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NEVER PRODUCES Sick Stomach nor unpleasant Head Symptoms.

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It is the active principal of Amorphous Quinine, teaspoonful equals two grains of the Sulphate.

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PHYSICIANS often wish to make palatable tonics for their female and youthful patients and will here find some excellent combinations.

FEBRILINE will combine with Antifebrin, Antikamnia

or any powder, syrup, fluid extract which does not contain acid or alcohol. Acid and alcohol, in any form or quantity, will develop the bitter taste.

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PARIS MEDICINE CO.,

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ORIGINAL COMMUNICATIONS.-SUMMERS.

155

impulses to muscles rythmically. We see this demonstrated in the peculiar effect upon respiration, the respiratory centers in in the bulb being cooled as it were by this neoplastic investiture, which destroys their automatism. So also inhibition and augmentation are affected, almost the same condition being present as that which follows the division of the vagi—the afferent stimuli to the abdominal sympathetic by the concentration of the diffused current being often sufficient to stop the action of the heart in diastole. Again I have observed and have no doubt most neurologists are familiar with the observation, that often non-medullated nerve fibers, fibers of Remak, under certain pathological changes seem to have taken on the character of medullated fibers, or at least to have assumed the semblance of a double contour, not well defined, it is true, and evidently from its irregular or heterogenous structure adventitious in origin. These I have found often so completely invested as to show the peculiar behavior of the nodes of Ranvier under the action of nitrate of silver. Now it is clearly evident that such a condition must have a most decided effect upon the distribution of nerve force as well as upon its generation, and I know of no condition which will more clearly exemplify this morphological state to the mind of the general practitioner than that of cirrhosis. Indeed, I am convinced that the pathological origin is the same in order and in fact. The gathering of adventitious tissue, for such indeed it becomes in time, about the delicate neuroblast destroys its true physiological relationship and interferes with the proper distribution of nerve force, and nothing short of its removal will restore the whole nervous organism to its physiological state. How many disorders may be accounted for by this condition! And is it not clear that the persistence in the use of any agent such as opium, alcohol, and other narcotics, the tendency of which is to throw around the nerve cell that character of environment which will become a permanent investiture will alter the whole relationship existing between the generation and conduction of impressions. Sudden cessation from the accustomed stimulus will throw the whole organism into disorder, for a new physiological plane has thereby been established to which all other parts of the organism must adopt their functional expression in order that vitality may at all be preserved.

Nothing else will satisfy the condition which habit has crystallized about the structure of the cell and the only hope of relief is in the absorption of the investing substance. From recent reports concerning the therapeutic action of gold we are led to hope that such an absorbing agent is found in this hitherto neglected remedy. Certainly its line of therapeutic action is in full accord with the pathological indications under consideration. I hope after some further observations to be able to report definitely upon the exact extent of absorptive power exerted by this therapeutic agent and to show the changes brought about in its action. If I have said enough to direct the attention of investigators to this fruitful field of physiological and therapeutical research I have not written in vain.

TREATMENT OF DIPHTHERIA.

BY M. W. PRICE, M.D., OF CLARKSVILLE, TENN.

The recent number of cases of diphtheria occurring in this city, and the location of the disease primarily in the larynx in all save one case, suggested to the author the advisability of writing this paper.

In the past two months seven cases of membranous affections of the pharynx and larynx have been treated in this city. Of the seven cases reported six were diagnosed diphtheria, and the the other one was pronounced by the attending physicians membranous croup. In all of these cases only two recovered. One of which was that pronounced membranous croup, and the other was the one in which the pharynx alone was involved. Owing to the fact that no record was kept of but three of these cases, it is impossible to give the treatment pursued by those who had charge of the cases. The treatment pursued in the case of membranous croup consisted in the administration of thirty grains of calomel in every twenty-four hours for three days, when he discontinued its use for thirty-six hours, at the end of which time the patient, instead of continuing to improve, grew worse, he administered forty grains of calomel in eight hours.

ORIGINAL COMMUNICATIONS.-PRICE.

157

The patient after this dose continued to improve, and is now well.

The next case was first seen by myself, and at that time had an acute tonsillitis and laryngitis. This was treated locally and appeared to improve for a few days. There was no sign of a deposit or membrane. At the end of a week the patient grew worse, and I prescribed calomel, 3 grains; bicarb. soda, 8 grains, divided in charts no. IV; one every hour, and sprayed larynx with listerine, oz. iii; sulph. carbolate zinc, grains xv; and on the tonsil used Monsells. sol 3 ii, glycerine 3 vi. At this time there was still no appearance of any membrane, but on the next night, Saturday, she grew much worse, but I was not called until Sunday morning, when Drs. F. J. Runyon and J. W. Brandon were called in consultation, and on account of the great difficulty in breathing, intubation was decided on and was successfully performed, and the following prescription given: R. Hydrag. bichloridi.....................

Ammon. muriat...

Tr. ferri. mur..
Glycerin...

Aqua dest. q.8......

M. Sig.: Teaspoonful every two hours.

.grs. i.

3i.

zi.

Zi.

3iv.

We also put patient on stimulating diet, consisting of brandy and milk, and strychnine. She appeared to rally some during the night and next day, but after stimulating with cream, brandy and strychnine, by rectum, she rallied; but on the next morning the tube becoming obstructed with membrane, she died before it could be removed.

We also kept in the room a quart of water constantly boiling, in which was two tablespoonsful of the following:

Besides this patient three others were intubated, and of these three, two afterward had tracheotomy performed, but with no beneficial results.

The last case I saw was first seen by Dr. Runyon, on January 31st, when there was an acute inflammation of tonsils, with de

posit on the left tonsil. He diagnosed it follicular tonsilitis, and prescribed a gargle of soda bicarb. and gave a good dose of calomel; but on account of having had a sister to die of this disease, which was the first case I saw, she was kept under observation. On Thursday and Friday, I examined throat, and while there was still an inflammation of the tonsils there was no deposit whatever, but at noon Saturday, upon examination the right tonsil was almost wholly covered with the deposit characteristic of this disease. We immediately prescribed the following:

M. Sig. One teaspoonful in a tablespoonful of water every two hours.

Locally a spray of peroxide of hydrogen, 1 to 4, was used every two hours. This treatment was continued for twenty-four hours, when the above constitutional perscription was reduced one-half and the following was substituted for the peroxide of hydrogen:

In the room we used the vapor formerly spoken of, consisting of oil eucalyptus, carbolic acid and turpentine.

This treatment was continued for one week, when we substituted chlorate of potash for the bichloride. This was discontinued on the following Monday, on account of headache, which we attributed to the use of the iron, put patient on quinine, 2 grains four times a day, and milk punch. On Thursday the 15th, we substituted the following for the spray we had been using:

R. Sodinm borate

Glycerine........

Listerine, q.s..........................

M. Sig. As a spray every four hours.

.grs. XV. 388.

Zii.

NO MO