use 1 in 40, and in the epididymus 1 in 20. (5) In tuberculosis of the ribs, iliac bones, and glands, I use a 1 to 10 solution. (6) It is preferable to inject small quantities at a time, a couple of drops for example, multiplying the points of injection. (7) Before having recourse to the method, the limb should be placed in a good position and maintained there. (8) If, after a time, there are signs of recurrence, the treatment should be forthwith recommenced." Current Medical Thought. He The Ichthyol in Atropic Rhinitis. DR. DAVID PHILLIPS has found great benefit from the application of ichthyol to the nasal mucous membrane in atrophic rhinitis. has treated up to the present time twenty-seven cases. In all except one improvement was manifested after the second application, and crust formation stopped in from a week to ten days. After three or four weeks the odor disappeared. The ichthyol is applied in the form of a five per cent. solution in keroline. mode of application is as follows: The nose is sprayed with an alkaline solution and thoroughly cleansed with a probe dressed with cotton. It is then dried and the five per cent. keroline ichthyol solution is applied thoroughly by means of the cotton-wrapped probe. patient is instructed to clean the nose with an alkaline spray night and morning, after which he sprays in a mixture of 1 part of kerolineicthyol to 5 parts of liquid alboline. A little eucalyptol or menthol may be added to this to disguise the fishy taste of the ichthyol. The use of the spray is generally followed by some serous discharge, which lasts about half an hour. -The British Medical Journal. Gelseminum for Tetanus. The AN editorial in The American Medical Journal, relates the successful treatment of two cases of traumatic tetanus by administering tincture of gelseminum in large doses until cure was complete. Chronic Ovaritis. IN a paper read by A. J. C. Skene, Medical News, the doctor says: The indications for general treatment are to lessen the blood supply and relieve the pain by correcting the deranged innervation. For the reliet of pain and hyperæmia he lauds the use of Bromide of Sodium and Fluid Extract of Hydrastis Canadensis; twenty to thirty grains of the Bromide and ten to twenty minims of the Hydrastis three times a day until the physiological effects of the Bromide are noticed. He thinks that Hydras tis given alone sometimes causes pelvic pain, but when combined with the Bromide it has no such effeat. Some cases are favorably influenced by ten grains of Salicylate of Sodium and five of Antipyrine. In cases of marked debility Aromatic Spirits of Ammonia, Camphor and Chloric Ether, with small doses of Cannabis Indica. Amer. Med. Jour. Prognosis Dangerous in Asphyxia. A DOCTOR was called to a woman who, with her child, had been suffocated. "They are both dead," he remarked, "we can do nothing." The unfortunates were removed to the hospital St. Louis, Paris, where the same statement was made. The house-doctor, however, asked permission to try artificial respiration with insufflations of oxygen, alternated with hypodermic injections of ether. Four receivers of oxygen were used, and the young doctor worked over his patients for three hours before a sign of life was perceptible. He finally succeeded in saving both patients. There was some sound sense in the saying of one of the Paris faculty: "Never admit as irremediable the death of an individual who has been asphyxiated, drowned or hanged."-N. Y. Med. Times. Which Method of Treatment of the So-called Varicose Ulcers of the Inferior Thigh is the Simplest and Best? BY DR. J. BRAUn, (Marienfeld, Bonat). Allgemeine Weiner Medecin. Zeitung, XXXVL, 1891. THE author depicts the unfavorable conditions of cure which very frequently accompany the ulcers of the inferior thigh as well as the dangers that the very same conditions may cause through neglect. The concurrence of the single little ulcers may produce such sores as would cover one-half of the periphery of the whole inferior thigh. The ulcers may suppurate, erysipelas may join it, and elephantiasis as well as deformation may even subsequently render the entire extremities useless. In therapeutic circles there is harmony in one point: the necessity of rest for the extremities. The other common remedies, as cataplasms with aq-chlorine, solutions of salicylous carbonic acid, iodoform in powder or gauze form, are rejected by Braun as inefficacious in the difficult cases. After a long experience he recognizes as the best and trustworthy remedy a 10 per cent. zinc lanolin salve of which he recommends the most extensive use. Braun causes the patients to wash carefully with lukewarm clean water the surface of the ulcers, to dry them by means of a compress, to keep in bed, and to apply a salve, consisting of Zinc oxyd. Lanolini.. Ungt. emoll. 15.0 110.0 .40.0 Thick-spread on soft linen to the surface of the ulcers, fastening the same with a linen bandage or a clean handkerchief. The pains soon disappear, the profuse secretion ceases, and the itching of the skin subsides immediately. The zinc lanolin, by virtue of its water absorbing character, sucks up a great part of the secretions, and, consequently, the ulcers, and the surrounding excoriations of the skin heal under a dry crust. During this treatment the author never saw a decomposition of the ulcers' secretions, and he ascribes this fact to the influence of the antiseptic lanolin. For unclean ulcers the salve is to be applied 4 or 5 times a day during the first days; the surface of the ulcers will then be very soon purified, and thereafter an application of three times a day will suffice. With this zinc lanolin salve even the deepest and widest ulcers will be surely cured, according to the author, as there never was an increase of the granulations. After the achievement of the treatment the patient wears an elastic stocking or a Martin bandage. For all other granulous ulcers too, as well as for watery eczemas, with the exception of hairy heads, the author recommends this zinc lanolin salve. For eczemas on hairy heads a white precipitate salve with lanolin as base of the salve, (mercur. precip. alb. 10.0 ung. emoll. 200, lanolin 70.0), rendered him the best services. On the Therapeutics of Erysipelas. Wenderoth (Beitrage jur Lehere zom Erysipel Gottingen 1888.) reports of the successful treatment of the erysipelas with 1 per cent. sublimate lanolin salve, performed in the interior clinic of Gottingen, since the year 1886. The affected parts, as well as a part of the skin surrounding them, are abundantly anointed with salve twice a day, and dressed with wadding. Every interior treatment, except the administering of wine, is avoided. Wenderoth reports of the treatment of ten cases in the similar manner, in which, with the exception of two the erysipelas would be iimited to the affected part, and which were cured in a very short time. Gottstein (Therapeutic Monatshefte, April 1891.) reports likewise a favorable result which he obtained by this method of the treatment of erysipelas, before he had any knowledge of the successes of Gottingen, and recommends very warmly said method. A patient, 56 years old, who was suffering of an erysipelas of the face, aggravated by fever and delirium, was energetically rubbed with sublimate lanolin 1.1000, and wine, under which treatment he was perfectly restored to health within seven days. Even little fresh wounds were healed by the aid sublimate landolin per primam. Mercury as a Specific in Typhoid Fever: Conclusions from the Study of Seven Hundred Cases. FROM a clinical experience embracing nearly 700 cases of typhoid fever, Smakovsky (L'Union Medicale, April 10th, 1891) concludes that the simplest and most efficacious treatment consists in the administration of calomel in fractional doses, according to the method of Professor Zachariine, of Moscow. Three-fourths of a grain of calomel is given every hour for ten doses, if necessary, or till copious, soft, greenish stools have been secured, a gargle of chlorate of potash being meanwhile used to prevent stomatitis. In cases in which cardiac weakness already exists, an infusion of digitalis is used before the calomel. If instituted in the course of the first seven days of the fever, this treatment is said to abort the disease, even when grave in type. If this result is not obtained, the drug exercises the most favorable action in shortening the duration of the disease and preventing complications. A second course of calomel may be given a day's interval after the first, the abortive action being produced sometimes only after this second administration. During the interval, and subsequently, if the disease is not aborted, the author prescribes : R. Subnitrate of bismuth. Pure naphthalin........... .gr. ijss 3-10 grs. ..gr.jss Sig. One powder. Four of these daily. The author is convinced that the mortality should be nil in all cases where the treatment is commenced before the tenth day of the disease, excepting with the very old, or where it occurs in the course of another grave malady. -University Medical Magazine. The Treatment of Whooping-Cough. THE following treatment is used very largely by certain of the leading specialists in diseases of children in Paris, in cases of whoopingcough. It is divided into three periods. The patient should remain in one room or in bed. and the physician employs belladonna and small doses of opium with aconite, as in the following prescription: Tincture of aconite.... of each I drachm. Two to five drops once or twice a day, according to the age of the child, is the proper dose. If there is no febrile movement the amount of the aconite can be much decreased, and if constipation is present the opium should not be used. In the second period, or when vomiting comes on, ipecac may be given in small amounts to allay gastric irritation, and in the third period, when convalescence is established, cod-liver oil tonics and Fowler's solution will be found of service.—Med. News. The Work of Leucocytes. A study of the relation of bacteria to disease is of great interest, and sheds abundant light, not only on the nature of specific diseases, but also on that of inflammation. In "Evolution and Disease," J. Bland Sutton reviews the leading facts connected with the evolution of the inflammatory process as manifested by a complex organism. Most complex organisms are pervaded by a corpusculated fluid, which may circulate throughout the organism by traversing lacunar spaces, or by means of narrow tubular passages possessing distinct walls. This fluid serves as a living medium to all parts of an organism. The red blood corpuscles carry oxygen, as is well known, and the white fulfil some very extraordinary functions. Should a portion of an animal die, leucocytes attack it; and if it be small, will cluster round and, by a process of intra-cellular digestion, devour it. If the part to be removed is large, leucocytes effect a separation between it and the living body. Not only are dead or damaged portions thus disposed of, but useless parts such as the tails and gills of tadpoles, remains of larval organs, and the tails of ascidians are slowly removed by the same process. Animal tissues are incapable of resisting an attack of leucocytes. An examination of the milk-teeth of children or puppies at the time they are shed, will attest the digestive powers of these cells. An ordinary magnifyingglass shows the irregular edge of the crown to be full of bays and recesses; and the micros-. cope reveals the presence in these spaces of leucocytes, which during life were busily engaged in destroying the fang of the tooth and thus causing it to fall out. Small pieces of clean sponge introduced into animal tissues disappear in a few days; while indigestible objects-glass, needle, or a fragment of metal are surrounded by a large number of leucocytes that are soon transformed into neutral tissue which isolates the intruders from neighboring parts. Should the intruded body contain articles of dirt, offensive to these cells, their action is intensified to a degree highly disastrous, for they die in the conflict, and in a few hours the foreign substance is surrounded by a fluid-pus-containing the dead cells. When this fluid is evacuated the cause of all the disturbance often escapes. Leucocytes, in their behavior to foreign bodies, may be compared to bees. When the offender is small, it is quickly stung to death and cast out. When large, it is deprived of life and rendered innocuous by a covering of wax. Leucocytes also attack pathogenetic bacteria, and attempt to destroy them. This amoebic warfare may be described from attacks actually witnessed by Metschnikoff in the water flea Daphnia. Spores gained an entrance into the body of the crustacean, germinated, and were dispersed by the blood over the body (in daphnia the blood circulates in lacunar spaces), and deposited where the blood moves slowest, viz., in the cephalic and hinder portions of the mantle cavity. In these places heaps of conidia collect. The leucocytes are not idle. They attack and devour the conidia, take them into their interior, and digest them. If a conidium is too much for one cell, others join it, forming a giant-cell, and thus struggle with the invader. Should the leucocytes overcome the spores, the daphnia lives. If not, the conidia overrun the crustacean and death is the result. Similar processes in animals more highly organized take place, the defending power of leucocytes being well illustrated in avian tuberculosis. Tuberculosis is unfortunately widespread in man; but in birds, especially those that live on grain, it is more common than in human beings. The liver and intestines of birds that have met their death from this cause represent numerous pale-pellow, rounded nodules, the centres of the larger ones containing pus. The smaller ones are homogeneous, containing in the centre small circular cells with larger ones-giant-cells--lodged among them; outside these a layer of smaller cells; and, lastly, a layer of fibrous tissue. The microscope reveals minute bacilli clustered in the centre of the mass and occupying the interior of the cells, especially the giant cells. nodules of moderate size, caseous material surrounded by a zone of cells containing bacilli, occupies the centre. Adjacent nodules may coalesce and thus produce larger masses. Blood-vessels connected with the nodules frequently present clusters of bacilli in their interior. The author (Sutton) is convinced that these bacilli, from whatever source arising, are introduced into the alimentary canal and find their way into the walls of the intestine. Here they are attacked by the leucocytes, which surround, injest and destroy them. The bacilli may be too numerous for the leucocytes, and the point where they gain entrance into the In tissues be transformed into a battle-field. Large numbers of other leucocytes quickly reinforce their comrades. Many of these die, others fuse and form giant-cells. The dead leucocytes form pus cells and give rise to the caseous centre in the nodules, From these nodules the bacilli are conveyed by blood-ves sels, or are even carried away by the leucocytes a giant-cell sometimes containing fifty bacilli and initiate new struggles in distant parts. When bodily conditions are favorable bacilli multiply very rapidly and overrun the whole system, nodules arising in the liver, lungs, brain and skin. Function is interfered with and death results. In addition to local troubles, bacteria produce general disturbances, one of the most important being fever. The behavior of leucocytes to pathogenic bacteria constitutes the absence of the inflam matory process. This is essential a local struggle between irritants and the white cells of the blood. When the whole of the blood is engaged in the struggle-as is in ague, pyæmia, anthrax-we have general inflammation or tever. The different varieties of fever depend on the habits of the bacteria, some being virulent or irritating to the tissues, and others slow in attaing maturity. Inflammation takes place in plants; for example, the gall on leaves due to the deposition of eggs in their interstices by insects. Each insect produces in this way a different kind of gall. One leaf may thus present at the same time several varieties of inflammation. It simplifies our notions of morbid processes to find that the phenomena known as the repair of wounds, inflammation, and fever, are manifestations of the same process by which a child loses its milk-teeth, the tadpole its tail, or the stag its antlers, rather than to look upon such conditions as the result of some special law.-Medical Record. S. Two to four capsules two to three times daily -Pester Med. Chirurg. Presse.-Times & Register. Therapeutics.-Therapeutical Uses of Menthol THE drug has an undoubted sedative action, upon the mucous membrane of the stomach. and often gives relief in gastralgia, nervo dyspepsia, and some forms of acute indigestion I often employ this formula with success : K Mentholis.... Elix. lactopep.: •••••.gr. v—viii .....dr. i M. Sig. To be taken in hot water every until relieved. In cases of obstinate vomiting, the same dose dissolved in lacto-peptine or brandy w often afford relief. In some forms of neuralgic or irritative headache, as well as those for which we are wont to prescribe the coal-tar products, men thol, in 10 grain doses in hot whiskey is some times very effective. In most varieties of pruritus, whether gener or local, the following lotion is quite reliable: K Mentholis.... Spts. vin. rect.. M. et. adde Acid, acetic. dil.. .....dr. i ...oz. i ...oz. ij M. Sig-Apply with sponge as required. Mentholated cologne forms a very comfort able and effective evaporating lotion in cct gestive headaches and similar conditions. forms also a valuable ingredient of liniments f various kinds, to which it may be added in the proportion of thirty grains to the ounce. All are doubtless familiar with its anesthet effect when used in the form of a spray in combination with ether and chloroform. The action of the agent upon various affe tions of the respiratory organs is also we marked. Here the menstrum or solvent shou be some of the bland oils like petroleum, what I have found still better, albolene glymol. A solution of twenty or thirty grains of menthol to an ounce of glymol, applied to the nasal passages by a proper atomizer, is the best thing I have yet used for colds in the head where there is almost complete occlusion from congestion of the mucous membrane. In the more chronic catarrhs of the naso-pharynx, the results are sometimes equally good. A similar solution often affords relief in cases of acute or chronic laryngitis and laryngeal cough, and phthisical patients remark forcibly upon the relief afforded by it in these conditions. To the solution of creosote, chloroform, and alcohol commonly employed in the Robinson and similar inhalers, menthol in 20 per cent. strength may be added with good effect. Certain forms of sore and irritable throat are greatly benefited by a gargle composed of an alcoholic solution of this drug. The uses of menthol are almost infinite, and being readily soluble in alcohol, ether, and the various oils, can be administered in many different forms. It is a decided anesthetic, an alterative, an antiphlogistic, and an antiseptic.-Dr. J. J. Berry in Medical Mirror. One Day With the Village Doctor. [The following article written by Chas. S. Cope, M. D., of Iowa, Mich., read before Michigan State Medical Association, June 12, 1891, and published in The Medical Age, contains so much practical thought that we venture to reprint it in full.] The general practitioner is a specialist in He must be every department of medicine. abreast of the times and ever ready to treat promptly and successfully every case that may present itself to his notice. While the surgical pendulum is swinging far past the centre, on towards the limit of its vibration in the unattainable, and every doctor now seeks to be a surgeon of renown, and we are solicited on every hand to notice the long list of successful operations being performed daily by our brethren of the knife and saw, it may prove refreshing to step aside from this grand procession and, seeking the humble walks of professional life, spend one day with. the village doctor, whose sole aim is to do good, and who seeks neither fame or station. Let us go with him on his daily rounds, notice his way of doing business, listen to the instruction he gives his patients, and look over his shoulder as he prescribes. We may find some of his prescriptions worthy of preservation, some of his methods worthy of adoption. His first call is in the early morning. A messenger in breathless haste announces that Mrs. K. had by mistake given the baby turpentine instead of castor oil. While his hands are busy with a hasty toilet, his mind is also busy sweeping the broad avenues of materia medica, where poisons and antidotes arise as apparitions at his command. As he takes down his medicine case, we see the doctor take down from the shelf a bottle of olive oil. In a few moments he stands before his patient, a child of six months. The mother had been up with the child all night as it had been suffering for several days with a heavy cold, and grown worse in the night. She at last had bethought herself of the castor oil, and, in seeking to give the child a dose of this medicine, by mistake filled her spoon from a bottle of turpentine that stood in a similar bottle on the same shelf. The quantities of phlegm that had accumulated in the child's throat and stomach served to parry this heavy stroke inadvertently aimed at its little life. There had been vomiting, and most of the turpentine thrown off, but the burn and irritation remained. The mouth and throat were blistered, and the babe in agony. It is given a half-teaspoonful of olive oil at once, and this is repeated in five minutes, and so on for half an hour; vomiting continues from time to time, but the oil is soothing, and with the burns on the lips and face covered with thick paste of saleratus and water, the child grows easier and rests quietly. Directions are left to give a half-teaspoonful of the oil every half hour till the bowels are moved freely, when the child will be out of danger. The following prescription left for the mother's use in the further care of her child, for restlessness and nervousness, will be found of great service. Containing neither opium child without danger of sericus consequence, nor chloral, it can be given to the smallest and yet attended with soothing, quieting results in every case: ..oz. j M. S. Shake the bottle. Dose-One-fourth to one-half teaspoonful in water; repeat as needed. For the cough, one grain muriate of ammonia in half teaspoonful of glycerine, every three hours. As the doctor steps into the street, he is hailed by a clerk on his way to open his employer's store, who says: "I wish you would give me something for my cough. It kept me awake nearly all night by a continued tickling and irritation in my throat. I don't raise |