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the flow comes on and abortion occurs. In these cases helonias, or preferably helonin, will tone up the uterus, and in a few cases under my care, has successfully carried the woman safely to the full term, much to the joy of all concerned.
In the tendency to cause abortion from uterine atony it closely resembles aletris. The opposite condition of irritable uterus, with spasmodic and expulsive action upon the slightest occasion owing to the extreme sensitiveness of the uterus, is found under viburnum and caulophyllum. There is a condition midway between these two classes, and the condition is best covered by such remedies as sabina, secale, ustilago, cimicifuga, etc.
Tanacetum.— As far back as I can remember, every housewife had a bed of tansy growing in her garden. If from any cause the menses failed to appear at the regular time, the patient was made to drink a cup of weak tansy tea, very hot, and some tansy leaves were put in a vessel, hot water poured over them, and the patient made to sit over this for half an hour. This generally had the desired effect.
What provings we have of this drug are unsatisfactory and not at all reliable. If a systematic proving were made of this remedy, I am certain that it would be found a valuable remedy in the prevention of miscarriage. I used the drug in the 1x dil. upon one case where there was quite a profuse flow, and threatened spasms, with perfect success. — Douglass, in Journ. Surg. Gyn. and Obs., July, '05.
ACCESSORY TREATMENT OF PNEUMONIA IN CHILDREN.
In adopting homeopathic principles, we do not give up any treatment that we know to be of use, and still feel perfectly free to use any means in our power; and while there may be some who, from their skill in the use of small doses, consider they may do without any palliatives, I must confess that I have not yet arrived at that perfection, and still consider that in cases of sudden collapse, from sudden fall of temperature, a hypodermic injection of strychnine is of great value, and look upon it as a palliative that will tide over a dangerous time. On this point Hahnemann gave expression to the following:
“I am not ignorant of the great value of palliatives. For sudden accidents that tend to run a rapid course they are not only quite sufficient, but even possess advantages, where aid must not be delayed an hour or even a minute.”
Another point in accessory treatment is the use of oxygen, and this we find of undoubted benefit, especially when cyanosis is a marked feature. Several cases have, I am sure, been pulled out of critical con
ditions by its use given for a short time at frequent intervals, about five or ten minutes, every hour.
On the importance of good nursing there is not much need to dwell, especially when we remember that 147 of the cases were under two years of age. Our cases have been thoroughly well nursed, and the way the charts which I have shown have been kept, entirely by the nurses, is an indication of the care they give. There are, however, a few points in the nursing to refer to.
Fresh air is much more important than a high temperature. The temperature of the ward is usually kept from 60° to 65o.
Baths. - The patients are always given a hot bath twice a day, at a temperature of 100° F.; but the baths are given more frequently if the temperature of the patient is over 104°. The duration of the bath is from ten to fifteen minutes; the patient is then taken out and wrapped in hot blankets. As many as six baths are sometimes given in twenty-four hours. Cold bathing is not found to be satisfactory: but in the case of hyperpyrexia ice sponging is used.
Diet.- Milk and barley water is given to infants; if unable to digest this, plain whey and cream are given.
Stimulants.– White wine whey is the stimulant most frequently used, and may be given alternately with the milk. Brandy well diluted with water is given, when the temperature drops suddenly and the pulse is found to be very weak. Strychnine is rarely used.
The position of the patients is important, and they should be supported with pillows, and not allowed to lie quite flat.
A steam kettle is brought into requisition when the breathing is dry and difficult, but not when there is any rattling of mucus.
Poultices are useful in some cases, but we find cotton wool jackets usually sufficient and less exhausting.– Moir, in Ilomeop. Revieu'.
THE OPEN TREATMENT OF BURNS. H. Sneve, St. Paul, Minn. (Journal A. M. A., July 1), advocates the open method in the treatment of burns, that is, the disuse of occlusive dressings and reliance on strict cleanliness and perfect drainage for the healing of the injured surfaces. The dangers in extensive burns are first, from shock; second, from toxemia ; third, from loss of function of absent skin covering: and fourth, from exhaustion. For shock, the first indication is to combat the vasomotor paresis, and the only drug at present to be recommended for this, he states, is adrenalin, cautiously administered: whiskey, morphin, strychnin, etc., are warned against as poisons to the susceptible and already overburdened nervous system. The symptomatic treatment of the resulting conditions is, he says, far better. To drive the blood out of the abdomen, he gives drinks and enemata of cold normal saline solution which add volume to the circulating medium ; chafes the hands and feet and applies local warmth to the extremities and especially to the nape of the neck. To meet the fall in body temperature, he uses the hot bath and maintains a high temperature in the room. Finally, to give the heart more fluid to work on, he uses saline infusion or hypodermoclysis. Toxemia, he believes, is directly favored by occlusive dressings which retain the discharges and prevent perfect drainage. The dangers of air-infection are, Sneve considers, negligible, the surface is at first well sterilized by heat, and later, the granulations and crusts protect against invasion. It is to toxemia that he attributes the sudden deaths occurring after severe burns, and the importance of insuring free escape of the secretions is emphasized. The functional activity of the uninjured skin is also of the greatest importance and for this reason the continuous full bath of Hebra is not the best treatment of burns, as the skin works best in its natural medium, the air. Cold spongings and frictions are perhaps the best stimulants to skin function and should be frequently practiced in treating burns. Supplying artificiai heat is another important indication, especially during the first few weeks of a severe burn. Exhaustion from constant discharges from burned surfaces is best met by grafting skin as soon as possible in those that have suffered a burn of third degree. Nourishing diet and other supporting measures naturally suggest themselves. In his summary, Sneve advises against any positive prognosis of burns in the beginning. He remarks on the slight amount of pain in cases treated by the open method. When this is present, it is best relieved by morphin, but he advises giving as little of this as possible and none during shock. Another astonishing feature of the open treatment is the favorable character of the cicatrices which are smooth, flexible and skinlike. He says: First, treat the shock as indicated above. Second, control the pain as necessary and keep everything from contact with the burned areas. Third, keep the patient surgically clean. Ordinary surgical principles govern here as elsewhere; bichlorid of mercury, carbolic acid and other strong antisepties are to be avoided when possible because they are such powerful cell poisons that toxic effects, both general and local, are to be feared; the delicate covering of granulations will not stand escharotic action without interfering with the production of smooth, flexible scars. Fourth, give frequent cold sponge baths to the sound skin with frictions, and keep room temperaTure high. Fifth, cut away all blisters, cleanse with normal salt soluition, dry thoroughly, and dust all second degree burns with stearate of zinc, carefully wiping away serous exudate until dry, brown, adherent crusts are formed. Sixth, leave third degree burns exposed without powder and keep surface clean until granulations are ready for skin grafting. Seventh, to maintain and to preserve function, body and limbs should be exercised as much as possible; the eschars of burns to fourth degree should be removed when nature so indicates and amputation should be performed when needed.
Books of the Month
PHYSICAL DIAGNOSIS. By Richard C. Cabot, M. D., Instructor in
Medicine in Harvard University. Third Edition, enlarged and revised. With five plates and two hundred and forty figures in the text. 577 pages. Cloth, $3.00. Wm. Wood & Co., New York.
This book presents an account of the diagnostic methods and processes needed by competent practitioners of the present day. It makes no attempt to describe technical methods which are in dispute among diagnosticians, and contains only such matter as is put to daily use by the author. It is a valuable, practical and interesting book.
AMERICAN EDITION OF NOTHNAGEL'S PRACTICE. MALARIA, INFLUENZA,
AND DENGUE. By Dr. J. Mannaberg, of Vienna, and Dr. O. Leichtenstern, of Cologne. Entire volume edited, with additions, by Ronald Ross, F. R. C. S., F. R. S., Professor of Tropical Medicine, University of Liverpool; J. W. W. Stephens, M. D., D. P. H., Walter Myers Lecturer in Tropical Medicine, University of Liverpool; and Albert S. Gruenbaum, F. R. C. P., Professor of Experimental Medicine, University of Liverpool. Octavo volume of 769 pages, fully illustrated including eight full-page plates. Philadelphia and London: W. B. Saunders & Company, 1905. Cloth, $5.00 net; Half Morocco, $6.00 net.
This volume gives an exhaustive study of three diseases, two of which are very common in this country. Like most of the German works it shows thoroughness and careful painstaking investigation. The untiring labor of the editors in preparing this work for the English-speaking market is evidenced on almost every page by the lengthy and valuable editorial interpolations. It is a most excellent book of reference.
HUMAN PHYSIOLOGY. Prepared with Special Reference to Students of
Medicine. By Joseph H. Raymond, A. M., M. D., Professor of Physiology and Hygiene, Long Island College Hospital, New York City. Third edition, thoroughly revised. Octavo volume of 687 pages, containing 444 illustrations, some in colors, and four fullpage lithographic plates. Philadelphia and London: W. B. Saunders & Company, 1905. Cloth, $3.50 net.
It is evident that in revising his excellent work for the new third edition, Dr. Raymond spared no labor to bring it up to present-day knowledge. Every page shows evidence of his careful revision, and in that portion devoted to the physiology of nutrition the author has profitably availed himself of Chittenden's valuable contributions to the subject. Besides more fully elaborating many topics previously discussed in the old edition, the author has introduced a number of new subjects, among which are the Influences of Alcoholic Fluids on the Excretion of C'ric Acid, Hemolysis and Bacteriolysis, and Ovarian and Abdominal Pregnancy. It would be difficult to find another volume of the same size containing so much up to date and accurate information.
AMERICAN EDITION OF NOTHNAGEL'S PRACTICE. DISEASES OF THE
SPLEEN, AND HEMORRHAGIC DISEASES. By Drs. H. Senator and M. Litten, of Berlin. Edited, with additions, by James B. Herrick, M. D., Professor of Medicine in Rush Medical College, Chicago. Octavo of 816 pages, illustrated. Philadelphia and London: W. B. Saunders & Company, 1905. Cloth, $5.00 net; Half Morocco, $6.00 net.
This, the eleventh volume of Saunder's American edition of Nothnagel's Practice, is in every way the equal of those which have preceded it. It represents the acme of knowledge on the subjects embraced.
Professor Senator's clear style, systematic arrangement of facts, and logical reasoning make his articles on the Kidney indispensable to the practitioner. The editor, Dr. Herrick, has enlarged on certain points whenever necessary, especially regarding treatment, diagnosis, urinary analysis, etc., so as to increase the value of the work to the general practitioner. He has also added articles on Cryoscopy and Phloridzin Glycosuria.
The sections on the Spleen and the Hemorrhagic Diseases were written by Professor Litten, whose pioneer work in these fields is widely known. The articles on the Mosquito and its relation to Malaria, on Splenic Anemia, on Congenital Icterus with Splenomegaly, and on the X-rays in the treatment of Leukemia have been brought down to date by the editor. Indeed, the editor's interpolations add