spinal meningitis, which occurred sporadically in Munich, he had seen good results, as well as in serous spinal meningitis. It was surprising that in uremia, in spite of the high arterial pressure, only a few drops of fluid are to be found in the cerebrospinal sac. Dr. Lenhartz had done lumbar puncture in 15 cases, of which 3 were cerebro spinal meningitis. In several cases there was no result, although the needle undoubtedly entered the vertebral canal. In one case, ending fatally after two days, 80 c.c. of slightly sanguineous fluid escaped. The puncture was without any effect in this case on consciousness, pulse-rate, etc. Only once had he found tubercle bacilli in the fluid, and in another case the tuberculous nature was proved by inoculation experiments. In one instance, after the escape of 100 c.c., the patient grew worse. Prof. von Ziemssen said that in severe cases the patients will always die. Exceptions cannot disprove the rule. In many cases the favorable course was certainly to be ascribed to the puncture."

A Case of Melancholia Dependent upon Ethmoid Disease, and Cured by Intranasal Operation. -Bosworth (N. Y. Med. Jour., LXII, No. 15) The patient, who had passed through the hands of a large enough number of physicians to indicate a marked neurasthenic element in the case, remained for 10 years unrelieved from his mental symptoms until an operation on the nose opened up the ethmoid cells, which had been occluded by a growth. of myxomatous tissue, depending on a deviation of the septum and a projection of the left middle turbinated bone.

His improvement after this little operation was prompt, and he resumed business very shortly and has now remained well for four years.

Two Successful Operations for Traumatic Insanity; with Remarks.-Cale (N. Y. Med. Jour., LXVII, No. 15)

Case I.-Young man, without hereditary taint, always healthy until hit on head with a club. The wound suppurated for three months, finally healing. Mental symptoms, characteristic of epilepsy and moral insanity, developed four years later. At the operation, which was performed several years after the symptoms began, a small piece of bone was removed from the site of original injury. The bone was found depressed at this point, but the dura appeared normal. The improvement in the mental symptoms which followed the operation was rapid, complete, and permanent.

Case II.-Adult, male, always healthy until hit with brick on top of head. A maniacal condition immediately developed, lasting several days, which finally merged into a condition of headache, loss of vision, and insomnia. The acute mania would return on slight excitement. About six weeks after receipt of the injury an operation, similar to that. in Case I, was performed. He made a good recovery and has since been working at his trade.

The length of time which has elapsed since the operations-four and three years respectively-warrants the statement that both patients have been entirely cured.

This substance is described as a derivative of para-amidophenol, one atom of hydrogen being replaced by the radicle of amygdalic acid, and another atom of the same gas by carbonate of ethyl or methyl. It is a crystalline substance of a grayish color, barely soluble in water.

The author has found that amygdophenin, administered in the form of powders or tablets, in doses of 1 gme. (151⁄2 grn.) several times daily, possesses decided antipyretic, analgesic, and antirheumatic properties. The remedy was invariably well borne as long as the dose did not exceed 5 gme. (77 grn.) in the twenty-four hours; a daily dose of 6 gme. (92 grn.) sometimes produced slight vertigo and tinnitus aurium.

Boral and Cutol.-P. Koppel (Sem. méd., 1895, XV, p. ccxxx)

Boral and cutol have been briefly described on page 1382 of Vol. VII, and on page 36 of Vol. VIII, of THE BULLETIN.

The results of recent experiments conducted by the author seem to further show that boral (aluminum borotartrate) and cutol (aluminum) borotannate) are possessed of energetic astringent and bactericidal properties, while they exert no irritating action on the tissues.

He has employed boral in purulent otitis, both as a wash and for insufflation.

Cutol he has used more frequently than boral. In moist eczema, cutaneous wounds with copious secretion, fissures, chapping, and ulcers of divers origin, he first removes the scabs after having softened them with oil, and then applies the following ointment or paste :

Cutol, rendered soluble by the addition of tartaric acid, has been used by the author, in the form of a 10-per-cent. solution in glycerin, in the treatment of follicular tonsillitis and in endometritis with abundant leucorrhea, the solution being applied by means of a camel's-hair brush. The tonsillitis is said to quickly disappear under the influence of this treatment. In catarrhal endometritis the solution is applied to the os uteri by means of a cotton swab, introduced through the speculum. This solution presents the advantages over glycerite of tannin of being a more potent astringent and bactericide, and of not soiling the clothes.

Cutol..

Olive Oil.

Lanolin

Add:

3 gme. 2 gme. 25 gme. Carbolic Acid (liquef.). . . . . . . ... 6 drops The use of powders and ointments containing cutol, applied morning and evening to the affected parts, has given favorable results in the treatment of local hyperidrosis Wearing socks soaked in a 10-per-cent. solution of cutol, and then dried, has proved very efficacious in the treatment of piantar bromidrosis.

The author has also had success in treating frostbites and chapping of the hands by applying the following ointment:

Secondary Effects of Lactophenin.-F. Kölbl (Wien. med. Presse, 1895, XXXVI, p. 1591)

small doses of lactophenin sometimes unexpectedly cause symptoms of collapse. Women and childreu are said to be especially susceptible to the effects of this remedy.

Dr. K. states that he has employed lactophenin in 20 cases of typhoid fever, in which disease it had previously been reported to yield good results.

He observed that the remedy influenced favorably the general health of the patients. Small doses produced a certain euphoria, while appropriate doses caused a considerable fall in temperature. However the author did not observe that lactophenin possesses any specific action over typhoid fever, nor that the duration and course of the disease were at all influenced by it.

The author questions whether the remarkable remissions in temperature sometimes produced by lactophenin are not in reality due to a state of collapse. He advises that, in this disease particularly, lactophenin be administered cautiously, and only to adults.

III, p. 672)

Dr. K. now reports that two similar cases have come under his observation. Both cases were robust, young persons. One of these was suffering from muscular rheumatism, and had taken 1 gme. (15 grn.) of lactophénin three times daily. The pain abated somewhat, but on the sixth day the patient lost his appetite; and catarrhal icterus developed in its typical form.

After suspending the remedy, the icterus persisted for fully two weeks longer. In the mean time the pain increased, but yielded slowly to sodium salicylate.

In the second case lactophenin was being tried in trigeminal neuralgia. After the patient had taken the remedy-1 gme. (15 grn.) three times daily for five days, icterus set in, which lasted eight days. Dr. K. also calls attention to the fact that even

The author has found that the albuminoid substances precipitated by acetic acid from a decoction of dried thyroid glands possess no special properties, and that the really active substance contained in the thyroid gland remains in the liquid obtained after separation of the albuminoid substances. From this liquid he has obtained a crystalline, very hygroscopic body, which gives the majority of the characteristic reactions of alkaloids. Its chemical formula is said to be CH1NO5, and it appears to be a derivative from the guanidine series. It is soluble in water and in alcohol, the aqueous solution being neutral or faintly alkaline in reaction and yielding a precipitate on the addition of lead acetate or acetic acid.

Intravenous injections of this substance, for which he proposes the name of "thyroantitoxin," determine in animals the quckening of the pulse, which is characteristic of injections of thyroid extract, and

checks the convulsions in thyroidectomized animals. In animals into which this antitoxin is injected immediately after extirpation of the thyroid body, no convulsions occur. The action of this substance, however, is confined to the production of convulsions, and does not extend to the other symptoms of cachexia strumipriva. The animals ultimately die, because the natural antitoxic function of the thyroid gland is not supplied by thyroantitoxin.

Solution of Ammonium Valerianate.-O. Boulouthian (Union pharm., 1895, XXXVI, p. 491)

A preparation of ammonium valerianate much used in France, is that of Pierlot, which is said to be a solution of ammonium valerianate and extract of valerian in water. Valerianic acid and its salts are considered by many medical men to be practically devoid of antispasmodic properties; and the author believes that the therapeutical value of the above preparation is due to the extract of valerian it contains.

Dr. B. has endeavored to obtain a preparation of ammonium valerianate which should also represent all of the active principles of valerian root, and be less expensive than the above proprietary article. By proceeding in the following manner, he obtained a very satisfactory preparation :

Ammon. Valerianate (Cryst.)... 4
Distilled Water .....

gme.
60 gme.
Am. Carb. to neutralize... (2 to 2.5 gme.)
Tincture Valerian..

Fl. Ext. Valerian Filter !

30 gme. ΙΟ gme.

This preparation, the author says, is perfectly limpid, and contains neutral ammonium valerianate and all the active principles of valerian root; the alcohol in it assures permanence for a long time, and helps to keep it neutral.

Diphtheria Treated with Ferric Chloride.-N. Rosenthal (Therapeut. Monatsh., 1895, IX, p. 602)

The author reports that during the last few years he has employed ferric chloride in 271 cases of diphtheria, with a mortality of but 8.2 per cent., a result which, he claims, could not have been reached by any other mode of treatment.

He prescribes a 2-per-cent. solution of the remedy, using glycerin as a corrigent, and gives from a teaspoonful to a tablespoonful every hour, day and night, until the membranes are removed, After that the remedy may be administered less often, but care must be taken not to discontinue the treatment too soon, for it has been shown that the Löffler bacilli are to be found in the secretions of the pharynx a long time after the diphtheritic processes have disappeared.

When the diphtheritic patches are extensive, Dr. R. paints the affected spots with solution of ferric chloride, either in its pure form or diluted with an equal quantity of water or glycerin. The applications are made three times a day with a splinter of wood, at one end of which is wrapped some absorbent cotton. The swabs are burned after each application.

The cauterizations are especially beneficial in the case of nasal diphtheria, the author states For this purpose he introduces a tampon of cotton, saturated with the solution, into the nostrils by means of a probe, removes the latter and exerts pressure upon the nose to express the remedy from the tampon,

while at the same time closing the exterior orifice of the nostrils. A few such applications usually suffice to remove all growths of suspicous appearance, it is maintained. Dr. R. does not insist upon the patients taking much food and alcoholic beverage, as recommended by many; for, in this disease, the stomach often rebels against food, as is evidenced by the vomiting frequently occasioned by the ingestion of nourishment. As a last resort he has employed feeding per rectum.

Dr. R. states that, as ordinarily treated, pharyngeal diphtheria usually runs into the more dangerous laryngeal diphtheria, whereas, with the ferric chloride treatment he has always been able to prevent diphtheria of the pharynx from extending into the larynx.

Erysipelas Treated with Ichthyol.-M. Eberson (Wien. med. Presse, 1895, XXXVI, p. 1587)

In a lengthy article bearing on ichthyol and its action, the author confirms the reports extant regarding the antiseptic, reducing, and antiphlogistic properties of this remedy, and its efficacy in the treatment of various skin and women diseases. He then adds a report of a few cases that have come under his observation. He was called to see a boy suffering with facial erysipelas For two days the author followed the usual treatment, but without success. The boy then presented the following symptoms: Temperature, 39.3° C. (102.7° F.), nose much swollen; face red and bloated, the redness extending on both sides as far as the neck, and up as far as the scalp; headache and nausea. On the third day the author began the the following treatment: Application of a 30-per cent. solution of ichthyol in glycerin; application of ice; tampon of a 5-per-cent. ichthyol solution to the nose, and quinine internally. The next day the temperature was down to 37.5° C. (99.5° F.), and there was marked improvement every way. After three days of treatment the fever no longer existed, and the face had diminished one-half in size. Recovery thereupon quickly followed. After the first application of ichthyol the boy remarked that the tension of the skin and the pain were diminishing.

The second case reported is that of a 24-monthsold boy affected with erysipelas of the right side of the face; his temperature was 38.9° C. (102° F.). Dr. E. made an application with the ichthyol solution two days in succession; on the third day the author found that the child had recovered.

In a third instance the author treated a woman, over 70 years of age, afflicted with erysipelas of the leg, by means of ichthyol; she recovered after two days of treatment. A relapse occurred two months. later, but a repetition of the treatment brought about a cure.

The author had twice occasion to test the remedy on himself.

After the manual delivery of the after-birth in a woman suffering with leucorrhea, a redness and swelling developed on the author's right wrist. He at first applied but a simple bandage of absorbent cotton. The next day he observed that the redness had increased in size; there was a sensation of heat in the part affected, and of chilliness of the body. He then applied a 50-per-cent. solution of ichthyol in glycerin, which soon gave relief. A second application was made the following day, and recovery soon ensued. A few weeks afterward the eruption broke out anew on that spot. The same treatment was pursued, and complete cure thereby effected.

While making an autopsy the author was stung in the arm by a large fly that had fed on the cadaver. He at first paid no attention to this event, but, in a few hours, the part became inflamed, somewhat painful and swollen. He then applied a 50-per-cent. solution of ichthyol. On the second day the swelling and the pain had diminished, and on the third all symptoms disappeared.

Dr. E. considers ichthyol a specific against erysipelas. He employs a 50-per-cent. solution in glycerin for adults, and a 25-per-cent. solution with children.

These solutions he freely applies, with a bristle brush, in concentric rings, beginning about an inch from the edge of the inflamed skin, and finally painting the center several times.

Fer Cremol, a Hematinic.-(Pharm. Ztschr. f. Russl.) "Fer Cremol" is described as a new compound of iron, with the coloring matter of blood, obtained by the action of a dilute neutral iron-solution on a solution of blood. The acid set free in the process is neutralized with a dilute solution of an alkali carbonate. The whole process is carried on at a low temperature (about o deg. C.); and the precipitate obtained is washed, expressed, and dried.

Fer cremol is a brown, almost tasteless powder, which dissolves in feebly ammoniacal water with a nice red color, without leaving a residue; it contains 3 per cent. of iron. The dose is about 3 to 8 grn. (0.2 to 0.52 gme.) three times a day, after meals.

Fluorol.-Duclos (Pharm. Ztg., XL, p. 700) "Fluorol" is the name recently applied to sodium fluoride. This salt is highly recommended by the author as a substitute for mercuric chloride, silver nitrate, potassium permanganate, and formaldehyd, as an antifermentative. It is said to rapidly check bacterial fermentation, but not to exert an influence upon so-called chemical fermentation.

An advantage claimed for fluorol, by Dr. Lagrange, is that it does not coagulate albumin; thus, the bacteria are not protected from the action of the remedy by a coat of coagulated albumin.

It is said that injections of a 1:200 solution of fluorol are neither painful nor caustic, and that they produce no irritation whatever when applied to the mucous membranes, while they render the latter unfit for the propagation of micro-organisms.

Preservation of Chloroform.-L. Allain (Pharm. Jour., LV, p. 261)

The author claims to be able to preserve chloroform indefinitely by saturating it with sulphur. Chemically pure chloroform is taken, and the sulphur is prepared from ordinary sublimed sulphur by leaving it in contact with four times its weight of strong water of ammonia for twenty-four hours. It is then washed with distilled water until neutral to litmus, and placed in a stove regulated to a temperature of 40 deg. C. (104 deg. F.), where it remains for four days, after which it is further dried over sulphuric acid for fifteen days.

Purified chloroform exposed to direct sunlight gave a precipitate with silver-nitrate solution after about forty-eight hours, but underwent no change under similar conditions when previously saturated with sulphur, except that there was a deposit of insoluble sulphur. Specimens thus treated have been exposed to sunlight for four months without any alteration that could be detected by the usual reagents, and were found to cause perfectly normal anesthesia in men and the lower animals, without accident.

In diffused light the absence of one-thousandth part of its weight of sulphur preserved chloroform indefinitely in the presence of a great excess of oxygen.

No explanation of the phenomenon is given. It is intended to perform similar experiments with selenium and tellurium in place of sulphur.

Mercuric Chloride Injections in Syphilis.— Sprecher and Allgeyer (Brit. Med. Jour., 1895, No. 1818, p. 71)

These clinicians give the results of treatment with injections of mercuric chloride in 126 cases of syphilis-53 men and 73 women; 115 had secondary syphilis, and 11 tertiary. The mercurial was dissolved in water containing five or six times as much sodium chloride as sublimate; and of this solution about 1 c.c. (16 min.) was injected. The injection was usually made in the nates, etc., and was followed by local massage. In men from 0.02 to 0.05 gme. (1-3 to 3-4 grn.) were injected, in women smaller doses. The injections were repeated once a week, in some cases up to twelve weeks.

No abscess ever followed, but local discomfort, redness, and stiffness were not uncommon, especially in the women. Forty-seven were mercurializedthat is, suffered headache, nausea, epistaxis, fever, stomatitis (20 cases), intestinal disturbances (14 cases), nephritis (1). cases), nephritis (1). Some had dyspnea. Severe mercurialism occurred in five women: four or five hours after injection, stomatitis, colic, diarrhea, fever, and albuminuria appeared, and lasted off and on for ten days.

The syphilitic manifestations disappeared after treatment in 108 cases, and generally after three or four injections.

Women were rarely able to stand more than 0.03 gme. (grain), and 0.05 gme. (grn.) usually caused severe symptoms of mercurialism.

On the whole, the authors are not enthusiastic about the new method of treatment.

Action of Ephedrine.--E. Grahe (Ther. Monatsh., 1895, IX, p. 557)

Ephedrine is the alkaloid obtained from Ephedra vulgaris, var. Helvetica. The hydrochlorate of this alkaloid has already been alluded to in a previous volume of the BULLETIN as being a mydriatic of considerable power.

It occurs in colorless, hygroscopic needles, melting at about 210° C. (410° F.) easily soluble in water, less so in alcohol, and insoluble in ether.

The author states that experiments with ephedrine hydrochlorate, conducted by Professor Dogiel upon animals, gave the following results: Instillations of a 2-per-cent. solution of this salt into the conjunctival sac of the dog produced, within 15 to 20 minutes, a pronounced, though not a maximal, mydriasis lasting six hours. The same effect was produced by

instillations of this solution in a curarized cat.

As regards its action upon the system, the author states that small doses, administered per os, subcutaneously, or intravenously, occasion a temporary increase of blood-pressure, and retard the heartcontractions; the latter being at first strengthened, but subsequently weakened, owing to a paresis of the terminal filaments of the pneumogastric nerve, and perhaps also of the unstriated fibers of the heart itself. Larger doses cause a decrease of bloodpressure, in consequence of a diminution of vascular tone.

Paresis of the pneumogastric nerve is always produced, and, in intensity, is in direct proportion to

the degree of poisoning by the drug. Mydriasis, with slight loss of the power of accommodation and refraction, is also a constant phenomenon, induced principally by sympathetic irritation, but probably in part also by a slight paresis of the oculomotor nerve-endings in the sphincter iridis, and in part also by a paresis of the muscular fibers of the iris itself.

(Sem. méd.,

Ichthyol in Burns.-L. Leistikow 1895, XV, p. 487) An experience of six years has demonstrated to Dr. L. that, of the various remedies recommended in the treatment of burns, ichthyol gives by far the best results. This remedial agent rapidly calms the pain and subdues the congestion as well as the edema of the skin, not only in burns of the first degree, but also in those of the second degree, if, previous to making the applications, the blisters be punctured. In the latter case a new growth of epidermis immediately begins to form, while at the same time desquamation or detachment of the scabs that may exist takes place.

In burns of the first degree Dr. L. has recourse to applications of the following powder:

One to 2 c.C. (16 to 32 min.) of this liquid are injected into the neoplasm at intervals of from two days to a week.

In a case of epithelioma of the cheek, which recurred after operation and was accompanied by swelling of the glands of the region, Dr. H. states. that he obtained complete recovery by injections of Boudin's solution daily for several months. In the course of this treatment, however, the patient had two attacks of erysipelas, which may have exerted a curative effect on the neoplasm.

A woman under the care of Dr. Planel is also said to have been cured of a tumor of the breast by injections of arsenous acid.

These injections were resorted to in several other cases of recurrent cancer, with the result that the development of the tumor was manifestly retarded, and the general condition improved, in some patients; in others, however, they had no effect whatever.

Fatal Fat Embolism after Forcible Stretching of Both Knee-joints.-Ohrens (Centralblatt für Chir., No. 35, 1895)

In addition to the dangers of brisement forcé, which other observers have reported, the author reports a case of fat embolism which was observed at Bruns clinic. The case is of so much greater interest, because under limited force, which could not even be called brisement forcé, compression fracture of the femur and condyles of the tibia occurred. The contractions were previously removed by extension almost entirely. The autopsy revealed a high degree of osteoporosis. similar cases were reported by Wahusau and Colley. Such observations should lead to the limitation of brisement forcé, and to the greatest care in its performance.

Two

Certain Measures for the Prevention of Recurrence of Malignant Tumors after Extirpation. -(Medical Week, III, No. 43, p. 510)

A German surgeon, Dr. O. Hasse (Nordhausen), who has had occasion to operate on a large number of subjects suffering from cancer or sarcoma, has found that the reproduction of these neoplasms after extirpation may be prevented by the adoption of the following course:

damage the tumor to be operated upon, by a rough

"In the first place, care must be taken not to

examination. The injurious influence of rough handling on the growth and multiplication of malignant neoplasms is well known. Yet many surgeons do not in the least hesitate to press and knead such tumors in the course of their examination, and, as persons affected with malignant neoplasms, as a rule, consult several medical men before they can make up their minds to have recourse to surgical intervention, it is easy to understand the ill effects, in respect of the ultimate evolution of the tumors, resulting from the repeated mechanical irritation to which they are subjected. As a matter of fact, it is precisely among patients who have consulted a large number of practitioners that Dr. Hasse has most frequently met with post-operative recurrences; whereas, on the contrary, such patients who have been fortunate enough to undergo but few and cautious examinations are usually permanently cured.

"Another point of great importance in preventing the reproduction of the tumor is to prepare the patient for the operation by injecting, for several weeks, alcohol around the neoplasm. For this purpose Dr. Hasse employs a mixture of 30 parts. of proof spirit and 70 parts of distilled water, which is injected twice a week all around the tumor, as well as around the infiltrated glands when these are present. The quantity of alcohol injected each time varies according to the size of the tumor, the dose being sometimes as high as 20 c. c. These