DENVER MEDICAL TIMES THOMAS H. HAWKINS, M.D., LL.D., Editor. DENVER MEDICAL PUBLISHING COMPANY. Henry O. Marcy, M.D., Boston. COLLABORATORS: Thaddeus A. Reamy, M.D., Cincinnati. G. Law, M.D., S. H. Pinkerton, M.D., Salt Lake City. Graeme M. Hammond, M.D., New York. Bradford Galloway, M.D., Leadville, Colo. Subscriptions, $2.00 per Year in Advance; Single Copies, 20 Cents. Address all Business Communications to 28 Sheridan Building, Denver, Colo. Address all Communications relating to Editorial Department, including Exchanges, Book Reviews, etc., to the Editor, 1740 Welton Street, Denver, Colo. We will at all times be glad to give space to well written articles or items of interest to the profession. [Entered at the Postoffice of Denver, Colorado, as mail matter of the Second Class.] EDITORIAL DEPARTMENT. Creosote in Pulmonary Dr. Charles Lamplough, resident medical Tuberculosis. officer of the City of London Hospital for Diseases of the Chest, records in the British Medical Journal, of May 28th, his observations upon a hundred cases of phthisis treated mainly with this well known drug in emulsion with cod liver oil or spirituous solution, and also by inhalations mixed with an equal part of alcohol. He concludes that the best beechwood creosote can be given with benefit, in amounts varying from 120 to 240 minims daily. The dose should be small at first, but can be rapidly increased to 40 minims three times daily for an adult. In three cases, doses of thirty minims thrice a day were well borne by children. There is rarely any gastric disturbance from these large doses; on the contrary, the appetite is often increased, dyspepsia is lessened, and cod liver oil is more easily assimilated. The cough, expectoration and night sweats are diminished, and the physical signs are improved. Creosote does not irritate the normal mucous membrane of the genitourinary tract, nor does it tend to cause, but rather to prevent hemoptysis. The drug is usually contraindicated in advanced cases of intestinal tuberculosis. On account of its much lower cost, the writer thinks that pure creosote is generally to be preferred to the carbonates of creosote and guaiacol. The Relations of Gout to the Thyroid Body. It has long been known that there is an excessive excretion of alloxuric substances in the urine during and following attacks of acute arthritic gout. Rachford (Philadelphia Medical Journal, April 16th) calls notice to the fact that these same products are increased by thyroid feeding, which will even produce an acute exacerbation in patients suffering from chronic rheumatic gout. He also alludes to the not uncommon occurrence of acute attacks at the menstrual period, at which time the thyroid gland is unusually active. Thus there is good reason to suspect that the thyroid secretion has something to do with the abnormal body chemistry of acute rheumatic gout. Pharyngeal and Laryngeal In reviewing the literature of this rare symptom, H. Lambert Lack (June Laryngoscope) divides such cases into two groups. In the first, and by far the largest class, the movements are presumably due to severe nervous lesions, such as cerebral tumors, meningitis or tabes dorsalis. In the second group the soft palate or some of its muscles are affected, and the movements are apparently excited reflexly by some local catarrhal condition, nasal polypi or adherent crusts. The writer reports a case of this kind cured by proper local treatment. A Modern Method of On the ground that glycosuria is (except in pancreatic cases) the result of hyperemic over-action of the floor of the fourth ventricle, Beverly O. Kinnear (Atlantic Medical Weekly, June 18th) advocates for the amelioration and cure of diabetes the use of cold over the spine, combined with oxygen inhalations. The ice-bag, he says, should not be placed higher than the second or third dorsal vertebra, as the object in view is to diminish the amount of blood circulating in the brain, which is not accomplished if the cold application is above the region mentioned. The preparation best suited for inhalation consists of two parts of pure oxygen, one of nitrous monoxide and 1 per cent. of ozone. The ice-bag should be employed for forty minutes three times a day one hour after meals. The oxygen is best taken standing and before meals, so that there may be no interference with deep inspiration. The writer advises two long inhalations from the cylinder at each treatment with an interval of two minutes between them. High Specific Gravity of Urine. Ordinarily a specific gravity above 1.025 is due to sugar or relative or absolute excess of urea. That the chlorides may be the cause of the abnormal density is shown by a case reported by Dr. M. D. Hoge in the Virginia Medical Semi-Monthly for May 27th. His patient, a woman, passed in 24 hours 700 c. c. of urine with the extraordinary specific gravity of 1.120. There was no sugar or albumin present, and all the normal ingredients were in usual amount except the chlorides, which were doubled (27.6 grammes), while the urine was diminished one-half in quantity. By way of explanation it was learned that the woman ate largely of salt pork, ham and mackerel, and seasoned her other food with a considerable amount of salt. She rarely drank water, but used tea and coffee. The Importance of In his introduction to a projected series of lectures on urinary analysis (St. Louis Medical Gazette, June) Dr. Hugo Summa, Professor of Medicine in the Marion-Sims College, lays down the principles which have for years governed his practice in these respects: 1. Every treatment (even hygienic recommendations, such as cold baths) should be preceded by urinalysis. 2. When in the course of treatment specific medicines are used, urinalysis is required again and again. 3. As soon as the patient has reached the period of convalescence, especially before he is dismissed from regular medical attendance, urinalysis is absolutely necessary. (Remember, for instance, pyelitis after typhoid fever; suppurative nephritis after vaccination, or some weeks after osteomyelitis.) 4. The treatment of the various forms of nephritis, especially those most commonly associated with uremia, require urinalysis, partly to prevent uremic attacks, partly to control the therapeutic measures. 5. In all chronic cases the determination of nitrogen is necessary from time to time in order to investigate the nitrogen-balance as to nutrition. 6. All operative procedures requiring the use of chloroform necessitate the most careful urinalysis, not only for the detection of some form of nephritis or diabetes mellitus, but also of temporary insufficiency of the kidneys. St. Louis Medical Gazette. A new comer into medical journalism bears this name. The editorial staff includes Martin F. Engman, Charles G. Chaddock, George C. Crandall, Carl Fisch, Frank L. Henderson, Phillip Hoffman, Bransford Lewis, Hanau W. Loeb, Norvelle W. Sharp, Albert S. J. Smith and George M. Tuttle. The first number is strong in original articles and department work. May the Gazette prosper as it deserves. Examination for Gonococci. To prepare a specimen of urethral discharge for microscopic microscopic examination, Valentine, in the April Clinical Record, repeats directions for a common and reliable method. 1. Spread the discharge, filament or sediment as thinly as possible over the cover glass. 2. Let it dry under a bell-glass, to protect it from dust or air-microbes. This usually requires about three minutes. 3. Pass it three times through the opened Bunsen flame, with an even motion, to "fix" it. 4. Drop eosin (saturated solution in alcohol) upon the coverglass and hold it over the closed Bunsen jet until a slight, visible evaporation results. 5. Hold it under a stream of water until all the eosin that can be washed away is carried off. If the cover glass stood on edge over filter paper gives it ever so slight a tinge, the washing has been insufficient and must be repeated until nothing but clear water comes from the glass. 6. Drop 2 per cent. methylene blue upon the glass, and let it rest so covered for five minutes. 7. Wash as described under No. 5, and mount for examination. Diagnosis of Tuberculosis Hegar is quoted in Pediatrics as recomPeritonitis mending bimanual vaginal or rectal examination. In this way, he says, small, often multiple nodules, the size of a hempseed, pea, bean or larger, can often be felt on the posterior surface of the uterus, in the cul-de-sac and along Douglas fold, at the sacroiliac articulation and in the paravaginal tissues. These nodules are frequently somewhat movable and are either attached to the peritoneum or embedded in the connective tissue in the form of enlarged lymphatic glands. The Infectious Period of Dr. J. W. Washbourn, a prominent London Scarlet Fever. bacteriologist, is credited by the New York Medical Journal as saying: "There is a general belief that the skin contains the virus, and it has indeed been stated that the patient is most infectious during the stage of desquamation. This latter statement is, however, incorrect, for there is evidence that patients are more infectious during the early stages than at a later period. While in some cases patients remain infectious for some time after desquamation has ceased, in many they are quite free from infectiousness during desquamation." Melancholia and the Blood. An important practical contribution to the study of melancholia is that by Dr. B. C. Loveland (New York Medical Journal, June 25th) in which he gives the results of a blood examination of fifty-seven cases in the early stage. In nearly every instance the blood was unduly concentrated, ranging up to as high as 8,760,000 red corpuscles per cubic millimetre. The hemoglobin was also above the average-as high as 128 G. The rational treatment deduced from such findings is to promote elimination by every possible avenue-"Not forgetting that water is nature's solvent, and the most powerful aid in cleansing the system, and exercise its strongest ally." The patient should be fed according to the requirements of the body, as shown by clinical examinations. Lastly, only such medicines as are needed to complement the dietary and hygienic methods in securing sleep and promoting elimination should be employed. The results in the author's practice were that of forty-five patients thus treated, thirtyfive recovered, eight were improved and only two received no benefit. The following is an illustrative case: "Mrs. B., a widow, 52 years of age, came under my care on March 4, 1896. She was not very thin, though she had lost some flesh since she began to run down. Diagnosis was confirmed by a noted specialist. Melancholia began a year before she was sent to me. General characteristics conform to the description in the early part of this paper. Blood examination at the time of admission: Hemoglobin, 100 per cent. (Fleischl); red corpuscles, 5,780,000 to the cubic millimetre. |