COLLOIDAL SILVER IN ACUTE PULMONARY TROUBLES.* IN "An Index of Diseases," G. Björkman, A. M., M. D., Professor of Physiology, Milwaukee Medical College, says regarding the treatment of broncho-pneumonia: The bacterial trio the strepto-, staphylo-, and pneumococcus is the main cause of broncho-pneumonia. Fortunately we have a remedy with very active offensive properties to all three, especially to the streptococcus, which is the sole instigator of the severest type of broncho-pneumonia,- colloidal silver in concentrated or half-concentrated solution given rectally or intravenously. The speedy descent of the fever curve is remarkable. When two or three ounces of the solution (one third for children) is given morning and night, with hydrotherapy, bronchopneumonia sometimes loses its foothold at once and yields with a willingness comparable only to diphtheria under antitoxin treatment. This treatment should, therefore, always be resorted to, even when a case seems hopeless. The remedy should be given sufficiently long to guard against relapse and sequelæ. If there are complications, the silver treatment may not always be successful; but in the uncomplicated forms, especially when the streptococcus is in the lead and the remedy is applied early, it is almost a specific. The prognostic views of broncho-pneumonia, hitherto so gloomy, will be considerably modified if collargolum gains more popularity in the disease. Under "Lobar Pneumonia," Professor Björkman states:The same holds good in every respect with lobar pneumonia. Even if a direct action on the pneumococcus in certain cases is less conspicuous, the visible mitigation of mixed infection is important enough to make the remedy an indispensable adjuvant. Professor Björkman also warmly recommends collargol in polyarthritis, as also in the various forms of sepsis, such as in infectious tonsillitis, lymphangitis, phlegmonous processes, pemphigus neonatorum, scarlatina, diphtheria, etc. It should be given intravenously in severe erysipelas, meningitis cerebrospinalis, perimetritis, appendicitis, etc. *Abstracted from Merck's Archives, Jay to Dec mber, 1905. PUERPERAL INFECTION.* EDWARD SPEIDEL, M. D., Professor of Obstetrics and Gynecology, Hospital College of Medicine, Louisville, recommends in puerperal infection the rectal use of collargol, 71⁄2 grains in 2 ozs. of water twice daily. An enema of a pint of warm water is first given and one half hour later the collargol is introduced by being poured into a small funnel at the end of an ordinary rectal tube which has been inserted into the bowel for 8 or 10 inches, the patient being in left lateral position with hips elevated, so that the solution is retained as long as possible. This, continued for two weeks and combined with nuclein injections, has resulted in the recovery of a number of patients, who, he is sure, would otherwise have succumbed. Dr. James Vance, of Louisville, said in the discussion: I have seen Dr. Speidel get some excellent results from collargol and nuclein, particularly in a case of large fibroid tumor with sepsis. Recently we had in the city hospital a case of large pus tube on the right side. There was nothing in Douglas's cul-desac. The urine showed hyaline and granular casts, and we deemed it inadvisable to give an anesthetic, so we tried collargol. We could not get it promptly at the city hospital. The collargol was given to this patient for a week, and during that time her temperature dropped considerably, her pulse improved, and she felt better. After that we could not get any collargol, and the patient went right back. Upon operation the abscess was found to have invaded the abdominal wall. The patient died. Dr. J. W. Kremer added: I had a patient at Gray Street Infirmary with puerperal infection, and we used antistreptococcus serum with bad results. Temperature was 103° and pulse 179 after a 20-cc. dose, and we thought she would die. A few days later, Dr. Spiedel, called in consultation, suggested nuclein solution. We gave two injections of one half ounce each with no result. Then we resorted to collargol for two weeks, and on the fourteenth day the temAbstracted from American Practitioner and News, September, 1905. perature fell to normal. and strychnin cured her. I believe that collargol with nuclein In closing Dr. Spiedel said that collargol and nuclein are endorsed by Williams of Johns Hopkins Hospital and by Edgar. THE CONSERVATIVE TREATMENT OF OCULAR INJURIES.* BY FRANK ALLPORT, M. D., CHICAGO, ILL. I HAVE seen such surprising results from unguentum Credé in dangerously infected eyes, where suppuration has already perhaps been firmly established, that I feel I should mention them in this paper. I usually care for these infected and perhaps suppurating ocular traumas in the orthodox manner, that is, by cold packs, antiseptic irrigation, atropin, argyrol, etc., but I direct that when night comes the eye be thoroughly cleansed, that argyrol and perhaps atropin be used and anything else done that seems advisable. A thick plaster of Credé's ointment is then spread upon a piece of gauze which is placed directly over the closed lids and secured in position by a soft bandage. This is allowed to remain all night, and is removed in the morning for the resumption of the daily routine treatment. I have never regretted using the ointment and have seen many eyes saved where salvation seemed well-nigh impossible. The amount of discharge is much lessened and it is surprising to see, when the ointment is removed, how clear the eye is and how the small amount of secretion has been drained from the eye to the ointment. I have even used this treatment in gonorrheal ophthalmia and have always been pleased with its effects. *Abstracted from the Railway Surgical Journal, Vol. XII, No. 3, page 104, November, 1905. Clinical Reports. CLINICAL SOCIETY OF THE NEW YORK POLYCLINIC MEDICAL SCHOOL AND HOSPITAL. Stated Meeting, held January 8, 1906. The President, DR. J. J. MACPHEE, in the Chair. URETHRAL FISTULA AND PROLAPSED KIDNEYS. Dr. Charles H. Chetwood showed a patient on whom he had operated two years ago for urethritis, and who at the present time had an incomplete fistula. When first examined his symptoms seemed to point toward the urethra and prostate, the latter being about the size of a small orange and very hard. The history indicated a gonorrheal infection, and, apparently, a syphilitic abscess of the prostate. The patient urinates every half hour, day and night, and the bladder contains about 12 ounces of residual urine. The appearance of the urine is indicative of kidney pus. Both kidneys are prolapsed and the right one is very palpable, enlarged and tender. The interesting feature of the case is the prolapse of both kidneys without any apparent explanation. There is no tuberculous history and none suggestive of kidney disease. The speaker's intention was to drain the prostatic abscess through a perineal incision, examine the bladder through the opening, and possibly catheterize one of the uterers. SYRINGOMYELIA OR LEPROSY. Dr. J. A. Bodine presented this patient. She was 21 years of age and her family history was negative. About six years ago she first noticed that she was unable to distinguish the impact of the soles of her feet against the sidewalk and began to have aching pains in her feet and legs. Later, pus formed beneath callous spots on the feet and discharged, leaving sinuses leading down to the metatarsal bones. Rest in bed healed the sinuses, but on resumption of her occupation they reopened. Pain was Her gen Three years ago her feet began to pain her, and then were manifestations of trouble in the axillæ and in both groins. also present in her spine from the neck to the coccyx. operated on for the contractures of the feet in 1902. eral health is now fair. The soles of her feet are covered with multiple perforating ulcers. The discharge is thick, brownish in color, and has a peculiar sickening, penetrating odor. There is an abscess under the skin in one thigh and another over the sacrum. There are marked motor and sensory disturbances of the feet and legs. The case was presented for diagnosis, which the speaker thought lay between syringomyelia and leprosy. Dr. W. B. Pritchard said that he considered this patient an example of syringomyelia presenting the exception in a distribution of symptoms in the lower rather than the upper extremities, though both were involved. The trophic disturbances in the feet with bladder symptoms, scoliosis, and, finally, dissociation sensory phenomena, indicated with fair clearness the diagnosis. It was not a leprous neuritis, as the nerves showed no bulbous enlargements and the skin was quite free from the characteristic plaques. Tabes had been suggested, but there was little in the symptom picture to sustain such a suggestion. Absence of the Argyl-Robertson pupil, the persistence of one knee jerk, with absence of true ataxic gait and characteristic pains were collectively conclusive in negation. The paper of the evening was read by Dr. Andrew R. Robinson, and was entitled: THE TREATMENT OF SYPHILIS. He referred to the different views held on the subject of the treatment of syphilis, and stated that he would endeavor to show that syphilis is a serious disease in a considerable percentage of cases, and especially on account of the tendency after immunity is reached, to fatal parasyphilitic affections; that the tendency to these parasyphilides depends as a special predisposing factor upon the dyscrasic condition accruing in the active contagion stage; that the intoxication producing the dyscrasia and leading to immunity often is most severe in the period between |