ABORTIVE TREATMENT OF BUBO.-To abort buboes following chancroids, Welander, of Stockholm, recommends early injections of the benzoate of mercury in a one per cent. solution, with one-half per cent. of the chloride of sodium. Wash the skin first with sublimate solution; inject on one or two points seven and one-half minims of mercurial liquid; cover with sublimated wool; put on a pressure bandage, and change twice a day. Rest in bed, if possible. The infiltration, as a rule, diminishes in a few days. Considerable fluctuation may develop, but it also soon disappears. The results of this treatment are very favorable. Out of the first thirty-three cases reported, tending to suppuration, this event was prevented in thirty. In all the author has treated one hundred buboes in this way, with thoroughly satisfactory results in seventy-eight.Archiv. f. Dermat. u. Syphilis.-Satellite.

PUNCTURE OF THE SUBCUTANEOUS TISSUE IN DROPSY.-Dr. Gerhart recommends these punctures in cases of marked dropsy. This little operation is performed in the following manner at his clinic: The patient is seated in an arm chair, with the legs extended over a board which rests upon a wooden receptacle. The legs are brushed with soap and water and washed with sublimate solution, while the physician disinfects himself as carefully as before an operation. The knife is placed in a carbolized solution or a hot two per cent. soda solution. On the anterior surface of each leg four to eight incisions are made through the skin. Immediately after, the legs are covered with a layer of gauze, then with thick layers of sterilized cotton held in position by a few turns of a guaze bandage. The patient remains in a sitting posture as long as possible during the day, and at night when in bed a sheet of waterproof material is placed under the legs. As soon as the cotton becomes saturated with fluid it is removed, and a fresh dressing applied under aseptic precautions. If necessary the cotton or gauze is loosened from the skin by irrigation with a three per cent. carbolic or one to two thousand sublimate solution.-Deutsche Medicinische Wochenschrift.

THE TREATMENT OF COMPLICATED RETROFLEXIONS OF THE UTERUS.-Dr. O. Kustner formulates the following rules for the treatment of these cases. If reposition cannot be accomplished by the ordinary manipulations the patient should be anesthetized to confirm the diagnosis. If adhesions are found they should be torn according to Schultze's method, the uterus restored to its normal position, and a proper pessary inserted. The patient should remain in bed until symptoms of reaction are no longer present. Thure-Brandt's method of separating the adhesions and replacing the uterus gives excellent results, but requires too much time. For this reason Kustner prefers Schultze's method, or laparotomy. If the latter operation is resorted to the incision should be made low down near the symphysis pubis, the uterus is then drawn up by forceps, so as make tense the adhesions which are divided with the Pacquelin. After the uterus has been freed from adhesions the question of ventro-fixation comes up. If the patient is young, and the tubes and ovaries healthy, the uterus should not be fixed, but a Thomas' pessary should be applied. On the other hand, if the patient is at or near the menopause, the uterus should be attached to the abdominal wall by two or three silkworm gut sutures; and if the tubes and ovaries are seriously diseased they should be removed.—Samml. Klin. Votr.— Wien. Med. Presse.

COLCHICINE FOR THE EYE.-Colchicine is recommended by Dr. Darier in certain eye affections, and is administered in pill form, each pill containing one sixty-fourth grain of the drug, of which from one to two or four, or even six pills, can be taken daily. Care must be taken to instruct patients to reduce the dose as soon as intestinal derangements manifest themselves. Some patients have taken as many as two hundred pills without complaining of unfavorable. symptoms.-Medical News.

THE TONGUE IN SCARLATINA.-Neumann (Deutsche med. Zeitung, 1891, Number 63, page 715) states that in this disease the tongue passes through three stages of change: (1) Tumefaction of the mucous membrane with disturbance of the epithelium; (2) Desquamation; (3) Regeneration of the desquamated epithelium. The appearance of the characteristic "strawberry" tongue is caused, as is well known, by the swelling of the filiform and fungiform papillæ deprived of their epithelium. Of forty-eight patients examined for this symptom, the "strawberry" tongue was found in thirty-eight (seventy-nine per cent.); in four the tongue was in one of three stages mentioned above; while in six no modification was observed. Dyspeptic troubles precursory to the disease often so modify the tongue that the mucous membrane shows no new modification under the influence of the exanthem. The "strawberry" tongue was observed to last for one day in three cases; two days in five; three days in six; four days in four; and more than four days in the other twenty cases. It appeared during the first three days in thirty-two per cent. of the cases, and upon the fourth day in sixty-eight per cent. The intensity of the cutaneous eruption seemed to bear no relation to the modifications of the tongue.-American Journal of Medical Sciences.

WHAT CASES SHOULD BE DRAINED AFTER ABDOMINAL SECTION?-Dr. Rufus B. Hall, of Cincinnati, has drained in every case of abdominal section which he has made since 1886. The objections to the drainage-tube that have been given at various times are that it is a source of septic infection, a frequent cause of hernia, a foreign body, a cause of irritation, and not infrequently omentum becomes fastened in the perforation, preventing its easy removal. As to the first objection, the author has seen no case of sepsis developed from the use of the drainage-tube; but it is evident that, unless the utmost care is taken, such an accident might occur. The tube should be pumped out every hour or two until it is removed. In his own cases he has seen two hernias developed in the line of cicatrix, but in neither of them did the hernia occur at the point where the drainage-tube was placed. He has seen no appreciable disturbance from irritation of the tube since he commenced using the small, perfectly smooth tube with no side perforations. The small, perforated tube of Dr. Price fulfills the requirements for abdominal drainage perfectly. If the dressing is so arranged as not to make pressure upon the outer end of the tube, no apprehension need be entertained as to it causing trouble from irritation, provided it be removed just as soon as the fluid becomes straw-colored. If one employs the old style large tube, with large side perforations, there is danger of omentum becoming forced through the openings, causing difficulty in removing the tube and possibly favoring the development of hernia; but in the use of the small tube with the narrow perforations, these dangers are reduced to a minimum.--Medical Record.

THE INFLUENCE OF ALCOHOLIC DRINKS ON THE URINARY SEDIMENT OF HEALTHY PERSONS.-Dr. Glaser has examined the urine of persons who were in good health after the use of alcoholic drinks, employing the centrifugal apparatus of Steinbeck. Beside the formation of uric acid and calcium oxalate crystals; the most important findings were an increase in the number of leucocytes and the appearance of cylinders and cylindroids. The increase in the leucocytes was so constant that the writer was able to decide as to a preceding excess in drinking. With the continued use of alcohol, the increase was so great that one would think one had a specimen of urine with pus in it. Hand in hand with this went the augmentation of the number of cylinders. He concludes as follows: (1) Alcoholic drinks, even in moderate quantities, act as irritants to the kidneys, causing the emigration of leucocytes and the formation of cylinders; further, they favor the excessive production of crystals of uric acid and calcium oxalate. This is either due to the increased metabolism of the tissue or an alteration by the alcohol of the relations of solubility of the salts of the urine, so that the oxalate of lime and uric acid are precipitated. (2) This action, after a single indulgence, does not extend over thirty-six hours, and with continuous use is cumulative.-Deutsche Medicinische Wochenehr.

INSANITY AND TEA-DRINKING.-During the examination at the Waltham Abbey petty sessions, of a woman who is charged with the wilful murder of her two children, a statement of some importance was made by the divisional surgeon of police, Dr. G. Fulcher, with reference to the habits of the prisoner. From some writing which was found on her, it was evident that the poor woman had meant to perish with her children, having been driven to this extremity by the belief that her children were hopelessly ill, and that she was being slighted by those from whom she had been accustomed to receive kindness. Dr. Fulcher found, on examining her, that, with the exception of a "weak heart," her physical condition was good, but she had been suffering for some time from headaches, palpitation, and sleeplessness. On being interrogated with regard to tea-drinking, she said she had been in the habit of taking a large quantity, that she had given it up, but had recently resumed the habit in consequence of her trouble. Dr. Fulcher was of opinion that the prisoner was the subject of melancholia, and he expressed the belief that the taking of tea in excess tended to undermine the constitution. The powerful effect of alcohol in excess as a nerve poison is a matter of daily experience. That many of the ailments from which women suffer, are at least aggravated, if not excited, by excessive indulgence in tea, not as an infusion, as it ought to be, but as a decoction, is equally well known; and, although we are not prepared to admit that this habit would actually induce a condition of melancholia, there is little doubt that in a woman of a neurotic temperament, especially if her food were deficient in quantity and of poor quality, the use of this beverage in excess would be one of the factors in producing and perpetuating a condition of mental instability. It would be well if those to whom the frequent cup of tea from the pot, which has a permanent place at so many firesides, and has become almost a necessity, as they think, recognized fully the pernicious effects of this over-indulgence, effects only surpassed in importance by those of the occasional "drop of gin," of which so much is heard in the outpatient department of our hospitals.—Lancet.

The Physician and Surgeon

A JOURNAL OF THE MEDICAL SCIENCES.

VOLUME XIV.

JUNE, 1892.

ORIGINAL CONTRIBUTIONS.

MEMOIRS.

NUMBER VI.

INFLUENZA: ITS DIFFERENT FORMS, AND ITS TREATMENT.*

BY J. BYRON NEWMAN, M. D., DETROIT, MICHIGAN.

NOTWITHSTANDING that influenza (called in France la grippe) has been an extensive topic of discussion during the last four years, I thought a short consideration of the subject this evening would not be considered superfluous, especially on considering the serious results of the disease upon man, society and even nations.

ANTIQUITY OF INFLUENZA.

We have no correct history of influenza prior to the midnight of the dark ages-the tenth century-but we have no reason to doubt its existence prior to that time. Classical writers of Greece and Rome speak of small-pox as existing one thousand years before Christ; if so, why not influenza? I look upon all specific diseases as due to some parasite and, as it was proved in the Contemporary Review a few years ago by Huxley, Tyndall and others, that there is no such thing as spontaneous generation, the inference is inevitable that all parasites existed from the beginning of all creation; furthermore as I look upon all epidemics as having their origin in endemics, and, as the local causes of endemics have always existed in the world, it is quite probable that the sons of Noah were sneezers as well as their descendants, provided always that their digestion was no better than that of the latter. Dr. Koch failing to inoculate some guinea-pigs with the cholera bacillus stated that these immune ones digested all the bacilli.

EPIDEMICS AND ENDEMICS.

At one time epidemics of influenza were looked upon as blasts from the stars and on account of the supposed influence exerted by the stars during the

* Read at a stated meeting of the DETROIT MEDICAL AND LIBRARY ASSOCIATION, and published exclusively in The Physician and Surgeon.

prevalence of an epidemic of influenza, the disease was called influenza.

But

my firm conviction is that we have to go neither to the stars nor to volcanoes for the cause of influenza, so long as we have an organic creation fixed; and pathological and physical mutations occurring upon the surface of our own planet.

I look upon all epidemics as an overflow or outflow of germs from endemics, or in other words, as wandering endemics; and upon endemics as depending upon local factors, such as the fermentation of vegetable debris and the decomposition and zymosis of animal matter, especially after local floods when millions of animals are left dead upon the plains or low lands.

According to the London Lancet, the journals of Calcutta used to speak of endemics of influenza as existing along the banks of the great rivers of Asia after the subsidence of local floods. The disease was called catarrhal fever. It affected man, horse, ox, sheep, dogs, and even birds. To be brief, I would beg to submit that the great rivers of Asia and the high latitudes of Warsaw and Moscow have contributed more endemics and epidemics of influenza to the world than any other localities on the face of the globe.

ETIOLOGY OF INFLUENZA.

Since Chaveau and Burdon Sanderson discovered that the specific contagium of influenza, instead of being an exhalation or miasm, was a living germ, the majority of the profession has looked upon the disease as of bacterial origin. Many attempts have been made by Klebs, Lipari, and others, to individualize the microbe, but heretofore without success, However, with renewed vigor and improved devices, it would appear according to a French journal, Lucas Championeire's Journal de med. et chir, prat., published on the 25th of March, that the little parasite has been discovered by Pfeiffer, Kitasato and Canon, all of Berlin. They found it to be a comma bacillus, I did not have the pleasure of seeing the journal, but Dr. Becelaere, with the permission, this evening, of this meeting, will read a translation of this discovery,

LOCAL MANIFESTATIONS OF INFLUENZA.

Clinically, influenza may be divided into four kinds, namely, the catarrhal, gastro-intestinal, nervous and the pulmonary, according to the vulnerability of different organs; for organs, like different individuals, appear to be differently affected; yet, sometimes all four kinds are present in the same individual, though in general they are not.

(1) CATARRHAL.-In this the mucous membrane of the eyes, nostrils, mouth, fauces, pharynx, middle ears, larynx and bronchi, suffer the most from the specific virus, From these regions there will be more or less discharge of specific character. From the middle ear the disease sometimes extends to the eerebrum, giving rise to purulent pachymeningitis and abscess of the brain. When the disease extends through the infundibulum there will be vertigo, with a frontal longitudinal pain, and an aching of the eyeballs. When the disease extends from the middle meatus of the nostril to the antrum of Highmore, there will be a diffused pain in the superior maxilla with a peculiar sensation of "edge on the teeth." The lining of the alæ nasa will be more or less inflamed, with some rhinitis. The tongue will either be rough with a yellowish-brown