constitutes with uric acid a soluble body. accidents due to size or situation of ordinary | clear upon the addition of formaldehyde. vegetations, the incomplete or unsatisfactory Tollens has often observed that formaldehyde results occurring under circumstances,-though rare, it must be admitted,―render necessary a classification in the nature of adenoid vegetations. Michel Dansac divides them into scrofulous, lymphadenoid, and syphilitic. 12 4 Hexamethylenetetramine, the formula of which is C,H,,N, has the same solvent properties. This compound is obtained by passing a current of dry ammonia-gas over heated triM. Lermoyez believes that an infrequent oxymethylene, or paraformaldehyde. It crysvariety of these vegetations may be recognized, tallizes from alcohol in rhomboids, easily solu viz., the tuberculous form, basing his opinion ble in water, slightly soluble in alcohol, and upon two cases in which ablation determined almost insoluble in ether. Its reaction is neuthe development of a tuberculosis latent until tral. In consequence of its slight toxicity, that time. Histological examinations of a re- compared with that of formaldehyde, hexacurring vegetation taken from a child 6 years methylenetetramine may be prescribed for inof age revealed its tubercular character, giant- | ternal use in doses as high as 6 grammes (about cells and Koch's bacilli being present in great numbers. This examination, made by Michel Dansac, has been described by that histologist under the title of "Vegetating Tuberculosis of the Pharyngeal Tonsil." The child was of tuberculous antecedents on the side of the mother, whose neck presented numerous scars of suppurating ganglia. The tuberculous nature of adenoid vegetation of the naso-pharynx, far from causing us to reject intervention, should, on the contrary, cause a resort to operative measures. Oper ation should be followed by active local and general treatment.-Revue de Laryngologie, etc. LUPUS ERYTHEMATOSUS IN AN UNUSUAL SITUATION. At a meeting of the French Society of Dermatology and Syphilography, M. Hallopeau and F. Monod exhibited two women with the remark that lupus erythematosus usually attacks the face and often extends to the hairy scalp, while exceptionally it may occur upon the limbs. It is, however, rare for it to involve the limbs and spare the face, as in the two cases presented. Upon one of the patients there were numerous patches upon the hairy scalp and but a small lenticular islet each of the eyes. In the other case the face was completely intact. These manifestations occupied exclusively the hairy scalp, the dorsal region, and the palms of the two hands. This unusual distribution of the lesions adds difficulty to the diagnosis.-La Tribune Médicale. HEXAMETHYLENETETRAMINE. upon Nicolaier has remarked that a urine which precipitates an abundance of urates becomes 11⁄2 drachms) in watery solution without fear of producing any disagreeable secondary manifestations. During all the time of its administration the urine preserves its acid reaction and is increased in quantity, but there is no precipitation of urates or crystals of uric acid. -La Médecine Moderne. COLD BATHS IN THE PNEUMONIA OF At a meeting of the Medical Society of the Hospitals M. Comby remarked that there is nothing to fear from the use of cold baths even in early childhood. In pneumonia the cold bath at 25°, 24°, 23°, 20° C. (77°, 75°, 73°, 68° F.), according to the age and according to the case, renders valuable service by lowering the temperature, restoring the tone of the patient, retarding the pulse and respiration. In the hospital the speaker orders baths for all his pneumonia patients, when the temperature exceeds 39° C. (102° F.) and the heart is not affected. In a child 3 years of age, suffering from grippal pneumonia, the treatment reduced the fever to such a degree that the patient was given strength to resist the disease. From this point of view no remedy can be placed in comparison with the cold bath. At 25°C. it is well supported even by the youngest children, and, administered prudently, is attended by no inconvenience.-La Médecine Moderne. DIABETIC COMA. M. Klemperer, as assistant in Leyden's clinic, has observed twenty-one cases of diabetic coma, and has endeavored to determine whether it is due to an acid intoxication. A striking fact is that all the patients eliminated large quantities of acid. This was proved This was proved | perimented with a tetratomic sugar (erythrite) by examination of the urine. The greater the with success in one case; pentose (a pentatomic quantity of ammonia, the greater the amount sugar), recommended by Ebstein, behaves like of organic acids, and, the less carbonic acid in glycerin. Some have thought favorably of the blood, the more acid was present. Does alcohol as a means of checking waste (50 this fact alone authorize us in concluding that grammes a day).—La Médecine Moderne. the acid is the cause of the coma? Klemperer does not hold this opinion, and for two reasons in the first place, researches concerning nutrition have shown that a comatose condition may occur in consequence of increased destruction of nitrogenous material in other maladies, as in pernicious anæmia; secondly, the administration of alkalies is without effect. In nine cases large amounts of alkalies were given by injection without preventing a fatal issue. It has been objected that the alkalies were given too late, after the acids had already caused irreparable lesions of the nervous sys tem. The following case, however, is a reply to that objection: A man, aged 21 years, under treatment for grave diabetes, took, in addition to an appropriate diet, 20 to 25 grammes (5 to 6 drachms) of bicarbonate of sodium on account of the presence in the urine of a large quantity of ammonia, which indi cated an increase of acids. Three or four weeks later the ammonia of the urine had diminished, the urine was often alkaline, and an examination of the blood only showed a slight decrease of carbonic acid (from 30 to 24). The patient died comatose on the very day of that examination. Klemperer believes that there probably exists in the blood a toxic substance which produces an increase of acidity and coma, but that we know no more. From a prophylactic point of view and as a means of restricting nitrogenous destruction he recommends fatty substances. It is necessary to give not less than 250 grammes (about 8 ounces) of fat daily; many patients support that quantity well and utilize it (10 to 15 grammes of loss). Some weeks later, however, disgust may develop, the loss increase to such a degree that a change of regimen will be demanded. A good adjuvant method consists in replacing hydrocarbons by milk (Leyden) or levulose (60 to 80 grammes). Glycerin, which has been recommended, is not supported, but passes through the system without change. Several varieties of sugar have also been tried (up to the present time 129 kinds have been artificially obtained). Klemperer has also ex DIAGNOSTIC AND PROGNOSTIC VALUE OF THE Sticker, several years ago, called attention to the presence of a red border upon the gums of patients suffering from pulmonary tubercu losis. He gave to this appearance the name of "border of Fredericq Thompson," after the authors by whom it had first been described. This border is situated at the insertion, and is clearly distinguished from the neighboring mucous membrane by its intense red color in acute phthisis, bluish red in the chronic form, and white in scrofulous subjects. It is easy to differentiate from the livid or grayish hue found in patients afflicted with gastro-intestinal disorders. The more rapid the progress of tuberculosis, the more intense the redness. On the contrary, the disappearance of the tint is a good prognostic sign. Sticker has verified this manifestation in 1000 patients, and has found it only in tuberculous subjects, especially in young persons and at the beginning of the malady. It is more frequent among men than women. M. Andreesen, of Ialta (Crimea), in his ca. pacity of physician at a health resort, has corroborated the value of this sign. In 139 actual or suspected tuberculous patients examined from that point of view the red border existed in 92, of whom 69 were actually tuberculous and 23 suspected. Tuberculous patients in whom the red border was absent soon improved. When fever appeared the redness became more vivid. The writer concludes that the presence or absence of this border upon the gums in a subject of tuberculosis may possess a certain diagnostic and prognostic worth.-La Mede cine Moderne. DR. H. C. BASTIAN, F.R.S., has resigned the Professorship of Medicine in University College, London, while retaining the office of physician to the hospital and Professor of Clinical Medicine. He will be succeeded as Professor of Medicine by Dr. Frederick Roberts.—Medical Times and Hospital Gazette. delirium, and especially in the period preceding an attack of delirium tremens, the rectal injection of 2 ounces of extract of asafoetida is often followed by a deep slumber and allows us to dispense with narcotics, the use of which is not free from danger.-La Médecine Moderne. ASCLEPIAS TUBEROSA IN PNEUMONIA. According to Ch. Churd, asclepias tuberosa (pleurisy root), given during the first twentyfour hours of a pneumonia, will nearly always abort the attack. It is efficacious at any stage of the malady.-La Médecine Moderne. CHLORALOSE IN DELIRIUM TREMENS. M. Haskovec has seen good results from the administration of chloralose in delirium tremens. He prescribes this drug in the dose of 10 grains dissolved in hot water. Sleep was quiet; the general tremor, as well as that produced by voluntary movements, was diminished. There was no secondary effect.-La Médecine Moderne. SOLUTIONS OF CHLORIDE OF ZINC IN AFFEC TIONS OF THE PHARYNX AND LARYNX. M. Fauvel states that, for thirty five years, he has daily employed more or less concentrated solutions of chloride of zinc, as:— M. Sig. Apply with cotton pressed on each feeble, the pulse compressible. Regulate the side of tooth. INSOMNIA. Asafoetida, in pills of 5 grains, given after supper and before retiring, will often produce a tranquil and refreshing sleep. In light diet and habits of the patient; remove constipation and indigestion. Give 30 grains of bicarbonate of soda, one hour before meals, in 4 ounces of water or aromatic tea. This treatment will also be aided by the following: M. Divide into 120 powders. Sig. Give I powder once or twice during the twenty-four hours, either per mouth, rectum, or hypodermatically. If at any time the patient should have severe dyspnoea, give the fluid extract of quebracho, in doses of 15 to 30 drops, every three or four hours, in water. In cases of subacute rheumatism the following will give quick relief :— B Fluid ext. cimicifuga, Fluid ext. piscidia, . āā 3v. M. Sig. Give 20 drops every three hours, in a tablespoonful of water. If the parts are painful, the following will give quick relief: Mix and apply to the parts every four hours; cover with cotton. In cases of senile heart, when we find the Continue this for one week or ten days, patient loaded down with fat, a lax abdomen, and then give the following: B Strychnin, nitras, Acidi nitrici, gtt. ij. gtt. v. and distended intestines, the following will give good results: : M. Sig. Take 1⁄2 teaspoonful before meals and one hour after, in a wineglassful of water. The whole body should be well rubbed with the following ointment: Take of equal parts of beef marrow and leaf-lard, recently prepared, 8 ounces; ol. cinnamomi, ol. eucalypti, and creasoti, of each 1 drachm. Mix and use once a day, special attention being given to the abdomen for at least fifteen minutes each time. If pneumonia supervene, the following can be given: M. Sig.: Give 1 teaspoonful every two hours, in wineglassful of spearmint-tea. with senile heart, I have given the following, with especial benefit : R Auri et sodii chlo., Sodii bromid., Syr. simp.,. gr. xvj. gr. xv. 3j. Zviij. . 3viij. When we have a gouty condition existing | rhinology. The bactericidal properties of this substance, its insolubility, and its ready pulverization render it particularly serviceable in affections of the nasal fossæ. The insufflation of nosophene, after a cauterization of the nasal mucous membrane with chromic acid, has an excellent influence in promoting cicatrization. The eschar falls five or six days after the daily practice of these insufflations. In dry rhinitis and rhinitis with hypersecretion the same method gives excellent results. The author has also employed nosophene in the treatment of balanitis and balanoposthitis, soft chancre, and intertrigo, and has always observed a very rapidly favorable action.La Médecine Moderne. M. Sig. Give from 10 to 30 drops after meals, in wineglassful of water. In some cases 1 to 2 drops every two hours will do better. The following is well adapted for nervous fluttering about the heart in nervous women:— B Fld. ext. pulsatilla, Fld. ext. caulophylli, Fld. ext. cactus grand., ǎā 3j. Ziv. tongue. B Glycerole of starch, may be used Extract of belladonna, -Le Progrès Médicale. [Neapolitan ointment (onguent Napolitain), or pommade mercurielle à parties égales (equal This not only tones up the heart, but parts mercurial ointment), is made by rubdestroys the appetite for tobacco. NOSOPHENE. Nosophene, or tetraiodophenolphthaleine, is a yellowish, inodorous, and insipid powder, insoluble in water, soluble with difficulty in alcohol, more soluble in ether and chloroform. It contains about 60 per cent. of iodine. Heated with concentrated sulphuric or nitric acid iodine is driven off; weak acids or alkalies are without action upon nosophene. This body behaves as an acid, and combines with sodium, mercury, bismuth, etc., to form salts. Nosophene and the nosophenate of sodium are not toxic, as has been shown by experiments upon animals, and iodine is not found in the urine, whatever the mode of administration of nosophene. M. Seifert reports the result of experiments which he has made concerning the therapeutic value of this drug. He first sought to discover if nosophene is non-toxic in man by In a short note to the British Medical Jourbeing decomposed within the body and liber-nal Arthur de Butts, of Folkestone, says: ating iodine. The results of these researches"From my own personal, as well as profeswere entirely negative. From the therapeutic sional, experience I have found them of the greatpoint of view, nosophene was first used in est value. I may specify strawberries, grapes, |