with vomiting. On arrival she was relieved and resting quietly. I accused them of imprudence in her diet, but they claimed they had not violated my instructions on that line. Two days later I was sent for again, but being absent my neighbor, Dr. Holcombe answered the call, and found her in like paroxysm, he remaining with her all night, paroxysms occurring at intervals, bowels acting sufficiently. I saw her again at 7 P. M. and thought her case entirely hopeless. She was vomiting genuine focal matter, her bowels having moved sufficiently up to noon, paroxysms would occur at intervals, bowels would knot up apparently as hard as a rubber ball. I suspicioned an obstruction in the intestinal tract from reversed peristaltic action, and made frequent attempts to move bowels by enema without satisfactory results. She was unable to raise her head off the pillow, pulse indistinct. I used strychnia and digitalis hyperdermically, quinine and milk per rectum, and gave her one grain of calomel every two hours until four grains were given, and to my surprise she retained the first dose, and there was no repetition of cramp or vomiting. Bowels were evacuated next day by enema, and she started slowly but surely on the road to recovery again.

I omit my treatment in this case of fever, as the profession is familiar with the very few drugs required in its treatment. In the vomiting I used oxalate of cerium, bismuth sub. nitrate, creosote, ingluvin, hot fomentations, poultices, counter irritation by blistering, strychnia and morphine hyperdermically. Patient having never menstruated before nor since, what could have caused this leucorrhoea? Was it of reflex character, from irritated and ulcerative condition of the intestinal tract? Or is it possible that typhoid bacilli could have infected the vagina, thus causing the flow, though hygienic measures and cleanliness were strictly guarded by the hand of the anxious and devoted mother.

What per cent. of reversed peristalsis recover? I saw a case in consultation, during my first year's practice, resulting from acute gastro-enteritis, terminating fatally; patient vomited castor oil given by enema.

Abstracts.

THE TREATMENT OF ENTERITIS WITH
XEROFORM.

In order to test the efficacy of the drug, Dr. Giovanni Petrucci, of the University Clinic of Parma, has treated about forty cases, mostly of acute catarrhal enteritis, with Xeroform alone. The dosage was 0.35 to 0.5 gram (51⁄44 to 72 grains) in wafers to adults, and 0.1 to 0.25 gram (11⁄2 to 334 grains) in gum emulsion for children, at about three hourly intervals. The remedy was always well borne even by individuals who were greatly weakened by age or disease. There was no noticeable by-effects. In two cases only there was a very slight and transitory nausea immediately after ingestion of the drug. Digestion was undisturbed. Pulse, respiration, and urine remained normal; the fæces became dark brown. The history of a few of the specially severe cases is as follows:

1. Teresa F., 35. Had had enteritis for eight months. It began as a violent diarrhoea, followed by the passage of mucus and blood; pain was marked. Bismuth, opium, astringent injections, etc., did her no good. The pain and diarrhoea returned continually after short intervals of betterment. At Petrucci's first examination, at the beginning of April, he found the patient very badly nourished and weak. The abdomen was tender everywhere, but especially upon the right side. No fever and no tubercular affection. Urine normal. Xeroform, 0.35 gram (54 grains) every three hours was ordered. Next day the dose was increased to 0.4 gram (6 grains). On the third day there was slight improvement, less abdominal tenderness, and more infrequent stools. Meteorism and borborigmi had almost entirely disappeared in a week. She had two stools daily, and there was no mucus in them. Strength and appetite returned rapidly, and after

*Abstracted from Rendiconti del l'Association Medico-Chirurgica di Parma, No. 8, 1900.

two weeks' treatment she was discharged entirely cured. The fæces were normal, and all the symptoms had disappeared.

2. Beatrice M., 37. Enteritis for three months; great weakness, anorexia, coated tongue, acid eructations. Frequent diarrhoeal stools containing mucus and blood, and great tenesmus. Xeroform, 0.3 gram (42 grains) ordered at intervals of three or four hours. There was remarkable improvement at once; and after thirty doses the patient was entirely cured.

3. Catterina P., 57. Weakly constitution. Colic, vomiting, and diarrhoea containing undigested food; cramps of the extremities. Treatment: Xeroform 2.5 grams (372 grains) divided into eight wafers. Cure in two days.

4. Emilia C., 8. Good constitution. Acute intestinal catarrh since three days; four to five daily diarrhœal stools, violent bellyache, pronounced meteorism. Directions: 1.2 grams (18 grains) of Xeroform divided into six wafers. Cure in one day.

5. Adelaide C., 49. Acute enteritis since three days. Numerous diarrhoeal stools containing mucus and blood; much tenesmus, violent thirst. Directions: 3.5 grams (521⁄2 grains) of Xeroform in ten wafers. Improvement by the second day, cure by the third.

6. Evaristo G., 50. Weak; has suffered repeatedly from malaria. Acute enteritis since two days; remnants of food, mucus and blood in stools; nausea, vomiting, and violent abdominal pain. Ordered 3 grams (45 grains) of Xeroform in nine wafers. Improvement by the second day; cure by the fourth, the patient returning to work.

7. Giovanni G., 69. Has scurvy; numerous extensive cutaneous hemorrhages and oedema of left foot. Violent diarrhoea and abdominal pain since two days. Directions: 2.5 grams (371⁄2 grains) of Xeroform in six wafers. The diarrhoea was cured in one day.

8. Giuseppe D., 4. For several months has had enteritis; abundant diarrhoea with mucus aud blood. Has been treated with bismuth and chalk without result. Ordered 1.5 grams (222 grains) of Xeroform in ten wafers, Cure in three days.

9. Maria B., 9. Acute enteritis for three days with violent abdominal pain, and four to five passages daily. Ordered 0.5 gram (71⁄2 grains) of Xeroform in six wafers. The pains diminished after the first three doses; cure was complete on the first day.

10. Dusolina B., 30. Acute enteritis, with mucus in the stools. Treatment: Three grams (45 grains) of Xeroform in ten wafers; cure in two days.

11. Amilcare, S., 19. Delicate. Has an abdominal disturbance for some time. Diarrhoea, pains, anorexia, great weakness. Treatment: Xeroform, 2 grams (30 grains) in eight wafers. The pains diminished on the second day; and both they and the diarrhoea entirely disappeared upon the third.

12. Dina, T., 24. Markedly anæmic; five months gravid. Since several days abdominal pain and diarrhea; fæces contain undigested food. Was given iron and Xeroform, 2.5 grams (371⁄2 grains) in six wafers. The remedy was well borne, although digestion was greatly impaired. Cure after two days' treatment.

13. Ferdinand B., 61. Suffers from pellagra since several years. Enteritis during the last five months; four to six daily passages containing undigested food, mucus, and blood. Abdominal pain and borborigmi. Has taken all the usual remedies; bismuth, Dover's powder, tannin, etc., without effect. Treatment: Xeroform, 2 grams (30) grains) in five waters; then 3 grams (45 grains) in six wafers. On the following day the abdominal pains and rumblings had almost entirely disappeared. The diarrhoea persisted, though in less intensity. Mucus and blood disappeared from the stools. The Xeroform was continued for several days, but without better result.

These results need but short commentary. The complete tolerance of the remedy, its absolute innocuousness, and its prompt action are apparent. It is readily intelligible that Xeroform, attacking the cause of the diarrhoea, rapidly relieves its symptoms, meteorism, colic, etc., so that special remedies for that purpose are unnecessary. In acute cases, where its bactercide action is more especially marked, it acts more rapidly than in chronic ones.

In the chronic forms the infective symptoms are less marked, and the slower astringent effects of the remedy upon the inflamed mucosa are evident.

Dr. Petrucci concludes that Xeroform is a most excellent remedy for the diarrhoeas of acute enteritis; that it is a therapeutic agent which answers all the clinical requirements of an astringent and disinfectant; that it acts upon the intestinal canal alone; and that it is well borne and has no harmful by-effects.

Selections.

BLOODLETTING AND SAline TranFUSION.-At a recent meeting of the Paris Academy of Medicine, M. Reynaud (Medical Press, Dec. 12, 1900,) said that in grave affections (infectious and intoxicating), besides the usual indication, which consists in attacking directly the cause of the malady, there exists another, not less important, which is to remove from the organism the greatest amount possible of poisons (in acting both on kidneys and the blood), and to render them less dangerous in diluting them in the blood.

Bloodletting removes from the blood a large number of toxins; done with moderation, it gives fulness and strength to the pulse, facilitates the working of the heart, restores to the capillaries their contractile tone, and at the same time it favors the gaseous exchanges, by reason of the greater activity it gives to nutrition. But that action, frequently heroic, of bloodletting, is only temporary; the toxic liquids of the organism are not slow to renew the mass of the blood; besides, as Barrie showed, diuresis is a little diminished by reason of the lowering of the vascular pressure.

By hypodermic saline injections the tension is raised and the diuresis increased, while the anatomical elements are stimulated, increasing thus the means of defense of the organism. The amount of blood drawn might be