at all, are, he believes, never due to dental irrita- with creasote, the surface having been ion. 3. The origin and character of the washed with a solution of cocaine bepain are sometimes useful as a means of fore each application. At the end of a diagnosticating the two conditions. month the granulation nodules had all When the pain begins in the skin or suppurated out, leaving little pits surbone, and subsequently is referred to rounded by healthy skin. The other the teeth, the probability is that the part was treated by scraping. There lesion is in the nerve trunk; if it is has been no return of the disease in stated to begin in the teeth, it inay not either part, but there has been more be due to them. Professor Horsley ex- tendency to contraction in the part pressed the view that constant pain is in which was scraped.-Provincial Medimost cases of peripheral origin, whereas cal Journal. intermittent pain is due to trouble near er the nerve centre; but this is opposed THE TREATMENT OF HEPATIC CONGESto the experience of most dental sur-TION.-Jules Cyr is quoted by the Regeons intermittent pain being a frequent view de Therapeutique, as using the accompaniment of dental disease. Last- following treatment: ly, the existence of "tender spots" along 1. Application over the liver of comthe course of the nerve or its branches, presses of cold water, often renewed; is generally an indication of irritation two or three leeches about the anus. along the whole course of the nerve, but occasionally occurs in cases ot peripheral irritation.-Lancet, September 3, TO DISGUISE THE TASTE OF COD-LIVER OIL. To remove the unpleasant flavor of cod-liver oil, Revista Balear recommends the following method: Cod-liver) oil, 400 grammes; ground coffee, 20 grammes; animal charcoal, 10 grammes. Mix them well together, and place them in a glass at a temperature of from 500 to 60° F. for four hours. Place the mixture aside for two or three days, and then filter through paper. The odor and flavor of the coffee persists, and conceals that of the oil.-Medical Press and Circular, September 7th, 1887. 2. At evening, three-fourths of a grain of calomel should be taken, followed the next morning by five drachms of Glauber's salts. 3. As beverage, milk and Vichy water, or seventy-five grains of ammonium chloride in a quart of water. clining, of water at a pleasant tempera4. A douch, while the patient is reture, given over the hepatic region. Med. News. Aquæ menthæ viridis, Aquæ camphoræ ad fl. 3ij M. Sig.-Teaspoonful every halfhour till child is comfortable. This does not preclude warm baths, hot cloths on abdomen, relief of constipation if present, massage, etc, but it does all opiates and soothing syrups.Medical Record. Dr. J. D. Bryant, the Surgeon-GenTREATMENT OF LUPUS.-Dr. Drewitt eral of the State of New York, and a described the case of a child in whom a Professor in Bellevue Hospital Medical patch of lupus had been treated in one College, has accompanied President part by Unna's plaster of salicylic acid Cleveland on his Western trip. |