MEDICAL MISCELLANY

ASTHMA AND HAY FEVER.-Do your cases of asthma give you trouble? Have you looked, time and time again, for a remedy which did more than promise relief for your asthma and hay fever patients? A contemplation of the bewildering array of remedies for these troubles, well-nigh exhausting the pharmacopeia, and the fact that so few preparations have given anything like general satisfaction to profession and patients, prompts us to ask these questions. Further, the conviction that in respirazone (Tilden's) this company has effected a correct combination of some of the most trusted and tried drugs used for asthma, prompts us to bring this meritorious remedy to the attention of our readers. We base this conviction on personal experience which has been amply corroborated by numbers of competent observers. Respirazone (Tilden's) gives positive and in most cases immediate results, and may be relied upon alone or combined with such respiratory antispasmodics, which, in the judgment of the prescriber, suggests themselves in individual cases. Try it on your next case of asthma, doctor, and you will not be disappointed.

AN INTERESTING CLINICAL CASE.-P, a white woman, 22 years of age, was taken into the hospital on account of syphilitic skin disease (roseola papula); a blennorrhagic vaginitis of most violent description with strong congestion of the mucous membranes of the vagina. The latter was of violent hue, somewhat brittle, and yielded abundant secretion of a greenish yellow pus, which showed under bacteriological examination abundant colonies typical of gonococcus, diplococcus and other varieties of bacteria. The gonococci infection reached to the neck of the uterus whose tissues suffered from the same degeneration as the vagina. Above the mouth of the neck,--from which a greenish yellow and somewhat thick pus oozed-was a syphilitic ulcer of the size of a dime, clean at the bottom, livid in color and rather deep. Upon careful examination, the patient was found to be pregnant in the third month; and, from the start, was subjected to energetic treatment as a serious case. Under the treatment employed she improved rather well; but, though the blennorrhagia was not cured, the syphilitic manifestations of the skin disappeared, and the ulcer at the neck improved somewhat, until confinement which took place at the eighth month, five months after her admission. The confinement was normal. However, the patient was attacked by a great flux and suffered a complete laceration of the right side of the neck; an incomplete laceration of the left side; an incomplete laceration of the rear wall of the vagina; and a two-thirds laceration of the perinæum. The placenta was removed at once; ample warm washes of a 1 per cent solution of permanganate of potash were applied and the uterus was stimulated by massage, but remained inert. All this was reported to me by the house physician. I arrived at the hospital four hours later in company with the well-known gynecologist, Dr. Mendez Capote, who, upon having examined the patient, decided to sew up the lacerations. He washed out the vagina and uterine cavity completely; adjusted with the scissors the edges of the lacerated tissues; sewed up the wounds and touched the ulcer at the neck with the cauterizer; then he gave another wash and plugged with iodoform gauze. When the patient was on the operating table, she had fever, 38.4° C. At 5 p. m. the fever was at 39°; then the vaginal plug was taken out and a great intra-uterine

wash of a one-half per cent solution of permanganate was applied very hot in a quantity of 5 liters. The fever was at 40° throughout the night,and washes were given every four hours. The following day at 8 a. m., temperature 40°, same local treatment. The fever lasted all day, falling to 39 by the wash, but rose again to 40°. The day thereafter, fever at 41; same treatment with more vaginal washes of bichloride of mercury, before the uterine washes; the fever keeps on at 41°. On the next day at 8 a. m., (temperature 41.5°), I took out the stitches made on the day of confinement, washed well both uterus and vagina,dried the latter with carbolated cotton and conveyed into the uterine cavity eight grammes of pure hydrozone, taking care that this liquid should flow towards the vagina, into which I poured about 60 grammes of the same liquid and drained the uterus with simple gauze saturated in hydrozone, while the vagina was drained by the same means. From that time on the fever declined slowly, and at 6 p. m., it was apyretic. The fever did not return and the patient's cure proceeds without difficulty. This case which is interesting by itself, proves of great value of setting forth two points; viz.: I. That, although the intrauterine injections of pure hydrozone may be dangerous, it can be applied if care is taken to keep the neck dilated as much as possible. 2. That in this case the superiority of hydrozone over the other treatments of puerperal septicemia, in connection with gonococcia, is indisputable; and that this splendid result should encourage repetition of its application. The son of the patient suffered from blennorrhagia in the eyes. He was treated with 4 per cent solution of permanganate and instillations of pure hydrozone twice daily, alternating with cauterizations of 40 per cent solution of nitrate of silver; and he kept his sight.-Dr. Matias Duque, Director of the San Antonio Hospital, Section of Hygiene. Abstract from the Revista Medica Cubana, April 15, 1903.

GLYCO-THYMOLINE AS A THERAPEUTIC AGENT IN TREATMENT OF NASAL CATARRH.-(Erle B. Woodward, M. D., Lincoln, Neb.)-Mrs. P., aged 38; bothered with catarrh from girlhood. Applied for treatment February 12, 1900, because of excessive dryness and itching of nares. Upon examination found the turbinates very much reduced in size. Discharge dried into crusts which clung to both septum and turbinates. As to odorthis case was no exception to the class. I gave her glyco-thymoline to use as a coarse spray three times a day, or as much oftener as she required. While it gave her great relief, her case did not progress as fast as we thought it ought, so I had her come to the office three times a week where I cleansed nose thoroughly with hydrogen peroxide and afterwards sprayed with glyco-thymoline. Finally I made a very thorough application of balsam of Peru, the glyco-thymoline to be continued at home as before. Before the end of one month crust and the disagreeable odor were matters of the past. The whole nostril had a very much more healthy appearance. I saw this case a few days ago, and she tells me that she is comfortable, but always keeps a bottle of the red medicine on hand. I cannot say that this case is cured, but I believe she is as nearly cured as such cases ever are.

THE TREATMENT OF SYMPTOMS.-In a highly interesting article on this subject, Walter M. Fleming, A. M., M. D., of New York City, uses the following language: "Long experience in the treatment of diseases in their incipiency, evidences beyond all debate, that almost invariably, the

attack in a large proportion of cases inaugurated by febrile symptoms of greater or lesser severity. Also, it may be noticed that constipation or torpid inactivity of the bowels prevails. Therefore, the first indication in the incubation or incipiency of the attack, of almost any form or nature, is primarily to allay the fever, pain-nervousness and solicitude of the patient, and secondarily to empty the alimentary canal. These two ends being accomplished, a long advance toward a possible abortive issue of the attack has been made, or in any event, the first indication and requirements are fulfilled, in proper progress toward a cure. Thus in the primary treatment of the numerous ills, which are characterized by the above quoted symptoms, the physician will find laxative antikamnia and quinine tablets at once handy, convenient, and reliable, safe and sure, and to which the turbulent symptoms of fever, constipation, pain-sleeplessnesss, nausea and generally wretched depression yield so promptly and gracefully, that it is certainly refreshing to the physician himself, to note the change in his patient, from suffering and solicitude to comfort and quiet. I certainly know of no other remedy which will so readily and decisively allay and control the symptoms above enumerated."

The increasing attention that is being given to the principle of nebulization has been markedly shown this summer by the interest manifested in nebulizing apparatus at the various association meetings. The Globe has been prominently in evidence, and at several of the larger meetings interested visitors were met in person by Dr. Dunlap, to whom the medical fraternity is indebted for the vapor massage idea in the treating of diseases peculiar to respiratory and aural tracts. While massage is a familiar term, there is probably only a small percentage of physicians who have a live appreciation of the tremendous possibilities of vapor massage for this purpose, especially, as administered internally by means of the positive acting appliance on the Globe nebulizer. This was shown during the demonstrations by the expressions of surprise and delight from physicians who tested the treatment themselves as applied to the middle ear, and in the deep and vibratory impulses by which the medicated vapor was forced with massagelife effect to the remotest portions of the bronchial passages. The history of this treatment shows that peculiarly stubborn cases of middle ear deafness and pulmonary difficulties frequently yield to vapor massage when all other methods are unproductive of desired results. Possessors of Globe outfits are fortunate in having available this important factor in modern therapeutics.

Indigestion, Gout, Diabetes.—Indigestion has correctly been called by prominent American physicians the "Bane of the American people." It is common with all classes, the rich and the poor, the banker and the mechanic, the statesman and the merchant, the young and the old, caused by the rush and hustle in the eager pursuit of everybody to accumulate the biggest wealth in the shortest possible time. This causes people to forget and overlook the most essential rules of diet and hygiene, necessary for a good and healthy constitution. The swallowing of food without mastication, the gulping down of great amounts of ice-water or of stimulating potions of strong tea or coffee or-worst of all-alcoholic tonics, combined with lack of physical exercise,must necessarily break down the digestive organs. The liver thus getting sluggish, faulty metabolism is caused, all other inner organs refuse to work properly. Either an excessive amount of uric acid is produced giving rise to so many distressing symptoms of gout, such as

sour eructations, fluctuating pains, insomnia, etc. etc., or retarding the gly. cogenic functions which finally result in diabetes. As the stomach, as well as the liver, kidneys, spleen and pancreas are affected and overtaxed at the same time, it will naturally be necessary to institute a rational treatment regulating the functions of digestion and assimilation. Clinical tests, made by well known physicians here as well as in Europe, have given Kutnow's improved effervescent powder a very prominent place amongst the therapeutic remedies for the aforementioned ailments. It is strongly recommended by acknowledged medical authorities for the treatment in rheumatism, gout and disorders of the stomach, liver and kidneys. "Its advantages", says a medical authority, "appear to rise from its possessing the power to eliminate from the body the excess of bile and acids, thereby purifying the blood and strengthing the general tone by improving the assimilative processes of the debilitated system.'

PROTONUCLEIN IN ANEMIA.-Dr. John Ferguson reports a case of extreme anemia, in the Canada Medical Record, which was relieved by protonuclein after other treatment had failed. The lips and conjunctivae were almost colorless. The skin had a pale lemon tint. The red blood corpuscles were only 1,200,000 per cubic millimetre. The urine was normal. No organic disease could be discovered. In spite of all efforts at treatment and feeding, he gradually grew worse and was sent to the Toronto Western Hospital. There the bowels were washed out daily with a large enema, containing boracic acid. Daily he was given a sponge bath, and the stomach was washed out. He was fed on peptonized milk, egg albumen and beef-juice. He had been in the hospital a little over two weeks, and all the appearances pointed to an unfavorable termination of the case. He was then placed on protonuclein tablets. The enema, lavage of the stomach, and the same nourishment was continued. Tablets were given every three hours. By the third day it became apparent that the patient was improving. The red blood cells which at first numbered 1,000,000 to the cubic millimetre rose rapidly to 3,500,000 and the patient left the hospital in excellent condition.

THE PENNSYLVANIA STATE BOARD OF HEALTH AND "VIN MARIANI." ---On April 22d last the Governor of Pennsylvania approved an excellent law passed by the legislature entitled "An Act regulating the sale or prescription of cocaine, or of any patent or proprietary remedy containing cocaine, and prescribing penalties for the violation thereof." A question arose as to whether the well-known "Vin Mariani," as a coca preparation, contained cocaine. The State Board of Health, on being appealed to, submitted the question to the analytical chemists, Prof. Sadtler and Dr. Genth, the samples examined being purchased by them in drug stores of their own selection. The analysis show that "Vin Mariani" contained no cocaine.-Monthly Cyclopedia of Practical Medicine, Philadelphia, September,

1903.

A STRONG REASON for the use of Gray's tonic in elderly people is that it wards off the tendency to inflammations of the respiratory organs; this fact has been noted and commented upon for many years past and is doubtless due to the fortifying action of the remedy upon the general constitution and its specific influence upon the respiratory tract. It is good practice to administer Gray's tonic to all patients in whom are noticeable the symptoms due to advancing years. The absolute freedom of the remedy from depressing or detrimental reaction makes it the safest and most preferable means of combating the exhaustion and enfeeblement of age.