THOMAS H. HAWKINS, A.M., M.D., Editor and Publisher. Henry O. Marcy, M.D., Boston. COLLABORATORS: Thaddeus A. Reamy, M.D., Cincinnati. Joseph Price, M, D., Philadelphia. Thomas B. Eastman, M.D., Indianapolis, Ind. S. H. Pinkerton, M.D., Salt Lake City Subscriptions, $1.00 per year in advance; Single Copies. 10 cents. Address all Communications to Denver Medical Times, 1740 Welton Street, Denver, Colo. We will at all times be glad to give space to well written articles or items of interest to the profession. [Entered at the Postoffice of Denver, Colorado, as mail matter of the Second Class.] EDITORIAL DEPARTMENT CARDIOVASCULAR WEAKNESS OF FEVERS. Stengel concludes that the pathology of this condition is connected largely with vasomotor depression, as the older writers held, and less with mechanical factors in the heart and vessels. In the management of heart weakness during infectious diseases, he employs strychnine with alcohol (not to exceed six or eight ounces. of good whiskey or brandy in 24 hours). When the circulation requires additional support, particularly when nervous symptoms are prominent, he has found camphorated oil (one grain of camphor in fifteen minims of sterile olive oil) by hypodermic injection most valuable. He frequently gives a grain or two of camphor in this way every second or third hour for several days in succession. He has come to use adrenalin solution in these cases (30 minims in a half pint or pint of normal salt solution subcutaneously or intravenously) only when an acute emergency, such as collapse from hemorrhage or perforation in typhoid fever, has been the indication for prompt support. Digitalis and strophanthus are far less satisfactory in the relief of the cardiac weakness of fever than in the treatment of valvular disease. The cold bath and its substitutes act chiefly as therapeutic agents in reducing the tendency to excessive weakness and in mitigating the nervous symptoms of fever. Generally speaking, the principal indications for cardiac stimulation in infectious diseases are alterations in the apex beat (more diffuse and wavy) the change in the character of the first heart sound (more valvular; sometimes blowing at base) and the depression of the systolic pressure at the wrist. Time and care alone can effect a complete restitution of the heart muscle and other tissues. For this reason, it is best, whenever possible, to forbid an individual just recovering from an infectious disease from resuming his occupation for a considerable period of time. When, despite our efforts, myocardial weakness is developing during convalescence, thermal baths, massage, and the use of arsenic, strychnine and phosphorus are advantageous. AIR. The atmosphere is a boundless source of life and a medium of death. Fresh air and plenty of it is absolutely essential to the maintenance of health. Historic examples of the effects of insufficient air are the "Black Hole" of Calcutta, in which 123 out of 146 British prisoners perished in a single night; and the 300 captured Germans, who after the battle of Austerlitz were crowded into a small prison with the result that 140 of them died that day and night. It is said that 61 societies in the boroughs of Bronx and Manhattan are interested in fresh air and summer outings for the poor. Vitiation of the air is noticed by the sense of smell when the carbon dioxid from respiration reaches .6 pro mille, and this limit should never be exceeded. To meet such sanitary requirements an adult individual at rest should be supplied with 3000 cubic feet of fresh air per hour. The air in a living room can hardly be changed throughout with comfort more than three times in an hour; hence each adult person ought to have at least 1000 cubic feet of room space. Account must also be taken of the products of combustion, a 16-candle power kerosene light giving off five times, and the same intensity of burning gas three times, as much carbon dioxid in an hour as is exhaled in the same time by a man. The most dangerous vitiation of the respired air, except specific germs, is from the decomposition of organic matter, namely: ammonia, amins, sulphur compounds, ptomains and leucomains. Chronic poisoning by these and by excess of carbon dioxid, through deficient ventilation, is marked by morning drowsiness and headache, nausea, malnutrition, anemia and debility. Subjects of this common form of poisoning are particularly suscepti ble to infection. The long continued inhalation of drain and sewer air produces gradual loss of health, anemia, fever, lassitude, headache, sore throat, vomiting and diarrhea. Acute mephitic poisoning from open, foul drains and cesspools is marked by sudden, severe vomiting and purging, headache, prostration and sometimes partial asphyxia. Up till 1846 the mortality of the British army, crowded in ill-ventilated barracks, was 11.9 per thousand. As more space was allowed to each man, this mortality fell to 2.3 per thousand in 1870, and still lower since that time. The relative death rate from consumption in prison is said to have been formerly about four times that among the free population. The regular practice of deep and full respiration in the erect posture is a highly important factor in the prevention of pulmonary disease. The chest may be further strengthened by daily ablutions with cold salt water or the shower bath, always taking care on drying to rub with the towel until reaction takes place. SUNSHINE. Photographic comparisons prove that the light on a bright day is 18,000 times stronger at the seashore, and 5,000 times as strong on the sunny side of a street as in the ordinary shaded and curtained rooms of a city home. Sunlight is as essential to human beings as it is to plants. Both grow pale and weakly for want of it The chlorophyl of grass and leaves and the hemoglobin of the blood are increased by exposure to the sun's rays. Sunlight is actively germicidal. jects infected with the bacillus pestis According to Rosenau, ob may be sufficiently disin fected on the surface by exposing them all day to a bright sun, providing the temperature is above 30°. Tubercle bacilli are destroyed by direct sunshine in three or four hours. The virus of smallpox is quite resistant to the solar rays. REST. Every living thing needs periodic rest. The healthy human infant should sleep twenty out of twenty-four hours. The adult in his prime requires at least seven hours of slumber. Old people are normally light and short sleepers. When a person cannot sleep well, the cause of the insomnia should be sought out very carefully. Hypnotic drugs ought hardly ever to be resorted to, and then only temporarily. Regular hours, a light evening meal and relaxation of mind and body favor sound and normal sleep. Sufficient waking rest and harmless recreation prolong life and render it better and happier. Physicians particularly need vacation, to prevent nervous breakdown. They frequently and advantageously combine science and pleasure by attending medical conventions in other cities. Rest is especially indicated to prevent dangerous complications in typhoid fever, and as prophylaxis against threatening tuberculosis. It is indeed nature's sovereign method of cure. Pyrosis of Pregnancy.--James H. Etheridge gives sodium bicarbonate or calcined magnesia after meals, or effervescing alkaline mineral waters with meals; also half-dram doses of aromatic spirit of ammonia. It is important to regulate the bowels. Podophyllin in Helminthiasis.-Neumann (quoted in Practical Medicine Series) reports experiences and experiments which show that podophyllin has a specific action on intestinal epithelium, which interferes with the ankylostoma clinging to it. The parasite is thus easily dislodged by male fern after administration of podophyllin. Gastric Ulcer.-Van Valzah and Nisbet advise restriction to a milk diet for a time. If the hyperchlorhydria is reflex, keep stomach empty for 24 hours. If due to associated hypersthenic gastritis, give alkalies (sodium bicarbonate with magnesia or chalk) in large doses at end of each feeding. Silver nitrate, to grain in water every morning twenty minutes before first feeding, is also very useful in hypersthenic cases. EDITORIAL ITEMS. Fourth Pan-American Medical Congress. Dr. Rudolph Matas, of New Orleans, Secretary of Section of General Surgery for the United States, informs us that an arrangement with the United Fruit Company has been perfected by which a steamer of this line will leave New Orleans for Colon on Wednesday, December, 28th, 1904, at 10 a. m. (instead of Friday, December, 30th, at 11 a. m. as previously announced) which will reach Colon (Panama) on Monday, January, 2nd, 1905, the opening day of the Congress. In view of the facilities offered to reach Panama via New Orleans it is expected that many will choose this route, and those who intend to do so will please forward their names to Dr. R. Matas, Secretary of Section of General Surgery, No. 2255 St. Charles Avenue, New Orleans, La., not later than December 22nd, 1904. Narkotil. Methyl-ethylene bichloride is a new general an esthetic. Pyrolin. This disinfectant consists essentially of magne sium acetate. Novozon. This is a mixture of magnesium peroxide and carbonate. Menopausal Flatulence. For this symptom Ringer states that eucalyptol is the remedy. Vitalin. This is the name given to a disinfectant mixture of resin oil and resin soap. Flatulence of Pregnancy. Ringer employs sodium sulphocarbolate, five to fifteen grains after meals. Intestinal Dyspepsia with Flatulence. Potter states that in these cases salophen is used with decided benefit. For Acid Dyspepsia. Ringer directs to drink a tumbler of hot water two or three times a day midway between meals. For Gastrosuccorrhea. W. H. Allchin (International Clinics) has found distinct benefit from atropine or belladonna. Stomach Flatulence and Acidity. Ringer gives one or two |