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diuretic remedy suitable in dropsies of every description (and extensively employed as such in the Siberian popular medicine). To prepare the infusion, the author puts (in the evening time) two drachms of the dried (not too old) leaves into a tea-pot, pours over the leaves two teacupfuls of boiling water, and keeps the vessel during the night in a very warm place, to use the infusion in the course of the next day (a cup in the morning, another in the evening). "Its taste is not very nasty, and becomes the less nasty the more the patient is habituated to the infusion." The author gives at length his own case. He is eighty years old, and has suffered from "oedema pedum" for more than ten years (chiefly every spring, but often also during summer, when the latter happens to be wet). At first he used Adonis vernalis and other diuretics, as well as elastic stockings; and obtained some benefit from them; but afterwards the said means ceased to bring any relief. Hence, about five years ago, he was compelled to resort to the infusion of cloudberry leaves, massage, and elastic bandage. The results were most satisfactory on every occasion. Under the use of cloudberry, the daily amount of urine always rises to 54, 60, 72, 83 ounces (to sink, after discontinuing the drug, 55, 45, 40, 38 ounces). Each time a month's treatment of the kind proves sufficient to remove oedema and pain.

OLIVER'S Atomizer.-Depending upon the principle that a stream of water forced through a narrow tube against a firm resistance will become broken by the concussion into a coarser or finer spray, which remains for a short time suspended in the atmosphere, Auphan, at Euzet-les-Bains, in 1849, and, subsequently, Sales-Girons, Demarquay, Mathieu, Lewin, and others, constructed inhalation chambers, or portable apparatus for the inhalation of nebulized liquids. The apparatus of Bergson, constructed in 1862, after a suggestion of Nothanson, produces a spray by the impact of a current of air with a stream of liquid drawn by its suction power into a tube placed perpendicularly to the air-tube, the fineness of the spray being regulated by the size of the apertures in the tubes. The apparatus described twenty years ago by Dr. Henry K. Oliver, of Boston, combines these principles; the spray from a Bergson nebulizer being made to impinge upon the wall of the vessel containing the tubes and liquid, and thus becoming reduced into a state of still more minute subdivision. In the improved Oliver apparatus, the spray from the Bergson tubes first strikes upon an overhanging projection from the air-tube, and is thence deflected across the diameter and upon the wall of the glass container, being thus twice broken up, each time into finer particles; the nebula thus formed being conducted to the mouth of the patient by means of a rubber tube and mouthpiece of sufficient aperture. A separate mouthpiece should be used for each patient. The air for propulsion may be conveniently supplied by means of hand-bulbs, or, for office use, be drawn from a reservoir in connection with an air-pump; a very neat and complete apparatus, which will be found extremely satisfactory, is made at a very moderate price by Messrs. Codman & Shurtleff (See Figure).

The very fine cloud produced by this instrument, remains suspended in the atmosphere for fully a minute, and, according to the observation of Dr. George A. Evans, the admixture of glycerine with the solution

to be nebulized prolongs the period of suspension. This persistent nebular can be drawn by the patient with the current of inspired air a much greater distance into the air-passages than is possible with the ordinary sprays from the simple Bergson or Richardson tubes, even though, in the latter case, the patient inhale merely the more distant particles lightly suspended in the atmosphere.

It is a fact, not generally appreciated, that when the ordinary spraytube is placed within the mouth, the stream of spray strikes the hard palate, pharynx, or other structures, being there in part deposited as larger or smaller globules, and in part transformed into a nebula, as in Oliver's apparatus. A small portion of the nebula is inhaled, but most of it is lost by exhalation, forming the dense cloud which is seen to issue from the mouth. Oliver's apparatus, forming outside of the body

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the nebula which alone can pass the glottis, allows a much larger proproportion of the fluid nebulized to reach the interior and deeper structures. It also avoids many of the objections which hold against the steam atomizer, such as the relaxing effect of the steam upon the mucous membranes. If it be considered advisable to warm the nebula, the vessel containing the medicament may be placed within another vessel containing hot water. By combining one of these instruments with an apparatus for the administration of inhalations of compressed air (Waldenburg's, or some of its modifications), the conditions are obtained which most highly favor the penetration of the vapor (into which, practically, the very fine spray becomes converted) into the ultimate air-cells.-Med. News.

WHAT to do in Cases of Poisoning. By William Murrell, M. D.The Antidote Bag and Case.-The antidote bag should contain every drug and instrument likely to be required in a case poisoning. It should be to the toxicologist what the midwifery bag is to the obstetrician. It should always be kept filled ready for use, so that in case of emergency the doctor would simply have to take or send for his bag, and would not have to look for stray bottles or instruments at a time when every moment is of importance.

The antidote bag or case should contain :

I. Instruments.-1. Stomach-pump or stomach-tube, which might also be used as an enema apparatus. There should be a small œsophagus tube for children. If a separate enema apparatus be required Ingram and Son's is one of the best, and it is warranted "not to split." 2. Hypodermic syringe. A cap at the end to prevent the piston from getting dry is a useful addition. Messrs. Burroughs, Wellcome & Co., make a small pocket hypodermic syringe of solid silver. It is unbreakable and can not possibly get out of order. 3. Flexible catheter, No. 8.

II. Emetics.-1. Sulphate of zinc in half-drachm powders; one or two to be given in hot water, repeated if necessary. 2. Powdered ipecacuanha in Dj powders; one or two to be given in water as an emetic. 3. Apomorphine (1 in 50 solution of the hydrochlorate in water) 3 ij. Five drops hypodermically as an emetic. III. Stimulants.-1. Brandy, 3 iv. 2. Sal volatile, iv. 3. Chloric ether, iv. 4. Coffee in 4 lb. tin; to be used as an enema in poisoning by opium or other nacotics.

It is possible that caffeine might be substituted for the coffee. The best solution for hypodermic use is the "Injectio Caffeine Hypodermica." It is made by dissolving 20 grains of caffeine and 171⁄2 grains of salicylate of soda in a drachm of water. It contains a grain in 3 minims, and 6 minims may be given at a dose. It must be remembered, however, that the warmth contained in a pint of hot coffee is not without benefit.

IV. Antidotes.-1. Dialyzed iron, 3xvj; should be given ad libitum in cases of arsenic poisoning. Wyeth's is the best. 2. Acetic Acid, iv; two teaspoonfuls or more in water in cases of poisoning by potash, soda, etc. To be frequently repeated. Vinegar is a good substitute. 3. Syrup of chloral, 3 iv; of great value in strychnine poisoning. Three drachms (30 grains of chloral) may be given to begin with. 4. French oil of turpentine, 3 ij; as an antidote in phosphorous poisoning. To be given in half-drachm doses every quarter of an hour. 5. Heavy magnesia (magnesia ponderosa); may be given almost ad libitum in poisoning by acids. 6. Tannic acid, ij; in strychnine poisoning may be given in teaspoonful doses. 7. Bromide of potassium in 3 ij powders; in strychnine poisoning may give two powders to begin with, and follow with one every ten minutes for an hour or more. 8. Nitrite of amyl capsules, 5 minims in each. To inhale in chloroform poisoning, and in poisoning by aconite. 9. Chloroform, 3 iv; in strychnine poisoning.

V. Hypodermic Injections.-1. Sulphate of atropine solution (1 in 100) B. P., 3j; in poisoning by aconite, morphine, pilocarpine, etc. The ordinary dose for hypodermic use would be two minims, repeated in a quarter of an hour if necessary. 2. Acetate of morphine solution (1 in 10) B. P., 3 j, useful to ward off shock. Ordinary dose for hypodermic use, five minims. 3. Aconitine (English) solution (1 in 240) 3j; in poisoning by digitalis. Two minims hypodermically; may be repeated in half an hour. 4. Pilocarpine nitrate (1 in 20) 3j; given in ten minim doses, frequently repeated, in poisoning by belladonna or atropine. 5. Nitrate of strychnine solution (1 in 50) 3j; in chloral poisoning given in two minim doses. 6. Tincture of digitalis, 3j; in aconite poisoning in 20 minims doses hypodermically.

Compressed tabloids of atropine, morphine, etc., may be substituted with advantage for many of these solutions. I have tried nearly all the Wyeth compressed hypodermic tabloids, and find that they are reliable. If the necks of bottles are not very carefully ground, the stoppers either leak or at a critical moment are found to be firmly fixed. The tabloids occupy less room, and need not be in stoppered bottles. Those who are interested in the subject should read Bartholow's Hypodermatic Medication, 4th edition, or Bourneville's Manuel des Injections Sous

cutanées.

VI. The Poison Book (latest edition).

An Antidote Bag or Case of some kind should be kept in readiness at every police station, and in the casualty room of every hospital.

It is a good plan to inspect the bag or case at intervals to see that everything is in working order. The piston of the hypodermic syringe always works badly if not looked after. A little vaseline may be applied to the stoppers of the bottles.

Martindales's Antidote Bag.-Mr. Martindale, of 10 New Cavendish Street, W., has for some years past, made me a bag which answers the purpose admirably.

It contains in a morocco bag a hypodermic syringe, a case of solutions, and a series of chemical and physiological antidotes. The following is the list of medicines: Dialysed iron, syrup of chloral, chloroform, aromatic spirit of ammonia, spirit of chloroform, French oil of turpentine, acetic acid, tincture of digitalis, nitrite of amyl capsules, sulphate of zinc, ipecacuanha, bromide of potassium, calcined magnesia, tannin, hypodermic injections of strychine, morphine, atropine, apomorphine, pilocarpine.

Its price is five guineas. A larger bag suitable for hospitals contains an additional supply of drugs, a catheter, and a lever stomachpump.

The Borroughs' Antidote Case.-The Burroughs' Antidote Case, made by Messrs. Burroughs, Wellcome & Co., is wonderfully useful and compact. It contains a stomach-tube of novel construction. Wyeth's dialyzed iron, sal volatile, French oil of turpentine, and tabloids of sulphate of zinc (ten grains), chloral hydrate (ten grains), and bromide of potassium (ten grains), with capsules of nitrite of amyl. There is also a hypodermic syringe fitted with a cap, a glass mortar and pestle for dissolving the tabloids, and a case of tubes for hypodermic use containing tabloids of apomorphine (one-tenth of a grain), sulphate of morphine (a quarter of a grain), sulphate of atropine (one-sixtieth of a grain), hydrochlorate of pilocarpine (one-third of a grain), sodio-salicylate of caffeine (half a grain), sulphate of strychnine (one-sixtieth of a grain), digitaline (one-hundredth of a grain), and aconitine (onehundred and thirtieth of a grain). It measures about eight inches by three and when full weighs less than two pounds. Its price is two guineas complete. It is a capital case and is a marvel of compactness and cheapness.

The Battery-A battery (interrupted current) is useful, and may be obtained for about $10. The best of all is the Appareil d'Induction Volta Faradique, made by A. Gaiffe, of Paris. It is a wonderful little instrument and is so small that it can be carried in the breast-pocket.

It is ready for use in a moment and there is nothing to spill and nothing to get out of order. It costs only about 20 francs, an absurdly small price. In poisoning by ammonia or nitric acid tracheotomy instruments might be required. In cases of prolonged insensibility the bladder should be emptied.

The Stomach-Pump.-Every doctor should have a stomach-pump, or an efficient substitute. It may not be wanted for years, but it may be wanted to-morrow, and a life, or many lives, may depend on its being in working order. A good stomach-pump, with flute key action. and every thing complete, may be obtained for £2 or even less, and it requires no special knowledge to use it. The only points to remember are that it is advisable to pump in a little water before trying to empty the stomach, and that the stomach should not only be emptied, but thoroughly washed out. Antidotes may be conveniently introduced in this way. In cases of poisoning with the mineral acids-nictric, hydrochloric, and sulphuric acids, for example-it is not safe to use it.

Fortunately, in cases of emergency it is no very difficult matter to rig up an apparatus that will effectually empty and wash out the stomach, without a stomach-pump. Take a piece of India-rubber tubing, about six feet long, and pass it down the oesophagus till it reaches the stomach; now hold the other end well above the head, and by means of a funnel pour in water till the stomach is nearly full. If the tube be pinched while distended with water, and the lower end placed in a basin below the level of the stomach, it will act as a syphon and the stomach will be emptied. This may be repeated three or four times till the water comes back quite clear and free from smell. In the absence of a funnel a common India-rubber bottle may be used to fill the tube, or, for the matter of that, even the mouth filled with water. A common Higginson's enema apparatus will do very well to inject the water, and if it has no valves, or if they do not work-not an uncommon occurrence-it will help to form part of the syphon. Those who are interested in the subject will do well to read a paper by Professor Harvey, formerly of Aberdeen, in the British Medical Journal for October 16, 1875.

Transfusion. In many cases of poisoning transfusion might be employed with advantage as suggested by Dr. Ringer in the Lancet of July 14th, 1883. It is not necessary to use blood, as a saline salution will do just as well. It would be best to inject it into the circulation direct, but in the absence of a suitable apparatus it could be introduced by the stomach-pump into the stomach or rectum from which it would probably be absorbed. The following is the formula I use: common salt, one drachm, bicarbonate of sodium, four grains, chloride of calcium, three grains, chloride of potassium, one grain, water, twenty ounces at a temperature 100° F. On several occasions I have injected this into the peritoneal cavity with good results. The only apparatus employed (Lancet, April 21st, 1883) was the canula of an aspirator attached to a piece of India-rubber tubing, the fluid being allowed to run in by syphon action.-Med. Reg.

ADMINISTRATION of Gaseous Enemata.-A share of professional and public attention has recently been directed to the adminis

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