necessity for very slow injection. This slowness is remarkable, forty minutes being required for the injection of five drachms of the liquid. Success is dependent upon slow injections and thorough observance of aseptic precautions. It is not painful, nor in about two hundred injections that the author has practised has he had any local accidents.

EFFECTS OF CERTAIN DRUGS ON THE VELOCITY OF THE BLOOD-current. DR. JOHN C. HEMMETER has been conducting some experiments in the Biological Laboratory of the Johns Hopkins University (New York Medical Record, 1891, vol. xl. p. 292), employing Ludwig's Stromuhr. The drugs used were ergot, digitalis, and alcohol; the animals were dogs and cats; the artery selected was the carotid. The results were: Ergot and digitalis reduce the rate of the blood-current, while alcohol increases it. The explanations are: 1. Ergot diminishes the energy of the heart's activity and at the same time increases peripheral resistance. 2. Digitalis increases the work of the normal heart and produces contraction of the arterioles. 3. Alcohol causes dilatation of capillaries and arterioles. The therapeutic use of digitalis and ergot in hemorrhage and of alcohol as a resuscitating stimulus, then, rest on a sound foundation.

STRYCHNINE NITRATE IN TOXIC AMBLYOPIA.

DR. E. MELVILLE BLACK makes a strong argument for the use of the nitrate of strychnine in tobacco and alcoholic amblyopia (New York Medical Journal, 1891, vol. liv. p. 287). The nitrate is chosen for hypodermatic use because it is less irritating than the other salts. The site chosen is over the biceps muscle, and cleanliness and perfect solution of the drug (eight grains to the ounce in distilled water) are essential; the required dose may go to twenty or twenty-five minims. In dosage of over ten minims he keeps the patient under observation for a half-hour after the injection. He instances four cases in which the patient's present condition, ophthalmoscopic examination and details of treatment were carefully recorded.

DIURETIN.

DR. KRESS, in an elaborate paper in the Münchener medicinische Wochenschrift, 1891, No. 38, S. 663, gives a very careful review of the literature of this recent valuable addition to our therapeutic armamentarium. He cites twenty cases in which this drug has been used. His conclusions are: 1. It is a true diuretic, increasing both the solid and watery constituents of the urine. 2. It is not an irritant, and its influence upon the organs of circulation is secondary. 3. It is most valuable as a diuretic in acute and chronic diseases of heart and kidneys. 4. It can be administered to two drachms per diem without unpleasant results, and continued without losing its value.

MECHANICAL TREATMENT OF CATARRHAL ICTERUS AND CHOLELITHIASIS.

DR. PÜRCKHAUER, in the Münchener medicinische Wochenschrift, 1891, No. 35, S. 609, after mentioning the well-known mechanical methods-as faradiza

tion of the gall-bladder, injection of a large quantity of water into the intestines, massage, digital compression of the gall-bladder-announces his own to be a thorough, regular, and persistent shaking of the body, continued over a long time, such as can be obtained by driving, riding, jumping, and dancing. He cites two instances in which a railway journey was brilliantly successful. In a case of acute catarrhal jaundice he found that a patient was relieved by jumping for the period of an hour. [We presume that a health jolting chair would meet the indications laid down by the author.-ED.]

EXOPHTHALMIC GOITRE.

Dr. CH. ELOY, in the Revue Générale de Clinique et de Thérapeutique, 1891, No. 36, p. 565, gives a brief account of the most valuable methods of relief of this rebellious disease. Under the heading of external treatment he praises hydrotherapy as a means of diminishing the nervous excitability and the tachycardia. The employment of electricity is insisted upon: faradic, bilateral applications for ten minutes with the positive pole at the nape of the neck and the negative over the carotids, and for five minutes over the tumor; galvanic currents of moderate intensity with positive pole over the præcordial region and the negative at the nape of the neck. The internal treatment consists of the alternating administration of preparations of arsenic and the bromides. Arsenious acid is to be prescribed in increasing doses for a week; during the next week to be replaced by bromide of potash, in two daily doses, to be taken in an alkaline mineral water. If a mineral water is deemed necessary the ferruginous waters are preferred. The hygienic treatment consists of the absolute interdiction of tobacco, tea, coffee, and alcohol, all violent efforts, emotions, and muscular fatigue. A milk diet is insisted upon. The success in treatment presupposes a docile patient, absolute obedience to the régime, and considerable patience on the part of both patient and physician.

THE EXACT ACTION OF ALCOHOL.

DR. E. MACDOWEL COSGRAVE, in the Dublin Journal of Medical Science, 1891, p. 186, has collected the opinions of various experimenters. DR. RIDGE found that the feeling, muscular sense, and vision were diminished by moderate doses. DR. LAUDER BRUNTON is quoted that "the influence of alcohol upon psychical processes is curious; for, while it renders them much slower, the individual under its influence believes them to be much quicker than usual." DR. RIDGE found that germination was prevented, one-quarter of 1 per cent. being sufficient to hinder growth and oppose the production of chlorophyll. DR. B. W. RICHARDSON reports that it stops the vital movements of the medusa, probably by its action on the colloidal matter, of which its organism is composed, while various authors are quoted to show that alcohol diminishes very markedly the carbonic acid gas exhaled by the lungs.

[While the collecting of the results of these experiments is valuable, yet it is worthy of remark that many of them were conducted long before it was possible to attain the exactness which now distinguishes the work of the physiological laboratory.-ED.]

STRONTIUM.

M. LABORDE furnishes a very interesting account of his physiological investigations of the salts of strontium in the Les Nouveaux Remèdes, 1891, No. 18, p. 430. Strontium and its salts are not poisonous, but even in large doses favor nutrition. Eliminated in the fæces it appears to prevent fermentation and even to be a parasiticide. The lactate of strontium appears to increase the excretion of urine and at the same time to prevent its decomposition.

TREATMENT OF PULMONARY TUBERCULOSIS BY HYPODERMATIC
INJECTIONS OF ARISTOL.

The report of M. NADAUD (de Larochefoucauld) is found in the Revue de Thérapeutique, 1891, No. 19, p. 508. The aristol is dissolved in sterilized oil of sweet almonds. The daily dose (of aristol) is one-half a grain. Twentyone patients suffering from pulmonary tuberculosis have been treated without other medication. Seven cases have improved, so that the cure which has persisted for three or four months may be believed to be complete. The treatment lasted twenty-five to thirty days. Five cases, in which improvement had been rapid, suffered from relapses which necessitated at the end of a month a repetition of the treatment, but no case has required a third course. Three cases of excavation had not in any way improved. Two patients died, one of diphtheria and the other of tubercular peritonitis. Six cases are under treatment and apparently will be relieved. His conclusions are that aristol administered hypodermatically is not poisonous; that it is eliminated in the respiration; that it is antiseptic and modifies nutrition; that the effects are prompt, showing themselves on the sixth or seventh day by a diminution of cough and the suppression of night-sweats; that after twenty or twenty-five days of treatment the body-weight increases; that this treatment is useful in first or second stages, but with large cavities or purulent expectoration the results are slight or negative; that the injection is not painful, nor does it give rise to any inflammation of skin, abscess, or induration.

[This report, as M. HÉRARD remarked at its presentation, should be carefully considered, but an opinion as to the value of aristol should be reserved. The observations are too recent and too few in number. Several years, not months, must elapse before a just judgment can be given.—ED.]

THE TREATMENT OF PHTHISIS.

In L'Union Médicale, 1891, No. 105, p. 325, DR. TAPRET gives an enthusiastic account of his observations at the Hôpital Saint-Antoine on the treatment of pulmonary phthisis by medicated air. In May, 1890, he obtained a closed chamber which had been used for experiments by Bert, concerning anasthesia under pressure, at the Hôpital Beaujon. His cases were unselected and remained in the chamber four hours each day, the air being charged with creasote vapor under pressure. Of the twenty-one patients, he discharged seven completely cured. The physical signs of pulmonary disease improved, their symptoms became less marked, and their general condition was greatly benefited. The bacilli did not, however, in all cases disappear.

No accidents occurred, nor indeed does this treatment give rise to unpleasant symptoms.

TREATMENT OF DIPHTHERIA.

M. ERNEST GAUCHER, in the same journal, No. 40, p. 693, makes a strong argument for the removal of the diphtheritic membranes by pledgets of cotton or brushes, and thorough cauterization of the surface with a solution of the following formula:

This is accomplished by wetting the cotton on a carrier, and thoroughly applying to the denuded surface. The third step is complete irrigation of the throat ten minutes after the disinfection is concluded.

EUROPHEN.

The question of antisepsis in operations in the nasal cavities has not, until recent times, attracted much attention, but in the Therapeutische Monatshefte, 1891, Heft 9, S. 482, DR. LÖWENSTEIN presents a very valuable contribution. He finds the insufflation of powdered europhen of great value after operations in the nose, not only because of its antiseptic properties, but as well as a remedy for checking hemorrhage. In ozæna he finds it inferior to aristol, which, when used after removal of the crusts and thorough cleansing of the nasal cavities, has yielded brilliant results. In chronic atrophic rhinitis europhen has relieved the symptoms and improved the appearance of the mucous membranes. He found, however, that a ten per cent. solution in fifteen per cent. of olive oil with eighty-five per cent. of lanolin, was more rapid and beneficial in its action, owing to the fact that iodine was liberated more freely. In three cases of perforating ulcer of the septum he achieved brilliant results.

THE TREATMENT OF URÆMIC COMA AND CONVULSIONS.

DR. JOHN FERGUSON sums up a paper upon this subject in the Therapeutic Gazette, 1891, No. 9, p. 583, as follows:

In cases of albuminuria of moderate severity, give the saturated solution of magnesium sulphate; if more acute and urgent put the patient in bed, with the head elevated. If there be severe headache, any muscular twitchings, or tendency to coma, give calomel, croton oil, and nitrate of potassium, and maintain the action of the bowels by salts. Induce free perspiration by warm packs, hot drinks, and the salicylates. Allow no animal food but milk, and give liquids very freely. If convulsions, a hypodermatic injection of morphine, followed by pilocarpine. In pregnancy, push this treatment vigorously, thus making interference unnecessary. To secure full action of the skin, the use of salicylate of sodium or potassium is strongly advised.

MEDICINE.

UNDER THE CHARGE OF

W. PASTEUR, M.D. LOND., F.R.C.P.,

ASSISTANT PHYSICIAN TO THE MIDDLESEX HOSPITAL; PHYSICIAN TO THE NORTHEASTERN HOSPITAL

FOR CHILDREN;

AND

SOLOMON SOLIS-COHEN, A.M., M.D.,

PROFESSOR OF CLINICAL MEDICINE AND APPLIED THERAPEUTICS IN THE PHILADELPHIA POLYCLINIC; PHYSICIAN TO THE PHILADELPHIA HOSPITAL.

PURIFIED TUBERCULIN.

ROBERT KOCH (Deutsche med. Wochenschrift, No. 43, 1891) has published the results of investigations directed to the isolation of the active principle of tuberculin. After using a variety of methods he finally adopted one that yielded measurably precise and satisfactory results. One part (say 10 c.cm.) of tuberculin is stirred in a beaker while a part and a half (15 c.cm.) of absolute alcohol is added. The glass is covered and permitted to stand for twenty-four hours. At the end of this time a flocculent sediment is precipitated from the dark-brown fluid. The supernatant fluid is then carefully decanted and replaced by a corresponding quantity of 60 per cent. alcohol. The fluid is shaken and again permitted to precipitate. This procedure is repeated three or four times, until the supernatant fluid remains colorless. The fluid is then further extracted by means of absolute alcohol, the precipitate collected upon a suction-filter and dried in a vacuum exsiccator. By this means a snow-white mass is obtained, which, upon being dried at 100° C. (losing from 7 to 9 per cent. of water), appears as a light-gray powder. The product so obtained represents about half of the active principle of tuberculin. It is readily soluble in water, especially when rubbed up in a mortar. The solution, however, does not long retain its activity; it is especially susceptible to evaporation. On long standing and high heating the purified tuberculin becomes less soluble. Solutions of purified tuberculin in 50 per cent. of glycerin retain their activity for months. Such solutions withstand the influence of considerable degrees of heat. Purified tuberculin is but slightly soluble in alcohol. It responds to all the chemical reactions for albumin. From its properties it is concluded that the purified tuberculin belongs to the group of albumins. The large proportion of ash to which it gives rise, and the variability of reaction to some of the tests employed, indicate that the product is not an absolutely pure one. Although tuberculin most nearly resembles the albumoses, it differs from them, and especially from the toxalbumins, in its resistance to high temperatures; it differs from the peptones, in being precipitable by iron acetate. It seems not improbable that further investigations will demonstrate, among the products of pathogenic bacteria, the presence of other similar bodies that may prove to belong to a distinct group of albumins.