or iso-osmotic solutions of cocain should be used in order to avoid oedematization of the tube and subsequent transient otitis media. -New England Medical Monthly. New Instruments. These are illustrations of the Lynch Aseptic Syringe-Container, an original device for storing and ministering serum, and more particularly Diphtheria Antitoxin. The barrel of the syringe is filled with serum in the laboratory and aseptically sealed with rubber stoppers. The serum is never again exposed, nor is breakage, with its attendant danger of particles of glass, necessary. The needles and rubber bulb (one of each accompaLying every dose of serum) are supplied in sterile wrappings, and, as will be seen by the illustrations, it is only necessary for the physician to pierce the stoppers with the needles to have a perfect hypodermic syringe. A feature of the device is that half of the contents of the Container may be administered, when, by withdrawing the needles, the apertures in the stopper will close, keeping the remaining serum intact and sterile. Dr. H. M. Alexander & Co. have adopted this device as a carrier for their Diphtheria Antitoxin, which is also supplied by Messrs John Wyeth & Bro., as authorized distrib utors. Straight Talk from Alkaloidal Headquarters. THE RAPID-FIRE GUN OF MODERN THERAPEUTICS. The same spirit of conservatism that opposed the introduction of modern weapons in warfare, of rifled guns, breechloaders, and smokeless cannon; and of modern methods of shipbuilding, the introduction of steam, the propeller, the compound engine, iron armor, etc., is still to be found combating the replacement of the old-fashioned drugs by the alkaloids, in ready-to-use granule and tablet forms. Nevertheless, the latter will prevail, because they are best, as shown by the following characteristics: 1. Their uniformity of strength. 2. Their uniformity of effect. 3. Their certainty of effect. 4. Their quick solubility and absorption, and consequent speedy effect. 5. Their portability, and the consequent reduction of the weight and bulk to be carried on the person-a vest-pocket case carries the essentials for emergency practice. 6. Their ease of administration and the absence of unpleasant and irritating effects. 7. The necessity of weights, scales, measures, and other pharmacal paraphernalia is obviated by the manufacturing pharmacist. 8. The perfection with which their action has been worked out allows really scientific application. 9. They do not deteriorate with age or in any climate, are easy to use, pleasant, safe and sure. 10. They give effects impossible to obtain from the old preparations. 11. Anyone of ordinary intelligence can be taught how to give them and when to stop. Trained nurses, while always desirable, are not absolutely essential. Every one of these statements can be verified by argument or by demonstration. The only question remaining is, whether one is to be ranked on the side of mossy conservatism or of intelligent progress. Samples, literature, and prices-current sent on application. THE ABBOTT ALKALOIDAL CO. Ravenswood Station, Chicago. Branches: New York and San Francisco. Diabetes Mellitus. The exact origin of this insidious affliction is not a matter upon which there is unanimity of opinion, and the textbooks offer little regarding treatment which is of benefit or comfort, either to the practitioner or to his still more interested patient. That Diabetes Mellitus can be successfully treated is clearly shown by the pamphlet which reaches our desk, containing the clinical reports of eighteen practitioners, covering eighty-three separate cases, the medicament used being Arsenauro. Stucky, Dixon, Sheridan, Beck, Hickey, and others quoted, are men whose utterances no one will have the temerity to question. We presume this pamphlet will be sent to any medical practitioner who applies to the publisher, Mr. Charles Roome Parmele, 45 John street, New York City. PACIFIC MEDICAL JOURNAL VOL. XLVI. APRIL, 1903. No. 4 Original Articles. CHRONIC COUGH OF THE AGED-ITS By G. A. GILBERT, M. D., Danbury, Conn. There is, perhaps, no more unsatisfactory condition to treat than that form of chronic bronchitis which is so frequently met with in old persons whose joints have become stiffened and enlarged with rheumatism, and who are harrassed and worn with a harsh, suffocative cough, the worst paroxsyms of which usually occur in the latter part of the night or early morning hours. The cough is accompanied by the expectoration of a thick, tenacious mucus, which, as one writer states, "is dislodged with so much difficulty that in the midst of the more violent paroxysms the action of the stomach is reversed and its contents ejected by vomiting." Although it has been found that the condition of these patients is very generally ameliorated during the warm months of the summer, yet, on the whole, they emaciate and grow more helpless from year to year, until they die either from exhaustion or the supervention of pulmonary sclerosis (fibroid phthisis), endocarditis, or chronic diarrhea. The fact that so many of these patients die in the manner described is sufficient evidence that the disorder is not altogether local, but one which affects the entire nutritive system; in other words, it is the same disease which has been so long (and not inaptly) styled by the laity "old-fashioned consumption." The term "consumption,' as used here, is applicable to the complaint, not because of the pathological lesions which exist but because of the gross symptoms manifested, e. g., cough, loss of strength and appetite, and emaciation. It has long been recognized, in these cases, that food is illy borne, and VOL. XLVI-13 that owing to failure of the digestive organs to properly perform their functions, the vital powers gradually become weakened from lack of nourishment. It will be seen, therefore, that the treatment here is essentially that of any wasting disease, but that the lining membrane of the alimentary tract and bronchia requires especial attention. From time immemorial, the various oils and their emulsions have been prescribed for their demulcent effect upon the sensitive bronchial surface, and in order to furnish the system the requisite fat fuel; but, in the cases we are considering, therapeutic results with these agents have often proven unsatisfactory, the existing gastric disturbances being aggravated instead of relieved. Especially is this true of the fish oil (cod liver), which many patients with delicate stomachs are unable to take. Recent experiments have demonstrated, however, that the oil of petroleum possesses distinct antiseptic properties, not only preventing fermentive processes in the intestinal tract, but increasing the absorption of proteid foods, thereby causing a marked increase in the patient's weight. The value of petroleum in relieving the cough of phthisis has long been known, but owing to the crude form in which it was necessary to administer it, many physicians had ceased to employ it. As a result, however, of increased facilities in the pharmaceutical art, a finely divided form of the oil had finally been evolved, and the profession have now presented to them a preparation of petroleum in purified form, known as terraline, which is not only palatable but easily absorbed, and produces none of the disagreeable eructations so common to most oils. This preparation has of late been introduced into many of the hospitals throughout the country, and the most favorable reports have already been given out concerning its therapeutic value in phthisis and other wasting diseases. The writer has recently employed this agent in the treatment of intractable cases of cough in elderly people, and the success obtained in every instance has caused him to abandon all other modes of treatment for the relief of this condition. The great advantage of terraline over the stereotyped cough mixture" lies in its remarkable antiseptic action and power to aid intestinal absorption, causing an increase in weight which cannot be obtained in any other way. Its action, too, in assuaging bronchial irritation and relieving expectorant cough, is unequaled by any other drug, thus rendering it an agent of especial worth in the cases we are considering. The following is cited here as an illustration of its value in this connection: Mrs. G., married, aged 66, of an exceedingly frail physique, had been troubled every fall and winter for several years with a harrassing cough, which would last until the advent of summer and warm weather. She was gradually failing in health and bodily strength, and grew thinner and weaker from year to year. She complained of poor appetite, and at times suffered considerable distress from flatulence after eating. The cough would come on in paroxysms the first thing upon arising in the morning, the patient becoming completely exhausted in her efforts to dislodge and expel from the bronchia the pellicles, of viscid, tenacious mucus. Violent paroxysms frequently occurred during the night, causing loss of sleep, which resulted in severe headache the following day. Entrance Auscultation revealed moist rales in the larger bronchia, front and rear, over both lungs, which were plainly apparent to the patient herself while lying down at night. The breathing was labored and noisy, and cough invariably resulted whenever a deep inspiration was taken. into the open air also resulted in a fit of coughing, which would continue unabated until the gelatinous mucous particles were raised with difficulty and expelled. Very little solid food was taken without causing distress, and sometimes vomiting. Faulty digestion has produced an illynourished condition of the system, which was manifest to the most careless observer. The patient was slowly but surely breaking down from lack of sufficient nourishment. The various oil emulsions had been tried in this case, but, owing to the gastric irritation caused, had to be discontinued. Innumerable "cough mixtures" were also taken; but, in no instance, was anything but temporary relief obtained. When seen, early in September of the present year, the patient was quite discouraged of ever obtaining permanent benefit from any form of treatment, and asked that only anodynes be administered. Believing, however, that the antiseptic and soothing properties of petroleum would prove beneficial here, terraline was ordered and |