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tific details describing the methods of bottling, and shows that the purity and healthfulness of the apollinaris water as it comes from the spring is preserved; it says that the chemical analyses which he made are in accord with those given at various times by the late Professor Virchow, Professor Liebreich, the late Sir Edward Frankland and other authorities, and that the water wherever it is bought is identical with the water taken direct from the spring, as apollinaris is bottled only at the spring and only with its own natural gas. The supply of both water and gas from the spring is considerably in excess of the present enormous demands.

Treatment of Chronic Ulcer of the Leg. Horatio W. A. Cowan, (Lancet, London, Eng., July 2, 1904,) says that the beginning of the present year he was called to a woman aged 54 years, who had a chronic sloughing ulcer for twenty-two years situated on the outside of the left leg, some ten inches long and three inches wide, with indurated edges and some thrombosis of the veins of the inside of the knee. Having first cleansed the ulcer with charcoal poultices for two days, he applied wet butter cloth and then spread antiphlogistine over it after which cotton wool and a bandage were put on. This was done every day by the patient's friends for four months. The ulcer is now quite healed over and the induration is all gone. She is able to resume her ordinary housework. Cowan adds: "I publish this case in the hope that it might be useful to others as Cnna's paste and all sorts of methods had been previously tried. I may say that I have no personal interest in antiphlogistine."

Acetozone in the Treatment of Summer Diarrhea. IN THE treatment of any form of diarrhea an accurate diagnosis must first be made. For convenience it is customary to classify diarrheas somewhat after this fashion: (1) diarrhea of relaxation, or serous diarrhea, due to disordered innervation; (2) crapulous or lienteric diarrhea, due to imperfect digestion ; (3) catarrhal diarrhea, acute or chronic; and, (+) ulcerative diarrhea, due to intestinal ulceration.

This classification is by no mean perfect, as is shown by the multiplicity of terms applied to the various pathologic states characterised by diarrhea. Thus we have the terms acute inflammatory diarrhea, acute summer diarrhea, choleraic diarrhea, dysenteric diarrhea, nervous diarrhea, tuberculous diarrhea, and the like. In each case the diagnosis is determined by the actual condition prevailing, of which the intestinal laxity is usually but a prominent symptom.

The question of treatment is one of the utmost importance. Without entering into a discussion of what soon proves to be a very broad subject, it may be worth our while to consider briefly the status of the antiseptic method of treating intestinal disorders, especially those caused by pathologic organisms and of which diarrhea is the chief symptom. Apart from well-directed efforts to clear the intestine of bacteria, reduce the temperature, sustain the vitality of the patient, regulate the diet, secure proper hygienic conditions, rest, and good care, the selection of the proper antiseptic agent demands the exercise of the physician's best judgment.

Whether or not it be possible to attain intestinal asepsis is, of course, a debatable question, but it is a well-established clinical fact that intestinal antiseptics do good and modify the course of enteric diseases of bacterial origin, notably typhoid fever, dysentery and summer diarrhea. However, there is a difference in the degree of efficiency of the various antiseptics, the utility of many being limited by the risk of untoward action from excessive dosage. In those cases of ileocolitis caused by the bacillus of Shiga many of the serious symptoms are due to a mixed infection, to combat which prompt and vigorous measures are required. :

The experiments of Novy and Freer (Contributions to Medical Research, p. 114) with benzoyl-acetyl-peroxide (acetozone) showed that this substance is extrenrely germicidal to the organisms found in the alimentary canal. Its administration to rabbits resulted in the “practical sterilisation of the contents of the stomach.” In several experiments with these animals "the intestinal tract apart from the cecal pouch, was found to be sterile." Neither bouillon tubes nor agar showed growths, though the controls gave abundant cultures. Other experiments showed that enzymes and toxins are also destroyed or rendered inert by acetozone. Further study demonstrated not only the remarkable germicidal power of acetozone, but also the fact that its aqueous solutions may be given internally, and even injected intravenously, without harm. From these data we infer that this substance ranks among the most powerful germicidal agents, while it exerts no harmful effect upon the human organism, and may, therefore, be employed as a therapeutic agent in the treatment of summer diarrhea and other infectious enteric diseases with the best effect. There seems to be abundant evidence to warrant the suggestion that acetozone solution should prove most

valuable in colonic flushing, as it is entirely free from the danger that attends the use of large quantities of even weak solution of mercuric chloride, and for that reason may be used fearlessly.

Diarrheas in Infancy. Rotch (Amer. Med.) regards the treatment of these conditions as still largely empirical, but believes it can usually be determined whether the large or small intestine is affected. The best success is obtained if the treatment is given by mouth, when the small intestine is the seat of disease, and by rectum, when the large intestine is affected. He also differentiates the group of cases with marked fermentation and little local lesion and ileocolitis class of cases when the lesions are more or less decidedly marked. No specific remedy or intestinal antiseptic has been found to absolutely kill the organisms or neutralise their toxins. Clear the intestines of bacteria by laxatives, support the strength, combat nervous symptoms, and hyperpyrexia are the chief indications. Of the drugs he recommends bismuth.

The following combination has been recommended after the alimentary canal is free of all irritants : R Bismuthi subnitratis ...

gii. Salol .................

.............. gr. xvi. 1 Aquæ cinnamomi .....

zi. 30
Aquæ, q. s, ad........

zii. 60
M. Sig.–Shake well. Teaspoonful in water every two hours.
For diarrhea in infants, with green stools:
B Hydrargyri chloridi mitis
Pulveris ipecacuanhea, aa ........

........... gr. i. .06
Sacchari lactis ............................. gr. xx. 1.30
M. Chart No. x. Sig.-One powder three times a day.

-Med. Recorder

xvi

...........

CORRESPONDENCE.

The American Society for the Study of Alcohol and

Other Narcotics. Editor Buffalo Medical Journal:

Sir—The American Medical Society for the Study of Alcohol and other Narcotics was organised June 8, 1904, by the union of the American Association for the Study of Inebriety and the Medical Temperance Association. Both of these societies are

composed of physicians interested in the study and treatment of inebriety and the physiological nature and action of alcohol and narcotics in health and disease. The first society was organised in 1870 and has published five volumes of transactions and twentyseven yearly volumes of the Quarterly Journal of Inebriety, the organ of its association. The second society began in 1891 and has issued three volumes of transactions, and for seven years published a quarterly bulletin containing the papers read at its meetings.

The special object of the union of the two societies is to create greater interest among physicians to study one of the greatest evils of modern times. Its plan of work is, first, to encourage and promote more exact scientific studies of the nature and effects of alcohol in health and disease, particularly of its etiological, physiological and therapeutic relations; second, to secure more accurate investigations of the diseases associated with or following the use of alcohol and narcotics; third, to correct the empirical treatment of these diseases by secret drugs and so-called specifics and to secure legislation, prohibiting the sale of nostrums claiming to be absolute cures containing dangerous poisons; and, fourth, to encourage special legislation for the care, control and medical treatment of spirit and drug-takers.

The alcoholic problem and the diseases which center and spring from it are becoming more prominent and its medical and hygienic importance has assumed such proportions that physicians everywhere are called on for advice and counsel. Public sentiment is turning to medical men for authoritative facts and conclusions to enable them to realise the causes, means of prevention and cure of this evil. This new society comes to meet this want by enlisting medical men as members and stimulating new studies and researches from a broader and more scientific point of view.

As a medical and hygienic topic the alcoholic problem has an intense personal interest, not only to every physician, but to the public generally in every town and city in the country. This interest demands concentrated efforts through the medium of a society to clear away the present confusion, educate public sentiment, and make medical men the final authority in the consideration of the remedial measures for cure and prevention. For this purpose a most urgent appeal is made to all physicians to assist in making this society the medium and authority for the scientific study of the subject. The undersigned will be pleased to give any further information. T. D. CROTHERS, M. D., Secretary,

Hartford, Conn.

BUFFALO MEDICAL JOURNAL.

A Monthly Review of Medicine and Surgery.

EDITOR:

WILLIAM WARREN POTTER, M. D.

All communications, whether of a literary or business nature, books for review and exchanges should be addressed to the editor: 284 FRANKLIN STREET, BUFFALO, N. Y.

Vol. XLIV.-Lx.

SEPTEMBER, 1904.

No. 2

University and Hospital Bulletin. THE JOURNAL in its next issue will inaugurate a new section,

to be known as the “University and Hospital Bulletin," which is to be devoted to the interests of the medical department of the university particularly, and the hospitals of the city in general, in so far as the work in them is connected with medical education. It is the intention to make this section an interesting and public-spirited supplement to the JOURNAL, in which shall be found as nearly a perfect record of university advancement as it is possible to give from month to month.

While, as a matter of course, questions of purely scientific character will be dealt with, they will be given in narrative formthe strictly technical paper and its discussions being reserved for the other pages of the JOURNAL. Opinions of a general character will not be expressed; but an effort will be made to present and maintain a strictly news department devoted to the University of Buffalo and the fostering and upbuilding of its interests. Clinical hospital work by university leaders will be given in what may properly be called serial form. Unusual cases in hospital practice and in charge of men who have no university connection, will be given space commensurate with the importance of the case, the ingenuity of its treatment or the rarity of its features.

As near as may be all departments will be represented from time to time; but standing features will include sufgery, medicine and pathology, the general news items of the medical department, hospital clinics, the work of the students and the fraternities. The faculty of the medical department will act as an advisory editorial staff of this new division, which, we believe, will prove of

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