VIN MARIANI THE STANDARD PREPARATION OF ERYTHROXYLON COCA." AREFUL, continued testing by up CAR wards of seven thousand practitioners in America, whose written opinions over their signatures (in our possession) are fullly in accord and clearly prove the efficacy and merits of "VIN MARIANI," may be thus summarized "Diffusible stimulant and tonic in anæmia, nervous depression, sequelæ of child-birth, lymphatism, tardy convalescence, general Malaise,' and after wasting fevers. "Special reference to the nervous system, in all morbid states, melancholia, etc. "Tonic in laryngeal and gastric complications, stomach troubles. "All cases where a general toning or strengthening of the system is needed. "The only tonic stimulant without any unpleasant reaction, and may be given indefinitely, never causing constipation." N. B.-- This Wine has been found always uniform and reliable, owing to the selection of finest ingredients and the greatest accuracy in its manipulation. When prescribing, therefore, the Medical Profession are strongly advised to specify "VIN MARIANI," in order to avoid the substitution of imitations, often worthless and consequently disappointing in effect. VIN MARIANI DOSE: MARIANI & CO., PARIS, 41 Bd. Haussmann. MARIANIS TONIC COCA WINE is only guid CAPSULED as pec fac-simile bear Nora MARIAS signate DOSE 52 West 15th Street, New York. Corresponding with Advertisers, please mention THE LANCET-CLINIC. omy, and treatment, but also (and not | cially, as they spring into our minds at the less to our advantage) by the fact, once upon our hearing of any suspicious which probably everyone must confess symptoms present in a case before us. to be true in his own case, that these It is our old friends, familiarity with diseases are now more readily suggested whom has bred contempt, that we must to us by the relation of any of their fear most. How many an aortic aneursignificant symptoms than was the case ism has been diagnosticated muscular at one time in the past. How long it rheumatism, how many cases of incipimay be before the present interest in ent caries of the spine have been looked the two affections cited may endure upon as due to lumbago, until the time cannot be foreseen, but it is probable for complete cure has slipped by! We that ere a long period has elapsed they are constantly reminded of some diswill again be often overlooked, until eases, while others not so frequently some future authority drags them forth seen are likely to be too little in our into prominence. minds in seeking for an explanation of the ailments of our patients.-Medical News. The good that is accomplished by this prominence given to individual diseases cannot be overvalued, and doubtless many lives have been saved by the almost constant presence in our minds of the frequency of the two affections mentioned. It is unfortunate that such fillips to our memory should be necessary, but it is by just such enthusiastic consideration of different diseases that many of our most marked advances are made. It is readily conceivable that, after the first accounts of various diseases that to us now seem as though always a part of medical knowledge, numerous cases similar to the one the report of which aroused men's minds were looked for, and, because looked for, found. This same temporary obscurity into which various diseases retire after the period of active interest in them has subsided is also noticed in regard to methods of treatment. It is partly for this reason that we every now and then find that what at first sight appear to be novel modes of treatment are in reality merely revivals of some method previously advocated. After a railroad collision, or after an hotel fire has occurred, there is for a time greater security in travel than for some time before. Just so at present there is but slight danger of anyone overlooking a perity phlitic abscess or an extra-uterine pregnancy, as our attention has been called to our previous comparative indifference to their importance and frequency. It is not, therefore, of these two diseases that we need to think espe Therapeutic Properties of Bicarbonate of Soda. A theory rather generally admitted by physicians is, according to Dr. Quinquand, that bicarbonate of soda is a liquefier of the blood; and it is, indeed, to this property that the sometimes formidable accidents observed in patients who abuse the waters and the salts of vichy and of certain other analogous minerals, are usually ascribed. According to our author, bicarbonate of soda is, on the contrary, a dehydrater of the blood; it concentrates this fluid, and is in no respect a liquefier. This salt often augments, morover, the number of blood-globules;-an argumentation partly relative in the sense that the concentration of the blood has just explained. It is therefore but just to regard as a myth what the practitioners of the time of Trousseau called the alkaline cachexia. Under the influence of the salt named there is always a diminution of the glucose of the blood. This is a general law; and this salt is therefore useful in diabetes mellitus. There is also a diminution of the carbonic acid of the blood, both venous and arterial. The proportion of oxygen in the arterial blood remains unchanged. As a general rule, the respiratory capacity does not vary. The urea in the blood always increases. The pulmonary exhalation of carbonic acid is increased. In the liver, the sugar either increases or does not vary. The glycogen is sometimes lessened. While a merely moderate | always proves injurious to the kidneys. dose of bicarbonate of soda influences Preparations of iron may add to the but little the urinary secretion, a strong congestion present. Iodides and the dose increases it. The amount of phos- salts of strontium and lime may render phates eliminated is increased, the some service.—International Medical chlorides likewise. Magazine. The use of the bicarbonate of soda in phosphaturic and uræmic cases is therefore contra-indicated. But whence come the accidents observed in the cases of those patients who abuse of this salt? -Merck's Bulletin. Dietary in Chronic Nephritis. Puerperal Fever. John O. Palak (Med. News, Philadelphia) says there are six forms of this condition. Sapremia, coming on early and due to the presence of retained membranes, blood-clots, etc., in which ptomaines develop, setting up In a discussion on the most suitable a local inflammation, and septicemia, dietary in chronic nephritis, which took which is general, and comes on usually place in the Académie des Sciences, after the fourth day. The writer also Dr. Dujardin-Beaumetz (La Médecine claims that septicemia does occur even Moderne, September 1, 1888) said it where the most rigid aseptic precauwas not the albuminuria, but the ac- tions are taken as regards the hands, cumulation of toxic substances in the instruments and external genitals. This economy, that required attention. The is due to the change in habitation of indication is, therefore, to assist the the bacteria, found in the acid fluids of elimination of these poisons, and to the vagina, to the alkaline fluids of the prescribe such a regimen as will most cervix, which acts as a culture medium tend to limit their production. To this for them. The only safeguard being end severe mental and physical exertion the use in the vagina, after the hands should be avoided. As toxines develop and instruments have received care, of in meat three days after the death of the a solution of bichloride (1 to 3,000), animal, he thought meats not absolutely preceding every instrumental interferfresh should be avoided; also, for the ence or manual examination, and folsame reason, fish, game, oysters, and lowed by a hot-water douche. Pencils cheese. Milk should form the most im- of iodoform may be left in the cervix. portant part of the dietary, but it should Where sepsis is feared, large rectal inbe sterilized. He never saw the album-jections of hot soap-suds, combined inuria increased by the administration with Rochelle salts, is an excellent of eggs. Meats should be well cooked. plan. The treatment of septicæmia Those which contain a considerable must be principally general, local atamount of gelatin are the most suitable. tention being of little avail. The free Among the starches he placed a high use of alcohol internally gives the best value on rice. He thought it also de- promise. Catharsis with salines is of sirable to limit, if possible, the forma aid in reducing the temperature and tion of toxic substances in the alimen- decreasing the congestion of the pelvic tary canal by the exhibition of such organs and surroundings.-Annals of intestinal antiseptics as benzo-naphthol | Gynecology and Pathology. and salol. Dr. G. Sée advised a diet somewhat as follows: Milk, one litre; white bread, two hundred and fifty grammes; coffee or tea, five hundred grammes; macaroni, one hundred grammes. He thought drugs of little use to patients suffering from albuminuria. With the exception of caffeine and lactose, which sometimes prove very efficient, diuretics should be avoided. The digitalis group The Etiology of Acute Bright's Agnes Bluhm (Deutsch. Archiv. f. klin. Med.) has classified the causes of all cases of Bright's disease occurring in the Medical Clinic at Zurich, during a period of five and one-half years. The infectious diseases are the chief cause of acute Bright's disease, occurring as it does after typhoid fever, acute exanthe stances as the eighth, pregnancy following a month later (June, 1885). She was delivered of her third child in March, 1886. On February 10, 1887, the catamenia appeared for the tenth time, and once more was followed by pregnancy; the patient was delivered at term, for the fourth time, in December, 1887. Since that date she has not become pregnant, but after hydropathic treatment the period was seen in January, July, and October, 1888, January and April, 1889, January and October, 1890, and April and June, 1891. Since the last date no period has been seen. Thus this woman, free from hysteria or ill health, has only seen her period nineteen times in eighteen years, yet has borne four healthy children.—British Med. Journal. mata, erysipelas, variola, diphtheria, | was delivered at term in January, 1884. tonsillar angina, croupous pneumonia, The ninth occurrence of menstruation acute peritonitis, and acute miliary was under precisely the same circumtuberculosis. Among the chronic infectious diseases, tuberculosis and syphilis are mentioned; a number of skin diseases are also included, as eczema, psoriasis, tuberculosis cutis, and erythema nodosum. Among toxic causes, three cases are noted following the use of mercury, lead and thallin. Among the other causes of acute nephritis are mentioned: intestinal diseases, icterus, circulatory affections, pregnancy, leukemia, and gonorrhea. In 9 per cent. of the cases, no etiology could be determined. The causes of the chronic parenchymatous form of nephritis are more uncertain, but it was due in the larger number of cases to malaria, misuse of alcohol, and unhygienic conditions. Among the causes of genuine contracted kidney, syphilis was present in 11 per cent. and arteriosclerosis in 17.7 per cent. of the cases; misuse of alcohol and lead were also concerned in the etiology of this form of nephritis. Regarding the development of acute nephritis after acute infectious diseases, it was observed that neither the severity nor the course of the primary affection exerted any special influence on the nephritis.— Occidental Med. Times. Amenorrhoea in a Fertile Woman. Terrier (Annales de Gynéc. et d'Obstét., August, 1892) publishes the following case: A girl, aged fourteen, menstruated in May, 1874. The catamenia appeared for the second time in September in the same year, for the third in August, 1875, and for the fourth in September, 1876. After the last date they were suppressed for twenty-three months, and recurred in August, 1878, after hydropathic treatment. They did not reappear till November, 1879 Once more they ceased, and did not recur till May, 1881, on her wedding day. But they did not return, and she became pregnant in September, 1881, and was delivered in June, 1882. In March, 1883, the catamenia appeared for the eighth time in the life of the patient, now aged twenty-three. A month later she became pregnant, and Light as a Caustic. In a very interesting article by Dr. Arnold in the Pacific Medical Journal, November, there are some striking passages concerning the caustic effects of light, with and without its accompanying heat rays. He says: For practical purposes the heat-rays can be filtered out of a beam of sunlight with a flat cell filled with a strong solution of alum, the most eligible. athermanous material; and concentration of the light may be increased about twenty-fold before the painful effects of heat concentration are experienced. A common whiskey flask free from flaws, filled with alum solution and a lens, such as sold for examining photographs, will serve for all minor purposes. This degree of concentration I have frequently employed on boils, warts, ringworms and the like, with instructive results; although they are too inexact from the trifling nature of the cases and from the absence of control experiments to describe them in detail. I have secured distinct escharotic effects from a greater degree of concentration, although cosmoline would barely melt at the focus of the lens, a temperature of about 125° F.; and that effect was attained in two cases with a slight pricking sensation hardly amounting to pain, although the entire thickness of skin was reduced to a whitish, pulpy mass. This agrees with an observation already referred to, and with Dr. Thayer's experience, in which the simple burning glass was used Miscellany. HEALTH DEPARTMENT OF CINCINNATI. Statement of Contagious and In without anesthetizing the patient. The fectious Diseases for week ending pain after a time was not complained December 23, 1892: of, notwithstanding the high tempera ture developed at the focus of the lens. He records as the principle objection to the treatment the unpleasant appearance Since 120° F. is about the limit of usual toleration of moist heat, and since 145° dry heat produces nearly intolerable pain in one minute, and in ten minutes causes quite active hyperæmia, it is plain that concentrated light, minus its grosser heat, is both anæsthetic and escharotic, the last in a mild degree. 2. 4. 5. Cases. Deaths. Measles. 2 6. 2 7. 8. 9 I 10. [I. 12. 16. In considering the former property, some allowance must be made for the effect of dessication, which, although hindered somewhat in this case by the transudation of serum, has an admitted | 13. effect. The latter property manifests 14. itself in the severe blistering of the 15. skin at elevations above the snow line and in small boats on the water in the tropics, being much severer in the early and late hours of the day, from the oblique position of the sun and the greater consequent reflection of the rays from the surface of the water.-Mary- 24. land Medical Journal. Pilocarpine in Erysipelas. 17. 18. 19. 20. 21. 22. 23. I 25. 26. 27. 28. 30. Public For erysipelas, Prof. Da Costa con- 29. tinues to strongly advocate and recommend the use of pilocarpine in robust, plethoric subjects. It is of striking value, and better results can be obtained than from any other mode of treatment. The proper dose is one-eighth grain of pilocarpine, or twenty minims of the fluid extract of jaborandi. Local means are of little use.-Med. Summary. Totals.... 14 Mortality Report for the week end- Other Zymotic Diseases. Cancer.. Phthisis. I 4 2 6-19 2 7 |