THE MICRO-ORGANISM OF TYPHUS.-Lewaschew states (Deutsche Medicinische Wochenschrift) that he has found, in blood removed from the spleen or finger in a number of cases of typhus, organisms which he regards as the cause of the disease. In fresh blood these appear as small, round, highly refractile bodies showing active movement. They lie between the corpuscles. Sometimes the organism is oval in shape and provided with a flagellum, or it may be represented by a thread, slightly enlarged at one extremity. These different forms probably represent one and the same microbe. The rise and fall of the disease are accompanied respectively by increase and diminution in the number of these organisms. British Medical Journal.

A SUPPORTER of the medical profession may be found in Kate Field, of Washington. She says: There are plenty of defects in medical art, and plenty of shortcomings. If an all-wise Creator could not make a human frame perfect enough to keep in order through all the hardships we put it through, it seems pretty audacious to demand of the poor human being who puts us in repair from time to time, that he should make his work permanently effectual. Of one thing, too, we may be certain. No profession is followed so largely for the love of it by all classes of its members as medicine; and again, that no other skill and learning is so often exercised without the faintest hope of reward as the experienced judgment of the average physician. If doctors were really the hypocritical experimenters that humorists in robust health seem to think them, they should yet command our respect for their professional enthusiasm and their philanthropy.

THE INFLUENCE OF PREGNANCY ON EPILEPSY.-A very exhaustive article by Dr. Guder on this subject is carried through two numbers of the Medicinishchirurgisches Centralbl. The author has made extended research into the data bearing on this question. This, taken conjointly with his own personal experience of such cases, enables him to draw the following conclusions: That epileptic attacks were, as a rule, absent during pregnancy, but that they were always sure to make their appearance during and after the puerperal period; that there was the fact of the off-spring of such women being predisposed to epileptic or eclamptic attacks, to be taken into consideration. For his part the author was disposed to persuade, as far as possible, epileptics from marriage and that if pregnancy did occur he was in favor of artificial abortion. He thought that an effective means of stamping out, or at any rate of preventing children being born with a predisposition to epilepsy, would be the sterilization of epileptics by castration or ligation of the tubes. As to the predisposition of epileptics to eclampsia there was still a great difference of opinion among observers in this direction. Nerlinger thought that for one thing a differential diagnosis of an attack, occurring during the puerperal state in an epileptic, was difficult to make, as to whether it was an epileptic or eclamptic seizure, and that as to the question of predisposition of epileptics to eclampsia the matter was by no means settled. And also that in young children predisposed by neurotic inheritance to epilepsy it would be a difficult matter to say whether the first attack was epilepsy or eclampsia. Fere thought that there was a close association, in predisposed neurotics, between epilepsy and eclampsia.--Journal of Nervous and Mental Diseases.

RECENT CHEMICAL EXAMINATION OF SWEAT.-The secretion of the sudoriferous glands of both man and lower animals has been the subject of critical examination by Gaube. He finds that the sweat of man differs from that of

the cow, horse, cat, dog and hog, by being acid in reaction, instead of alkaline, but fails to mention the nature of the acid. Gaube also finds digestive ferments in the perspiration of both man and the lower animals. He has separated a pepsin, an amylase and an emulsion. He terms these diastasic ferments "hidrozymases" and states that the sweat of man contains a larger proportion than the secretion of other animals examined. In the light of the recent investigations of ferments, it is not startling to discover them in any of the secretions. -Medical Fortnightly.

ORBITAL HÆMORRHAGE IN YOUNG CHILDREN.-These hæmorrhages occurred beneath the periosteum, in the course of infantile scurvy, a disease generally known as scurvy rickets. The subjects were hand-reared infants, generally between six and eighteen months of age, who had been brought up mostly on "infant foods." After a period of ill-health, spontaneous hæmorrhage came on beneath the periosteum in various parts of the body, sometimes, but not always, during the course of an attack of rickets. In the orbit the hæmorrhage occurred in two forms, either as a line of blood staining at the orbital margin, or as a large effusion producing displacement of the eye and distention of the upper lid; the form which the hæmorrhage assumed was due to the anatomical disposition of parts in the orbit. The hæmorrhage subsided rapidly at first, but did not disappear entirely; the eye was left prominent for many months. The treatment was essentially that of scurvy; in addition to the ordinary food, juice of fresh meat, a little fruit or vegetable, cod-liver oil, or cream should be given. The slighter cases recovered rapidly; the more serious ones were slow in progress and often fatal.-British Medical Journal.

MITRAL STENOSIS IN CHILDREN.-Dr. Octavius Sturges in a lecture (Lancet) spoke as follows: Mitral stenosis in children, then, which is almost always rheumatic, is not at first disabling. I doubt the wisdom of making patients of these young subjects solely for the reason that their hearts are thus changed. The need for early treatment will depend very much on the recurrence or not of rheumatic attacks, and the worst event to be feared in the course of them is pericardial adhesion. Children who keep free from such attacks will go on for a long time without heart trouble. Other children less fortunate will have frequent recurrence of what is really acute rheumatism, though of short duration, with only slight pyrexia and transient joint pains. With these latter the heart deterioration in the way of dilatation is apt to be very rapid, and is indicated by dyspnea, palpitation, and presently edema. And there are two physical signs which as these cases progress indicate what the end is to be. One, and the earlier, is the detection from time to time, with the successive rheumatic attacks, of renewed pericardial friction; the other, and the later, which becomes the more obvious after the rubbing has finally ceased, is rapid enlargement of the heart area, both across and lengthways. Of the origin of this change it does not become us to speak positively in the patient's lifetime. But we know for certain, and can show you in our museum, that the common cause is adherent pericardium.-Saint Louis Medical and Surgical Journal.

KATZENJAMMER.-Resorcin is said to act admirably in cases of nausea and depression following a carouse. It is given in the dose of from five to ten grains in plenty of water flavored with syrup of orange peel, and may be repeated once or twice at intervals of half an hour. A single dose of ten grains is, however, said to be usually sufficient.

CATHETERIZATION OF THE FEMALE BLADDER.-Professor Parvin advocates the use of the ordinary male catheter, instead of the female, as by its greater length the bladder can be emptied without soiling the clothes or necessitating any exposure of the patient. It is passed into the bladder just as easily as the other kind.-College and Clinical Record.

ANTISEPSIS IN PNEUMONIA.-Albert Robin reported to the academie de medecine a case of broncho-pneumonia, followed by death, in a syphilitic woman undergoing since about a month intensive mercurial treatment. Robin makes the remark that in this case internal antisepsis resulting from the mercurial medication did prove no safeguard against pneumonic infection.-Deutsche Medicinische Wochenschrift.

BURNS. The following is an excellent dressing for burns:

Apply two or three times a day.-Weekly Medical Review.

3j.

aa 3j.

J. V. B.

TOPICAL TREATMENT OF ECZEMA.-Professor Unna, of Hamburg, (Germany,) prescribes the following salve in the treatment of intensely pruriginous chronic eczema, complicated with infiltration of the deep layers of the skin:

THE DOCTOR AND THE HOTEL CLERK.-A good story is told of the late Dr. Thayer, of Burlington, concerning his experience at a hotel in Cincinnati, where he stopped, while attending a national medical congress, many years ago. Arriving somewhat late in the evening, he went immediately to bed. Upon inspecting his bill, previous to leaving, Dr. Thayer saw he was charged for a supper the night of his arrival, and inquired as to same, saying he had had no supper that night. "But," the clerk said, "you were here; you might have had it." "Oh, well," said the doctor, "I can fix that," whereupon he immediately made out a bill against the hotel for medical services, the amount covering the charge for the supper. Upon presenting the same to the clerk, the latter said: "Doctor, I was not aware we had called on you for professional service." "Oh no," said Dr. Thayer, "but I was here, and you might have done so." The procedure, being so original, so pleased the proprietor that he presented Dr. Thayer with his whole bill, and asked him cordially to make him a visit in the future. -Dr. J. H. Linsley in Medical Record.

The Physician and Surgeon

A JOURNAL OF THE MEDICAL SCIENCES.

VOLUME XIV.

NUMBER VII.

JULY, 1892.

ORIGINAL CONTRIBUTIONS.

MEMOIRS.

THE USE OF LARGE DOSES OF ACETATE OF LEAD IN
HÆMORRHAGE.*

BY JAMES NEWELL, Рн. D., M. D., DETROIT, MICHIGAN.

I AM aware that in presenting an article on the use of acetate of lead in the treatment of hæmorrhage, I am not offering anything which can lay claim to novelty or originality, but I believe that in the matter of dosage of the remedy, I shall be in position to offer for your consideration something not found in any of the works; and which has been touched upon in only the most meagre manner by the writers whose names grace the columns of the medical journals and periodicals of America.

In advocating the use of large doses of acetate of lead, and I emphasize the word large, I may probably in the minds of some be laying myself open to a charge of disregard, and recklessness of the sacredness of human life, from the fact that many of the laity and not a few of the profession entertain the opinion that the drug is a dangerous poison, in the quantity I shall recommend for its administration. I will refer to this phase of the question further on.

All of the treatises on therapeutics speak of the efficacy of the acetate of lead in restraining hæmorrhage, when the location or source of the loss of blood is beyond the influence of such mechanical measures as may be employed to bring about its arrest, but in all the references which I have looked up, and they have been many, I have been unable to discover an advocate of the use of the large doses of which I shall speak. I have also been for many years an extensive reader of the medical press and with the exception of one or two articles, I have not come across any advocacy of the use of the dose I have been accustomed to administer.

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

Whether this absence be due to the fear that the advocacy of such doses might bring odium and discredit on the men using it, or to the fact that the remedy is not so employed, except by a very few, I am not in position to determine, but I incline to the latter opinion as being the correct answer.

I will not trouble or inflict you with quotations or excerpts from our writers on therapeutics regarding the usefulness of the remedy in the ordinary or common dose in hæmorrhage, for you can refer to them at your leisure if you have the inclination, but I will confine myself to the experience which I have had from using the remedy in my own practice, and to the writings of those who are advocates of its hæmostatic action in the dose and manner I shall endeavor to point out. That acetate of lead has a marked influence in arresting hæmorrhages which are located so as to be inaccessible to the ordinary mechanical means employed for their suppression and restraint, I have not the least doubt, but mark you, it must be given in much larger doses than is usually employed, or recommended in the books.

This is the only point upon which I differ, in regard to its use, and it is to this that I particularly desire to draw your attention.

The hæmorrhages in which I have found the salt to be exceedingly beneficial, are hæmoptysis, epistaxis, and post-partum uterine hæmorrhage.

That it exerts its hæmostatic action in a method independent of its wellknown astringent quality, I have not the least doubt, and that such action is through the influence of the nervous system, I fully believe. "Its effects are similar to those of digitalis: it slows the action but increases the power of the heart, while at the same time, it elevates the tension of the arterioles. The astringent is, however, a dynamical and not a chemical action." ("Bartholow's Materia Medica and Therapeutics," third edition).

The rapidity with which it exerts its action is also difficult of explanation on the supposition of its astringing action on the tissues.

In that alarming form of hæmorrhage, bleeding from the lungs, I have again and again tested its efficacy; and that it will cause its arrest, and that permanently, I am as confident, I was going to say, as that opium or morphia will produce sleep. I fully realize that this is a strong statement, but my experience with the remedy has been so constantly and uniformly successful, is the reason why I thus place such confidence in its hæmostatic action in pulmonary hæmorrhage.

I shall recall but one of the many cases in which I administered the remedy in pulmonary hæmorrhage, not only for the reason that it was a typical case, but for the fact that I am able to thereby contrast its efficacy, with other standard hæmostatics, administered by a physician who had gained a reputation much higher than I ever expect to acheive.

E. C., aged twenty-two, whose father had died of consumption when he was a child, had been ailing for three or four months. Consulted a physician who, in a brusque manner, informed him he had consumption and would die before a year. Neither relishing nor believing the opinion he at once consulted and placed himself under the care of a leading physician of western Ontario, a resi dent of the city of London, and an ex-president of the college of physicians and surgeons of Ontario. What the diagnosis was, I cannot say, but after six months of treatment, the young man was seized with pulmonary hæmorrhage. He was