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which the hæmorrhage ceases—by the for- mically and repeated from time to time as mation of a thrombus which closes the may be necessary. The use of ergot in eroded vessel. The object in treating the these cases is deemed to be useless. The patient is to favour this thrombosis, to di- ice-bag so often employed is also of very minish the activity and force of the circula- doubtful value. It may, however, help to tion, so that the natural process of heal- keep the patient quiet, and, if so, is ading may take place. Therefore keep the vantageous. patient quiet by rest in bed, with the shoulders slightly raised. In the next

Pinworms. Treatment according place it is important to restrict the dietary

Zinn should aim to destroy the young in very considerably, and to diminish the

the small intestine by a vermifuge interliquids. This tends to diminish the blood-pressure. Give the food cold at

nally, washing out the adult parasites in short intervals,

the large intestine by high enemas, supand substitute some meat-essence for the beef-tea. Small,

plemented by scrupulous care to cleanse carefully-made sandwiches are useful in

the hands before and after meals and after these cases. Give some ice to suck to re

defecation to prevent ingestion of the eggs. lieve thirst. With the object of promot

He tries to give the calomel and santonin

between meals, commencing with 0.5 gm. ing hyperæmia of the cutaneous vessels, and thus diminishing the blood-pressure in

(7.5 grains) each of calomel and jalap in internal organs, the surface of the body powder at 3 p. m., with a warm soapsuds should be kept warm-wrapping the legs day he gives 0.05 gm. (0.75 grains) san

enema at 6 p. m. the first day.

The next in hot blankets and the use of hot-water bottles are most important. At the same

tonin and 0.1 gm. (1.5 grains) calomel at time, plenty of fresh, cool air must be en

8, 10 and 11:50 a. m., with two tablespoonsured. The friends are too apt to think

fuls of castor oil at 2 p. m., and again at that fresh air is injurious. With the ob

4 p. m.

The third day a full warm bath ject of reducing the blood-pressure and

is taken and morning and afternoon a soap

suds enema; this is repeated the fourth and favouring thrombosis, it is important that the bowels should act freely, and a purga

fifth days with a full bath at night. This tive is usually indicated at the onset of

completes the course, after which the body

and bed linen should be changed. The hæmoptysis. A dose of calomel and colo

dosage should, of course, be smaller for cynth, or blue pill, followed by a saline, is

children. The food should be light and often indicated; the action of the bowels may be kept up by small doses of mag

fluid and he prefers to give the course un

der conditions that permit microscopic exnesium sulphate (gr. 20-30), with a little

amination of the stools. With this simple sulphuric acid, given three or four times daily. The cough disturbs the patient and

course of treatment Zinn claims to have

cured in less than a week a condition that tends to interfere with quiescence. In

had tormented the patients for years. treating the ordinary case of pulmonary tuberculosis the cough remedies are restricted to the night, but when hæmoptysis

DIETETICS AND HYGIENE. supervenes it is usually wise to give the cough remedies also during the day—either a linctus or a lozenge; the use of a medi

The Diet After Abdominal Operations. cated respirator should be discontinued. With regard to drugs, these are of the

Paterson says that there is still a lingering least importance. Astringents such

superstition that patients must be half

starved after an abdominal operation. A gallic acid are considered useless. Morphia

few months ago a surgeon writing on this used with care and judgment is the best hæmostatic: it calms the patient, diminishes

subject advised nothing but water for the blood-pressure, and thus tends to fa

twelve hours, and in stomach operations vour the natural arrest of the bleeding by

nothing but a little water for three days. thrombosis; gr. 14, more or less, with gr. 1 W. Zinn, M. D., Therap. Monat., Berlin, Jan., 1-100 atropine, administered hypoder

1910.

· The Practitioner, London, March, 1910.

as

2

- 300 Grams

• 325 Grams

The author regards such starvation as jelly, eggs and Benger's food on the sectotally unnecessary, and in old or feeble ond day, and often fish or chicken cream patients positively harmful. Even after on the third day. Patients who have been operations on the stomach he begins feed- exhausted by weeks or months of vomiting his patients at once. In one of his ing will not stand starvation, and their gastro-jejunostomies for pyloric obstruc- tissues possess feeble power of repair untion, he allowed the patient to have two less they are provided with plenty of mutton chops and a milk pudding on the nourishing food. third day. He was thoroughly exhausted by months of vomiting, and was ravenously hungry. He thoroughly enjoyed his

THERAPEUTIC NOTES. meal, and was all the better for it. Paterson does not, of course, suggest this as a routine treatment, but mentions the case to Liquid Soap.-A liquid soap, without emphasize how groundless is the fear of the disagreeable odor and stickiness of orearly feeding. If the anastomosis be ef- dinary soft, or green soap, may be made ficiently performed, the risk of the sutures as follows: giving way may be neglected so far as feed

White Castile soap ing is concerned.

Stronger ammonia

25 Grams As soon as the patient wishes a drink Alcohol

· 350 Grams small quantities of hot water are given, Soft water and if this is retained one ounce doses of This contains the same amount of soap as milk diluted with two parts of water. The tincture of green soap. Cresol (10 Cc.) quantity is gradually increased up to two may be added to give it an "antiseptic ounces hourly. A cup of tea is allowed odor.”Am. Jour, of Clin. Med. the same day as the operation if the patient wishes it. On the day after the operation, Benger's food and calves' feet jelly

Expectorants. The best drugs to inare given as well as milk. As soon as the

crease the secretion of the mucous membowels have been opened the patient is al- branes of the upper air tract, says Osborne lowed fluid ad libitum, eggs, thin bread in the course of a most interesting series and butter, and other soft solids, and of articles, on Suggestions for the Pharmausually ordinary diet is resumed in a week copeia of 1910, are ammonium chlorid in or ten days. As a general rule the pa- small doses, ipecac, and iodids. tient's inclination is a reliable guide to the

While ammonium chlorid is disagreeable quantity of food required, although in a to take, if given in a sour mixture it is not few cases some coaxing and diplomacy are

seriously unpleasant. Just because a panecessary to induce the patient to take ade- tient happens to have a cold of some sort quate nourishment. It is impossible to lay it is no reason why he should have his down hard-and-fast rules as to feeding, stomach knocked out, his digestion interand general rules have to be modified in

fered with, and his appetite lost by nasty, individual cases. After operation for sep- sweet-tasted expectorant mixtures. There tic peritonitis no food is given by he is no need for squills in any form mouth until the bowels have been thor- as an expectorant. There is no need oughly well opened. After gastro-jeju- for senega in any form as

an expecnostomy for gastric or duodenal ulcer, es- torant. The syrup of tolu makes pecially if associated with hyperacidity, a nice, smooth menstruum, but still is sweet. the diet must be more limited in quality, Tolu has no expectorant properties whatalthough the quantity need not be cur- soever. The syrup of wild cherry is not tailed. Paterson always urges these pa

unpleasant, but still is sweet, and any sedtients to keep on a milk diet for at least six

ative effects form the minute amount of months. On the other hand, after gastro- hydrocyanic acid that it contains is mythjejunostomy, or partial gastrectomy for

ical. These last two syrups, however, cancer, he feeds the patients up more

10. T. Osborne, M. D., Jour. A. M. A., Feb. rapidly, allowing mutton or beef essence, 5, 1910.

should be retained in the Pharmacopeia as pus infection and the worse risk of stirring making a change in the appearance and taste up the opposition of the fanatical anti-vacciof a cough mixture that must be repeated nationists. Only a very small percentage if the previous taste palls on the patient. of persons successfully vaccinated in childThere is no use for the fluidextract of wild

hood ever

contract smallpox and few cherry.

die of it, but these failures to mainOf all expectorants or stimulants to mu- tain immunity make it incumbent upon cous membrane secretion, there is none yet everyone to submit to one re-vaccination offered that is better than ammonium in adult life. There are precious few cases chlorid. Small doses of it in the early of smallpox in such re-vaccinated persons, stages of congestion, frequently repeated, and the statistics published some years ago and larger doses, infrequently repeated, in by Welch of Philadelphia, raised considerthe second and third stages of bronchitis, able doubt as to whether a single one of or an allied condition, should be given. them, really had been successfully re-vac

Ipecac is another valuable drug to in- cinated. That is, there are no cases in crease the secretion of mucous membranes. which two good normal scars proved to It renders the mucus more liquid and less be the results of successful vaccination in tenacious. The dose as

an expectorant infancy and adult life respectively. If this should be very small, as large doses, of is true, it is unnecessary for a general course, will cause nausea. There is also practitioner to vaccinate himself and all no specific ability of ammonium chlorid and contacts every time he finds a case. ipecac to act only on the mucous mem- It is highly necessary, then, to find inbranes of the upper air passages. They stances of smallpox after two such normal are just as valuable for catarrh of the bile vaccinations. At present, there is ample ducts, or any other mucous membrane. justification for the charge that we re-vacThe following combination as an expec

cinate too often. Soldiers sometimes have torant is a good one:

it performed twenty times in as many years

and it seems ridiculous. Nothing should R.

be done, of course, to put the slightest Codeinæ sulphatis

| 20 gr. iv obstacle in the way of universal vaccinaAmmonii chloridi

5 Ziss Syrupi ipecacuanhæ

tion but it is beginning to be felt that too

5 or fi.Ziss Syrupi acidi citrici

25 fl.zi

much re-vaccination is one of these obAquæ, ad

.1001 ad, fl.ziv stacles by causing undue opposition. We M. et Sig.: A teaspoonful, in water, every hope therefore that there will be detailed two hours.

reports of every case of smallpox in which

it is certain that there have been two sucThe above prescription is simply a frame.

cessful vaccinations in infancy and adult The codein might be omitted if there were life respectively, being careful to eliminate no unnecessary cough, i. e., cough without

cases of spurious vaccination or those in expectoration. Heroin might be used in

which pus infection has been mistaken for its place, if one preferred. The dose of the

a success. ammonium chlorid might be increased, and the frequency of the administration decreased. The ipecac might be omitted, if

SOCIETY PROCEEDINGS. the expectoration were free. If the patient were a child, the syrup of citric acid might be changed to syrup of tolu or syrup of EASTERN MEDICAL SOCIETY. prunus virginiana, if deemed best.

At the regular monthly meeting of the Eastern Medical Society, held March II,

1910, President A. J. Rongy in the chair, The protective power of re-vaccination the following program was followed in is not sufficiently realized by sanitarians, regular order : civil or military, and there is a tendency 1. Presentation of a Case of Congenital, to repeat the operation unnecessarily. Unilateral, Bony Occlusion of the Posterior with the consequent though small risk of Nares, by John Guttman, M. D.

gm. or c.c.

2. Presentation of a New Cysto-urethro- Uses. Burnham's Soluble Iodine has a scope, Embodying the Nitse Principle, by field of utility identical with the iodides, Leo Buerger, M. D.

broadened materially, by its special qualiPresentation of a pathologic speci- ties. It is recommended in syphilis especmen cast of the entire male urethra, shed ially in the late stages and in the various after accidental cauterization with strong sequelae of this disease; in rheumatic and silver solution, by A. L. Wolbarst, M. D. allied diseases; in constitutional disorders

4. Papers. (a) Vesical Calculus, by such as scrofula, glandular enlargements, Martin W. Ware, M. D.; (b) Vesical and goitre, etc.; in many skin diseases, acne, Renal Tuberculosis, by A. E. Isaacs, M. D.; eczema and psoriasis particularly; in (c) Gonococcic Infection of the Bladder, respiratory diseases, such as chronic and Urethra in the Female, by Augustin H. bronchitis, laryngitis, etc; in circulatory Goelet, M. D.; (d) Neoplasms of the Blad- diseases, such as arterio-sclerosis, angina der, by Albert A. Berg, M. D.; (e) The pectoris and other heart affections; in many Bladder in Prostatic Obstruction, by diseases of women; diseases of the eye, Parker Syms, M. D.

particularly those of specific origin; as an Discussion by Eugene Fuller, M. D., antiseptic for surgical purposes and wound Ralph Waldo, M. D., L. J. Ladinski, M. D., treatment in general; finally wherever A. L. Wolbarst, M. D., John F. Erdmann, iodine or the iodides would be properly inM. D., Arnold Sturmdorf, M. D., Charles

dicated. Goodman, M. D., and others.

Dosage-Internally. Dose—2 to 30 drops well diluted, 2 to 6 times daily, preferably on an

empty stomach. NOTES ON MODERN PHARMACEU.

The dose should be gradually increased in TICAL REMEDIES

syphilis and other systemic conditions, where large doses are necessary, until the desired therapeutic effect is obtained.

Hypodermically: 2 to 15 minims, 25 to 50% BURNHAM'S SOLUBLE IODINE. dilution, Description. Burnham's Soluble Iodine Externally. As an antiseptic 2 drachms to is a dark brown liquid with a slight odor a pint of water will be found effective for the of iodine and characteristic taste. Is read

average purpose. This may be increased in

strength when necessary. ily miscible with water in all proportions.

Special Advantages. Burnham's Soluble Formula. The analysis of the Council on

Iodine, it is claimed, is more freely and Pharmacy of the A. M. A., showed that

completely absorbable than any other prepthis product contained approximately 3.0

aration of iodine, with less of the objecgm. per 100 c.c. of free iodine and 2.0 gm.

tionable features common to the usual combined iodine. The analysis of our

methods of administration. As a consecommittee shows a slightly larger percent

quence, it is claimed that the therapeutic age. Allowing for error it is fair to state that the free iodine is very close to 3.5 gm.

results from its use are manifested more

promptly and decisively, a claim apparentper 100 c.c. and the combined iodine 2.5

ly well substantiated by extensive clinical gm. in the same proportion. The prepara

observation. tion is slightly acid.

Manufacturers. The Burnham Soluble Physiologic Action. The action of

Iodine Co., Auburndale, Mass. Burnham's Soluble Iodine is that of the iodides generally—alterative, tonic and reconstructive—with the added advantage A crop of boils is usually the result of of being less irritating to the stomach and an infection scattered by a single boil, intestines, more freely absorbable and ap- though certain constitutional states, by parently more prompt in effect. It is not lowering the vitality of the tissues, may caustic or escharotic, and it is claimed render them an easier prey to the invading that it can be tolerated by many patients germs. Therefore, in the treatment of who are unable to take iodine in any other boils every care should be taken to protect form.

the surrounding skin from infection.

BOOK NOTICES.

Samuel H. Gilliland, Marietta, Pa. VIII. Dental Pathology, Dr. George V. I. Brown, Milwaukee, Wis. IX. Exhibition of Hygiene, Dr. Alexander C. Abbott, Philadelphia, Pa. It will not be necessary for one contributing a paper or exhibit to the Congress to be present in person. Arrangements will be made to have contributions suitably presented in the absence of the author. The official languages of the Congress will be Spanish and English. Members of the following professions are eligible to present papers or exhibits: Medicine, pharmacy, chemistry, dentistry, veterinary medicine, engineering, and architecture. Papers may be sent direct to the chairman of the particular section for which they are intended, or to Dr. Alfred Reginald Allen, secretary, 111 South Twenty-first street, Philadelphia, Pa.

International Clinics. Volume IV. Nineteenth Series, 1909. Published by J. B. Lippincott Company, Philadelphia, Pa.

Medical Chemistry. Seventh Revised Edition. Ninety illustrations. By Elias H. Bartley, B. S., M. D., Ph. G. Published by P. Blakiston's Son & Co., Philadelphia, Pa. Price $3.00 net.

Fundamentals and Requirements of Health and Disease. In three parts. By Thomas Powell, M. D. Illustrated with many original drawings. Published by The Powell Publishing Company, Los Angeles, Calif.

Spondylotherapy. By Albert Abrams, A. M., M. D., (University of Heidelberg) F. R. M. S. Illustrated. Published by The Philopolis Press. San Francisco, Calif.

Diagnostic Therapeutics. By Albert Abrams, A. M., M. D. (Heidelberg). One hundred and ninety-eight fllustrations. Published by Rebman Company, 1123 Broadway, N. Y. Price, cloth, $5.00.

The Dietetic Treatment of Diabetes. By B. D. Basu. Published by The Panni Office, Bhuvaneshvari Ashram 40, Bahadurganj, Allahabad.

Rational Immunization in Tuberculosis. By E. C. Hort. Published by John Bale, Sons & Danielsson, Ltd., 83-91 Great Titchfield Street, Oxford Street, W.

AN IMPORTANT ANNOUNCEMENT.

new

Those of our readers who are interested in the various forms of physiologic therapeutics (including Hydrotherapy, Electrotherapy, Massage, Hyperemia, etc.) will be glad to know that it is proposed to shortly inaugurate a journal devoted solely to the delineation of the progress made in these various lines of therapeutic endeavor.

The American Journal of Physiologic Therapeutics will be published bimonthly and the subscription price will be $1.00 a year. The names and addresses of all interested physicians should be sent in and those who are desirous of subscribing at once may enclose their remittance when writing. It is to be hoped that a widespread interest may be aroused in this matter. Write now, while this is fresh in your mind, to The American Journal of Physiologic Therapeutics, 72 Madison Street, Chicago, Ill.

ITEMS OF CURRENT INTEREST.

The International American Congress of Medi. cine and Hygiene will be held May 25 in Buenos Ayres, Argentine Republic, in commemoration of the first centenary of the May revolution of 1810. In order to facilitate the contribution of papers and exhibits from the United States, there has been appointed by the President of the Congress, Dr. Eliseo Can. tôn, and the Minister of the Argentine Republic at Washington, a committee of propaganda, of which Dr. Charles H. Frazier of Philadelphia is chairman, and Dr. Alfred Reginald Allen of Philadelphia is secretary. The Congress has been divided into nine sections, each section being represented in the United States by its chairman in this Committee of Propaganda, as follows: I. Biological and Fundamental Matters, Dr. W. H. Howell, Baltimore, Md. II. Medicine and Its Clinics, Dr. George Dock, New Orleans, La. III. Surgery and Its Clinics, Dr. John M. T. Finney, Baltimore, Md. IV. Public Hygiene, Dr. Alexander C. Abbott, Philadelphia, Pa. V. Pharmacy and Chemistry, Dr. David L. Edsall, Philadelphia, Pa. VI. Sanitary Technology, Dr. W. P. Mason, Troy, N. Y. VII. Veterinary Police, Dr.

Columbian spleen is the name given to the large spléens so often found post-mortem in Panama. It is partly "an interstitial fibrosis and partly lymphoid hyperplasia,” and in no way related to Kala-azar of India. Dr. Samuel T. Darling now reports (Jour. of Experimental Medicine, July 17, 1909) ' finding in Panama, small round or oval organisms in a fatal disease resembling Kala-azar, though they differ somewhat from the Leishman-Donovan bodies which cause the Indian disease. Perhaps here we have a door opened into a new American pathological field and we may expect further discoveries of profound importance. Our lurking enemies are being found out with commendable rapidity.

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