THE NIGHT SWEATS OF PHTHISIS. Night-sweats, when they are a mere flux from the vessels or lymphatics, and not a relief of pyrexial processes, ought to be checked, and this can generally be done by arseniate of iron, gr. to gr. at bed-time, or picrotoxin, do gr. to gr., or nitrate of pilocarpine, gr., or the old-fashioned oxide of zinc in from 3-grain to 5-grain doses, which generally succeed and do no harm. Preparations of belladonna and atropine, though they are effectual controllers of night-sweats, are less satisfactory, Dr. Brocq advises the following in same because their continuance for a long period condition: : often induces dryness of throat and mouth, dilatation of the pupils, and disturbance of sight-accommodation.-DR. THEODORE WIL M. Sig. Apply locally.-Medical and Surgi- LIAMS, in Medical Times and Hospital Gazette. cal Reporter. PHTHISIS. Ext. pinus Canadensis, Syrupi papaveri, Emulsionis petrolati (An gier), 3j. Dij. 3j. 3j. q. s. ad 3vj. Misce et fiat emulsio secundum artem. Sig. One-half ounce one hour after each meal.-Extract from editorial in Pacific Medical Journal. CHRONIC BRONCHITIS AND BRONCHORRHOEA. Syrupi codeinæ, Syrupi Tolutani,. 3ss. 3j. āā 3j. Emulsionis petrolati (An gier), q. s. ad 3vj. BORAL AND CUTOL, TWO DISINFECTING Boral is described as being aluminium borotartrate, and cutol as aluminium boro tannate. The former is soluble in water, the latter not. Both preparations are said to be therapeutically applicable as disinfecting astringents, particu Dose: One capsule thrice daily after food. larly in dermatology. Cutol, it is reported, Philadelphia Polyclinic. NOCTURNAL ENURESIS. R Liquoris atropinæ sulphatis, 3iss. mxlv. chloratis, Syrupi aurantii, . ad 3j. has proved serviceable in cases of facial erysipelas. It may be rendered soluble in water by the addition of tartaric acid, and in this soluble form it has been successfully employed in acute gonorrhoea, it is stated. Cutol contains 76 per cent. tannin, 13.23 per cent. alumina, and 10.71 per cent. boric acid. No drink to be taken after 6 P.M.; 5 drops | American Medico-Surgical Bulletin. THE Medical Bulletin. JOHN V. SHOEMAKER, A.M., M.D., Editor. Philadelphia, Feb., 1895. THE PREVENTION OF TUBER CULOSIS. powerful current of thought sets strongly in the direction of prophylaxis. "An ounce of prevention is better than a pound of cure," says a homely old saw, the truth of which we all acknowledge. The truth becomes all the more impressive when, as in the present case, we unfortunately possess no specific therapeutic method by which cure may be certainly effected. Thoughtful physicians will, therefore, continue to welcome papers which aim at the diffusion of sound information in regard to this great topic. FEW subjects can be of greater interest to we matt the medical profession or of more importance to the community than the earnest study of means to prevent the spread of consumption. In every great centre of human life and activity this fatal disease is constantly claiming its hundreds and thousands of victims. A purely clinical experience had, indeed, broadly indicated many of the modes by which consumption is propagated. The demonstration, however, of the bacillary origin of the disease came as a fresh stimulant to our efforts to cope with its manifestations. Diligent experimentation in the laboratory, coupled with the labors of clinical investigators, has thrown much light upon many points relative to the genesis and spread of pulmonary consumption. Some acute observers had, long prior to the promulgation of Koch's discovery, been convinced that phthisis is, at least under certain circumstances and to a certain degree, communicable from one to another individual. With increased knowledge of the exciting cause of the malady we are doubtless at present far better prepared to utilize former observations and to form some conception of the direction which prophylactic measures should take. Accordingly, in every great state or municipality the attention of health authorities has been steadily directed to various proposals looking toward the suppression of tuberculosis. From every point of view the subject is one of the most important of the times. It interests alike from a scientific, humanitarian, and politico-sociological stand point. Numerous are the discussions and publications which of late years have illustrated anew every phase and manifestation of tuberculosis. A A lucid exposition of the modern attitude toward consumption we have recently met with in a series of clinical lectures delivered by Dr. William Murrell at the Westminster Hospital, London.* In these addresses the lecturer, whose wide experience and habits of scientific investigation are well known, passes in review the various aspects of the general subject upon which our knowledge has been modified or amplified by the researches of late years. Dwelling slightly as a preliminary upon comparative mortuary statistics and the disqualification of the consumptive for the battle of life, the speaker cites a few decided instances regarding the communicability of consumption among persons who live in intimate association. The statistics of the Brompton Hospital, which had been thought to bear adversely upon this question, are shown to be fallacious. Illustrations are next given of the experimental evidence upon which a belief in the contagion of consumption is based. Exceptional sources of contagion are then alluded to, such as the use of uncleansed wind-instruments upon which tuberculous sputum has dried. Attention is called to an occasional source of infection on ship-board, especially upon sailing vessels, where married people, one of whom is consumptive, share the same small and ill-ventilated cabin. With other observers, also, Dr. Murrell recognizes the dangers which lurk in sleeping-cars and public omnibuses, especially when the latter vehicles pass some large hospital and carry, at certain times, a number of consumptive out-patients. The source of contagion, in all such cases, is dried and pulverulent sputum disseminated in the air. 1894. *The Medical Press and Circular, Nos. 20, 21, 22, and That tuberculosis can be transmitted by effect. In the words of Dr. Henry Bennett, inoculation the experiments of laboratory "free extreme ventilation is the most imporworks have amply proved. Accidental infec- tant means of preventing and also of healing tion of human beings takes place in the same pulmonary consumption." As regards the manner, from time to time, and reference to a ventilation of workshops and a proper relation number of well-attested cases of the kind may between the size of workrooms and the be found in the pages of the MEDICAL BUL number of people pursuing their avocations in LETIN. A more immediately practical inter- them, much improvement may be effected by est, however, concerns the transmission of this enlightened legislation. The proper construcdisease from animals to men. Tuberculous tion and ventilation of schools, barracks, meat and milk derived from infected cows prisons, and other buildings in which large have no doubt been responsible for many numbers are lodged will also be of much infludeaths. "A suggestive case is recorded by ence in restraining the extension of phthisis. De Lumalleree. A soldier returned home The influence of light, and especially of direct consumptive, after undergoing confinement in sunlight, is decidedly beneficial in preserving a Prussian military prison. Previous to his the standard of health and resisting the inroads return no one in the village had for many of disease. It has been demonstrated that years suffered from consumption. He expec- light is antagonistic to the growth of microtorated freely, and it was observed that the organisms. It is, indeed, unfortunate that fowls swallowed the expectorated matter. many dwellers and workers in populous cities These fowls were given to a woman in the are, to a large extent, deprived of the benefit village who was in perfect health, and in the of heaven's sunshine. Such persons grow up course of four months she consumed sixteen of pallid and weakly, and fall ready victims to them. She had no direct communication attacks of pulmonary tuberculosis. Many with the patient, but after a time became con- occupations, as is well known, give rise to a sumptive. One of the fowls was killed and form of pulmonary disease which causes proexamined, and tubercle was found in the liver gressive emaciation and has a fatal terminaand other organs." It is exceedingly impor- tion, although it may not be of tubercular tant that cattle should be properly housed, and character. Monotony and confinement are that their sheds should not be overcrowded. energetic factors in the production of tubercuAttention to these matters and the early isola- losis, even where ventilation is free, where tion of suspected animals would go far toward food is in abundance, and where work is not stamping out tuberculosis. All milk used in excessively laborious. Finally, the stronglythe household should be boiled, especially hereditary tendency of the affection has conwhere there is a family tendency to tuberculo- stantly to be kept in mind. sis. Meat should be thoroughly cooked. The foregoing review of the predisposing or secondary causes of pulmonary consumption enables us to perceive that many of them are, at least measurably, within our control. If the It has been shown, also, that soil and drainage are very closely concerned with the production of tuberculosis. The more pervious and dry the soil, the less does the disease pre-medical profession, as a unit, abetted by legisvail. "The beneficial effect of drainage is strikingly shown in the case of Salisbury and Ely, the reduction in phthisis mortality being, in the former place, 49 per cent., and in the latter 47 per cent." Overcrowded dwellings and workshops are other factors which are largely responsible for the spread of phthisis. It is obvious that the continued inhalation of air which has passed through the lungs of consumptives must have a very deleterious lative bodies and health authorities, were to join in a crusade against preventable causes of the disease, countless valuable lives would be saved and, directly or indirectly, the resources of the community would be correspondingly increased. As a mere matter of political economy, to say nothing of higher reasons, we believe that public money spent in the work of sanitary reform will return to the public treasury through other channels. Much may be done by personal habits. Much will require the sanction of legal enactment. As is so clearly pointed out in the series of lectures upon which we have commented, a combination of personal effort and legislative action is required in order to limit the devastations of so wide-spread a malady. Compulsory enact ments relative to compulsory disinfection of rooms and houses in which consumptives have lived and died would have a very beneficial effect. Similar laws could be passed in regard to the sanitation of sleeping cars and shipberths, as well as the regulation of dusty occupations. Agitation and instruction by the medical profession is capable of accomplishing great good in checking the extension of such a common and destructive disease as pulmonary consumption. THE USE AND ABUSE OF COMPRESSED TABLETS. THE HE imperative duty of the practical physician is, after having used his best endeavors to form a correct diagnosis, to adopt such measures, medical and other, as shall tend to restore health, or, if that be not possible, to prolong life and relieve suffering. Successful therapeutics necessarily depends closely upon accurate diagnosis. After the most appropriate remedy, or combination of remedies, has been carefully selected, questions as to its mode of administration arise. In deciding these points we must be governed by the age and character of the patient and the nature of the disease. Children have a natural aversion to unpalatable medicines, and this aversion is shared by many of larger growth. The tolerance of the stomach, also, is a condition of treatment which should never be overlooked. In order to administer drugs in as palatable a form as is consonant with efficient action, many different forms of preparation have been devised. The crude decoctions and infusions have, in this country, been very largely abandoned on account of the bulk of the dose required and the generally unpleasant taste of the liquid, although, in certain instances, the quantity of the fluid is of appreciable influence in determining the effects. Tinctures and fluid extracts furnish us with more concentrated doses, and objectionable tastes can be more readily disguised. The isolation of the active principles of so many drugs and their preparation in soluble form have been of exceeding benefit to therapeutics. These active principles are potent in small doses, their solutions are usually well tolerated by the stomach, and, if not, we administer them inclosed in small capsules, by subcutaneous injection, or in some cases by the rectum. Insoluble substances, if they possess antiseptic power, are of advantage for their local effect, as they disinfect the alimentary canal and remove or diminish the sources of auto infection. In order to escape the drawbacks due to an unpalatable medicine, it has long been the custom to incorporate it in a pill or inclose it in an easily-soluble capsule. More recently the compressed tablet has been invented. Each of the different forms in which a drug may be administered has its own advantages or defects. As a general rule, fluid preparations are, by virtue of their more rapid absorption, more rapid in their action than when given in the solid form. Powdered mineral salts dissolve so readily that they may be ranked, in this respect, with the fluids. Compressed tablets share with pills and capsules the advantage of being readily carried about by that large class of patients whose ailments do not confine them to the house, and whose occupations render the use of fluid preparations decidedly inconvenient, if not impossible. There are two great objections, however, to the use of tablets,—their comparative insolubility and their possible or probable loss of power in the case of many drugs, from the manner in which they are made. It is believed that the processes employed in their manufacture may effect a chemical change in the composition of active principles. In acute diseases, where we seek a rapid action from potent drugs, compressed tablets are decidedly inferior to the fluid preparations. Aconite, digitalis, opium, belladonna, and similar efficient substances are far better given in fluid preparations or in that of their active principles. It is often well to give the tincture of aconite in relatively small doses, repeated at short in |