night and 5 in the morning, increasing is innate as regards the individual. the doses if these do not control the temperature. If the stomach rebels, he gives it hypodermically or per rectum. The writer has seen such good results from quinine that he is inclined to agree with Dr. Burney Yeo in thinking that it is not given often enough, and is inclined in future cases to use it systematically from the first. With cold applications he has no experience. Failing circulation calls for alcohol and digitalis. Nutrition and Growth in Connection with Pulmonary Phthisis. DR. ALEXANDER JAMES (Edin. Med. Jour., Oct., 1885) discusses this subject and arrives at the following conclusions: 1. That phthisis tends to occur when the assimilative power fails, as indicated by the occurrence of it, or tubercle in the lungs, intestines or brain, at different ages, and that the development of the reproductive function, the disappearance of enlarged cervical glands, and the growth of hair, indicate a lessened activity in the vital processes in adult life as compared with early years. 2. On the general principle of the connection between supply and demand, we may suppose that this assimilative power is, to a greater or less extent, dependent on functional activity of the part. This seems borne out by the fact, that in tall people, with large lungs, and with proportionately less demand for functional activity (i. e. less loss of heat) phthisis is common, and also by the fact that, as age advances, the natural tendency to emphysema, by increasing the functional activity of the lungs, seems to render them less liable to phthisis. 3. This assimilative power, though in part dependent on functional activity, this we have evidence in the different sizes to which individuals grow, the functional activity being the same, and in the varying proneness to phthisis in individuals, the surroundings being the same. Bronchial Asthma, and Hay Fever. SIR ANDREW CLARK (Am. Jour. Med. Sci., Jan.) considers the theory of bronchial asthma in the light of the pathology of hay fever, and arrives at the following propositions : 1. Asthma is a neuro-vascular trophic disease, and has its roots in a special vulnerability of the respiratory mucous membrane, of the respiratory nerve centres and of certain portions of the sympathetic. 2. The irritation exciting the nerve discharges which bring about the asthmatic paroxysms may arise in the blood, in any one of the mucous tracts, but more particularly the respiratory one, in certain cutaneous inflammations and in the central nervous system itself. 3. The paroxysm begins by a more or less diffused hyperemic swelling of the bronchial mucous membrane, and is continued by the development of various parts thereon of circumscribed congestive swellings, which come and go with greater or less rapidity, and resemble in many particulars the swelling of the skin in nettle rash. 4. At their first appearance these swellings become coated with a viscid mucus, hinder the entrance and exit of air, and by their vibration produce for the most part the drier râles, characteristic of a certain state of the asthmatic paroxysm. Toward the close of an attack, the swellings after free secretion subside, the dyspnoea is relieved, and moist take the place of dry râles. 5. The secretion from the swellings being sometimes acid, and even corrosive, may excite some contraction of the bronchial muscles; but such contraction cannot become, either by its nature or its amount, the chief factor in the evolution of the asthmatic paroxysm. 6. The hyperæmia and circumscribed swelling of the bronchial mucous membrane hindering the free entrance of air, and thereby the full aeration of the blood, both the periplural nerves and the respiratory centres are irritated, and exaggerated discharges of respiratory impulse are sent to the inspiratory muscles, which are thereby thrown into violent and sometimes even tetanic contractions. 7. These violent inspiratory efforts, increasing the Hallerian extension force of the thoracic walls, straighten the bronchial tubes, and, notwithstanding the tendency of inspiratory forces to increase the size of the swellings, make the entrance of air into the lungs far easier than its exit. 8. When the inspiratory efforts cease, and the expiratory recoil begins, and is continued by the muscles of forced expiration, the smaller bronchi, especially those containing mucous wheals, are compressed, and all the passages are relaxed and lose their straight direction. Thus the egress of air is greatly hindered, and the act of expiration so prolonged that it is sometimes suddenly interrupted and prematurely closed by the violent inspiratory efforts originated in the respiratory nerve centres, through the circulation of imperfectly oxidated and decarbonized blood. In this way inspiration gains upon expiration; the alveoli are distended with air; the diaphragm is depressed; the chest, in all its dimensions, is dilated; the breathing becomes more and more difficult: death seems imminent, and the paroxysm is at its height. 9. After a time, varying greatly in duration, the attack begins to subside, and, partly by secretion from the bronchial mucosa, partly from the exhaustion of the excitability of the respiratory and vaso-motor centres, respiration becomes easy, lividity and swelling of the face disappear, restless anxiety is displaced by growing calm, and the attack is brought to an end. Production of so called "Rose Cold," by means of an Artificial Rose. DR. JOHN N. MACKENSIE, of Baltimore, in the Am. Journal of the Med. Sci., for Jan., reports a case wherein a patient subject to attacks of "rose cold," the most intense coryza was induced by bringing into her presence a carefully made artificial rose. On the following day, after the deception had been explained to her, she was able to bury her nose in a specimen of the genuine article without unpleasant effect. Treatment of Catarrhal Phthisis, of Ha moptysis, and of Chronic Bronchitis by Terpene. PROFESSOR GERMAIN SEE gives the following résumé of his paper on this subject: 1. It diminishes and quickly arrests purulent expectoration in catarrhal forms of phthisis. Whether the muco-purulent secretions proceed from the bronchi, irritated by tubercles, or from the walls of pulmonary cavities; whether the malady is at an early stage, or at a phase of purulent breaking down, or even of cavities already formed; terpene should. be used whenever the formation of pus is sufficiently abundant to tire the patient, to exhaust the strength, or to cause him to waste away. 2. It should be used with success in the hæmoptysis of the early stages of 3. In the treatment of pulmonary catarrhs; of chronic bronchitis not dependent on asthma, and only producing dyspnoea by choking the bronchi, terpene constitutes the best method of lessening bronchial hypersecretion. tuberculosis; that is to say, when the | sociated with chronic constipation and 4. The action is quick, sure, and free It even offers advan 5. The best way of administering this medicine is either in the form of pills or tincture, and the best dose is one gramme. 6. In catarrhal, or emphysematous, or nervous asthma, which is to be distinguished from primary catarrh, iodine and pyridine have an incontestable superiority. Bulletin de l'Académie de Médecine.-Journal American Medical Association. Treatment of Intestinal Obstruction by the DR. H. ILLOWAY (Am. J. Med. Sci.) three cases where it was successfully used. In cases where it fails, operation is indicated as a last resort. Sugar in Phthisis and Dysentery. DR. VILDOSOLA, in a Habana Medical paper, states that cane sugar is valuable as a diet in consumption and chronic bronchitis; also in dysentery, and even in dyspepsia. He says that dysentery, which cannot be controlled by ipecacuanha and other remedies, is frequently found to yield to sugar-cane in a state of fermentation when chewed. London Lancet. DISEASES OF THE URINARY ORGANS. of women, the following pill is given: B. Quiniæ sulphat., gr. xlviij.; ferri sulphat. exsic., gr. xxiv.; strychniæ sul Diabetes Mellitus Successfully Treated with phat., gr. i.; M. Ft. pil. xxiv. S.One after each meal. Boracic Acid. F. A. MONCKTON reports, in the Australian Medical Gazette, a case of diabetes mellitus cured by the use of this drug. He says, while pointing out that the value of boracic acid as a diabetic remedy has only been proved in this one case, let me earnestly beg that those who have an opportunity of watching its effect will try it. When placed on the boracic acid the patient's urine had a specific gravity of 1.025. Seven grains of the acid were given three times a day, and at the end of ten weeks the specific gravity was 1.016; no sugar. He continues the drug, however, as it produces no unpleasant effects. No stringent dietary regulations were observed in this case.-Medical World. Vesical Irritability. DR. E. ERICH, of the Maryland Woman's Hospital, tells us (Med. Times) that many of the patients applying for relief at the out-door department of the hospital complain of vesical irritability, frequency of micturition, with burning pain at the meatus and much straining. In a large proportion of these cases the urine is alkaline and frequently cloudy. These symptoms are usually quickly relieved by the following combination. R. Acidi benzoici, 3 j.; sodii biboratis, 3 iss.; aquæ, f3 vj. M. S.-TableM. S.-Tablespoonful every three to four hours. If the trouble does not yield to this medicine, Dover's powder in three grain doses every two to three hours is frequently found effective. As a tonic in the anæmic condition so often attendant upon the pelvic troubles | An Injection for Paralysis of the Bladder. The Union Médicale credits the following formula to Dumreicher : Extract of nux vomica, 3 to 6 grains; distilled water 6 ounces. One-sixth of the whole is to be injected into the bladder every day, and retained for an hour. At the same time, electricity may be used with advantage, and micturition is to be regulated, as much as possible being passed every four hours.-N. Y. Medical Journal. Lagophthalmos in Diabetes. Facial paralysis has not had much attention drawn to it in diabetics. Dr. FIEUZAL, in the Bulletin de la Clinique National Ophthalmologique de l'Hospice des Quinze-Vingts, of September, 1885, relates three cases of the facial paralysis under the title of "paralytic lagophthalmos in diabetes." The first case was that of a man in whom the right side of the face became paralyzed suddenly; corneal ulcers developed; the duration of the paralysis was three months, and ended in complete recovery. A year later the left side of the face was paralyzed for four months. There was no history or evidence of syphilis, and none of rheumatism, but the urine was loaded with sugar. The treatment was simply that used for diabetes, together with some galvanic stimulation of the muscles. The history of the other two cases was practically of the same kind as the one we have briefly sketched.—Medical and Surgical Reporter. CONSTITUTIONAL DISEASES. Baths in the Treatment of Cerebral Rheumatism. The following are the conclusions formulated by Dr. H. DUPRÉ in a recent thesis on this subject (Revue Médicale): 1. Hydrotheraphy ought to be employed in cases of cerebral rheumatism with hyperpyrexia and delirium, whether the articular symptoms be present or not. 2. The condition of the pulse and temperature, and the nervous symptoms, are the indications to be followed in deciding upon this plan of treatment. 3. In presence of such great danger any temporizing method is inadmissible. 4. Baths are to be preferred to any other plan of treatment. 5. In subacute cerebral rheumatism baths of a temperature of 63° to 75° F. should be used. 6. In the acute form a temperature of 85° to 90° F. is preferable, and this may afterwards be reduced, if deemed desirable, by adding cold water. 7. This method is often successful, but it should not be considered as certain, for there are cases in which it occasionally fails. 8. There are no absolute contra-indications to the use of baths, though, of course, the method is not without its dangers; it may give rise to congestions of various kinds, syncope, pleurisy, and the like.-Medical Record. Splenic Anæmia. The affection known as Hodgkin's disease is often confounded with splenic leucocythæmia, as there is in both an exaggerated development of the lymphatic ganglionic system, but in the former the characteristic alteration in the blood is wanting. Dr. Banti has described another form of anæmia in which the ganglionic system is unaffected, but in which there is a very noticeable hypertrophy of the spleen. There is no apparent cause for the impoverishment of 1836-No. 3 a. The The the blood, as it seems not to be due to either scrofula, rachitis, syphilis, or alcoholism. Climate, sex, and age appear to exercise no causative influence upon the disease. At the autopsy the liver is found to be somewhat enlarged, and of a yellow or brownish red color. It appears under the microscope to be the seat of a circumlobular interstitial hepatitis, arising from around the branches of the portal vein. hepatic cells are normal, or are atrophied and the seat of fatty degeneration. The spleen sometimes fills a large part of the abdominal cavity, and may weigh. as much as five or six pounds or more. Its color is brownish-red. The capsule seems to be thickened and opaque in certain places. The microscope shows the lesions to consist of an atrophy and sclerosis of the Malphigian corpuscles and of a general sclerotic degeneration. of all the network of the organ. disease begins insidiously and presents, ordinarily, three stages in its evolution. In the first there is hypertrophy of the spleen, which ordinarily passes unperceived; in the second stage the symptoms of anæmia appear; and in the third the cachexia supervenes and leads rather rapidly to a fatal issue. The patient is easily fatigued, his breath is short, and the pulse is forcible and rapid. The skin and external mucous surfaces are pale, and there is often oedema of the lower extremities. Then the symptoms become gradually worse. The skin assumes a dirty-white appearance, the adipose tissue disappears, and the oedema becomes generalized. Finally, come hemorrhages and fever. As secondary symptoms may be noted, hypertrophy of the liver, dyspnoea, dyspepsia, diarrhoea, weakening of the mental faculties, etc. The only treatment advised by Dr. Banti is extirpation of the spleen.—Ibid. |