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truth, when he declares that in resolving a problem in very strong irritation. The organism is found between dietetics for the sick, the physician "often ends in taking the layers of horny substance. his own digestive organs as his type, and prescribes for Dr. Lendenfeld adds: “It is well known that several his patients according to the likings of his own stomach." | fungi in certain stages of their life appear very similar to It is especially noticed in the use of stimulants, that the amaba, and so it is not impossible that my amaba is in personal equation strongly influences the judgment. some connection with them. I do not consider this This is so true that the lecturer has evidently not himself probable, however, as I made no observation which might been quite able to escape from it. (Med. News.) lead one to suppose that the amaba ever divided into a
multitude of swarming spores." (Jr. of Royal MicroELEVATION THE ARMS AN INDICATION OF scopical Society, Dec. 1885.) PERITONITIS,—Mr. Lediard calls attention to the fact that patients on whom ovariotomy and like operations
HYDROPHOBIA: THE PRINCIPLES OF PASTEUR's have been performed, may often be found lying with
PREVENTIVE TREATMENT.—Dr. Biggs (N. Y. Med. their arms raised above their heads. This position he Journal, March 27th) states the principles of Pasteur's considers coincident with the commencement of peritoni
preventive treatment of hydrophobia thus: tis. When the inflammation is at its height, the hands
The period of incubation of rabies as transmitted will be clasped behind the occiput. The object is to
from the dog to other animals is very variable, but in lift all pressure from the distended bowel by fixing the
man, as a rule, is exceedingly long, being rarely less than diaphragm, thus making all the breathing thoracic.
thirty days. By the passage of rabies from dogs through London Lancet, Sept., 1885.
a series of rabbits, the period of incubation of the dis
ease may be finally reduced to about seven days, as it TREATMENT OF ERYSIPELAS.—Dr. Daniel Lewis, in
occurs in these animals. The virulence of the spinal the Journal of Cutaneous and Venereal Diseases, gives
cords from rabbits dead of a seven day rabies may be some remarkable instances of the rapid cure of erysipelas solutely dry air at a given temperature. Man or animals
diminished in a constant degree by suspension in an abby the application, externally, of white lead-ordinary white paint—to which is added a little “dryer," for the
that have been subjected to a series of inoculations with purpose of having it become dry sooner than it will if it
a very weak virus, and gradually going on to a stronger contain only linseed oil or turpentine.
and finally to the most virulent form, gradually become He also uses internally tincture of iron and qui
insusceptible to the most virulent virus. The period of nine.
incubation of this virus is very short, and the time required to confer insusceptibility to the disease is much
less than the ordinary period of incubation of hydroPATHOLOGY.
phobia as produced in man by the bite of a rabid animal. AMOEBA INFESTING SHEEP.-Sheep in New South Hence, if too long a time has not elapsed after the bite Wales are affected by a disease which appears to be very
of the rabid dog before treatment is commenced, the similar to epithelial cancer, and is met with on the feet person or animal may be rendered insusceptible to the behind the hoofs, and also on the lips and nostrils and disease before the period of incubation has elapsed. The the gums of lambs. The epithelium in these places time that may elapse in the human being bitten by a rabid grows with pathological rapidity, the horny layer pro
animal before successful treatment may be commenced duced soon attaining a thickness of 3-5 mm., the wool is probably as a rule not less than twenty days, and in drops out in the diseased parts, and below the thick some cases may be considerably more than this, but is outer layer a festering process sets in. After some time a perhaps as variable as the period of incubation of the new epithelium makes its appearance below the festering
disease in different cases in the human subject resulting layer. Then, provided the lamb does not die, the thick
from the bites of rabid dogs, and is dependent upon the horny layer is thrown off like scurf, and the epithelium same idiosyncrasies of the individuals. below attains new wool and replaces the old skin. In studying the circumstances in which these sheep
SURGERY. live, Dr. R. V. Lendenfeld found that they were invariably exposed to being wounded in those places which GONORRHEAL RHEUMATISM.—Dr. Thomas R. eventually developed the disease, blistered by standing Fraser, of Edinburgh, has an elaborate and thoroughly on rocks heated by the sun after they had been standing exhaustive article on "the fa:lure of salicyl compounds in in water for several hours, or pricked by the spines of the the treatment of acute rheumatism accompanied with invariegated thistle, and it was found by a process of flammation of the genito-urinary mucous membranes" artificial breeding in an aquarium that the disease is in the Edinburgh Medical Journal, which he concludes produced by an ameba (A. parasitica), which enters the as follows: wound and multiplies rapidly in the epithelium, causing 1. That many of the cases which have been considered to be gonorrheal rheumatism were merely cases venous piles, do not excise, ligature nor inject the tumof toxæmia, produced by a toxic substance absorbed ors, nor dilate the sphincter ani internus, but give your from an inflamed genito-urinary mucous membrane. patient hunyadi janos water to free cartharsis, removing The cases I refer to are met with especially among the thus the liver engorgement. Replace the uterus, if misexamples of chronic mono- or oligo-articular inflam- placed, or give astringent injections or suppositories, and mation.
nature will complete your work. 2. That in other cases the disease is a rheumatism modified by toxic infection from a venereal or nonvenereal inflammation of the genito-urinary mucous mem
HYGIENE. brane. The rheumatic or toxæmic phenomena may in How To DisiNFECT INFECTED DWELLINGS.—The these cases be present in very different degrees of rela- following method of thoroughly disinfecting a room in tive prominence, sometimes the rheumatic, and, at other which an infectious disease has existed is reported in the times, the toxæmic phenomena being the more promi- | Centralb. f. Chirurgie, No. 12, 1885, by Prof. König, who nent. This, the true form of gonorrhæal rheumatism, has successfully employed it for 20 years: presents itself chiefly as an acute or sub-acute disease.
The windows of the infected room having been 3. That in no variety of gonorrhæal rheumatism is closed tightly, 50 to 60 grammes (172 to 2 oz.) corrosive the progress of the disease materially influenced by the
sublimate are placed on a small shovel of burning coals; administration of salicyl compounds; and as the distinc- after that the person leaves the room immediately and tion in acute, and even in sub-acute cases between gon- closes the door. The sublimate evaporates rapidly and orrheal and ordinary rheumatism is always at the com- exposes the room to its vapors for three or four hours. mencement, and sometimes during a great part of their Then the door is to be opened, and, covering the nose progress, a matter of much difficulty, the failure of the and mouth with a piece of cloth, the person re-enters, salicyl compounds in the former disease is a valuable as
opens the windows and closes the door again.
The room sistance in diagnosis.
having been thus ventilated for several hours, the posThe doctor recommends no special form of treat- sibly remaining vapors are to be rendered harmless by ment, but speaks well of iodide of potassium, colchicum, the burning of sulphur in the closed room. After reguaiac, and alkalies; while blisters, moderate pressure, peated ventilation the room may again be occupied. the uninterrupted induced electrical current, and passive Therapeutic Gazette. movements, are of service in the more chronic stages of the joint affection.
TOXICOLOGY. Treatment of GONORRHEA with DECOCTION OF MUSCLE POISONING.—The Medical Press gives the LEMONS, AND CITRIC ACID.-Cut three fresh ripe lemons following instance of muscle poisoning. At Wilhelmsinto pieces, and place them in an earthen vessel, add ten haven two vessels were taken into dry-dock on October ounces of water, reduce by gentle heat to one-third. 18th, 1885. The sides of these vessels were covered with Press and separate the solid matter. The liquid is in- the common muscle. The ships were not copperjected three or four times a day. It should be made bottomed. The dock work people collected large quanfreshly every two days. The decoction is said to destroy tities, took them home, prepared and ate them. Ninethe gonococcus in two or three days. It may be used in teen people were attacked with symptoms of poisoning. the acute stage.
Nine of the cases were serious. One death occurred The following is the formula suggested by M. about two hours after the eating, and four others followed Rebatel, and found by M. Jullien to be especially useful in about four and one-half hours. The post mortem in cases of obstinate gleet: citric acid 1.50, salicylic acid examination showed conditions of irritant poisoning. 0.05, water 250 grammes; to be injected twice a day. The There was redness, swelling, and in many places comsalicylic acid is added merely to preserve the liquid. plete detachment of the mucous membrane from the
small intestine. The spleen was swollen and thickened. TREATMENT OF HÆMORRHOIDS.—Dr. G. F. Center, Examined carefully by experts, it was found that both of Jacksonville, Fla. (St. Louis Courier of Med.), in an Aesh and decoction contained the poison. Neither heat article on the treatment of hæmorrhoids, sums up as fol- nor alcohol weakened this poison. Small animals were lows:
killed by it in half an hour. The poison acted like To sum up all that is worth knowing about piles, curare by paralyzing the motor centres. Virchow places we would say: Dilate the sphincter ani internus with a the poison in the series of poisons which develop in fish dilator for external venous and internal arterial piles, and both living and dead. All active extracts of the poison do nothing more, unless, in the case of external venous were rendered inactive by being moistened by sodium piles, you remove the tumors, for cleanliness after defeca- bicarbonate. Thus it would seem as if the poison was tion, and this is only necessary in old cases. In internal an alkaloid which has not as yet been isolated.
cians in the place. However, she recovered and was the first of many other cases to get well.
The patient has been married twice. By the first CEREBRO-SPINAL-MENINGITIS.*
husband, she had a dead child, born at full time; during
this confinement her menstruation was regular throughBY GEORGE DUFFIELD, M, D.
out. By her present husband, she has had one child, HEN we have had a case of severe illness, one in which lived to be 9 years old. During her second con
finement she had no menstrual flow. eral weeks and such a one recover, we are apt to feel In September, 1876, her child died. She went one very happy and we are anxious to let others know of our afternoon to his grave, and while there lost consciousness good fortune in the saving of our patient.
and lay for long time upon the wet ground. It was The case I am about to report is one of this kind, night when consciousness returned, and with difficulty and is full of interest from beginning to end. A few re- she reached her home. About 11:00 o'clock of the same marks on the history of the patient and her family will night she again lost consciousness; a physician was sumgive a clearer view of the case and show how poor the
moned and she was found to be paralyzed upon the prognosis was from the start.
whole left side. Sensibility and the of this side Mrs. C., aged 39, was seen first by me March 9th, were completely lost for two whole months. The limb 1885.
remained numb, sensation not returning to the normal When she was a child of five years, in an epidemic
for more than two years. of scarlet fever, she contracted the disease, which was When she was able to get about the house on followed successively by severe attacks of whooping. crutches, she would often fall and remain unconscious cough and measles. The eruption in the latter was for from ten minutes to an hour, the length of time denearly or quite suppressed.
pending on whether anyone was in the room or not, since During this attack of measles there was a violent artificial respiration and restoratives would shorten the attack of enteritis, which lasted for several weeks. attacks. the close of this attack, a cataract in the right eye was The only premonitory symptoms that had ever been discovered. It had a white and glistening appearance,
noticed by the friends were, that she would always call and has retained its whiteness ever since.
for water, and in going for it would fall by the way. During her early childhood she had always been In these attacks she never bit her tongue or frothed troubled with constipation. When but 16 years of age at the mouth. she began teaching a district school. She would at times In 1879, during an epidemic of diphtheria, she go four or six days without having an evacuation of the was attacked the second time with cerebro-spinal meninbowels.
gitis. When 17 years of age she got her feet wet during The attack began with severe vomiting, which lasted her menstrual period and caught cold. An epidemic of eighteen hours, and which could not be relieved. This cerebro-spinal-meningitis was then prevailing at La was followed by delirium with the characteristic spots of Porte, Ind., where she then lived, and was very fatal in purpura hæmorrhagica, which appeared all over the its progress. She contracted the disease. The attack body. Another consultation was held as in the former began with a chill and cramp of the lower extremities, attack, with the same result; however, she rallied and which was followed by convulsions and active delirium pulled through, showing that her staying powers were and high fever.
still good. The patient was given up to die by the best physi
No paralysis followed this attack. In a few weeks
she was about again. The attacks of loss of conscious*Read before the Detroit Medical and Library Association,
ness came on every two or three weeks, but were never
very severe-lasted but a few moments at a time. She noticed, upon my examination of the spine, that she complained that after these attacks it was hard to think complained of considerable pain when pressure was made straight.
over the second lumbar vertebra, and as she said, it ran This history is, indeed, one full of varied symptoms, up and down her spine and made her dizzy, and that and carries much interest with it when we consider her when she passed water this pain was more intense than sickness, which I am about to describe.
at other times. Yet, if you will allow me to say a word about her While I was talking to her she was seated on an parents, brothers and sisters, you will be surprised that ordinary chair; presently a cry escaped her lips, her the constitution of the patient was as strong as it proved facial muscles became set, her eyes rolled back, her head to be.
was drawn back upon her shoulders in opisthotonos, and Her father was a strong robust man, predisposed to her face denoted severe pain. The convulsion lasted apoplexy, from which he died. When enraged or fright- about twenty seconds. She did not seem to lose her ened he would lose consciousness, and often had to be whole consciousness. As it passed away she placed her bled in order to bring him to life.
hands to the back of her neck and screamed for some The mother is living. She has had several attacks one to relieve the pain in her neck and head. of inflammatory rheumatism. She has a systolic She was placed in bed with ice to her spine, neck murmur.
and forehead. As the ice was applied the pain seemed One sister died of congestion of the brain, her child to shift to other portions of the sensorium, and became dying of cerebro-spinal meningitis.
more severe, but again subsided. Another sister has phthisis. Three brothers have I ordered 20 grains of bromide of potassium with 6 died of paralysis. One, now living, has had two strokes grains of chloral, to be repeated every two hours if necof apoplexy. I can discover no history of syphilis in essary. Ice was kept to the head and spine until the either the parents or grandparents.
next day, the 14th, when it was removed for a short On the morning of the gth of March, 1885, while in time, but as the pain returned it was again applied, with attendance upon her husband, who was recovering from relief. There was considerable pain in the back, especially an attack of pneumonia, Mrs. C. consulted me, first, for so over the tenth dorsal vertebra; pressure over the hypo. constipation and headache, which she said had troubled gastric, umbilical or epigastric region caused severe pain, her for several years, dating from an abscess of the which was felt in the spine, and not on the surface rectum, she thought, which had left a stricture, and which irritated. caused much pain and tenesmus. Thinking that her During this time the patient was conscious, the headache was due alone to constipation, I prescribed a temperature and pulse were normal. Strange to say, the pill of the extracts of belladonna, nux vomica, and appetite kept up and the patient took food with considphysostigma, of each 74 grain, to be taken upon retiring. erable relish. Her tongue was coated, and she had indefinite pains March 16.—The third day since the onslaught, a through her abdomen. She told me the next day that change had occurred; the eye-lids drooped and could she had had an evacuation of the bowels, but only with not be raised by the patient, the pulse was weak and the aid of an injection. She had habituated herself to intermitted slightly. I added some carbonate of amthese irrigations for some years, and never had a passage monia to the medicine and gave some brandy, to ada from the bowels without their use.
strength to the enfeebled heart. March 10.—Her head still ached through the tem- March 17.- Ptosis was complete when the patient ples, her skin was dark and bronzed—not jaundiced, but was visited; pupils responded to light. When the eyerough and dry-her temperature was 99.5°, and her lid was held open the vision was very dim. The will pulse about 80 per minute. She told me, at 3 p. m., that power, a strong factor in the disease, still kept up. The she had not passed her water since she got up in the patient could grasp my hand, but to exert any pressure morning, and had no desire to do so. Percussion over she was wholly unable, for the fingers failed to respond the hypogastric region was negative. Introduction of a to the nerve force sent to them. catheter evacuated but about an ounce of concentrated The intermitting pulse of the previous day had again urine, sp. gr., 1.035.
Urates and chlorides present assumed its normal regularity. in large amounts. Acid. She had never had any mis- March 18.—Ptosis still complete; total inability to placements or weaknesses of the uterine organs; had had raise the lids, the pupil contracted when light fell upon no miscarriages, and had always been regular. To the retina, to about 18 of an inch and then relaxed again crease the flow of urine I gave her two drachms of the to about 14 of an inch, and remained in this position. infusion of digitalis every two hours, and was soon grati- The patient was totally blind, not able to tell faces fied to find my patient's kidneys acting freely.
or to differentiate between light and darkness. The March 13.–For the past two days she refused to temperature as taken under the tongue was 99.5° F.; take any medicine, saying she was not ill enough. I pulse 64.
The family thought it necessary and so called in red and angry. The pharynx was also congested and consultation Dr. David Inglis. The doctor agreed with pain was experienced upon swallowing. me in considering the prognosis bad indeed, and sug. March 23.- Under anodynes she was kept quiet gested that to the bromide of potassium, the iodide be during the whole day. added, keeping up the stimulants as before.
March 24.-I was called early in the morning. March :9.—The first signs of delirium manifested About 6:00 o'clock the patient had grown rapidly worse. themselves to-day. The patient, becoming uneasy, would She complained of great roaring in the ears, and dimness spring from her bed seeking light.
of vision. When I reached the house, about 6:30 o'clock, Her skin became very sensitive, so that the bed- she was totally blind. She had no paralysis of the lids, clothes had to be held up by means of hoops; irritation face or tongue. She was totally deaf, being unable to of the skin, no matter how slight, would cause intense pain hear even the loudest noises. She spoke at times inin the region of the medulla. To the iodide of potassium coherently and without meaning to her sentences. Her (10 grs.) one-half drachm of the Auid extract of ergot temperature was 100° F.; pulse 90; respiration 22. Very was added.
little pain in the back and none at the occiput. I preMarch 21.-Ptosis disappeared, eyelids could be scribed again iodide of potassium, grs. xv, with two drops easily raised and objects near by could be seen, though of tincture iodine every two hours, and continued the they appeared irregular and enlarged. She slept for stimulants as before. eight hours consecutively.
By evening she was somewhat better.
Her speech For some reason her temperature rose to 102°, and
was freer. her pulse went up to 100 beats per minute. No compli- By the 26th instant, the eyesight began to come cations could be discovered.
back; her hearing improved and her speech was much March 22.—The pulse and temperature were again more connected, showing that the exudate was being at the normal. The vision was clear; the face; looked absorbed. only streaked, she said, and were of normal size. The March 27.—The night previously had been passed grasp of the hand, so long enfeebled, was again fairly quietly, the patient sleeping considerably. At 11:00 a. strong, and I hoped that the worst had passed. When I m. she complained of severe pain in the back of her made my evening call, I found things changed. The neck. Ice was applied and the bromides increased with temperature was 100. She was weak and restless, rolling marked relief. About 1:00 p. m. another severe parfrom one side of the bed to the other, as if in great oxysm of pain in the neck, lasting nearly two hours, left pain, turning on her back her head would draw back- the patient totally blind for the second time. During ward and her whole body arched would rest upon her this attack her temperature was normal, though her reshead and her heels; her face was distorted, eyes wide pirations were increased to 40 per minute. Her skin open and staring; her arms were placed under the neck was moist, though pressure upon the muscles caused and at times the woman would scream dreadfully, a pain in the back of the neck, while the muscles felt sore spasm would then appear and would exert its force upon after pressure was removed. the muscles of the body, after which the patient would March 28.–The patient is able to speak, though sink down and moan piteously. On questioning the still blind. She remembers the attack of yesterday, and nurse and husband, I learned that the patient, desiring seems to remember all the happenings of the day. This to have a movement of the bowels, instead of using the morning her temperature is normal; pulse 76. The spine bed-pan, was given an injection and then arose and is tender in spots over dorsal and cervical regions. strained at stool, with the effect that I have above de- In the evening her sight began to improve, things scribed.
appearing misty and enlarged. The field of vision was The patient, too, became delirious; the eyesight be- very small; she was unable to measure distances. came very dim; sounds, especially that of music, was March 30.-The improvement has progressed so far heard in the ears, the sounds were discordant and at uninteruptedly. The appetite is improving. The sight times would be loud and violent, and so disturbing the is improving slowly. patient.
March 31.–For most of the night there was considThe pupils were dilated and did not respond to erable pain over the lumbar region and the sphincters light.
recti and vesici were relaxed, and the fæces and urine The eyelids could be raised at will. The respira passed involuntarily. There was also considerable pain tions were increased to 42 per minute.
in the pelvic organs. The temperature was normal, and Cold irritated the patient so that hot applications the pulse at 80. were applied to the nape of the neck with beneficial re. April 2.—The temperature was normal; pulse go sults. The bromide of potassium was increased and ten and weak; skin relaxed and moist; and, strange as it drops of chlorodyne added to each dose. The tongue may seem, the patient was muttering in delirium. The had been peeling and the abraded surface looked very right side of the face was relaxed as though a few filaments