able. Out of twenty-one cases of miliary tuberculosis of the peritoneum that he had been able to look up for this paper, seventeen were practically cured at the time of leaving the hospital. His own opinion was that the operation for tuberculous peritonitis afforded the patient an opportunity to gain in strength and nutrition which would not be possible under any medicinal treatment. Pyloric Stenosis.-Dr. J. G. WILLIAM GREEFF read this paper. He said that he had come to the conclusion that the cases reported as congenital pyloric stenosis were really instances of an acquired stenosis. As yet nothing was definitely known as to the origin of this condition. Almost all authors were of the opinion that it was congenital, and Henschel believed that it could occur in a family showing an evident tendency to hypertrophies. A number of names had been reported which had recovered, and the symptoms presented in these cases were very much like those of chronic intestinal catarrh. Dr. Greeff reported a case that he had personally observed in which it had been possible for him to make the diagnosis intra vitam. When first seen, the child was three weeks old, was emaciated and vomited after almost every meal. The stomach was very much enlarged and the greater curvature was three finger-breadths below the umbilicus. The stomach was washed out daily, and the diet suitably regulated. Under the internal administration of nitrate of silver the quantity of mucus diminished but the vomiting persisted. The vomiting continued even after a wetnurse had been secured This vomiting usually occurred immediately after feeding and in great gushes. It began two weeks after birth. The child steadily lost weight, until, at its death, it weighed six pounds. It was because of the poor general condition that the speaker had not favored operation, although he had made the diagnosis of pyloric stenosis quite early. The operation was finally done by Dr. W. T. Bull with the sanction of Dr. Holt, who concurred in the diagnosis. The operation revealed a thickened mass, 2.5 cm. long and 1.5 cm. in diameter at the site of the pylorus, the boundaries of the tumor being well defined. A posterior gastroenterostomy was done, but the child died twelve hours later from shock. At the autopsy the intestine throughout was found very small. The stomach measured in its greatest diameter, between he cardiac extremity and the pylorus, 12 cm., and beween the smaller and large curvature, 7 cm. Microscopcally, the mucous membrane showed signs of catarrhal nflammation. The stomach wall throughout was hyperrophied. This was very marked at the pylorus, and a very small probe could hardly be passed through the ylorus. This thickening of the pylorus was plainly due o a muscular hypertrophy. The microscopical examinaion confirmed these findings. The fibrous tissue surounding the glands was hypertrophied. The muscular nd connective tissue layers were in a condition of proounced hypertrophy and hyperplasia. The speaker said at the mild cases of this disorder would recover without peration under appropriate treatment. If such treatent failed, it was well, after careful observation for a eriod of two or three weeks, to consider the advisability an operation. He did not personally think operation ould be advised unless this was done very early indeed, t it was just at this time that very few felt like taking e responsibility of deciding the question of diagnosis and eration. Through chemical influences it was possible increased working of the pylorus to take place, thus iding to consecutive hypertrophy and stenosis. Hernia.-Dr. WILLIAM DE GARMO read this paper. e page 251). Dr. A. JACOBI opened the general discussion. He said at appendicitis was a very frequent disease in children 1 infants, and there were anatomical reasons for this. appendix of the new-born was one-tenth the length he colon, while that of the adult was one-twentieth the gth of the colon. The appendix continued to grow up the thirteenth year, both in length and width. After time it began to atrophy, and about the fifteenth year might even be smaller than at birth. The appendix in the young was very wide, so that it was easy for an accumulation of fæces to take place. The muscular layer was very well developed in some children, and, hence, in them, after a severe colic, the fecal accumulation would be expelled. Not so, however, in children of lax fiber and weak muscular tissue, and, consequently, this class of children were apt to come into the hands of the surgeon. He saw no reason why some cases of pyloric stenosis might not have an anatomical basis, even though the great majority were functional. Complete obstruction was either the result of inflammation or an arrest of development. The normal diameter of the pylorus was 6 mm. at birth, and it increased one-quarter of a millimeter with each month. There was certainly a congenital hypertrophy of the circular layers of the pylorus, as had been reported many years ago by Hirschsprung of Copenhagen. Dilatation of the stomach might be followed by that of the œsophagus, yet dilatation of the stomach was not so frequently seen as might be expected because of the early onset of vomiting. Death followed frequently within a few weeks or months. A congenital spasm certainly existed, a spasm which was comparable with rectal tenesmus or vaginismus. The few cases that he had seen that had terminated favorably were those in which there had been persistent vomiting and hyperacidity. The latter could be controlled by the administration of alkalies and washing out of the stomach. Henry Ashby's conclusions, both from a large personal experience and from a study of the literature were, that the ordinary form of congenital stenosis of the pylorus was associated with a hypertrophic condition of the pyloric sphincter; that the essential feature was a spasm of the sphincter; that there was usually a secondary hypertrophy of the walls of the pyloric orifice of the stomach; that the mild cases might recover under dietetic treatment; that serious cases required some operation, preferably dilatation of the pylorus. When these children could not retain food they must be fed by the rectum, not only being given food, but large quantities of water. Dr. WALTER LESTER CARR, referring to the operative treatment of tuberculous peritonitis, said that opinion was by no means settled as to the value of the operative treatment of this condition. No doubt, where there was marked ascites the operation would give prompt relief. Some authors had reported very much better results from medical treatment. We should take the position that we were dealing with an infection, and that if the systemic infection were not too great it might be allowable to operate; in any case he believed that an exploratory laparotomy was unobjectionable. Dr. MARK I. KNAPP said that the cause of the pyloric stenosis was invariably mechanical, but it had not been shown that the condition was present at birth, although it was known to exist a few weeks after birth. The growing child would respond very easily to stimulation, and in this instance the stimulation was largely chemical, although to some extent mechanical. The same cause which gave rise to peristalsis produced the hypertrophy and stenosis, the difference being that in the case of intestinal peristalsis there was a canal of large lumen, whereas in the case of the pylorus of the infant the canal was very small and easily obliterated. Dr. Jacobi called attention to the fact that the stomach of the new-born infant was very little more than a dilated œsophagus. The two curvatures were not so developed as in the adult, and the stomach was a mere pouch hanging nearly vertically. Iodides per Rectum.-For patients in whom the internal administration of iodides produces gastric disorders, v. Zeissl advises its administration per rectum. He uses sodium or lithium iodide 3ss to water 3i with 5 minims of laudanum injected through a Nelaton catheter.-Die ärztliche Praxis. THE NEW YORK ACADEMY OF MEDICINE. SECTION ON GENERAL MEDICINE. Stated Meeting, Held December 15, 1903. LEWIS A. CONNER, M.D., IN THE CHAIR. Malignant Endocarditis of the Tricuspid Valve with Perforation of the Interventricular Septum.-Dr. LEWIS A. CONNER presented this specimen. The patient was a male, twenty-four years old, born in Hungary, and was admitted to the hospital October 30, and died November 20, 1903. He gave no history except illness for two days with fever and chills. His temperature was very high, and septic in character. The leucocytic count was 19,200. No physical signs were found. Five days later a faint systolic sound was noted, and a systolic murmur over the lower half of the precordium. The murmur grew louder and harsher. Its maximum intensity was midway between nipple and the sternum. There were no signs of pulmonary emboli. Two blood cultures gave pure growth of a diplococcus resembling the gonococcus. A bacteriological examination of smears taken from the urethra was negative. The patient had a persistently high temperature, and high leucocytosis, became rapidly anæmic, and died three weeks after admission. was negative. When he died he evidently was exsan At the autopsy no marks of cutaneous syphilis were found. The stomach was found to be distended with 1300 c.c. of blood. The heart was moderately hypertrophied and weighed twelve ounces. The aorta was very much dilated and sclerotic. An elongated sacular aneurysm of the descending arch of the aorta was found which extended from the beginning to just above the diaphragm. It had perforated the oesophagus, causing a fatal result from hemorrhage. At the autopsy the heart was found to be moderately enlarged, weight about fourteen ounces, with muscle yellow, soft, and friable. The pulmonic and mitral valves were normal. A large and ragged thrombus was found on the tricuspid valve with ulceration and extension through septum at the base of the aortic cusp. The aortic cusps were involved. The lungs were congested, and oedematous, but no infarcts were found. In the spleen there was found one small infarct. There was a parenchymatous nephritis. He called attention to the following features: (1) Absence of signs of tricuspid obstruction. (2) Absence of pulmonic infarctions. (3) The obscure etiology. men. Dr. MORRIS MANGES reported a primary case of melanosarcoma of the liver that he saw twelve years ago, history of which was somewhat similar to the one related by Dr. Conner. The rapidity of its course was a very striking feature. The patient was a woman, twenty-si years old, and her liver, within four weeks, increased from a moderate enlargement to one entirely filling the abdiThis took place in the shortest time he had ever noted; it was impossible to make a diagnosis until one week prior to her death. At autopsy the liver looked entirely different from the one presented; it was melanotit, but more microscopical, than macroscopical. There were secondary cutaneous manifestations, yet the liver itse was not pigmented and yet the microscope showed z enormous invasion. No primary focus could be found. and it was assumed that it was a primary melanosarcon of the liver, Melanosarcoma of the Liver.-Dr. LEWIS A. CONNER presented this specimen, which was removed from a patient fifty-four years old, a waiter by occupation, who died November 20, 1903. He had been a hard drinker. He had jaundice twenty years ago which lasted two weeks; otherwise he claimed that he had always been well. Symptoms of his present trouble began six weeks before admission, when he had severe pain in the epigas trium. He lost flesh. Two days prior to admission he began to vomit. The pain, vomiting, and emaciation continued until he died of exhaustion one week after admission. He recalled one or two cases of mycotic aneurysm of the femoral artery resulting from malignant endocarditis In one of these he recalled a very peculiar effect. Th aneurysm was very small, mycotic in origin (it was the fourth he had seen that involved the lower extremity and there was much doubt regarding the diagnosis account of the latency of the phenomena. The aneury was found to be very small and out of all proportion to the amount of erosion. He thought there must have hea other factors in play than the mere mechanical pressure. Dr. E. E. SMITH had seen a case similar to the last ( reported in which he had examined the blood and stomat contents. The blood showed nothing unusual. After the test-meal the stomach contents showed an increas At the autopsy the liver was found to be hard and nodular, the mass filling almost the entire abdomen. It weighed ten pounds and eleven ounces, was greenish-black in color, with many small yellowish-to-white nodules. Upon section there were myriads of small nodules, yellowishwhite, or black. The right suprarenal showed a black nodule the size of a pea. Miliary metastases were found in the right auricle and mucous membrane of the stomach, in the bladder, in the pleura, pericardium, and peritoneum. A careful search of the skin and mucous membranes failed to reveal scars, nævi, or primary growth. He called attention to the following features: (1) Size of the liver. (2) Many miliary metastases. (3) Difficulty of detecting the primary growth. acidity. The patient gave a history of great pain st had existed for several weeks. The patient was ve anæmic and a probable diagnosis of gastric ulcer was re Soon after entering the hospital there was noticed a thr over the region of the seat of pain and vomiting of bl The patient came to operation but nothing was revea Soon afterward the patient died and the autopsy reveal thoracic aneurysm that had eaten into the oesophagus c to the opening into the stomach. Dr. CONNER asked Dr. Hodenpyl regarding the c of these sarcomas, if they did not arise from the pig cells. In the case related he said it was difficult to see b it could have arisen in the liver. Dr. HODENPYL replied that he had seen cases of m otic sarcoma of the liver but that they were alway secondary manifestations. All those that he had set originated in the pigment cells of the skin or subcutane Dr. CONNER answered no. He said that although tricuspid lesion was present the lungs were fre emboli. Before death there had been one or two he rhagic areas over the elbow, but these were not in any the result of irritation or emboli. Dr. MANGES said that Ziegler spoke of the possibi primary melanosarcoma of the liver. Fatal Hæmatemesis from Perforation of the Esophagus by a Latent Thoracic Aneurysm.-Dr. LEWIS A. CONNER presented this specimen, which was removed from a patient who died December 2, 1903. The patient had been well until two or three days prior to admission, when he developed a slight cough, and pain in the left side of the chest. There was no dysphagia. He began to vomit large quantities of blood, but the vomiting ceased after admission only to begin again twelve hours later, subject by a passage in Hemmeter's book in wh just before his death. Examination of patient's chest The Clinical Value of the Average Analysis of Ge Contents.-Dr. CHARLES SUMNER FISCHER read this He said that he had been led to a consideration c states the following: "It would be a valuable contrib by various gastroenterologists of the United States if they collected and reported the frequency of hyperacidity and other gastric diseases occurring in their localities so as to throw light on the influence of race, climate, geographical distribution, etc.," and again, by a statement of Riegel, "that the determination of the frequency of hyperchlorhydria by statistics will remain impossible so long as every dyspeptic is not examined by lavage and that hyperchlorhydria is found more frequently in private practice than in hospital because the symptoms of this condition are generally not severe enough to send the patients to these institutions." He said that so long as various observers in different parts of the country did not employ the same methods and base their conclusions upon uniformly imposed conditions so long would it be impossible to estimate correctly the actually prevailing conditions and frequency of chronic gastric diseases. He chose the acid secretion of the stomach as a subject for discussion because it was the unction about which the most was known and which gave he greatest aid in diagnosis. In the determination of hydrochloric acid the greatest errors of judgment were nade. He said the whole question resolved itself into his: Can we get a better knowledge of the gastric acid ecretion by employing carbohydrates or proteids as xemplified in the ordinary test-breakfast of Ewalt-Boas r the more complicated meat containing meal of Riegel, r had we better use both of these meals; or would it not e better to discard both of these meals as placing the gan under natural conditions and examine the stomach nder the circumstances in which it finds itself and conining the food to which the individual had been accusmed or which has led to his discomfiture? test for the development of the gastric acid secretion was to give satisfactory data for judging the average functional capability of the stomach should appeal not only to the appetite, inducing special senses of sight, taste, and smell, but should also be a direct stimulant to the secretory centers in the stomach walls, for Pawlow demonstrated that the acid secretion during the first half hour of digestion was due to the first, and that the real chemical stimulation began later. In the words of Troller, the test must be a physiological stimulant, and a physicalchemical stimulant. He said that if we accepted the results obtained by clinicians and physiologists, the ordinary trial breakfast did not fulfil the requirements of a physiological test for the acid secretions, and it failed in the following: It failed to excite the appetite, and hence the vagus stimulation in those cases in which it was taken with repugnance; it failed to be a physical-chemical stimulant in that it did not act as an energetic stimulant to the secretory centers located in the stomach walls; lastly, it failed in that it placed the individual in a false condition of life for examination. Therefore it was not surprising that this meal should give a variety of results in clinical work, 50 per cent. of which were erroneous, at least upon the first examination. In taking the statistics from hundreds of cases of gastric analyses in women, three-quarters to one hour after a trial breakfast, he found that 60 per cent. were hypochlorhydric, 30 per cent. normal, and the remainder hyperchlorhydric. In these cases, upon the third examination, he found that 57 per cent. had remained stationary, wereas 43 per cent. had changed as follows: Of the subacid cases, 22 per cent. became normal, and 2 per cent. were even hyperacid; of the normal cases, 14 per cent. became subacid, and of the hyperacid cases, 2 per cent became normal. Among men the changes were not so marked. Taken collectively, among men and women, it was found that 60 per cent. remained stationary, and 40 per cent. changed upon the third examination. He stated that long ago he came to the conclusion that first examinations should be excluded in all cases as being entirely unreliable; there were too many disturbing factors which were likely to influence gastric secretion, such as misunderstanding on the part of the patient as to the time and the food, and most of all, such factors which related to the emotions, such as anxiety, uncertainty, and fear. Upon second examinations these were largely removed. The variations could not be attributed to nervous influences, for neuroses were excluded from the list. There remained but one conclusion, that the ordinary trial breakfast did not fill all the requirements of a reliable test for the gastric secretions. This, he said, was not surprising when one recalled the experiments of Pawlow. In order to obviate the objections to the test breakfast, some authors advised administering proteid in some form; this, he said, would act either as an energetic stimulant to the acid secretion in cases in which subacid conditions were due to continuous overstimulation, or it would act as a neutralizing agent when hyperacidity was the result of gastric irritability of an intermittent nature. In order to obtain uniform results as nearly as possible according to the ideas of Bushman, and in order that the results might be traced directly to the influence of the proteid, and in order to demonstrate more closely the difference between a proteid and carbohydrate diet for purposes of diagnosis. he said he had discarded the ordinary meal as proposed by Riegel, and simply employed the ordinary test breakfast of Boas, plus the addition of one-quarter of a pound of lean, finely chopped beef, prepared by boiling, and slightly seasoning to make it more palatable. In the examination of hundreds of cases he had found the results were more constant; of the cases examined, 40 per cent. were subacid, 46 per cent. were normal, and 14 per cent. were hyperchlorhydric upon the second examnation. Upon further examination it was found that 35 per cent. remained subacid, 54 per cent, remained normal. He reviewed briefly the separate lines of experiments nich had been pursued for years and which had a direct aring upon the question, classifying them as diagnostic, etetic, and the purely physiological. The first two were sely allied and had for their object the study of the exme development of the acid secretion of the stomach, d the results that had been obtained in each case were ectly interchangeable. The value for diagnostic purses of the ordinary trial breakfast of Ewald-Boas or the teid meal of Riegel he said had been variously estimated different writers. The objections to the test breakts were its simple, non-stimulating character, that it was iseous and did not appeal to the special senses and did give an adequate idea of the secreting possibilities of stomach. On the other hand its uniform character med to be the quality which appealed most to those preferred it. The chief objections to the meat-conning meal seemed to be its non-conformity of character the greater difficulty in manipulating it. Leaving le the consideration of uniformity or manipulation, the le subject seemed to resolve itself into a discussion he stimulating properties of carbohydrates and pros to gastric secretion. The object of a large part of erimentation had been for dietetic treatment of hyperrhydria; but the results obtained could be applied equal advantages to the question of diagnosis. He that the controversy in regard to the proper dietetic ment of hyperchlorhydria began in 1891, and he ly reviewed various phases of the struggle. 2 said that in every case of chronic gastric disease Iving abnormal acid secretion, the object of the Fical analysis of the gastric contents was to develop, ssible, the average capability of the stomach to te acid and any vagaries of the same which might It was necessary to place the stomach under conas such as had existed during the period of illness. sked if that could be done by giving simple tea, withilk or sugar. A partial solution of this problem was in the results obtained by Pawlow by physiological iments on the influence of real and fictitious feeding, he principle impression conveyed by these experi ATE were that, so far as diagnosis was concerne 1, any receiving hydrochloric acid with her meals. During the past ten days she had gained four and a half pounds in weight. She suffered from gaseous distension. In the urine occasionally casts were found and a trace of albumin There was a high arterial tension. CASE III. This patient was a man, thirty-one year old. The gastric contents showed no free hydrochl acid and no lactic acid. He had had symptoms for ce year past, and during the last six months constant gastric symptoms. He lost some weight. There was no cacheria no tumor, nor any appearances of gastric carcinoma from which he suffered. CASE IV. This patient was a woman, sixty years d who appeared as though suffering from a chronic gas tritis. Her teeth were defective, and this was probab the cause of the irritation from which she suffered Hyperchlorhydria was always present. Improve occurred when the diet was regulated. He said a pers sixty years old, with persistent pain, loss of weight, p sistent gastric symptoms, etc., would be considered sufferer from gastric carcinoma. and 11 per cent. remained hyperchlorhydric. Comparing He said that frequently one was confronted with th difficulty in making a diagnosis between hyperchlorby and gastric ulcer. As already stated, there was no oth way of making a diagnosis except as a result of treatme: He referred to one case in which a diagnosis of gast ulcer was made. Free hydrochloric acid increased in t examinations. There was free and copious vomiting blood. The patient was transferred to the surgical w operated on, but no gastric ulcer was found. In ta with surgeons and asking them whether they considers visual exclusion as satisfactory evidence of the abo of gastric ulcer, he found that they considered it pos evidence of its absence. Dr. Peabody begged leave differ with them. He believed that it required a thorough examination of the gastric mucous mem than was consistent with life. In the case referre above none was found. CASE I. This was a woman, twenty-seven years old. A CASE V. This patient was a woman twenty-six old, who began to have pain in the stomach eighty ago. She had an attack of pain followed by voy blood, nearly one pint, about five years ago; these a of vomiting and pain continued up to the prese usually greater after meals. Physical examination negative. There was an increase in free hydrochloric An operation was performed and no gastric ulcer He thought that vomiting of blood, with pain pe in character and localized, justified the clinical da of gastric ulcer when there was an excess of free chloric acid present. CASE II. This was a woman, thirty-three years old. After the administration of the test breakfast, in one hour the stomach was always found to be empty. When examination of the contents in less than one hour there Dr. Peabody had a man under observation wh about fifty years old and who had had persister: C symptoms, pain, vomiting, great distress, emat these symptoms lasting for more than one year. a gastroenterostomy was performed upon him for a pylorus which was very much thickened. He dilated stomach. No gastric carcinoma was found! effect of the operation was most satisfactory, the gaining in weight constantly. He referred to case of a woman who came under his observational ago. She was admitted to New York Hospita diagnosis of gastric carcinoma. She lost forty weight during the year previous. A gastroente was performed for carcinoma of the pylorus. F years she led a life of comfort and regained the forty lost. He said she was now in the hospital with attacks of pain which had no relation to her trouble. This pain lasted eight or ten days an perature rose from normal to 103° to 104°; as subsided the temperature returned to the tumor could be felt. He interpreted her conditi one of local peritonitis. He believed the caree was found a complete absence of free hydrochloric acid, recurring and, as it grew, caused attacks of perito and a trace of lactic acid. In this case there was no sus- adhesions from time to time. He said he laid great weight upon gastric did not He belie especially exa other me did not think it wise to give too much weight to them. Dr. GEO. ROE LOCKWOOD believed that the discrepancies h T. WILLIAM ARMSTRONG said he was not so much in or of the test breakfast as was Dr. Lockwood, and that e were limited to three or four examinations we could more from the Riegel test than from the test break Therapeutic Hints. ction of Anesthesia in Prostatic and Renal Surgery. ark, reasoning from the evidence adduced for and ist the method of subarachnoid injections of cocaine, ves that the following conclusions are justified: (1) the method is as safe as, if not safer than, general thesia. (2) That we may safely employ up to of a grain of cocaine without fear of toxic effects. hat shock, when present, is decidedly less than that neral anesthesia. (4) That it is attended with langer of annoying sequelæ and symptoms. (5) on account of the variability in the length of its etic action it is contraindicated in prolonged operarocedures.-Medical and Surgical Monitor. Surgical Treatment of Early Diagnosed Cancer of the J. E. Janvrin concludes that in about one-third cases of uterine cancer, involvement of the regional in the pelvis takes place. This involvement rarely in the incipient stage, and abdominal radical operaith the removal of the pelvic glands lessens the high tage of recurrences.-American Gynecology. cinal Treatment of Gallstones.-H. Richardson says ycocholate of sodium will dissolve gallstones in the , and even when cholecystitis is present glycoof sodium is indicated not only as a prophylactic a solvent for stones already present, and that in ases only in which there is occlusion of the gall-duct cal interference permissible.-Therapeutic Gazette. Books Received. While the MEDICAL RECORD is pleased to receive all DISEASES OF THE EYE. By Dr. L. WEBSTER FOX. RABIES. By Dr. DAVID SIME. 8vo, 290 pages, muslin. JAHRESBERICHT ÜBER DIE VERWALTUNG DES MEDIZINAL- XLVI. Jahrgang, 1902. 8vo, 267 pages. Mahlau & Waldschmidt. A HANDBOOK ON THE PREVENTION OF TUBERCULOSIS, A MANUAL OF MEDICINE. By Dr. W. A. ALLCHIN. A SHORT PRACTICE OF GYNECOLOGY. By Dr. HENRY THIRTY-FOURTH ANNUAL REPORT OF THE STATE BOARD TECHNIK UND DIAGNOSTIK AM SEKTIONSTISCH. VON Dr. SUNDHEITSAMTE. Julius Springer, Berlin. MANUEL PRATIQUE D'HYGIÈNE. Par le DoCTEUR TECHNIQUE DU MASSAGE. Par PROFESSEUR J. ZAB- PROSTATIC HYPERTROPHY FROM EVERY SURGICAL Goundou. Its Relation to Yaws.-A. Nell has met with several cases, and concludes from his observations and inquiries as follows: Yaws bears a causal relation to goundou. In goundou there are symmetrical osteomata on the nasal processes of the superior maxillary bones; they are always congenital, either apparent at birth or to be detected on close examination as faint bosses or ridges; general enlargement in size is always concomitant with body growth, and stops with full adult life. An "acute enlargement" follows or accompanies an attack of yaws; hence some congenital cases are not noticeable if no acute enlargement had occurred, and adults with slight ridges or bosses should be questioned regarding goundou or yaws in the family.-Journal of Tropical Medicine. Treatment of Angina Pectoris.--William H. Waugh treats this disorder by giving glonoin, of a grain every minute until the face flushes. This effect is deepened and prolonged by giving atropine, of a grain, every ten minutes until the mouth begins to dry. There will be no further attack as long as this effect endures, and the effect may be definitely prolonged by repeating the atropine whenever the dryness of the mouth subsides. On the theory that spasm betokens weakness, strychnine, of a grain, every fifteen to thirty minutes, may be administered until the pulse regains its normal tonicity. In the absence of the remedies advised, anything that will bring the tears to the eyes will break the attack. Alcohol in any shape, volatile oils, ammonia, camphor, pepper, ginger, or any other spice or ether given hot and in concentration will answer. In the interval the mental and physical welfare should be attended to.—Therapeutic Gazette. |