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Journal of the American Medical Association, November 19, 1887.

* Progressive Muscular Atrophy Beginning in the Legs.” By J. B. Marvin, M. D., Professor of Principles and Practice of Medicine and Clinical Medicine in the Kentucky School of Medicine. Reprinted from the Practitioner and News. Louisville, Kentucky: John P. Morton & Company.

*Report on Progress in Medicine.” By J. B. Marvin, M. D., Professor of Theory and Practice of Medicine and Clinical Medicine in the Kentucky School of Medicine. Read before the Kentucky Medical Society at Paducah, June 14, 1887. Reprinted from the South-Western Medical Gazette.

Report of Twelve Cases of Alexander's Operation.” By J. H. Kellogg, M. D., Battle Creek, Michigan. Read in the Section on Surgery and Anatomy, at the Thirty-Eighth Annual Meeting of the American Medical Association, June, 1887. Reprinted from the Journal of the American Medical Association, August 20, 1887.

"The Radical Treatment of Trachoma." Paper read before the Central Illinois District Medical Society, at its Semi-Annual Meeting, in Springfield, Illinois, October 19, 1886. By A. E. Prince, M. D., Oculist to Wabash Hospital and State Institute for Deaf and Dumb and Blind. Reprinted from the Saint Louis Courier of Medicine.

“Four Cases of Poisoning from Tyrotoxicon, with Three Fatal Results. Investigations as to the Origin of the Poison; Results of the Autopsy and Chemical Analysis.” By Victor C. Vaughan, M. D., Ph. D., Director of the Hygienic Laboratory in the University of Michigan. Reprinted from the Medical News, December 3, 1887.

"An Experimental Study of the Effects of Puncture of the Heart in Cases of Chloroform Narcosis." By B. A. Watson, A. M., M. D., Surgeon to Charity, Saint Francis and Christ Hospitals, Jersey City, New Jersey. Reprinted from the “Transactions of the American Surgical Association,” May 13, 1887. Philadelphia: William J. Dornan, 1887.

“Four Months Among the Surgeons of Europe.” By N. Senn, M. D., Ph. D., of Milwaukee, Wisconsin. Attending Surgeon to the Milwaukee Hospital; Professor of the Principles and Practice of Surgery and Clinical Surgery in the College of Physicians and Surgeons, Chicago, Illinois. Being a Series of Letters to Dr. Chr. Fenger. Reprinted from the Journal of the American Medical Association, Chicago, 1887.

MEDICAL PROGRESS.

THERAPEUTICS.

THE TREATMENT OF DIPHTHERIA.

An elaborate paper on the management of diphtheria by Dr. G. Geulpa, is concluded in the issue of October 30, of Bulletin Gen. de Therap. The special point brought forward by the author is “irrigation, the most frequent possible.He has employed a solution of the perchloride of iron for this purpose, chiefly from habit, but other solutions

of lime, carbolic acid, and boric acid-may, he admits, be quite as efficient-may be more efficient-for the agent used is quite secondary, the main consideration being the frequent irrigation. Dr. Guelpa advocates the early and persistent, and almost continuous application to the parts threatened with an extension of the diphtheritic process.

Cauterizations are negatived. Perchloride of iron solutions, five to ten per one thousand in strength, have proved most successful in a long series of cases of different periods. The irrigations are practiced every quarter of an hour during the day, and every half hour at night, in the milder cases with moderate force through the fauces and nares, as is done with the nasal douche; but when the resistance to the passage of the fluid requires it, the hand-ball should be used to pump the fluid through. When irrigation is practised early and efficiently, it is comparatively rare to find the disease spreading to neighboring parts. It is relatively easy to bear by the patient, and to apply by the attendants.

As Dr. Guelpa submits many cases illustrating the utility of the method, there can be little doubt of its value. There are no difficulties in the way. As it is the irrigation rather than the character of the medicament that determines the result, the practitioner has a wide choice of materials, and, hence, those objecting to the disagreeable iron chloride, can employ other medicaments. Probably, those agents having a solvent action, as papain, lactic acid, lime, etc., can be used with the expectation of the best results. It is the early, frequent, and copious irrigation that accomplishes the important curative results obtained by Dr. Guelpa's method.

NOTES AND FORMULÆ.

BICARBONATE OF SODA IN NOCTURNAL INCONTINENCE.—Dr. Sell states that bicarbonate of soda in teaspoonful doses at bedtime, has often proven successful for him in nocturnal incontinence of urine.

DANGER FROM SANTONINE.—A case of santonine poisoning is reported by Dr. Laure from a dose of ten centigrams given to a three and one-half years' old child, without using the precaution of giving some purgative with the santonine. Death nearly ensued from difficulty in maintaining the circulation. The necessity is here shown of the addition of calomel to facilitate the intestinal secretion.

ANTIPYRINE IN HEADACHE.-Dr. Davies expresses his belief, in the Lancet, that chemistry has, in antipyrine, found a most invaluable remedy for migraine and other forms of headache, that seems to be due to worry and overwork. In those cases where he has tried it, the effects have been marvelous. His plan of giving it is, ten grams, repeated every hour for two or three hours, and then at intervals of six hours for a day or two after, to prevent all chance of a recurrence.

THEINE IN NEURALGIA.—Dr. Mays (Polyclinic) recommends the hypodermic use of theine in certain forms of neuralgia and lumbago. On account of the low solubility of theine, it is advised to use it according to the following formula:

R. Theine,
Benzoate soda........

...äā 3j.
Chloride sodæ...
Aqua distil....

f. 3j. M. Sig. Six drops equal half a grain of theine. Dose, from three to twenty drops.

gr. x.

COLLAPSE AFTER ANTIPYRINE.- Dr. Blore relates the case of a woman who had suffered from a fever following abortion. Quinine was first given, and then antipyrine. Of the latter drug a dose of thirty grains was given, and three hours later fifteen grains more. After the second dose she went into a collapse, and died at the end of about thirty hours, in spite of every means employed to excite a reaction. The author believed the fatal collapse was not a result of the disease, but was caused by the rapid fall of temperature induced by the antipyrine.

THE BINIODIDE OF MERCURY IN GONORRHEA.–Dr Illingworth finds that the biniodide of mercury is very serviceable as an injection in gonorrhoea when in solution of iodide of sodium. He combines it with carbonate of soda and sulphate of zinc, as follows: R. Solution biniodide mercury...

zij. Jodide sodium.......

3ss. Solution morphine (B. P.)...........

zss.
Bicarbonate soda......

ziss.
Şulphate zinc..........
Water........

3 vj.
M. Use as injection.

gr. x.

TOXICAL ACCESSORY EFFECTS OF ANTIPYRINE.—Dr. Guttmann reports in two cases effects of a most threatening nature, being special exaggerations of the toxical phenomena of the remedy, which have been frequently observed; breathlessness, violent palpitations of the heart, with cyanosis in a high degree in the first case; intense excitation (pulse as high as one hundred and thirty-two), oedema and ephemeral amaurosis, with violent pruritus and urticaria in the second case. These alarming symptoms followed a single dose of one gram. On account of these dangerous idiosyncrasies Dr. Guttmann advises the initial dose to be no more than one-half gram.

ELIMINATION OF MERCURY.-Apropos of the mercurial treatment of syphilis, we quote some observations by Meichailowsky on the elimination of mercury as influenced by the route by which administered.

When mercury is applied by friction, it appears in the urine in two hours after the first application; but when lanolin is used as the vehicle, the urine furnishes no reaction until six frictions have been made. In general, it can be said that the presence in the urine of mercury given by inunction, is in a direct ratio with the number of applications, and, as above stated, the character of the vehicle used.

When mercury is administered by subcutaneous injection, excretion by the kidneys goes on in the same manner as when the drug is rubbed into the skin. The simultaneous administration of iodide of potassium lessens the excretion considerably.

It has been ascertained that the urine of patients in the vicinity of those receiving mercurial inunctions, after thirtythree or thirty-four days, manifests the evidences of mercurial impression.

It was demonstrated, also, that warm-air baths had an extraordinary effect in increasing the elimination of mercury, and when salivation had occurred, it was notably diminished also. After twenty to twenty-five air baths the most rebellious stomatitis rapidly disappeared.--Bulletin Gen. de Therap., October 30, 1887.

gr. lxv.

TAPEWORM PILLS.-The material devised by Unna for coating pills which are intended to act solely on the lower intestines (keratin, a solution of animal horn in strong ammonia water), is being utilized in Germany for the preparation of a pill of pomegranate root to be used in the treatment of tapeworm. The formula is as follows:

R. Etheric extract of male fern,

Extract of pomegranate root..............ää ziiss.

Pulverized jalap........ Mix and divide into seventy pills, which are to be coated with keratin. The treatment is as follows, and is said to be absolutely certain (by Dr. K. Bettelheim, of Vienna, in the Centralblatt fur klinische Medizin, Number XLVI, 1887): Twenty of the above pills are given in the morning, fasting, and within three hours the balance of the pills. If the pills do not operate in eight or nine hours, a clyster consisting of any saline purgative dissolved in a pint of warm water should be given.

ANTIPYRINE HYPODERMATICALLY.—Antipyrine is now recommended as an analgesic in a variety of conditions. This action of the drug seems to be most prominent when it is administered hypodermatically. The following is a good extemporaneous manner of preparing a solution for subcutaneous use: R. Antipyrine......

gr. XXX. Water, recently boiled........

3ij. . M. S. Twenty drops hypodermatically.

Frånkel found that for the relief of pain three and threequarters grains of antipyrine were equal to one-third of a grain of morphine. He commonly used a fifty per cent. solution, but crystals of the drug frequently clog the syringe when used of this strength.

Antipyrine in good doses, fifteen to thirty grains internally, bas afforded complete relief in dysmenorrhoea, neuralgia, rheumatic arthritis, lumbago, and many other most opposite condi. tions, where pain, or pain and fever, are present.

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