Gummy Pelvic Cellulitis Simulating a
Malignant Tumor.

At a meeting of the Academy of Medicine Professor Fournier cited a case of gummy cellulitis of the true pelvis, occurring in a person, 34 years of age, who had inherited syphilis, and which was cured by the mixed treatment. He drew the following conclusions: 1. We must hereafter include in the list of possible syphilitic accidents the production of pelvic infiltrations involving (at least, secondarily) the bladder and the rectum, simulating malignant tumors and capable, when the nature of the disease is suspected, of being cured rapidly by specific treatment. He stated that he had never met with another case of the kind.

2. This cellulitis had been the result, not of acquired, but of hereditary syphilis. It is to be noticed that it occurred in a man, 34 years of age, and without any preceding manifestation of syphilis, or, at any rate, no evidence could be found. The effects of inherited syphilis may, therefore, occur at any time, even at an advanced age.

It is a fact that sometimes, and more often than is supposed, hereditary infection does not display itself by any manifestation, stigma, or dystrophy. The mouth and teeth may be devoid of evidence in these "deceptive" cases of hereditary disease. Professor Fournier especially recalled the case of a young girl, born of a syphilitic father and mother, and herself syphilitic, who died at the age of 18 of syphilitic tabes, and who had beautiful teeth.

In the case which formed the basis of Professor Fournier's remarks the first suspicion of syphilis was excited by the excessive infantile mortality which had raged in the patient's family. Out of 15 brothers and sisters, 12 had died and for the most part at a tender age. Furthermore, chance permitted Fournier to recognize in the older brother of the patient-one of the few survivors of the family-the ophthalmoscopic signs of hereditary syphilis.

The treatment consisted of injections of 2 centigrammes ('/ grain) of benzoate of mercury a day and the daily administration of 4 grammes (1 drachm) of iodide of potassium. At the end of a week there was already decided improvement. After the lapse of two months no trace remained of the pelvic infiltration, which had raised the thought of cancer, and even of the inoperable variety.-Le Bulletin Médical.

Therapeutic Notes.

Turpentine in Scarlet Fever.

Tobeitz, in an article on the pathology and treatment of scarlet fever, according to Archiv für Kinderheilkunde, recommends the use of turpentine in this disease. He states that, instead of its producing an inflammatory condition of the kidneys, it cures albuminuria and prevents nephritis. He uses it in the form of an injection hypodermically, given in 15-minim doses injected into the outer aspects of the thigh, followed two days later by 20 drops given internally in capsule, on sugar, or in the form of an emulsion. Journal of the American Medical Association.

The Action of Calcium in Epilepsy.

Dr. Audenino and Dr. Bonelli, of Lombroso's Clinic, Turin, having found that there is a deficiency in the absorption, and therefore in the elimination, of calcium in epileptics, have tried this remedy in the treatment of epilepsy. They used various

preparations of calcium, by mouth and hypodermically, chiefly calcium bromide. In the same cases they always used during a similar period other remedies, including potassium bromide, and found that the calcium salt was far superior in efficiency to the other methods and preparations. The authors believe that the efficiency of Richet and Toulouse's milk-diet treatment of epilepsy lies in the quantities of calcium thus brought into the system. The marked beneficial influence of calcium upon the nerve-centers has recently been proved by Sabbatani. Calcium salts produce, in all cases, a marked diminution in the number of epileptic attacks.-New York Medical Journal.

Calcium Hypochlorite for Burns.

F. Tichy calls attention to the virtues of calcium hypochlorite as an antiseptic for burns. He applies a cool bandage with oil on the first day, which he finds causes the vesicles to form quickly, which he opens after twenty-four hours under antiseptic precautions. He then applies compresses steeped in the following solution, and renewed after twenty-four hours, but kept moist by pouring on fresh solution during that time. It is of importance to leave the compresses on as long as possible, and to keep them constantly damp. Great care must be exercised in removing the old compresses not to disturb the scabs under which the wound is to heal. The solution which he uses is:

R Calcium hypochlorite, 2.4 to 5 grammes (36 to 75 grains).

head, coryza, and perhaps pharyngitis, with symptoms of general malaise, fever, and muscular pain. There are also cases with laryngitis rapidly extending to the bronchi and others beginning primarily in the bronchi. In the first class, if there is much headache and frontal pain, he recommends the following:

B Camphoræ, gr. j.

Ext. belladonnæ, gr. i-iss.
Quininæ sulph., gr. i-ij.
Morph. sulph., gr. 1/40-

M. et ft. cap. No. j.

Sig.: One such capsule every half-hour for four doses. Then one every three hours. Journal of the American Medical Association.

Olei picis liq., mxv.

Ext. marrubii fl. (horehound), 3ss.
Olei anisi, mj.

Spts. frumenti, 3j.

Mellis despumati, q. s. ad žij.

M. Sig. One-half to one teaspoonful three or four times a day. Journal of the American Medical Association.

Calcium Chloride in Hæmorrhages.

Valère Cocq, whose experience with calcium chloride in hæmorrhages has been satisfactory, ascribes the following formula to Bertignon:

B Crystallized calcium chloride, 4 grammes (60 grains).

M.

Syrup of mint, 30 grammes (1 ounce). Distilled water, 90 grammes (3 ounces).

To be taken in the twenty-four

Dissolve, filter, and add:

Spirit of camphor, 5 grammes (85 minims).

-New York Medical Journal.

Bronchitis.

According to Musser, bronchitis frequently begins with an acute cold in the

The mixture may be renewed on the following days if necessary.

The following douche may also be prescribed:

R Calcium chloride, 10 grammes (150
grains).
Sterilized

distilled water, 200 grammes (7 ounces).-M.

It should be preceded by a hot evacuant

From three to four during each of the three meals.-New York Medical Journal.

For Chronic Pyelitis.

Dr. Liégeois says that the charge that has been brought against turpentine, of speedily upsetting the stomach, may be brought with. truth against benzoic acid and sodium benzoate, the drugs that of late years have replaced turpentine. The truth is that turpentine, taken in small doses with meals, does not upset the stomach in such a way as is asserted of it. Such slight action as it has in that way may be overcome by combining with it the soft extract of cinchona, as follows:

R Venice, Bordeaux, or Canada turpentine,

Soft extract of cinchona, of each, 10 centigrammes (111⁄2 grains).

M. et ft. pil. No. j.

Three during each of the principal meals.

The author's special formula in chronic calculous pyelitis is as follows:

B Canada balsam,

Balsam of Peru, of each, 10 centigrammes (11/2 grains).

Calcined magnesia, enough to make 1 pill.

M. et ft. pil. No. j.

Three to be taken during each of the principal meals.

The author says: "I purposely add the balsam of Peru to Canada balsam; the former is to some extent a peptic adjuvant; it doubles the anticatarrhal properties of turpentine; it prevents the ammoniacal fermentation of the urine consequent on the transformation into hippuric acid of the cinnamic and benzoic acids contained in it; and it enjoys, rightly or wrongly, a special reputation for expelling calculi, as says Lazarus Rivière, balsamum peruvianum ad calculos expellendos.""-New York Medical Journal.

Acute Dysentery.

J. D. Hunter, who has resided in Peru for nearly forty years, where severe types of dysentery are endemic, usually gives ipecacuanha in a 45-grain dose as soon as the patient is seen, preceded, a half-hour before administering, by 15 to 30 minims of laudanum or a hypodermic of 1/ grain of morphine and a sinapism to the pit of the stomach. In spite of the laudanum and sinapism the patient is likely to experience severe nausea and vomiting. Peruvian practitioners usually give an infusion of the contused ipecac-root and sometimes enemata of this infusion. The clear decanted liquid, as used in these infusions, is rather less disgusting to most patients than the powdered ipecac. A second dose of the medicine is given within twenty-four hours, usually the next morning.

Where ipecac fails or, for any reason, cannot be used, many Peruvian doctors use an emulsion of castor- and almond oils in small, repeated doses, or other fats. Sulphur, gr. xx, and Dover's powder, gr. x, every four hours, is also good; or the sulphates of magnesium or sodium may be profitably tried. Res. podophylli, gr. 1/s, and powdered ipecac, gr. 1, every hour until the stools become bilious was also found to be effective in some cases. Turpentine, much lauded in chronic dysentery, the author also likes in acute cases, and recommends the following:

R Ol. terebinth., 3ij.

Tr. opii, 3j.

Syr. acaciæ, iss.

Mucil. acaciæ, viiss.

87

M. Sig.: Tablespoonful every two or three hours, reducing the dose after twentyfour hours if there is improvement.

Lactic acid is beneficial if there are greenish, slimy stools, especially in children. Fifteen-grain doses are given, largely diluted, with syrup of acacia every two hours. Iodoform with small doses of opium. acts well in some cases with severe abdominal pain. Medical Standard.