THE BEST ANESTHETIC FOR CHILDREN. BURNETT (Archives of Pediatrics, April, 1904,) advocates the use of ether as a routine anesthetic for children except in conditions such as acute bronchitis, pneumonia, nephritis, and marked respiratory obstruction, which contraindicate its employment. The unpleasant effects of ether are due chiefly to faulty administration and the fault is in using too much ether and forcing it upon the patient too rapidly. Whatever form of inhaler is used, the ether should be greatly diluted at first and it should be increased so gradually as to avoid choking and coughing as completely as possible. In this way ether may be given to children with great satisfaction, particularly if preceded by nitrous oxid and a transition gradually made from that anesthetic to ether. Nitrous oxid should be used with great caution and sparingly in infants even in this way before ether and in all children air should be given at an early period. In administering chloroform to a crying, struggling child it. should be given at a much slower rate than during normal breathing. Children generally become quiet quite suddenly during the induction of chloroform anesthesia, and it is a wise plan to suspend the administration for a moment when this occurs and note the effect of the dose which has already been taken in. It will often be observed that a marked and prolonged effect follows the initial dose and this demonstrates the wisdom of the pause in the administration; as otherwise an unnecessary and perhaps dangerous amount may be given. When it is seen that the initial dose has not been excessive, the administration may be resumed and as the respiration is now more regular the narcosis progresses with much greater safety. The most important principles of chloroform administration are the avoidance of a concentrated vapor and an even use of the smallest amount of the anesthetic compatible with satisfactory anesthesia. It should always be given drop by drop. ABSTRACTS. Collargolum Enemata. DR. HEINRICH LOEBL, Assistant in the Franz Joseph Hospital at Vienna, in Die Therapie der Gegenwart, April, 1904, says: that during the last few years there has been a constant increase in the number of favorable collargolum publications. Good results have been recorded from its use in apparently absolutely hopeless cases, and we convinced ourselves, in our division, of the fact that anyone who administers it to a considerable number of we did not employ unguentum Credé, preferring the intravenous Septic patients will have the same experience. In serious cases Injection of 1 per cent. collargolum solutions (24 grains to 1⁄2 02. sterile water), which we used with excellent results. But great obesity, anemia, venous paucity, and the like, may hinder the intravenous injection. Besides, a single injection is rarely enough, and only a limited number can be given if a new vein is used for each. Finally, the needle may be displaced from the lumen of the vein by a motion of the patient when the constricting bandage is loosened. In one case where the veins could not be reached on account of their anemic narrowness and the patient's well developed panniculous adiposus, he used collargolum as an enema. The method has the following palpable advantages: it can be used by any attendant, is neither painful nor troublesome, is entirely safe, permits the use of larger doses, and brings the drug in contact with an excellent absorbing surface. It is no less efficacious than the intravenous injection. The intestine is not irritated, even when 1 per cent. solutions are given for fourteen days, and the collargolum enema is almost entirely absorbed, for a cleansing enema given twelve hours later brings only a slightly blackish fluid. Having given the enema to two dying patients and demonstrated the absorption of collargolum by historical examination, Loebl used the enemata in 27 cases, which are detailed with illustrative temperature charts. Six were sepses of varied origin; of these, 4 were cured, 1 was not benefited, and 1 died. One of the cured cases was a staphylococcemia in which other remedies had failed; and one other case is especially noteworthy because it appeared hopeless when the collargolum was begun. The fatal case was so desperate that the surgeon refused to operate, and even it showed some improvement the next day, so that a less marantic individual (she was 65 years old and tubercular) might have been saved. Out of nine cases of puerperal infection five were cured, three were not benefited, and one died. In this series one beginning parametric infiltration with irritative peritoneal symptoms underwent rapid involution and in five other cases there was an inhibitive effect on suppuration. In one case of obstinate rheumatism and in four cases of renal and vesical infection there were no results. Six consumptives with rapidly progressing febrile phthisis, one of them moribund and all of them entirely recalcitrant to every internal medication, received the enemata without any especial effect. In sanatoria, where there is natur ally a larger proportion of mild cases, there is probably a greater chance of success. As regards the technic, the patient is given morning and evening an enema of 1 or 2 pints of lukewarm water. Half an hour after defecation, 71⁄2 grains of collargolum in 1 per cent. solution are administered by a funnel or syringe. This amount (11⁄2 ozs.) is almost invariably retained; the bowels usually move only after the cleansing clyster on the next morning. The enemata are given twice daily for at least eight and not more than fourteen days. No unpleasant by-effects have been observed. Loebl concludes that the collargolum enemata give the same results in acute infections as does unguentum Credé of collargolum intravenously. In many cases the method has a surprising effect: and it has more than once been effectual when joint affections or phlegmasia alba dolens had appeared. It is probable that the method will save cases which we would otherwise lose. For these reasons he heartily recommends a trial of the treatment. Since November, 1903, when he demonstrated the method in the Royal and Imperial Medical Society of Vienna, he has received many favorable reports on it, both in hospital and in private practice. Prof. Netter, Member of the Paris Academy of Medicine, writes in the Bulletins et Mémoires de la Societe des Hopitaux of April 28, 1904, concerning the administration of collargolum by mouth and per rectum. He finds that the gastrointestinal route, which Loebl and Jousset have used successfully, has the advantage of simplicity and often gives excellent results. By mouth he gives pills of 1-6 to 1-3 grain collargolum with sugar of milk and glycerin; or solutions in albuminised water, 34 grain to a dessertspoonful, the daily dose being 21⁄2 drams to 1 oz. For rectal injections 11⁄2 to 71⁄2 grains collargolum should be given twice daily. Or 11⁄2 grain to 41⁄2 grain collargolum suppositories may be used. Several of his patients have taken collargolum per os and per rectum for months at a time, one without interruption for a year. In noninfectious diseases, such as nervous and gastric affections, in which silver nitrate is used, collargolum acts well, has no caustic effect, and never causes argyria. He gave it to six epileptics and got the specific action of bromide from much smaller than the usual dose; and the distressing symptoms of bromism and the eruptions, bad breath and mental depression were avoided. He even used collargolum alone and patients have passed five or six months without any attack. He also used it successfully in several cases of neurasthenia and neuralgia. A chorea that was intractable to antipyrin and arsenic was cured by it and it was also effectual in migraine. Given by mouth in infectious intestinal diseases. dysentery, and muco-membranous enteritis of children and adults, it gave marVelously rapid results. The internal use of collargolum is also preferable to injection or inunction in infectious diseases with a prolonged course, such as phthisis pulmonum. In typhoid especially the drug has a direct effect upon the pathogenic organisms, diminishing fever and diarrhea and shortening the disease. Results in influenza were equally good. In certain tuberculous cases collargolum alone. appeared useful. Cases with cavities seemed especially benefited; in several there was rapid diminution of expectoration. In infectious endocarditis subsequent to biliary inflammation the prolonged use of the drug certainly lowered temperature and increased the patient's strength. The Inconvenience of Hats. FROM an article bearing the above title, which appears in Cosmos (Paris, July 16), we learn that the new fashion of going without a hat is not limited to this country. According to the writer, it has everything, hygienically, in its favor, and the arguments against it need only be stated to be refuted. He says: The mass of hair that covers the top of the head is a feature of the human race in both sexes, and appears to be one of its most stable physical characteristics. Nevertheless, long observation is unnecessary to prove that this characteristic is weakening, and that the vigor of the hair is decreasing in man. Now a question presents itself is this due to a transformation of the species or must we attribute the fact to man's habits? This second solution appears to be correct, which is consoling, since it allows us to hope that the evil may be checked. This loss of hair that has become more striking from one generation to another by heredity, is due, according to some scientists, to the habit of covering the head. This habit must affect the hair injuriously in three ways: (1) by depriving it of the life-giving light of the sun, of free ventilation, and of the movement of the hairs by air-currents; (2) by pressure on the small arteries of the scalp, which bring nourishment to the hair; (3) finally, because all head-coverings are an excellent culture-medium for microbes, and facilitate their development. In fact, the hat, since it prevents the germicidal action of the sun's rays and the movement of the air, and retains on the head the heat and moisture of the enclosed air, offers all the most favorable conditions for obtaining a culture of microorganisms. Furthermore, it is well recognised that the chief causes of baldness are the microbian affections of the scalp, which destroy the sebaceous glands. We may, then, suppose that it is the custom of covering the head that diminishes, little by little, the vigor of the hair. Although this is not absolutely proved, it is infinitely probable, and in any case it would cost nothing to try a change in the present fashion. This change is absolutely desirable, especially for men, for with women, besides the fact that their hats cover only part of the hair, they are generally lighter; the preservation of the hair for the species is due to the women alone, the men counting for nothing in the matter. The promoters of this reform are meeting, at the outset, with certain objections: (1) to uncover the head may bring on colds, neuralgia and rheumatism. They answer that colds, catarrh, and the like, are of microbian origin and can not come from the scalp; (2) as for neuralgia and rheumatism, they are convinced that if the habit of leaving the head uncovered is adopted in youth, these troubles will not follow. In fact, they say, the uncovered parts of the head are not subject to them any more than the covered part-less perhaps; (3) so far as the incontestable danger of exposing the bare head in the sun is concerned, there are many ways of avoiding this without smothering the scalp; (4) the fear that septic bodies may be deposited on the uncovered parts, especially in cities, certainly deserves consideration; but care in the toilet will enable us to escape the consequences; (5) finally, the fear lest the hair should be injured by sun, wind, or cold has no serious basis, since unprotected parts of the head are covered with vigorous hair.”—Translation made for The Literary Digest. Facts About Apollinaris. IN FRANCE, England, Germany and the United States, mineral spring waters play an important part in the daily economy; in each of these countries the sale of apollinaris is larger than it ever was before, and according to the London Lancet thirty millions of bottles of this water are consumed each year. The Lancet, which is recognised everywhere as the highest authority on matters pertaining to health, recently sent one of its special commissioners to the apollinaris spring, which is at Neuenahr, Germany, in order to place before the medical profession an authoritative description of the bottling of this water. The report of this commissioner, published in the Lancet of January 30, 1904, shows that he was given access to every nook and corner of the vast establishment in which the apollinaris spring is situated, and that he saw from beginning to end the process by which the water is bottled there, ready for delivery to all parts of the world. This report is full of interesting scien |