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in the use of the drug. Tweedy published his results in the London Lancet and failed to obtain any anesthetic effects, although beginning with a solution of 1 to 250 and diminishing its strength, Lewin pointed to the numerous confirmatory experiments of German occulists showing the anesthetic value of the drug.

Onodi presented his views and experiments to the Royal Society of Physicians of Buda-Pest (International Clin. Rundshau, March 4, 1888). He used solutions varying from 1 to 2,000 to 1 to 500. His experiments were made on four rabbits and twelve human subjects. With two drops of 1 to 2,000 solution, anesthesia of the cornea occurred in twenty-one minutes, in thirty-four minutes anesthesia of the sclera. Pupils are always dilated. With two drops of 1 to 1,500 solution, corneal anesthesia occurred in eighteen minutes.

With two drops of 1 to 1,000 solution, anesthesia followed in fourteen minutes, but the pupil was narrower by one-third. Anesthesia complete in forty-four minutes; also scleral anesthesia.

With two drops of 1 to 500 solution, anesthesia occurred in fourteen minutes. In In twenty-six minutes it was complete. There was no reaction to strong pressure. The pupils were contracted. Edges of the eyelids sensitive. Sclera anesthetic. In all four cases (rabbits) the anesthesia persisted four hours later, but diminished in intensity.

Solutions of the same strength were used on human subjects on the gums, tongue, and conjunctival and urethral mucous-membranes It was proven that anesthesia occurred only after the use of the strong solution, and was incomplete, and occurred only on circumscribed areas. Along with the anesthesia there frequently occurred a perversion of sensibility, so that the subjects of the experiment would complain that they felt as if the gum, or tongue, etc., was covered with mucous, or as if a stone were pressing on the anesthetized mucous membrane.

This experience leads him to doubt the value of erythrophlein for therapeutic use.

Prof. Kaposi (Wien Med. Woch., March 3, 1888) was the first to try erythrophlein with tabulated results. His experiments, seventeen in number, were made upon patients with lupus (by injection), granulating wounds by penciling, and he summarizes as follows: "Erythrophlein subcuta neously employed produces local anesthesia. The dose varied in my experiments from 2 to 20 milligrams (4 to grain.)

Anesthesia occurs fifteen minutes after the injection; diminution of sensibility sometimes after a few moments. Both last from one to three hours. The anesthesia occurred only in the smallest or middle zone of the area of injection. The larger or external zone was paresthetic, and at times showed points of perverted sensibility and anesthesia in irregular confusion.

Analgesia was often more complete than anesthesia, as the sensation of touch was seldom lost.

Local symptoms of irritation occurred with the smallest doses; sometimes with doses of 2 milligrams (grain) but always with ten to twenty milligrams (to grain). These symptoms were the burning sensation at the site of the injection, and in very severe pains radiating from this point in various directions; they lasted many hours, and in some instances one to two days. Objective symptoms were redness, swelling, elevation of temperature at the area of injection, and in wheal formation. General toxic symptoms occurred from fifteen minutes to one hour after a dose of two centigrams (grain). They consisted of dizziness, dilatation of the pupils, weakness and slowing of the heart and pulse, acceleration of the breathing, nausea and vomiting, and these continued for many hours. Kaposi says that not only can erythrophlein not be used for local anesthetic purposes, but warns against the danger of experimenting with it.

Dr. F. Goldschmidt (Cbl. f. Klin. Medizin, No. 7, 1888), after repeating and confirming the previous experiments on rabbits, used a solution of 1 to 1,000 upon patients. Fifteen minutes after the instillation of one

drop, corneal anesthesia lasting three to four hours occurred. Only a slight conjunctival irritation was complained of and a feeling of burning and heat. No change in the pupils or accommodation. Duration of anesthesia was different with different people. When the eyes were inflamed the burning feeling was stronger.

He found a practical use for erythrophlein in the extraction of iron splinters (two cases) and splitting of the tear duct. Both operations were done without jerking or other sign of sensitiveness on the part of the patients. He does not believe that erythrophlein will find such general use as cocaine, because it is accompanied by dilatation of the blood-vessels.

Professor von Reuss (Internat. Klin. Rundschau, 8, 1888) came to these conclusions:

A solution of 1 to 2,000 in trachomatous eyes produced a diminution of sensibility which did not increase to insensibility. This affected the cornea and conjunctiva of the bulb. Sulphate of copper and nitrate of silver caused the same subjective feeling of pain as on the subjects upon whom no erythrophlein was used. After convalescence from iritis (posterior synechiæ punctate deposits on the membrane of Descemet, no ciliary injection) almost complete insensibility of the cornea occurred in thirty minutes; eight hours later acute pains in the eye, and twenty-four hours later ciliary injection.

Two to four drops of a solution 1 to 400 caused the feeling of a foreign body in the eye, burning pain, diminution of the interpalpebral space, and injection of the cornea. Cauterization of an ulcer of the cornea caused great pain. Diminution of sensibility began after fifteen minutes, but even after repeated instillations, was never as complete as after cocaine, and was not sufficient (to cite an example) to cause insensibility to the pain of tattooing a leucoma of the cornea. Cauterization and direct galvanization was as painful as before. In all cases opacity of the cornea occurred after an hour or two, as well as weeping, hyperemia of the conjunctive and ciliary injec

tion. The opacity was epithelial, and in some cases this layer was elevated like a vesicle, or it seemed an epithelial defect. In twenty-four hours the eyes appeared to be normal; in short, the 1 to 400 solution was too strong.

A solution of 1 to 800 instilled once into the eye caused no disagreable symptoms; twenty-five minutes later diminution of s nsibility. There was no complete anesthesia. A second instillation caused symptoms similar to those caused by 1 to 400. There was no change in the pupil or in accommod tion.

Dr. Koenigstein (idem) failed to get anesthesia with a solution of 1 to 1000. The patient experienced so much pain that he was compelled to use cocaine.

Professor Lipp has had very different results from tho e reported by Professor Kaposi. He used the drug in the skin and syphilis wards at Graz, and the following is a resumé of his results, only half of which has as yet come to hand (Wien. Med. Woch., March 17, 1888): He injected, generally, one centigram (grain) of erythrophlein, and noticed the slowing of the pulse, sometimes palpitation of heart, dyspnea and convulsive pains about the heart. At the site of injection he at times observed inflammatory pains, especially those which radiated in many directions, diminution of sensibility to pricks of needles and rarely complete anesthesia. The drug is not nearly so quick, certain, and free from irritation as cocaine. Not rarely from eight to fourteen days pass by before the infiltration and swelling disappears. There were no abcesses produced. Patient sometimes complain very much.

Speaking accurately, anesthesia is very rarely produced, but analgesia mcre or less complete is almost constant: diminution or total suspension of the capability of the skin to feel pain. His test for complete anesthesia was where needle pricks through the cutis into the subcutaneous tissue were not painful. The primary area of analgesia at the site of injection is as large as a copper cent (about the size of a kreutzer).

This is complete only in a small central portion. It begins generally five to thirty minutes after the injection and lasts one half to several hours.

The secondary or peripheral phenomena are the most remarkable. They consist in an area of analgesia which follows the nerve branches in the neighborhood and extends over several inches of circumference. It is more intense and lasts longer than that at the site of injection.

The following two cases serve as illustrations: Injection at 8:30 o'clock of one centigram (grain) erythrophlein in the arm, extensor surface near the elbow. 8:45: On the extensor surface of arm, beginning five centimeters (two inches) from the site of the injection and extending downward fifteen centimeters (six inches) and two or three centimeters (one to one and one fifth inches) wide, an area of diminished sensibility. 9:10: Beginning pain and hyperemia at site of injection. 9:50: The area of analgesia has increased. In the more central parts complete insensibility to needle. pricks. 10:45: The analgetic area has increased still more. It begins two centimeters (one and one fifth inches) below the site of the injection and extends twenty centimeters (eight inches) to the wrist, with a width of from four to six centimeters (one and one half to two inches), so that the greater portion of the arm is analgetic. With the exception of the edges, the analgesia is complete. The patient feels as if the whole arm were dead. Deep needle pricks were not felt. 12:15 Analgesia the same in intensity and area. From this time until next day (twenty-four hours) the area of analgesia diminished, but even twenty-four hours after, or longer, there was a circumscribed area insensible to pain. Another and similar case is given in detail, where, five and one half hours after the injection, there was a secondary area of injection sixteen centimeters (six and onehalf inches) long and three to five centimeters wide. Not only were needle pricks two, three, and three and one half centimeters deep not felt, but an incision three

centimeters long, extending down into the subcutaneous connective tissue, followed by suture, caused no feeling of pain whatsoever.

ON THE USE OF SUPER-SATURATED SOLUTIONS OF BORIC ACID IN THE TREATMENT OF CYSTITIS. (Journal de Médecine de Paris, February 12, 1888.) Having read in a previous number of this journal that it was possible to make a stronger saturated solution of boric acid than four per cent, M. Lavaux obtained one nearly four times as strong by the following procedure: To one hundred parts of boiling water (distilled) he added fifteen parts of boric acid and one part of calcined magnesia. Allowed to cool and filtered, only a minute portion of the salts were found to be precipitated. This solution he used in three cases of cystitis.

The first case was a patient with tuberculosis in the third stage. He had had a stricture which had been dilated, and marked improvement of the cystitis followed. But at a certain stage the cystitis remained stationary and the urine contained a large quantity of pus. It was at this stage that the super-saturated solution was used. The patient felt severe pains with frequent desire to urinate for two or three hours after, then all symptoms vanished and next day a decided diminution in the quantity of pus was noticed. The ordinary four-per-cent solution was then used, with an eight-per-cent at intervals of forty-eight hours. The latter was tolerated almost as well as the former. The cystitis yielded completely in five days.

In the second case reported, cystitis in a woman with metritis, the super-saturated solution was only used after the disappearance of the pain and frequent micturitions. A marked decrease in the amount of pus followed. The solution was tolerated much more easily than in the preceding case; the pain was light, and the frequency of micturition only slightly increased.

The third case was one of very severe cystitis, previously treated by cocaine and four-per-cent boric-acid solution. Here, too, a decided diminution of the purulent secre

tion was obtained, and the pain was not severe. His conclusions are that the supersaturated solution, in its therapeutic effects, is much superior to the four-per-cent solution, which is too feebly antiseptic. As the stronger solution is somewhat irritating, it is well not to have recourse to it during the acute stage.

FIVE HUNDRED AND FOURTEEN OPERATIONS FOR STONE IN THE BLADDER.-Prof. Dittel (Wien. Med. Woch., Nos. 5, 6, and 7, 1888), in an article on "Fifty More Stone Operations," gives a resumé of five hundred and fourteen cases, tabulated as below:

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Average duration of treatment is of course in days. The chemical composition of only 400 concretions has been tabulated. Of these 267 were urates, 92 phosphates, 31 oxalates, 2 cystin, 8 foreign bodies. The 514 operations were made on 500 patients.

SEPARATION OF PERITONEAL ADHESIONS OF THE RETROFLECTED UTERUS.-(B. S. Shultze, Zeitsche. f. Geburtshilfe u. Gynecol.) This eminent writer protests against any forced reposition with the sound. He first separates all adhesions with the fingers and then effects reposition bi-manually. Complete narcosis is necessary for palpating the false ligaments and the most exact examination per rectum, vaginam, and supra pubes. The adhesions should be separated by means of two fingers, the index and middle in the rectum, and pressure with the other hand over the abdomen just as when an adherent placenta is removed. Fecal matter should have been previously removed from the rectum by means of hot-water irrigations

(104° F.) It is of great assistance to allow the hot-water irrigations to continue while the two fingers are at work high up in the rectum.

Absolute rest and application of the icebag are necessities after the operation. For this reason the operation is unsuitable for out-patients and office practice. It is important to separate similarly adherent ova ries, as they play an important role in the complex of symptoms following retroflexion of the uterus.

The principles of this treatment are, (1) to recognize the adhesions accurately, (2) to separate them in situ, (3) to replace the uterus made movable and to retain it in place by a suitable pessary. Nevertheless, the writer considers laparotomy for the cure of retroflexion justifiable "when the retroflexion can not be cured by any other means and the woman is deprived by it of her ability to work or to enjoy life.-Deutsche Medical Zeit. No. 14, 1888.

SYPHILITIC COMA.-(Althaus, in Deutsch Med. Woch.) The writer gives eight cases observed by himself in men between twentyfive and forty-two years of age. In two cases all cerebral symptoms were wanting; in the other six vertigo, epileptic convulsions, and paralysis preceded. As cause, mental strain and excesses venereal and ale holic, is given. Prodromal symptoms precede by several hours or days, and consist of headache, confusion of ideas, disturbances of speech, motion, and perversion of sensibility. These too may be wanting. The coma comes on during the night during sleep. The patients are found unconscious in the morning, the eyeballs sunken, pupils not reacting, axes of vision divergent. The body is limp and reflexes absent. Paresis or paralysis of sphincters of the bladder and anus. Pulse slow, temperature subnormal. This condition lasts about four days and terminates either in gradual, although generally incomplete recovery (dis turbance of speech or psychical disturbance remaining), or the case ends fatally. Unconsciousness and absence of reflexes con

tinue and become total, the pulse increases and becomes thready, the temperature rises, the pupils dilate, exitus laetalis. Early energetic specific treatment, frictions, or injections make the prognosis better.

TRANSPLANTATION OF THE SKIN OF CHICKENS ON GRANULATING WOUNDS.-P. Redard (Paris Society of Biology), following up the experiments of Wiesmann, Dieffenbach, G. Martin, who successfully transplanted skin from bird to bird, succeeded in obtaining rapid regeneration on the human subject by grafting the skin of chickens. The life of a child two years old was threatened from profuse suppuration following a burn of eight months' standing, in which almost the whole scalp had been destroyed. Transplantation of frog skin had been tried unsuccessfully. Redard succeeded in two months in obtaining a regeneration of skin to the extent of 7x8 centimeters (3 x 3.4 inches) by grafting with chicken skin. He thinks chicken skin especially adapted for this purpose because delicate, rich in vessels, spreads nicely on the surface and adheres without being absorbed. He takes a portion of the skin from under the wing of a young chicken. It should contain connective tissue layer but no fat. The pieces should be from one half to one centimeter (one fifth to two fifths inch) in size. Suture is unnecessary, as they adhere well. Asepsis and iodoform bandage are of great importance.-Deutsch Med Zeit, March 8, 1888.

Abstracts and Selections.

TEREBINTHINATES.-Therapeutists have late y evinced a revival of interest in the terebinthinates. One result of this is seen in the extended use of terebine in bronchial artections. I now invite the attention of practitioners to two other allied products, more particularly as to their use in dis ases of the respiratory mucous tract. These are (1) the essential oil of the mountain pine and (2) hydrate of terpin.

1. The mugho or mountain pine is the Pinus pumilio of Lambert, and from which exudes the once-prized Hungarian balsam.

By distillation of the young branches with water a volatile oil is obtained long known as oleum templinum or Krummolzöl. This is the most potent agent in the so-called "pine-cure" practiced at Reichenhall and other German spas. At these resorts the vapor of the water, as it escapes into the inhalation rooms, is medicated with the volatile oil. The pine baths at these spas are not medicated with the Krummolzöl, but with a much cruder product-namely, an extract obtained by evaporating a decoction. of the wood and branches, and perhaps also the residue after the distillation of the oil. rheumatism, gout, and other affections for Moreover, the baths are mostly employed in which thermal baths are suited; while the inhalations are chiefly used in diseases of the respiratory tract. By improved apparatus and greater care in the selection of the material a much finer product is now obtained, in fact, a very pure essential oil, oleum pini pumilionis; and this it is which has lately been imported under the fanciful name "pumiline."" This essential oil possesses in a

high degree the odor of the most fragrant variety of the pine, and, moreover, is less irritating than other fir oils. Sprinkled or sprayed about a sick-room it imparts a lasting and grateful fragrance to the air, which is not oppressive, and it seems to be disinfectant; or it may be thrown into a little warm water and allowed to evaporate; or it may be diffused by a steam inhaler (Dr. Lee's or Siegle's) or a hand-ball atomizer. Either of these methods may be utilized for the purpose of maintaining an atmosphere laden with pine odor as a substitute for that of Arcachon, Reichenhall, or Bournemouth. The oil can also be taken internally, and is admirably adapted for inhalation. For prolonged inhalation a few drops may be put in a suitable respirator, and will be preferred by most patients to other inhalants. For short steam inhalations ten to twenty drops may be put into any common inhaler half full of water at 150° to 160° F. and the vapor inhaled. It is, however, much better to diffuse the oil through water by magnesia, powdered silex, or prepared tale in the proportion of 40 to 60 minims of oil to a scru ple of magnesia and an ounce of water. A teaspoonful of this mixture added to half a pint of cold water is to be stirred in the inhaler, and then half a pint of boiling water being added, a convenient temperature is obtained; as it cools, a little more boiling water can be added if it is desired to prolong the inhalation. This medicament will be found much milder than the vapor olei pini

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