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The prompt arrest of this abscess from a single injection of an alkaline 15 per cent. solution of papoid greatly surprised
The cure cannot be attributed to peroxide of hydrogen, as this had been used for months with favorable, but not curative results; employed after the papoid, it simply or mainly oxydized the debris or digested pyogenic membrane, facilitating its removal.
Had I employed the papoid and been aided by rest to my patient, I am confident that I could have cured the case, probably several months earlier.—Dr. O. A. Hyde, Med. f S. Rep.
Recent Observations on Sulfonal.
Sulfonal has been doing very satisfactory work in general practice, largely supplying the place of narcotic drugs in conditions in which the use of the latter is unadvisable. The usefulness of this remedy has called forth many expressions of opinion from all parts of the country. Among these, we cite the following from Dr. J. H. Mackay, printed in the Medical Surgical Record of May, 1892 :
“Sulfonal has been introduced into my medicine case to stay. Not often will it be needed, but in a few cases no other remedy can fill its place. My first experience with the remedy was in a case of grip. My patient was nervous, restless, had a hacking cough and headache, and had not slept for upward of thirty-six hours. At nine o'clock in the evening, as there was no indication of sleep, and he was worn out, I gave twenty-five grains in a half cup of hot water. At eleven he fell into a dreamless, physiological sleep, which continued without interruption for eleven hours. He awoke refreshed, with mind clear, pulse normal, and no headache or subsequent drowsiness, ate some breakfast, spent a comfortable day, and slept well on the following night without repeating the dose of sulfonal. Other remedies, of course, were given for cough and fever. Another case was one of alcoholic insomnia. Patient had been on an extended spree-one of many such—and was verging on delirium. For several days and nights sleep was impossible. The stomach was irritable, and the pulse rapid. He had been there before, and had learned the use of
antidotes and hypnotics, but they only increased the irritability of the stomach and the excitability of the heart and brain. I gave twenty grains of sulfonal, and in two hours afterward the vomiting ceased, the pulse slackened, and the patient slept for several hours. The vomiting did not return. Before using sulfonal, I had exhausted my resources to quiet him.”
Among the newer uses which have been made of sulfonal in therapeutics, we have observed the report of Dr. Julius Althaus (Amer. Jour. Med. Science), in which the author successfully treated post-grippal psychoses, where insomnia was present, by the use of prolonged baths, and sulfonal. Dr. Hammond is reported as making successful use of this remedy in the use of insomnias following the opium habit; and several observers attest its value in alcoholic delirium. Sulfonal has also given very satisfactory results in inveterate and incurable cases of epilepsy where there is super-excitability of the brain, and where the attacks are very numerous. The alleviation was very marked in all cases, although the doses were smaller than the average dose for insomnia, being from ten to thirty-six grains, administered in warm tea broth at bedtime, or given in fractional doses during the day.
Remarks on the Value of Vegetable Alteratives in Chronic, Venereal,
Tubercular and Malarial Diseases. * Speaking of the elements of those medicines which serve a useful purpose in exhaustive and debilitating diseases, Dr. Manley says, that there are limitations to the province of physiological chemistry or bio-chemistry, in being able to satisfactorily explain the modus operandi of very many of our most ' valuable medicinal agents. This is particularly true of the vegetable tonics, when administered in wasting diseases. We may prescribe iron, arsenical, quinine or other salts in malarial, tubercular, or syphilitic anemia, occasionally, in vain, when, if we place our patient on fresh infusions, decoctions or tinctures, immediate benefit will follow. The profession is not by any means in accord with those who would have us believe
* Thos. H. Manley, M.D., New York, member of N. Y. State and County Medical Association, American Medical Association, Visiting Surgeon to Harlem Hospitals, etc.
that the time has arrived when medicines can be prescribed according to any set of rules, whatever scientific basis their construction may rest on.
Warburg's tincture, one of the most valuable anti-malarial remedies known, unfortunately is a secret, quack remedy, though owned by the British government. Huxam's tincture, so long a secret compound of the Birmingham chemist, is now common property of the profession.
Codliver oil and its many preparations have held their own well in pulmonary tuberculosis. But, there are many phases of surgical tuberculosis and those conditions of malnutrition resulting from syphilis, in which the oil is not well borne. Here the vegetable tonics, particularly those rich in the alkaline salts, are invaluable. The tincture of hops, decoction of sarsaparilla, gentian, columbo, or chamomile, either may be taken alone or in combination. A valuable combination of herb extracts was elaborated in the Southern States by members of the medical profession, as a substitute for mercury and the potassium iodide, during the late war of the rebellion, when all pharmaceutic supplies were shut out by the blockade and the advancing lines of the enemy. It is known to pbarmacists and practitioners as Verrhus Clemiana, and is composed of clematis-erecta, prinus-verticillatus, fraxinus Americana, rhus-glabrum, and one-eighth of one per cent. of venatic acid; all indigenous in the Southern States. I have extensively employed this compound in many cases of chronic, tubercular, glandular and bone diseases, besides other wasting maladies, with excellent results. Indeed, in these times pharmacy yields a large number of vegetable elixirs, so palatable and easy assimilation that one should always give them a protracted trial in the vast majority of tubercular or syphilitic bone or joint disease, before any sort of sanguinous operation should be thought of.— Doctor's Weekly.
Quinquaud has confirmed Unna’s statement as to the presence of a special microbe in soft chancre. It is a bacillus with rounded ends, and is generally arranged in chains. It is present in prodigious numbers in the lymphatics and intercellular spaces.-Med. Review.
Bismuth for Burns.
Von Bardeleben (Deutsche medicinische Wochenschrift, No. 23, 1892) recommends the topical employment of bismuth in burns, except those of a slight character, in which weak solutions of silver nitrate and elastic collodion suffice. He thinks severe burns requiring early amputation may also be excepted from burns amenable to the bismuth treatment.
After thoroughly cleansing the burned sites, the author washes them with three per cent. carbolic, or three per cent. salicylic, acid solution. He then removes any blisters and their contents that may be present, employing antiseptic precautions while so doing. Then he thoroughly powders the whole region with: R Bismuth subnit. subtilliss. pulv. amyl, aa 50,0 (3 xiiss.); M. f. pulv. This he dresses with layers of cotton which, when saturated by the secretions, are removed, except the lowermost layer which is left to maintain exclusion of the air. This dressing may be left in situ one or two weeks, even a month, thus avoiding all pain incident to change of dressing. In most cases the pain of the original injury disappears within a few hours after applying the bismuth.
In burns of the face, von Bardeleben uses no other dressing. He disinfects the burn, removes the bullæ, and powders the wound with bismuth. The crusts developed are gradually removed in a week or two by grease, especially where they are most adherent, i.e., at hairy surfaces, such as the eye-brows, beard, etc. If any denuded surfaces remain, they soon are covered with skin under the employment of silver nitrate.
Butyl-chloral Hydrate in Ear Disease.
Dr. Hare has reported a case of neuralgia and insomnia due to middle-ear disease, in which butyl-chloral hydrate produced decided benefit. Five grains in pills every two hours were administered until thirty grains had been taken; this amount was followed by total relief. Dr. Hare has found this new medicament valuable also in insomnia due to heart disease, and in loss of sleep from pains in the head or face, particularly where the branches of the facial nerve were affected.
DIPSOMANIA.—Alexander gives the following as a good remedy to enable drunkards to resist the drink crave: R Tinct. capsici, m. X.
Sodii bromidi, gr. x.
Spirits ammoniæ, 3 i. Sig.–Give at a dose several times daily.-N. Y. Med. Jour.
CATARRHAL AFFECTIONS.-An excellent cleansing and disinfecting solution for free use in the nasal cavities, by means of the spray apparatus, douche or syringe, is prepared as follows: R Acidi boracici, 3 i.
Sodii boras, 3 i.
M. LINIMENT FOR GOUT.-In his small work on rheumatism and gout, Satterlee recommends the following local application : R Ol. gaultheriæ.
M. Sig.- Apply freely and cover with cotton batting.-Med. Sum.
::---An especially efficacious formula is the following: R Aqueous ext. of galega,
Lactophosphate of lime,
Simple syrup, 3 xij. Four to eight tablespoonfuls a day in water, beer or milk.-St. L. Clinique.
CARDIAC TONIC.—Dr. J. O. Hirschfelder, San Francisco, in a clinical lect. ure, recommends the following: R Caffeine.
Benzoate of soda, 3 j.
Camphorated water, 3 vj. M. Sig.–Tablespoonful three times a day— Med, and Surg. Reporter.
Oleoresin cubeb, grs. v.
Pepsin (Fairchild's), gr. j. M. Ft. capsul. Sig.-One such capsule three or four times daily; and as an injection : R Zinci sulpho-carbol., grs. ij-x.
Sol. hyd. peroxid., 10 per cent., 3j.
- Medical Summary.
Balsam Peru, 3 ii.
M. Sig.–For inunctions against strumous swellings--codliver oil internally. Tonic alimentation.- Union Medicale.
Ozena.-Schnitzler advises :
Iodoform, aa 3 iii.
M. Sig.-For insufflations against ozena.
The following powder may be used for the same purpose : R Iodoform (powdered).
Burnt coffee finely powd’d, aa ziii. Mix with care.-Union Medicale.
Celerina (Rio), 2 oz.
M. Sig.–Teaspoonful four times daily.