differently in different affections. Typhoid and intermittent fever receive the greatest reduction of heat. In pneumonia, pleurisy, and especially in puerperal fever, the antipyretic properties of antifebrin are less conspicuous. The entire absence of rigors in the reascent of temperature is an especial feature of the antifebrin action.

It is difficult to as yet define the exact indications for antifebrin, and to explain the modus operandi of its physiological action. Against any action from the part of the gastric juice speaks the wholly negative result obtained in a case of so-called artificial digestion (by means of pepsin and muriatic acid at 92° F.). The cyanosis, however, above referred to justifies the assumption that at least a part of the antifebrin is changed back into aniline.

As to the dose, Krieger advises to begin with 10 to 15 grains, and to gradually increase it; 50 grains were in many instances given pro die with perfect impunity.

A number of surgical cases coming under the observation of Krieger convinced the author that antifebrin possesses also distinct antiseptic virtues. In these cases the drug was used either as a powder or dissolved in ether or collodion. The closed wounds thus treated healed invariably per primam intentionem; the open ones showed little or no irritation and suppuration.

The action of the drug upon micro-organisms will form the subject of a later publication of Krieger. A more extensive application of antifebrin for internal and surgical purposes is facilitated by the extraordinary cheapness of the drug.

THE CURABILITY OF ALCOHOLIC CIRRHOSIS.

According to a Paris correspondent, a short time since M. TROISIER communicated a case to the Société Médicale des Hôpitaux in which the ascites resulting from cirrhosis of the liver had disappeared under the influence of iodide of potassium and strychnine, and the visceral lesion itself had seemed to be cured. In the discussion which ensued it was pointed out that ascites sometimes passes away spontaneously in the course of a cirrhosis, and, on the other hand, the affection of the liver may go through all its phases without giving rise to peritoneal effusion. M. Troisier now goes further. asks whether there does not exist a particular form of alcoholic cirrhosis in which the lesion,

He

stopping short of destruction of the liver-cells, is susceptible of retrogression; and he relates another case in support of this hypothesis. A confirmed drinker, aged 68, was under the care of a colleague, and presented all the symptoms of hepatic cirrhosis. Between the months of December and September one hundred and sixty-five litres of fluid were removed by tapping at different times. At the present time the peritoneal cavity is empty, the liver slightly enlarged, and the patient in excellent health. M. Bucquoy said that he had seen several similar cases, and he entertained no doubt that other members of the Society had had a like experience.-The Lancet, December 25, 1886.

To be given to children of 8 months to I year in 4- to 5-drop doses; 1 to 2 years in 5to 8-drop doses; 2 to 4 years in 8- to 12-drop doses; 4 to 8 years in 10- to 13-drop doses; 8 to 12 years in 12- to 15-drop doses; over 12 years and to adults in 15- to 20-drop doses.

In

The medicine is to be taken either only in the evening, or evening and morning. children younger than 8 months Vetlesen has not yet tried the remedy. The number of cases thus treated is one hundred and sixteen; in eighty-three (71.6 per cent.) the result was favorable, and in thirty (25.9 per cent.) the result was excellent. Injurious effects have never been observed. Control

ling experiments have shown that neither of the two drugs, when given alone, could bring about the favorable results attending their combination.

CARBOLIC ACID IN WHOOPING-COUGH. DR. F. P. ANDERSON, of Grosse Isle, writes to us that he has treated a number of cases of pertussis during the past three months with small doses of carbolic acid, and in one case only did he resort to other remedies.

In several cases in the same household the paroxysms of coughing and vomiting were arrested so promptly as to cast doubt on the

correctness of his diagnosis, a doubt dispelled by temporarily withholding treatment in one subject.

The triturated tablets containing one-tenth grain of carbolic acid were administered generally, and introduced without objection into the child's mouth. To an infant of 3 months of age a half tablet (gr.) was given every three or four hours; to children from 1 year to 3 years of age the dose is one tablet. Care must be exercised in increasing dose for age.

The cases treated during the fine weather of October and November were discharged cured in from two to three weeks, although from the commencement the intensity of the symptoms was modified. All but one were taken in hand as early as the affection was recognized; this excepted one had been whooping and vomiting for several days, and yielded almost as readily as the other.

The weather throughout was favorable, but many patients were of the poorest class, and received little care.

Attention to this use of carbolic acid was directed first by Dr. Macdonald, of Liverpool, England, as long ago as 1881.

THE TREATMENT OF TYPHOID FEVER BY CORROSIVE SUBLIMATE. In the Deutsches Archiv für Klinische Medicin of November 30, 1886, GLÄSER, of Hamburg, reports the results obtained in twentythree cases of typhoid fever by the use of corrosive sublimate. The cases selected were those in which the diagnosis was plain, and which were of at least moderate severity, and which had not advanced so far that medication was useless. The number of cases treated was too small to be of value in statistics of mortality, but large enough to give a result as to the effects of the drug upon the principal symptoms of typhoid.

The following were the results obtained : 1. In twenty-three cases five deaths, a mortality of twenty-one per cent.

2. Four cases showed a fall in temperature to the normal before the nineteenth day of illness, on the thirteenth, fifteenth, sixteenth, and nineteenth days respectively after sublimate was given on the sixth, eighth, and tenth days.

Two parallel cases which had no sublimate showed a fall of temperature on the fifteenth and sixteenth days.

Six cases showed a fall of temperature to the normal on the twentieth to twenty-third days after two doses of sublimate on the

eighth day, and on the ninth, tenth, eleventh, and fifteenth days, one dose.

Five parallel cases, without the sublimate treatment, showed similar defervescence.

In eight further cases the fall to normal temperature came later; two on the fifteenth day, one on the sixteenth, two on the seventeenth, one on the eighteenth, one on the twentieth, one on the twenty-second day after taking the sublimate.

3. Sublimate had no influence upon the condition of the tongue; in eight cases it remained dry, and did not alter until defervescence occurred.

4. The roseola of typhoid was in eleven cases aggravated by sublimate to such a degree that the face was affected, and the cases resembled measles.

5. The general condition of the patient was not in the least improved.

The influence of the treatment on the duration of the illness and its relapses is best shown by the following table:

The question of greatest interest in these reports is the dosage and the bearing of the cases upon the possibility of effectually destroying the bacillus of typhoid fever in the organism. When the amount of blood (at one-thirteenth of body-weight) to be disinfected is considered, we find that using a solution of sublimate, 1 to 4000 or 5000, its proportion to the blood would make the actual proportion of mercurial to the blood 10400, which is a solution inert as a parasiticide. In the series of cases cited it was given in eight doses pro diem, the total given being three-tenths of a grain in a day and a half, the solution used being 1 to 4000 or 5000.

The series illustrates in an interesting manner the difficulty of practically disinfecting the blood while still within the body without at the same time destroying life.

THE ACTION AND THERAPEUTIC VALUE OF VEGETABLE ASTRINGENTS. The term astringent in its widest sense as including styptics may be defined as referring to substances which either when locally ap

plied or after absorption into the blood cause contraction of the tissues, diminish secretion, and arrest hemorrhage. Those which so act after absorption into the blood are known as remote astringents, and include acids, many salts of the heavier metals, ergot, digitalis, gallic and tannic acids, and many of the substances containing them. To the last of these it is customary to apply the name of vegetable astringents, and their mode of action and therapeutical value has been carefully investigated by DR. RALPH STOCKMAN, who publishes his results in the British Medical Journal for December 4, 1886. His paper includes an elaborate series of experiments as to the mode, form, and amount in which these bodies are absorbed and circulate in the blood, and are excreted, and as to their action on the blood-vessels and circulation.

His

Our space will not permit an analysis of these experiments, for which we must refer the reader to Dr. Stockman's paper. conclusions as to the therapeutic value of vegetable astringents are, however, of considerable interest and value. Considering gallic acid first, he says that either when locally applied, or after absorption into the blood, gallic acid evidently exercises no other action than that of a weak inorganic acid, and certainly has no claim to any special action as an astringent. The only action which it can have in this direction is the power which it possesses, in common with all other acids, of diminishing the alkalinity of the blood, and thereby increasing its tendency to coagulate. Stronger acids, however, will act much more powerfully in this direction than it does. Any influence in lessening the calibre of the bloodvessels, either by peripheral or central action, must be denied to it. When locally applied, the fact that it does not precipitate albumen must prevent it having any influence on a catarrhal inflammation.

As regards tannic acid, the matter is somewhat more complicated. Locally applied, its action for good depends on its power of precipitating albumen, the layer of tannate of albumen which is formed acting as a protective to the underlying mucous membrane. To this action is due its value in catarrhal inflammations of the alimentary canal, and in discharging surfaces generally.

The preceding experiments show, however, that its usefulness is limited to such cases, and that as a remote astringent it is valueless. In weak solution and uncombined its action on contractile tissues, such as the vascular walls, is simply that of a dilute acid, while it

is only when stronger solutions are used (much stronger than can ever exist in the blood, even if it were not in combination there) that its power of precipitating albumen comes into play. When its chemical affinities have been satisfied by neutralizing it with a base or with albumen, it is no longer capable of precipitating albumen, and exercises, therefore, little or no influence on the parts with which it comes in contact.

Independently of these considerations, the very small quantity in which it exists at any one time in the blood, and that in combination, must also militate against its having any remote action. As we have seen, the only channels of excretion besides the bowel are the kidneys, and hence it is hardly possible that it can have an astringent action on any of the other mucous membranes, such as the bronchial. It is now almost an axiom in therapeutics that substances which do not possess a very decided general action can affect only those mucous membranes by which they are excreted, and it is improbable that tannin is any exception to this.

With regard to its action on the kidneys, it is conceivable that it may have a favorable influence in diminishing albuminuria, but even this is to be regarded as doubtful. Many eminent clinicians have expressed disbelief in its value, and the only cases which the author has been able to find, in which the amount of albumen in the urine was carefully estimated from day to day, tend to confirm this view. They are four cases of chronic Bright's disease reported by Briese (Deutscher Archiv. f. Klin. Med., xxxiii., p. 220, 1883) in which the administration of tannate of sodium for long periods had no influence, either on the amount of urine or the albumen present in it.

TWO

FATAL POISONING FOLLOWING VAGINAL DOUCHES WITH CORROSIVE SUBLIMATE SOLUTION.

FLEISCHMANN, of Prague, reports the following instructive case: A perfectly healthy primipara, aged 17, exhibited no symptom of kidney-disease or of any other complication of pregnancy. To disinfect the vagina before labor two douches of 1 to 2000 solution of sublimate were given, one before and one after examination by a midwife. It was noticed that a small amount of bloody mucus was expelled from the vagina after the douches. In a few hours abdominal pain, diarrhoea, and a rise of temperature occurred, all the symptoms and lesions of mercurial poisoning developed, ne

phritis, salivation, and continued diarrhoea, and, after giving birth to a living child, the patient died in coma on the ninth day after the douches were given. The pathological anatomical diagnosis made at the autopsy was "corrosive sublimate intoxication, acute nephritis, dysentery, stomatitis and pharyngitis in the stage of ulceration, parenchymatous degeneration of heart and liver, lobar and lobular pneumonia, bilateral, acute cystitis."

On investigation it was found that after receiving the douche the patient had left her bed and gone about her work in the ward. It is not probable that any considerable amount of fluid remained in the vagina after the douche, as all ordinary precautions were taken to secure its expulsion. It is, however, quite possible that some of the fluid may have gone into the uterus and become absorbed by any superficial lesions which had occurred in the beginning dilatation of the os uteri.

It was also true that the patient had diarrhoea before the douches were given, and in his remarks upon the case Fleischmann calls attention to the danger attending the use of sublimate in puerperal patients in whom any lesion or disordered condition of the kidneys or bowels exists. He quotes the words of a well-known obstetrician, who asserts that the use of sublimate should be limited to the disinfection of the external genitalia and hands and instruments.-Centralblatt für Gynäkologie, No. 47.

THE MYDRIATIC PROPERTIES OF HY DROBROMATE OF HYOSCINE.

MR. JOHN TWEEDY states in the London Lancet for December 4, 1886, that he has found that a few drops of hydrobromate of hyoscine in a half of one per cent. solution proved to be a rapid, powerful, and unirritating dilator of the pupil alike in the healthy and in the inflamed iris, and a paralyzer of the accommodation. Notwithstanding its great activity, when given internally or subcutaneously, he has not yet met with any instance of its producing toxic effects, such as occasionally follow the use of duboisine, though these contingencies may be possible with stronger solutions. Mr. Tweedy has found that the action of hyoscine is almost three times as rapidly produced as by atropine in removing the "nearest point," in paralyzing accommodation and in fully dilating the pupil, while the effects of hyoscine also last longer than those of atropine, and are not so easily counteracted by eserine. The indication seems to be that if hyoscine is to find a place

in ophthalmic therapeutics, it will be chiefly in cases of iritis and in other conditions where it is desirable to produce as much dilatation of the pupil as possible, and for as long a time. as possible.

It is further worthy of note that the application of hyoscine to the eye does not seem to cause the unpleasant taste and feeling in the throat which often follows the use of atropine.

THE ANTISEPSIS OF THE HANDS.

BELAIEFF; of Kiew, recommends the following as a sure and easy method of cleansing. and disinfecting the hands:

Before the disinfecting fluid is applied the hands are thoroughly rubbed with a vaseline salve containing the coloring-matter called aqua-marine, in the proportion of 1 to 5 or 8 of vaseline.

The nails and spaces about the nails should be thoroughly filled with the salve, and its color affords a good indication of the thoroughness of its application. The hands are then well scrubbed with soap and brush until every particle of color has disappeared, when a thorough douching with solution of corrosive sublimate, I to 2000, completes the process.

Kümmall has stated that an efficient disinfection of the hands occurs when they are brushed for three or five minutes with potassium soap, and then thoroughly washed with three or five per cent. solution of carbolic acid, one-tenth of one per cent. solution of sublimate, or one-third of one per cent. solution of thymol.-Pharmaceutische Post, December 11, 1886.

CALOMEL AS A DIURETIC.

The virtues of calomel have in these days come to be somewhat undervalued, a reaction doubtless from the indiscriminate prescription. of former times. DR. MENDELSOHN (Deutsch. Med. Woch., No. 45) calls attention to its value as a diuretic, especially in cardiac dropsy, basing his remarks upon papers recently published by Dr. Jendrassik, of Pesth, and Dr. Stiller, already fully described in the GAZETTE. The former, having noticed the marked diuresis which ensued in a severe case of cardiac dropsy after the administration of jalap and calomel, found by further observation of other cases that this effect was due to the calomel and not to the jalap. In the great majority of the cases the daily quan

tity of urine reached from two to five or more litres on the second to fourth day of calomel treatment. Stiller's experience is confirmatory of this, and Dr. Mendelsohn adds his own testimony to the value of the prescription. He says that when calomel is prescribed in doses of from 0.2 to 0.3 gramme (ie., 3 to 5 grains) three times a day, diuresis occurs within eight hours. It is not necessary to induce salivation to get this result, which often takes place with surprising rapidity; the anasarca and serous effusions disappear, and the patient is much relieved. It is said to be even more effective than digitalis, squills, and other remedies in certain cases, especially when the pulse-tension is not very low. Calomel does not, however, act through the heart, and is often advantageously combined with digitalis.-The Lancet, November 20, 1886.

INCONVENIENCES IN THE USE OF
TINCTURE OF IODINE.

The Répertoire de Pharmacie for 1886 describes a method of removing the disagreeable yellow stain which remains after the application of iodine:

In the case of the hands where the skin has become hardened we can employ dilute ammonia, soda, charcoal, or common soap; but in treating women whose skin is tender, and in those parts of the body where the integument is not hardened, we prefer the sulphites, the bisulphites, or alkaline hyposulphites, substances inodorless and non-irritating, which absorb iodine by both their acid and their base.

We have used especially the sulphite of sodium in solutions of to. This is pencilled upon the place where the iodine has been applied or used in compresses. In a few moments after application the pain and irritation caused by the iodine have disappeared.

EXPERIMENTAL RESEARCHES ON THE BIOLOGICAL ACTION OF BERBERINE.

CURCI's experiments lead him to the following conclusions (Annali di Chimica e de Farmacologia, July, 1886): Berberine has a paralyzing action on the brain, and especially on the voluntary motor centres, and on the centre for food appetite. It has a weak action on the sensitive centres. On the spinal cord and on the reflexes it acts late, that is, when the blood circulation is very languid and the

heart is nearly paralyzed. This is in mammals. In batrachians the reflexes persist even after the arrest of the circulation. At the time it acts on the respiratory centres, at first exciting and then paralyzing them. The action of berberine on the circulation is rapid and energetic, the vessels are paralyzed, and the blood rushes to the periphery. The arterial pressure falls to zero, the heart beats more frequently, and the temperature falls. The vaso-motor nerves are first paralyzed, and then the muscular fibres of the heart and of the vessels. In consequence of the vascular paralysis all the other functions languish, and the state of the circulatory system may be the true cause of death, in which respiration is first arrested, and immediately afterwards the heart. It has no action on the vagus, either excitant or paralyzing, even in toxic doses. It causes a fall in temperature by increased dispersion of heat, in consequence of the vaso-motor paralysis, and it is not a poison of the protoplasm. Under the influence of berberine blood remains for a longer time undecomposed, and yields oxygen with more difficulty. It relaxes the tissue of the spleen,

and increases rather than diminishes the size of this organ. It increases the peristaltic action of the intestine, both by its direct local action and by its general action after it has been taken into the blood-current; and produces at first diarrhoea and then a condition resembling dysentery. resembling dysentery. Acid urine is secreted even in the herbivora (rabbits). At times it is albuminous, and contains granular epithelial casts. The kidneys are congested, and sometimes present the signs of inflam-' mation. Most of these conclusions were

already published by the author in 1881.

The London Medical Record, No. 136, October 15, 1886.

THE DETECTION OF BLOOD-CLOTS IN THE PRESENCE OF IRON RUST.

DANNENBERG has found a new crystalline substance, which he calls hämidin, the formation of which, in a crust in which blood is suspected, he considers a proof positive of its presence. It is produced in the following

manner :

Two, four, or six drops of strong solution of potassium hydrate are dropped upon the crust, and allowed to remain there an hour. When the crust has softened it is carefully transferred to a porcelain dish and washed. few drops of ammonium sulphate are added and the whole gently warmed. After ten minutes water is added and the whole fil