fear of impending dissolution so often witnessed in these cases. Respirazone administered for a few weeks stopped the asthmatic attacks, and mitigated the chronic bronchial symptoms in a material manner. MEDICAL REVIEW. L. T. RIESMEYER, M.D., EDITOR. DEPARTMENT EDITORS: DR. F. J. LUTZ, General Surgery. PUBLISHED UNDER THE AUSPICES OF THE CASE III.-A lady, aged 33 years, of highly, nervous temperament, and a long-standing uterine disorder, be gan to have attacks of bronchial asthma at short inter vals. There were no symptoms whatever of any pul monary or cardiac disease, hence the conclusion was that the seizures were either of neurotic, or reflex origin-probably both factors entered into the case. Teaspoonful doses of respirazone every twenty minutes until nausea occurred invariably arrested the spasm. YEARLY SUBSCRIPTION, $3.50. SINGLE COPIES, 10 Cents. The continued use of the remedy had the effect of gradually lengthening the intervals between the attacks until they were finally arrested altogether. The uterine trouble also improved under the use of respirazone the result no doubt of the powerfully alterative action of the iodide of potassium upon the pelvic viscera. BY O. H. DREYER. TO CONTRIBUTORS AND CORRESPONDENTS. All letters whether intended for publication or not must contain the writer's name and address, not necessarily for publication. No attention will be paid to anonymous communications. Members of the profession who send us information of matters of general interest to our readers will be considered as doing them and us a favor, and we shall take pleasure in inserting the substance of such communications. The formula of respirazone shows it to contain iodide Secretaries of medical societies will confer a favor by keepand bromide of potassium, helianthus aunnus, ipecacing us informed of the dates of the meetings of their respecuanha, lobelia, and leonarda cardia. These are all tive societies, and of officers elected. drugs of known and approved therapeutic value, most of them being alteratives which exert a specific action on mucous and serous structures. This combination is, therefore, a rational and scientific one, and can not fail to be of the greatest utility and value in properly selected cases. Communications, Medical Books for review, and all letters containing business communications or referring to the publication, subscription, or advertising department of the REVIEW, must be addressed to O. H. DREYER, Publisher 112 N. 4th Street, St. Louis. EDITORIALS of Blood. Uterine Ante-Deviations. Pecker (Archives Entered at the St. Louis Postoffice as Second-Class Matter. de Chirurgie; Brit. Med. Jour.) is of opinion that en teroptosis, or Glenard's disease, may set up uterine anteflexion and all its consequences, and he narrates two cases in illustration in which there was both ante. flexion of the uterns and prolapse of the right ovary into the pouch of Douglas. The badly nourished lax abdominal viscera press upon the fundus uteri, exag The Diagnosis of Diabetes From a Drop gerating or initiating its flexion forwards. Further, the prolapsed intestinal coils, directed to the left by their mesenteric attachments, determine the inclination of At the annual meeting of the City Hospital Medical the uterine axis to the right, so that there is rotation of the anterior surface of the uterus to the same side, and in consequence the right ovary falls into the pouch of Douglas. The muscular substance of the uterus is weak in these chloro-anemic women, and the organ becomes sharply flexed; dysmenorrhea is thus produced, and the menstrual blood meeting with resistance passes in some degree through the tubes into the peritoneal cavity, and then sets us a posterior pelvic peritonitis. The author, The simplest test, and one which seems to give the therefore, regards the peritonitis as a consequence and most pronounced color contrast, appears to be methyl not as the cause of the ante flexion. Such being his blue (the methyl blue used in these experiments was views of the causation of the displacement, he recom Merck's). If two glass slides containing, respectively, mends a treatment giving tone to the uterus and other a film of diabetic and non-diabetic blood are prepared involuntary muscular organs (for example, electricity, in the manner described in the above mentioned editormassage, etc.) along with the dilatation of the cervix ial and immersed for a certain length of time, usually with Hegar's bougies, and the replacement of the ante- about twenty seconds (the time varying according to flexed fundus. the thickness of the blood-film), into a one per cent Society, Dr. L. Bremer demonstrated his method of diagnosing diabetes from a drop of blood. Since the demonstration of the Doctor's discovery before the St. Louis Medical Society some new facts have developed with regard to the decreased affinity of the blood in diabetes for certain aniline stains, which we have alluded to in an editorial upon the same subject (see MEDICAL REVIEW, January 2, 1897). ized by numerous minute, round perforations, which were either absent, or much less numerous in the nor. mal blood. This difference in the naked eye appearance was observed in each individual specimen. This difference of appearance between the blood of only two indi. viduals may not,of course, be of any significance whatever and will have weight only in case of a similar behavior of the blood of many diabetic individuals compared with the blood of many non-diabetic individuals. aqueous solution of methyl blue, the non diabetic blood, different appearance. The former, too, was characterafter rinsing in water, appears green while the diabetic blood has absorbed very little or none of the stain, so that the color-contrast is very pronounced. A similar behavior is manifested toward eosin, the non-diabetic blood taking on the stain with much more avidity than the diabetic blood. The former appears red, the latter pale orange-yellow. The difference in the color contrasts vary with the shorter or longer immersion of the speci men in the staining fluids. The color contrast mani fested by the eosin test seems most pronounced when the specimen is overheated. The overheating (to about 160° C.) of a lot of specimens occurred accidentally and thus this phenomenon was accidentally observed. Gas light or electric light do not allow the perception of the contrast as readily as daylight. This is particularly the case, of course, with specimens that are differentially stained with eosin. The eosin-methyl green test for diabetic blood and the gentian violet-eosin test for diabetic urine (see MEDICAL REVIEW, January 2, 1897), were also demonstrated to the Society. A most interesting fact and one that may have an im portant bearing upon the question of the nature of diabetes, consists in the property which non diabetic blood acquires when it is immersed in diabetic urine. After such an immersion the non-diabetic blood acquires a similar behavior when subjected to the staining process by certain aniline dyes as the diabetic blood. This be havior is not manifested when the specimen is immersed into non-diabetic urine or urine to which glucose has been added. What may be the final outcome of the application of the principle discovered and demonstrated by Dr. Bre mer as regards the behavior of diabetic and non diabetic blood toward various aniline stains, there can be no doubt about the decided difference, in this respect, in diabetic and non-diabetic blood and urine. The priority of discovering a naked eye method of diagnosing a dis ease from a drop of blood is very pertinently claimed by Dr. Bremer, who should have the full credit in this respect, no matter how much his present methods may in the future by elaborated, simplified or modified by other investigators. The principle discovered by the Doctor needs, of course, additional corroboration by the examination of many specimens of diabetic blood gathered from numerous individuals who are afflicted with the various recognized forms of diabetes and who are in various stages of the disease. A peculiarity of the (unstained) specimens of diabetic blood gathered from the patient presented to the St. Louis and the City Hospital Medical Societies has been of interest to us since we, as well as Dr. Bremer, were able in every instance, to identify by the naked eye the patient's blood from a specimen of (unstained) non-diabetic blood after the respective specimens were spread upon the slides in the manner pointed out by us in the editorial of January 2, 1896. The diabetic blood had a smeary (almost greasy) ap pearance, while the normal blood presented an entirely The technique of the test (see MEDICAL REVIEW of January 2, 1897), is a comparatively simple one, although there are sources of error that have to be overcome by practice. The operation for obtaining a drop of blood is done in the following manner: The right hand of the blood yielding individual is held by the left hand of the operator. The ulnar side of the tip of the ring-finger of the right hand is "quickly" pierced by a surgical needle to the depth of about one fourth of an inch. It is of importance in the application of these tests that a control specimen of non diabetic blood be always compared with the specimen of diabetic blood. An Impediment to Medical Progress. We have received a communication from Dr. Geo. M. Gould, editor of the "American Year Book of Medicine and Surgery," in which he states that the publishing firm, Wm. Wood & Co., of New York, refuses to permit the editors of said publication to use in their abstracts of Medical Progress articles and illustrations first printed in the Medical Record and the American Journal of Obstetrics. Addressing the medical profession in general the Doctor submits the following questions: "Do you wish to limit the dissemination of your contributions to Medical Science by such an exclusion of them on the part of publishers from reputable publications? Is this literature the property of yourself and of the profession, or not? Does your gift of it to a journal make it the private property of the publishers of that journal? Is it not rather a loan for temporary use only? "Will you not hereafter demand that there be printed with your article a statement that the right of abstracting the text or reproducing illustrations is guaranteed ?" Dr. Gould, as well as the enterprising firm of Wm. Wood & Co., enjoy an enviable reputation and it seems strange that this well known publishing house should see fit not to allow the editors of the Year Book to make abstracts from said journals. It is usually considered a compliment to a journal to be frequently quoted by other journa's and, therefore, to have as many abstracts made from its original articles and as much of its other contents reprinted as possible. We know of no similar instance where a publishing house, includ ing Messrs. Wm. Wood & Co, refused medical writers the abstracting of articles, provided, of course, that due credit be given in every instance. It is to be regretted that Dr. Geo. Gould, who is so well known to the medi cal profession for his many excellent qualities as a man, physician and writer, should be placed in this predica ment by an equally favorably known publishing house. This state of affairs is certainly an impediment to scien tific progress and the dissemination of medical know ledge and might become a serious matter if it were the rule, instead of a great exception. We sincerely hope, therefore, that the cause for Messrs. Wm. Wood & Co.'s course in this matter be soon removed, so that the "Year Book of Medicine and Surgery" may be as complete as its talented editor can easy and cheap-Who said "cheap and nasty ?"-road to prominence, brilliance, eminence and leadingness. But they are, at all events, not selfish enough to keep it longer hidden. If there be anyone desirous of the fame that can be conferred by the American News Bureau, who is still ignorant of its methods, or of the name and address of its manager, let him remain so no longer. CORRESPONDENCE make it with an unrestricted use of the entire medical An Appeal to the State Boord of Health. literature. Fin de Siecle Newspaper Enterprise. Editor MEDICAL REVIEW.-Whilst our State Board of Health has done much to elevate the standard of medical education, it deserves all the praise that could be accredited to it for its efforts in this matter. Not only this, but the public health is becoming careThe following letter which has been sent to a number of physicians in Philadelphia-members of the Faculty fully looked after in the way of preventing the spread of the Philadelphia Polyclinic-is of much interest as of contagious and infectious diseases; even the water a fin de siecle specimen of newspaper enterprise. It and milk supply is rendered pure and healthful. Yet seems to explain, in a measure, why not infrequently miraculous cures and wonderful operatious by Eastern "great" doctors are minutely and skilfully described in nearly all the St. Louis newspapers. The letter is printed in full, as it deserves, in the editorial columns of the Philadelphia Polyclinic. Here it is: DR. THE ASSOCIATED News Bureau, ARTHUR LESLIE, General Manager, 150 Nassau Street, All the leading newspapers of NEW YORK, December 10, 1896. DEAR SIR—We are just in receipt of a report of the operation that was performed on which was there is one more thing that will, I think, if looked after, immortalize the name of our State Board. I refer to that wart on the belly of the nineteenth century, "Osteopathy"-bone and nerve adjusters-the embodiment of fraud and mendacity. We are told that all power is vested in the State Board of Health and that such a scheme should be tolerated and allowed to impose on the credulity of the sick under the guise of scientific medicine is a problem that surpasses solution. It is unpleasant to thus urge our authorities to rectify such things as this, which tends to lower the dignity of our profession and places it on a level with the most consumate ignorance and superstition. I do not expect that our State Board could quarantine against all the ignorance, egotism, superstition and gall that hangs like a pall over this country, but it is not expecting too much to ask that a fraud of such gigantic a great success. We trust that you will take the trou- proportions as that of Dr. (?) Ertill, of Kirksville, Mo., ble to make this office the medium for a statement to should be allowed, under the cover of something unthe medical and newspaper world in regard to this op-known to this witness, to impose on suffering humanity eration. You can readily see that it can not be kept without being held responsible for, at least, something. out of the papers much longer, and we would like to Now, in conclusion, I respectfully ask that every have from you a personal account, which will be pub-reader of this article will send me a postal card simply lished throughout the United States in all the leading papers, giving your name the prominence that it demands. If you can consistently do so we would like to have you send us at once a photograph of yourself, so that we can properly illustrate the article. This photograph will be returned to you when we have finished with it. Hoping that you will favor us with an early reply, we remain, Yours very respectfully, expressing their views on this matter, and when I get E. HOUSTON, M.D. Anatomical Legacy Refused.-Howard University, Washington, D.C., very properly refused to accept the body of the late Dr. Caroline B. Wislow, who The first communication being answered, a second, bequeathed it to that institution to be dissected by the and sometimes a third, follows. female medical students. Her skeleton was to be wired It is perhaps to be regretted, says the Philadelphia and mounted for use by the students of the Martilla Polyclinic, that the members of the Polyclinic staff are Minor Normal School. The action of the University not sufficiently ambitious to avail themselves of this resulted in the cremation of the body. TRANSLATIONS. BY EDGAR THOMPSON, M D. Urethral Spasms.-According to Dr. E. Lagelouze (La Rev. Med.) the spasmodic contractions of the urethra form an obscure chapter in the pathology of the urinary tract. Spasms have been confused with organic strictures because both are closely associated. The subject is obscured by a defective terminology. As ordinarily understood a spasm is an exaggerated activity of the involuntary muscles. Applied to the urethra this would indicate that the spasm was due to a contraction of the non striated muscles which are so abundant about the urethra. This is not entirely true. In the membranous portion of the urethra the spindleshaped fibres are reinforced by striated fibres to such an extent as to form a veritable sphincter. On the other hand the physical agents, as electricity for example, are frequently used to produce a tonic state of contraction in cases of urinary incontinence. The chemical excitants which stimulate the muscles are numerous. They may be applied from without but usually originate in the urine. Contractures are often seen to result from a concentration of the urine, etc. The excretion of toxins and poisons cause urethral con tractions by the local irritation of the chemical bodies as they pass along the urethra. Under certain conditions the irritation will originate in the muscles themselves. When there is a deviation from the normal nutrition of the muscle, toxins will accumulate. The same thing occurs when the muscle is fatigued by excessive labor. That fatigue causes contractures is very evident. Often, after a person has resisted for a long time, the desire to urinate by a voluntary compression of the sphincter muscles at the neck of the bladder, he will find that when he does finally desire to pass his water The author suggests that the pathology of this affec- he will be unable to do so because the muscles that he tion is not a spasm of the non striated muscles, but a had voluntarily controlled have persisted in a state of contraction of the ring of striated, voluntary muscle true contracture. The extra work thrown on the musfibres situated about the membranous portion of the urethra. The striated muscles in repose are not absolutely relaxed; they persist in a certain amount of activity which is called the muscular tone. This mild stimulation is constantly maintained by impulses from the cells of the anterior cornea of the spinal cord. Under various in. quences the tone of the muscles may be temporarily increased. A series of contractions may occur. But if the contractions succeed each other rapidly a tetanic stage or a contracture is produced. A contraction then is an exaggeration of the normal tone, while a contracture is an exaggeration of the contraction. The pathological state is only an exaggeration of the physiological state. Consequently, a study of the means which Nature employs to create a simple contraction will reveal at the same time the pathology of a contracture. The agents involved are the muscles, nerves and cen tral nerve cells. It is then possible to conceive a con tracture caused by some influence exerted on either one of these three elements. * ** Experimental physiology shows that muscles can be directly impressed and stimulated without the interposition of the nervous system. Mechanical excitants (compression, section, percussion) and physical excitant (electricity, heat, light) and chemical excitants all cause a direct response from muscle fibres. Examples of the effect of mechanical excitants on the fibres of the deep urethra are common. Retention of the urine has resulted from the strong contracture set up by the passage of a cold sound, or by the contusion from a badly passed sound, or by too rapid dilatation. cles in holding back the urine tired them out and this fatigue induces the contracture. Stimulation of the nerves cause contracture in the same manner as direct excitation of the muscles, but more strongly. Examples of this action are seen in the contracture of the pectoral muscles after the luxation of the shoulder and in the contracture of the arm following tendants on Charles IX, of France, once decided to a puncture of the nerve. It is said that the medical atpractice phlebotomy on him. A nerve was pricked by mistake and a contracture of the forearm followed which lasted for many months. A similar contracture in the urethra has been noticed during the course of an urethrotomy. At the moment of the incision of the stricture the instrument was firmly embraced by the spasmodic contracture of the muscular walls. The urethrotome could not be removed for 24 hours. Contractures can also be indirectly induced by an excitation of the sensitive nerves. A contracture of the masseter muscle is often occasioned by a dental neuralgia. The contractures of the muscles about an articulation in painful joint troubles are examples. [The author Pain."-Translater.] This fixing of the joint is a sort is probably unacquainted with Hilton's "Rest and of muscular vigilance. In the urethra spasms occur from pain in the deep urethra. It is the same sensory reflex that causes an urethral spasm in cases of calculus and hypertrophy of the prostate. Finally, the contracture can be caused by a direct excitation of the central nerve cells. The excitability of the central reflexes is controlled and inhibited by the psychical centers and when the communication between the two is interrupted the reflexes lose their control and pared, as recommended by Professor Albert Robin. become much more active. Thus it is that post-hemiplegic contractures occur for the reason that the reflex centers of the cord are cut off from cerebral centers by the degeneration of pyramidal tracts. The contractures are produced by an analogous mechanism when the centers have been suppressed and inhibited. Such conditions occur in hysteria, neurasthenia, the hypnotic state, etc. In all cases the reflex centers are free to exercise their spontaneous and automatic action. Also in the urethra contractures can be produced by a direct excitation of the genital centers in the lumbar region of the chord when these centers are separated from the brain by myelitis. Certain toxic substances can augment the irritability of the nerve cells and cause contracturet. Thus animals intoxicated with strychnine react by violent contrac tures to every slight stimulation. Blowing the breath on the skin will suffice to call up the paroxysm. * The following test will easily detect impurities: A solution of pure phosphoglycerate of lime (Chapoteaut) gives no precipitate with the ammonio magnesium reagent or acetate of uranium. It is precipitated by heat, alcohol and ether. Nitrate of silver causes a precipitate (which is redissolved by an excess of water) also acetate of lead (soluble in acetic acid). The dry phosphoglycerate of lime treated with alcohol leaves a sticky residue on evapora tion of the alcohol. The very prominent position which phosphoglycerate of lime and its preparations now hold in therapeutics and its undoubted value as a nerve tonic in the treat. ment of neurasthenia warrant physicians prescribing the pure and therapeuticrlly active drug only.-Translated from the Tribune Medical by F. S. Mason. ABSTRACTS MEDICINE. Serumtherapy of Leprosy.-Deluca (Giorn. Ital. d. Mal. Vener.; Brit. Med. Jour.) treated a case of leprosy by injection of serum from a rabbit inocula. ted with the disease. Ten injections of 10 cubic centi metres each were given in the course of a fortnight. They caused cessation of fever, a certain amount of transudation in the lepromata analogous to that produced by Koch's serum, and some shrinkage in the swelling. Another case was treated by injection of blood serum from another leper in whom the disease was in the latent state, but without any result-Cara. squilla (Proc. Academy of Medicine of Colombia— Cor reio Med. de Lisboa, 1896, xxv, 122, 124) immunized horses with blood serum from lepers by injecting 15 to 60 cubic centimetres every two days on three occasions, and then every month. The serum, taken with great care, is then employed as follows: In a leper from whom blood to the amount of 150 to 250 cubic centimetres has been drawn, 1 to 5 cubic centimetres of horse's serum is injected after five days; a second injection is made three or four days later, according to the degree of reaction, then a third and fourth; in some subjects reaction does not take place till after this This salt is now made by digesting glycerine at 28° for six days at a temperature of a 110° C., with phosphoric acid 60 per cent. The mixture allowed to cool on the seventh day leaves a glassy transparent mass, which is then saturated with the milk of carbonate of lime. The whole is then filtered and the clear liquid exactly neutralized with lime and again filtered and precipitated by alcohol at 90°. The precipitate is drained as dry as possible and dissolved in cold water, filtered and evaporated at a very low temperature. Various modifications of this general mode of manufac ture have been proposed, but the phosphoglycerate of lime prepared by Chapoteaut's process (late assistant to period. The reaction manifests itself, as in the case of Pelouse) is the one generally used in dispensing. It is important in prescribing phosphoglycerate of lime, to insist on a chemically pure and fresh preparation, as there are numerous adulterations, especially as the phosphoglycerates have always a tendency to decom pose, however well prepared. Capsules of four grains each are the best form for internal administration as the salt is then preserved from the action of the air. Hypodermic injections should always be freshly pre other serums, by fever, circulatory disturbances, changes in the secretions, etc. After some days the leprous lesions undergo somewhat rapid modification; the tubercles desquamate and shrink, the ulcerations become vegetating and cicatrise. The disturbances of sensibil. ity are lessened, and, when the lesions are not too far advanced, improvement takes place rapidly, and to an astonishing degree. Carasquilla states that he has treated 100 cases by this method with good results. |