PRACTICAL MEDICINE.

TREATMENT OF HEADACHE.

The following is an extract from Prof. J. M. Scudder's article on Positivism in Medicine:

Let us take headache as a last example, and briefly note the remedies that have been found most useful, and the indications for them. It is true that some people have an infallible recipe for headache, and the literature of medicine is full of medicines "which have been found useful in such cases."

The headache is from enfeebled circulation, the eyes are sunken, the face pallid, the pulse feeble. We give ten drops of sulphuric ether on sugar, or five grains of carbonate of ammonia, and with an hour's rest the headache has ceased and the brain is ready for work.

Our patient has a flushed face, bright eyes, contracted pupils, and increased heat of head, and the "head aches all over." We cure it with gelseminum.

The patient feels dull and sleepy, would sleep if it were not for the pain; eyes are dull and pupils dilated. We cure it

with belladonna.

The pain is frontal, especially in left orbit, is sharp and burning, and there is contraction of the tissues about the eyes and brains in some cases. We cure it with rhus.

The pain is in the back of the head and extends to the neck; movement of the head increases it. We cure it with sticta.

The patient is nervous, and feels as if she had lost all her friends. Give her pulsatilla.

The veins are full, the head feels full, as if it would burst, and there is dizziness. Cure it with podophyllin.

The tongue is full, heavily coated, with fullness and weight in epigastrium, disgust and nausea. This is a case for an

emetic.

There is extreme nausea, sometimes vomiting; the face is sallow, yellowness about the mouth, intestinal uneasiness. Give nux.

The paroxysms of headache are preceded and attended by scanty urination, and we give acetate of potash or other renal depurant.

The patient is a sufferer from chronic headache, and there is marked dizziness and difficulty in commanding the voluntary muscles. Give iodide of ammonium.

The headache is distinctly periodic, and we cure it with quinine in antiperiodic doses.

This list of remedies might be increased, but we have enough to show the necessity of a careful adaptation of the remedy to the condition of disease as defined by the symptoms. What is true of headache is true of every named disease, and there is no case that may not be analyzed in this way.

SACCHARINE DIABETES.

The treatment employed in the University Hospital of Philadelphia, is given in a recent number of the Medical Record as follows: In the hygienic treatment of this disease, Dr. Pepper's first effort is directed toward cutting off the supply of all the starchy elements of food. If the urine becomes less abundant under this exclusive regimen, some hope of ultimate cure is held out. In some very obstinate cases, even after excluding all starchy matter from the diet, the urine still continues to contain a large proportion of sugar.

The best diet for a diabetic patient, in Dr. Pepper's opinion, is, for breakfast, eggs and any kind of meat, except oysters, gluten bread and tea, or coffee, with milk and without sugar; for dinner, tomatoes, lettuce, onions, spinach, string-beans, meat, light sour wine, and lemons, or perhaps oranges, but none of the sweet fruits; for supper, about the same diet as for breakfast. None of the starchy foods, no alcohol and no sugar are allowed.

Among drugs, opium is regarded as the most valuable; of this an immense amount has been taken daily, in several instances without producing any of the symptoms of poisoning. A boy lately under treatment for this disease took seven grains of opium per diem. In his case the only bad effect was the production of obstinate constipation. Cases have occurred

where even this was unnoticed. The opium, either directly, by diminishing the amount of the secretions, or, more probably, by its action on the nerve-centers, relieves the excessive thirst and voracious appetite, and reduces the amount of urine, and the amount of sugar in the urine. In one case the amount of urine secreted daily, was reduced from twenty-eight pints to eleven pints, and the total amount of sugar in the urine decreased in proportion. Ergot, which has been found to act almost like a specific in simple diuresis, has also been employed in saccharine diabetes with much profit. The dose commonly given is one fluid drachm of the fluid extract four times a day. Where the skin is rough and dry, jaborandi has been shown to be of value by reason of its great powers of diaphoresis. When jaborandi is employed, the opium and ergot are discontinued.

SALICYLATE OF SODA IN CHILDREN'S DISEASES.

Ignaz Weiss, assistant in the Children's Hospital at Budapest, from experiments made in the clinic of Prof. Bokai, draws the following conclusions in regard to the administration and therapeutic value of salicylate of soda in the febrile diseases of children:

I. In typhoid diseases of childhood, it is a powerful antipyretic remedy, which, while it may not abridge the course of the disease, certainly lessens the suffering.

II. Better results are obtained from its use than have heretofore been had with quinine, cold baths, cold packs and the various mineral acids.

III. The good effects from this remedy can be especially noticed when it is given in larger doses at short intervals. This course can be followed without producing any evil effects.

IV. It has no influence over the course of diphtheria.

V. After the administration of this remedy in acute arthritis, the fever and also the pain are diminished in a remarkably short space of time.

VI. In intermittent fever, it is only useful when given immediately before the expected attack; as soon as it is discontinued, the attacks return.

TREATMENT OF CONSTITUTIONAL SYPHILIS BY SULPHATE OF COPPER.

Drs. Martin and Oberlin gave a brief report on this subject at a late meeting of the Paris Academy of Medicine. The authors treated 50 patients, who showed varous manifestations. of syphilis, by the copper sulphate. The results were quite satisfactory, the 50 patients all being cured. A comparison of this method was made with the ordinary mercury methods, and it was found that the copper salt proved more efficacious and required less time for its beneficial action than did the mercury salts. The copper was also well borne by most patients; in only one case it produced initial vomiting, followed, however, by permanent tolerance of the drug. In a case of very grave syphilis, when mercury had proved useless, the administration of copper effected a rapid and complete In a few patients, the gums became affected, a greenish tint appearing at their free border. But this cupric gingivitis yielded more rapidly than the analogous mercurial affection ordinarily does. Actual sponginess of the gums was not observed. The salt was exhibited by the mouth in doses of

cure.

gr. per day. An aqueous solution was employed. External application was also made by adding 5 drachms of the salt to full bath.-Translated from the French, in Medical Record.

SCIATICA.

In a case of chronic malaria, with chills and fever, followed by neuralgia, Dr. William Pepper's treatment consists in the use of quinia, iron, arsenic and belladonna. In many cases he has found that more relief is afforded by large doses of arsenic than by any other remedy. Occasionally he has injected the arsenic under the skin. When there is distinct local inflammation, he is accustomed to treat the case with large doses of iodide of potassium and with minute doses of the bichloride of mercury. When he desires to bring about absorption of the inflammatory matters inside the sheath, he

has found the best treatment to consist in severe blistering, or the use of the actual cautery.

The actual cautery, in particular, has been shown to possess great absorbent power, and powerfully relieves over-sensibility of the nerves. Another excellent plan of treatment sometimes pursued, consists in the hypodermic injections of morphia and atropia right down into the adjacent muscular structure. For this purpose the habit is to employ from the one-sixth to the one-fourth of a grain of morphia, and from the one-ninetieth to the one-sixtieth of a grain of atropia. As the disease subsides, care is taken that the morphia habit is broken up. In still other cases, where the localized pain has been intense, the most satisfactory results have been derived from the hypodermic injection of from eight to ten minims of chloroform into the adjacent tissues, great care being had to keep the needle out of the way of the arteries. Though incomparable as a temporary destroyer of pain, the effects of the chloroform are not permanent. Galvanism has been employed with success in some cases. The mode of application is with the positive pole at the seat of pain, and the negative pole along the nerve-trunk. Where the muscles have wasted to any great extent, the Faradaic current is the one which it is generally best to employ.-Medical Herald.

PHTHISIS.

An excellent article on the above subject by J. A. Octerlony, M. D., appears in the Medical Herald for July, 1880. We give a few extracts:

The longer the

Now, it is not only true that consumption is a curable disease, but that the likelihood of our being able to accomplish anything in the treatment is vastly increased the earlier we can place the patient upon appropriate treatment. case runs on, the more advanced the constitutional disturbance, and the more extensive the local disease, the less our hope must be of accomplishing any good beyond, perhaps, palliating the sufferings of the patient.

Remember this group of symptoms: slow emaciation, fever, habitually accelerated pulse, sweats, loss of appetite, impaired