PRACTICAL

PREPARATIONS, ETC.

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Entered at Phila. Post Office as second-class matter.

HOW TO PRESERVE ANATOMICAL SPECI

MENS.

Any anatomical specimen or organ may be preserved indefinitely by keeping it immersed in a five per cent. solution of formalin, which only costs a few cents per gallon, but the specimens become decolorized

No. 9

and hardened. The method of Kaiserling is not expensive, and preserves the original color of the organs, as well as the tonicity of the tissues so that they are in good condition for dissection at any time. The method is as follows:-Prepare two solutions, solution No. 1 being the fixing and hardening fluid:

Formalin

....

.8 ounces

Distilled water .... .2 1-2 pints

Potassium nitrate

Potassium acetate

Solution No. 2., the preserving fluid is

prepared as follows:

Potassium acetate

Glycerin ...

Distilled water ...

These quantities are sufficient to preserve tissue the bulk of the human liver. After removal of the specimen, place it on cotton in a container, and cover with solution No. 1. Place in a dark place for 24 hours, and then pour off the fluid and add a fresh bath, and again set away in the dark for four to eight days according to the size of the specimen. When the specimen is completely fixed and hardened, drain from the bath for a few moments and place in 95 per cent. alcohol for a few hours, but not longer than six hours. The alcohol restores the original color lost in first bath. Now place in a glass container and cover with so

If he confined his efforts to the extraction of a small quantity of blood we might forgive him, but unfortunately such is not the case, for he stands indicted for increasing and creating febrile and other diseases, by the inoculation of humanity with micro-organism.

After every rain he issues forth with "malice afore thought," and introduces malarial and other fevers into the system by the depositing of germs under the skin into the delicate tissues, and upon fruit or food,or he carries these into the air and much mischief is done. Wherever we go, he goeth. In the silent watches of the night his song is heard and his sting is felt. We cannot escape him. If we flee to the mountains he is there. If we penetrate the caverns of the sea he is with us, ever present and songful. We cannot escape him, but may kill him.

Should we kill a few, thousands take up his cause and revenge his untimely "taking off" by thousands. What are we to do? He increases so rapidly and is so prolific

that his colonies obscure the sun by clouds. We cannot endure him. If we cover ourselves with netting or bar our doors against him he enters the chimney. We suffer and endure, because we do not know how we can rid ourselves of him. Yet it is a simple matter. Drain all pools of water and swamps, or propagate fish in them, for fish like mosquitoes and eat them. Drainage is the remedy for that songful pest, the mosquito.

THE PRICE OF ALCOHOL.

The price of alcohol is kept high by reason of the governmental tax and through the machinations of combinations, yet if the duty and revenue tax were taken off it could be manufactured here as cheaply as anywhere. The temperance question does not enter into the question at all, since experience with whiskey shows that it will be used as a beverage without regard to price, and tax or no tax, duty or no duty. The duty and tax has an immense influence on the cost of medicine, and every physician of every school is interested in this matter.

Outside medicinal uses, the physician could use alcohol in large quantites to great advantage for fuel and lighting purposes if the cost permitted. In Germany alcohol is tax and duty free. It sells there at fourteen cents a gallon. It is made from beet roots and is used as fuel and for lighting purposes. Lamps are used there with a mantle something after the Welsbach, with alcohol as fuel, which gives a more brilliant light and costs less to run than the ordinary oil lamp. Motor wagons and engines under twenty horse power use it extensively.

Now if the great oil trust could be coerced into silence, and our astute representatives would open their eyes to common justice, the people might reap abundant benefit.

Original Communications.

Brief and practical articles, short and pithy reports of interesting cases in practice, new methods and new remedies as applicable in the treatment of diseases, are solicited from the profession for this department.

Articles intended for the Summary must be contributed to it exclusively. The editor is not responsible for the views of contributors.

Write only on one side of the paper.

HEUMATISM IN CHILDREN.

BY IRA A. MARSHALL, M. D.

RHEUMATISM in children,

as in

adults, may be classified into the following: Holt, in his admirable work on diseases of children, says that the rheumatic diathesis in children manifests itself by quite a different group of symptoms from those seen in adults; for this reason the disease was formerly supposed to be a rare one in early life. It is only in recent years that its frequency and its peculiarities have come to be appreciated.

Rheumatism, in childhood then, is manifested not alone by arthritis with acute or subacute symptoms, but by a large number of other conditions which are not to be regarded in the light of complications, but rather as forms of the disease.

ETIOLOGY.

It is not the aim of this short paper to discuss the cause or various theories regarding the nature of rheumatism and its exciting cause. The drift of medical thought of to-day is strongly toward the view that acute rheumatism is an infectious disease, probably of microbic origin. Although the character of the micro-organism is not yet determined, probably it is a diplococcus.

The excessive formation of acids in the system may be regarded as a result of the infection or as a condition necessary for the activity of the specific poison.

Heredity is a very important etiological factor. Nearly two-thirds of the cases reported are from rheumatic families. Other causes are exposure to cold, wet and poor hygienic surroundings and insufficient foods, especially fruits.

SYMPTOMS.-THE GENERAL AND ARTICULAR

MANIFESTATIONS.

The clinical types of rheumatism in children present very notable contrasts to those in adults. A typical attack of acute articular rheumatism such as is seen in adult life, with sudden onset, high temperature, severe inflammation of several joints, profuse acrid perspiration, is rarely seen in a child under nine or ten years of age. In most of the attacks of childhood the onset is not very acute, the temperature is but slightly elevated, only 100, 101-5 degrees F.

The swelling and the pain are moderate, the redness often absent. The number of joints involved is generally small, those most frequently affected being the ankles, the knees, the small joints of the foot, wrist or elbows. The symptoms are often not severe enough to keep the patient in bed, and only the pain in the joints of the lower extremities prevents him from walking. The duration of these attacks is from one to three weeks.

Frequently the disease is limited to a single joint. The swelling is moderate and may not be evident except on close examination, in a few cases there is none. Muscular spasm about the joint is often marked. The tenderness is sometimes localized-it may affect the ligaments, tendons and even the muscles.

CARDIAC COMPLICATIONS.

These may occur where the articular symptoms are very mild. The most frequent is endocarditis. There is much more seen in the acute rheumatism of children than of adults. If it does not occur in first attack it will in second. Rheumatism may not be suspected until a valvular disease has developed. Pericarditis is less frequent than endocarditis and usually occurs in children from seven to twelve years of age.

TONSILLITIS.

The association of tonsillitis and pharyngitis with rheumatism appears in many cases to be a close one. Children who are subject to it should be regarded as rheumatic. Acute tonsillitis often ushers in an attack of rheumatic arthritis, sometimes acute endocarditis. Rheumatism may be associated with any form of tonsillitis,but its

connection with quinsy seems closest. Many authors consider tonsillitis as being the window through which the rheumatic poison enters the system.

DIAGNOSIS.

Family history, previous history of patient, examination of patient, search for nodules, heart complications, joints, so-called growing pains; worse in cold, damp weather, pain in joints, swelling.

PROGNOSIS.

Most cases recover; the greatest danger is from the heart complications.

TREATMENT.

All authors and men of wide experience rely upon the salicylates and alkalies. I usually commence the treatment by giving protiodide or the mild chloride of mercury in 1-10 grain doses, following it with effervescing sodium phosphate until bowels are thoroughly moved. Then I commence on salicylate of strontium, true, from oil wintergreen, or sodium salicylate and sodium benzoate from benzoac acid.

I also like the salicylate of lithium very much or ammonium. I have better results with the strontium as it does not so readily nauseate and is also a fine intestinal antiseptic. I give also the bicarbonate of potassium until the urine is strongly alkaline, then I replace the bicarbonate with diuretin, which I have found in my experience to be the best diuretic we have.

A great part of the rheumatic toxins are carried off through the kidneys, after the salicylates dissolve the acids and cet them free in the circulation. The diuretin will help eliminate them; it is also a fine heart stimulant and keeps urine alkaline. I have given to older children salophen, which acts nicely, also salol. Anders considers antipyrine a specific. Bromide of lithium and salol is a fine combination. Try them. The joints often require special attention. if there is much swelling and tenderness. I take:

Nearly all cases of rheumatism become anemic. Tonics are required. Basham's mixture acts very well. I prefer albuminate of iron, with the proper diet, hygiene and flannel clothing to protect the body from sudden change in weather. If the case becomes subacute or chronic, syrup hydriodic acid and iodide of sodium are considered the best preparations of iodine I have ever used in these cases, especially where the tonsils are chronically enlarged. sodium iodide does not upset the stomach or produce iodism like potassium. Mixed with aromatic elixir makes a pleasant remedy and the most effective I have ever found.

Does not produce a bad effect on the heart muscle. Many a little fellow can be saved from hours of suffering if we look after them closely. It we only make the correct diagnosis-do not take some old woman's advice, "The child has only growing pains," when you know that it has rheumatism. Innocence and purity always appeal to our heart. Show me a doctor who loves children, and I will show you one who is successful, who is to be relied upon in the hour of need. Ironton, Mo.

A CHAT WITH THE BROTHERHOOD.

BY LUIGI GALVANI DOANE, M. D.

OCTOR Littlefield, of Anderson, Ill., a

noted and highly respected physician,asserts that he can produce small trilobites by mixing alcohol, ammonia and chloride of sodium (salt.) Dr. Vail, of St. Louis, although he does not refute the above statement, speaks of the fly as an agent of contagion and reports an experiment conducted in his laboratory. Jelly, when exposed to the air, was found to contain colonies of germs, deposited by the flies while feeding. Millions were seen (under the microscope) on the legs and wings of dead flies.

The mosquito, too, is accused of the same crime, against sanitary science. While musical he is a murderer. If we could exterminate the mosquito and fly many contag ious diseases would be avoided. In 1900, at a meeting of the Kings County Medical Society, Dr. Hunt, the President, read a paper