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less poisonous and irritating than cocain. Alexander reports eleven cases in which the mastoid was opened under administration of Schleich's local anesthesia, in six of the cases slight headache and vomiting followed the operation, but it is doubtful whether these symptoms were due to Schleich's solution or the result of the concussion. The operation is considerably prolonged by the use of local anesthesia. Whenever possible general anesthesia should be used.

DEPARTMENT OF INTERNAL MEDICINE.

BY O. E. LADEMANN, M. D.

ST. LOUIS.

A Case of Acute Miliary Tuberculosis Following an Abortion. (M. Westenhoeffer, Deutsche Med. Wochenschrift, 1903, M. 13.) A women with a chronic apex tuberculosis, otherwise healthy, a condition resulted simulating the sepsis following an abortion. Post mortem revealed a diffuse tuberculosis of the general organism.

A Supra-phrenic Abscess.-(H. Nothnagel, Gesellschaft fur innere Medizin in Wien Mai 14, 1903. )-Demonstration of an interesting anatomical preparation of a supra-phrenic abscess resulting from a case of tonsillitis with the following explanation. The formation of a secondary abscess near the base of the right lung terminating in a large supra-diaphragmatic abscess with pulmonary emboli; the latter by means of the vena azygos, vena cava superior, through the heart into the pulmonary arteries.

Paralysis of the Recurrent Laryngeal Nerve in a Mitral Stenosis.— (Hofbauer, Wiener klin. Wochenschrift, 1902, M. 41.)-Although such cases have been reported, it is disputed as to the cause. Ortner being of the opinion that the paralysis is due to pressure on the nerve by the dilated left auricle, where as Krauss describes it as being due to the ligamentum Botalli crossing the nerve exerting a pressure on it. The case of the author speaks in favor of the latter, as the husky voice manifested itself with the other early symptoms of a cardiac lesion. The alteration in the voice being most pronounced when the patient leaned forward or lying on the left side.

Aneurism of the Arch of the Aorta in a Child. (A. C. Jordan, Lancet, February, 1903.)-A boy 63 years old, who since his earliest days had a double otitis media. The boy suddenly died during an attack of some febrile disease, the symptoms of which were headache, vomiting and a swelling of one knee, the latter disappearing spontaneously before death. The necropsy revealed a saccular aneurism of the ascending portion of the arch of the aorta which had perforated into the pericardial sac with otherwise perfectly intact arterial walls and valves of the heart. As etiology the author gives a localized septic aortitis, possibly the result of a small septic embolus which had lodged in one of the vasa vasorum.

Decapsulation of the Kidneys.-(Johnson, Annals of Surgery, April, 1903.) From experiments conducted on dogs the author concludes that decapsulating the kidneys does not influence the circulation of those organs any, as claimed by Edeboles. Johnson is very skeptical as to the published results of the mentioned author, as among them are cases of floating kidney otherwise in a healthy condition. Edeboles in his publication also speaks of unilateral occurrence of Bright's disease, which has never satisfactorily been proven to exist and, finally there is not a single case where a cure has lasted any length of time.

Paroxysmal Hematoporphyrinurie. (Pal, Centralblatt fur innere Med. 1903 M. 25.)-An individual, age 66, with a luetic history, a dilated and hypertrophied left ventricle with an accentuated second aortic sound and a slight blowing systolic murmur, after every prolonged exposure or chilling of the body experienced pain in the abdomen and right lumbar region. The urine for the next twelve to twenty-four hours was of a black color, containing serum albumin, casts and a large quantity of hematoporphyrin. As hemaglobin and blood corpuscles were absent, the color of the urine was due to the increased hemato-porphyrin. The clinical picture resembled that of a paroxysmal hemoglobinurie. It is possible that syphilis played a role.

The Widal Reaction in an Abscess of the Liver. (Megele, Meunchner Med. Wochenschrift, 1903, M. 14.)-Though the symptoms did not speak in favor of typhoid, and the autopsy absolutely negative, the Widal serum reaction was positive in a dilution of 1:40 and 1:100 with a twelvehour bouillon culture. Shortly before death the patient became icteric, suggesting a hepatic lesion, the clinical picture being one of sepsis. Necropsy a large abscess of the liver, spleen enlarged, lymphatic glands swollen, intestines negative. The intestinal lesions in typhoid fever may be absent, as Chiari has shown in five cases, but was able in each case to cultivate the typhoid bacillus from the spleen and mesenterial glands. Cultures in the author's cases were made from the abscess and mesenterial glands, showing staphylococcus pyogenes aurens in pure cultures.

Two Cases of Aneurism of the Hepatic Artery.-(A. Sommers, Prager med. Wochenschrift, 1902, page 469.)—In addition to the eight cases of this rare occurrence found in literature. Sommers reports two cases which he observed in the Grazer clinic. In one case the patient had severe attacks of pain in the abdomen, intestinal hemorrhages and a continuous icterus. The aneurism was found to compress the bile ducts with a perforation into the ductus choledochus. The other case presenting intestinal hemorrhages and abdominal pain, but no icterus. In this case there was an aneurism of the gastro-duodenal artery pressing on the pancreas and duodenum with a perforation into the latter. Although the diagnosis of an aneurism of the hepatic artery has never been made during life, the writer lays importance on pain in the right hypochondriac and epigastric region, with intermittent icterus and hemorrhages of the upper portion of the intestinal tract.

Ascaries Lumbricoides Causing an Acute Ileus.- (M. Schulhof, Muenchner med. Wochenschrift, 1903, m. 24.)-A woman 47 years old, having passed no flatus or stool for two days previous to entering the hospital. A high enema gave a negative result, vomiting increased with beginning signs of collapse. A laparotomy showed the greater portion of the small intestine collapsed with increased peristalsis through which spindleshaped bodies could be felt. The gall-bladder was found to be enlarged, resistent and adherent to the hepatic flexure, giving one the impression as if it were malignant. The operator being convinced that there was no occlusion of the intestines began to close the abdomen, when suddenly the patient vomited two ascaries. The following day two more were vomited followed two hours later by a movement of the bowels containing three round worms, the stools since being regular. In all a total of twenty-two worms were passed.

Dispragia Intermittens Angio Sclerotica Intestinalis (Angio Sclerosis of the Intestinal Arteries.)-(Ortner, Wienerklin. Wochenschrift, 1902, M. 44.)—An interesting case in a man 55 years old, who two or three hours after a large meal quite regularly experienced intense burning pain in the abdomen, particularly about the umbilicus and ileocecal region, associated with a choking sensation, superficial breathing, eructations of gas and a feeling of impending death. During the attack which lasted several hours, the ascending and transverse colon could be seen and imparted a moderately soft and elastic sensation to the palpating hand. The patient died of a septic peritonitis two days after an exploratory laparotomy. The postmorten showed sclerotic changes in the thoracic and abdominal aorta. The author regards this condition as analagous with intermittent clandication and attributes the chain of symptoms to arterial spasms in the pathologically altered vessels.

Aneurism of the Thoracic Aorta Perforating into the Pleural Cavity. -(Verhoogen, Journ. de med. de Bruxelles, 1902, No. 41.)-A cigarmaker, age 60, with a tubercular affection of both apices, for the past two years subject to paroxysms of intense pain in the left lumbar region, the attacks gradually increasing in severity with cramps in both legs and a paraesthesia of the soles of the feet. After an observation of some time the cause of this chain of symptoms was accounted for a pulsating tumor synchronous with the heart's action, about the size of a man's fist, appeared to the left of the spinal column. A pleuritic effusion next began to manifest itself, which necessitated frequent aspirations. The patient suddenly died in an attack of syncopy, having previously expectorated blood. Autopsy: Aneurism of the thoracic aorta about the size of a child's head situated between the 5th and 9th dorsal vertebrae, adherent to the left pleura which it perforated through an opening the size of two fingers. Between the 4th and 7th dorsal vertebrae there was an extensive pressure necrosis.

DEPARTMENT OF THERAPEUTICS.

BY W. T. HIRSCHI, M. D.

ST. LOUIS.

In

Saliva as a Therapeutic Agent.—(Dr. J. Bergmann, Die Therapie der Gegenwart, May, 1903.)-The author mentions four pathologic processes in which saliva is of decided benefit: 1. Throat affections, e. g., simple catarrhal tonsillitis, scarlatinal and diphtheritic affections. these affections saliva acts as a hygienic and therapeutic agent. The former by keeping mucus membrane clean, the latter by moistening the inflamed areas. 2. Gastric Superacidity.-The alkaline saliva neutralizes the acids of the stomach. The salivary flow can be decidedly increased by permitting the patient to chew some substance, e. g., gum. Ewald has shown that it requires 12 grams of sodium bicarbonate to neutralize .3 per cent (3 per mille) of HCl, and Wagner proved that this would liberate a large amount of sodium chloride which is a gastric irritant, and would further increase flow of HCl. 3. Obesity. By removing liquids from the body the weight of the body can be reduced. The individual must chew some substance and expectorate the saliva produced. This method is less depressing to the circulation than is diaphoresis and reduces the appetite at the same time. 4. Edema and Ascites.-Leube demonstrated that through chewing and expectorating the saliva 400 to 1000 ccm. of fluid can be removed in one day. He considers this method more efficient than using drugs to increase the salivary flow.

Experience with Boracic Acid in the Treatment of Obesity. (D. K. Seng, Berlin, Die Therapie der Gegenwart, April, 1903.)—The author reports six cases (all women) which he treated with sodium biborate or boracic acid, the dosage in no case exceeding 2 grams per day. One patient after fourteen days treatment complained of loss of appetite, nausea and vomiting, and then discontinued the treatment. The second patient, age 50 years, weight 207 lbs., took 0.5 gram boracic acid twice daily,during four weeks, when she also discontinued the treatment, as she did not reduce in weight. The diet consisted of 1800 calories solids, and 1000 c.c. liquids, including one bottle of beer. The third patient after a few days of 1.0 gram boracic acid daily complained of headache, palpitation of the heart, tachycardia and insomnia. This was repeated several times with similar results and then given up. The fourth patient, age 40, weight 145 lbs., received 0.5 gram boracic acid twice a day in hot water for eleven weeks, during this time she lost nine pounds. With the exception of a slight diarrhea, and polyuria she experienced no unpleasant effects. No attention was paid to her diet, which consisted largely of carbohydrates. The fifth patient had the same experience as No. 1 and discontinued the use of boracic acid. The sixth patient reduced her weight very little in six weeks, but noticed an improvement of a neuralgia in arm and hands which she had several years, and did not improve under the use of the salicylates. Dr. Seng considers this treatment unreliable, as many people soon have unpleasant effects of the boracic acid, and frequently fails to reduce their weight.

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Volume XXIV

SEPTEMBER TWENTY-FIFTH

Editorial Department.

Number 6

FROM time to time we notice in the daily press lengthy interviews given by Thomas A. Edison to the Associated Press representatives. In due

Edison,

The Wizard.

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time these interviews appropriately decorated with "scare heads"find their way into the "patent insides, and are published in every local weekly throughout the land. They are read first by the urban dweller as he sups his morning coffee, or as he rattles along to his office in the trolley or elevated train. Later, the farmer at his fireside, reads the wonder work of the mighty Edison, and at the first convenient opportunity he discusses with his neighbors the genius of the Wizard of Menlo Park. Now, we do not wish to discredit the real scientific achievements of Edison, for his work in physics stands as a monument to his genius and to the wonderful advancements made in applied sciences during the nineteenth century. A century of achievement which has no parallel in the world's history. It is unfortunate, however, that Edison presuming upon his reputation as a physicist should intrude himself into the domain of medicine, without first mastering the fundamental branches of the science, and thus acquiring, at least, elemental knowledge of pathology. He is doing himself a great wrong and medicine a far greater wrong when he parades as a startling critic of the work of clinicians of known reputation and well grounded knowledge of medicine.

Further, he is conceitedly presumptuous to proceed to publish interviews about the therapuetics of cancer before he has even advanced to the experimental stage of his own theories, to say nothing of having not even proved a point in actual treatment. He has created a distrust in the treatment of cancer by Roentgen ray application by his unwise plunging into deductions, before even it has been demonstrated, beyond doubt, that the case in question is suffering from cancer and that the X-rays have contributed towards producing the disease.

Again, after startling the lay public by saying the X-rays cause cancer he proceeds, by his august authority as an electrician, to warn against their use in therapeutics. After an interval sufficient to allow the dissemination of his criticisms to every village and farm, he comes forth with another interview, to say, that he, the mighty Edison, has found the cure for can

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