Influence of the 606 Treatment of the Mother on the Child.

Taege and Dubot (Abst. in Fortschritte der Med. No. 10, 1910) each reports a case in which a syphilitic mother, after having given birth to a miserable, plainly syphilitic infant received an injection of 606 with the result that both the mother and the child were cured with one stroke; the latter picking up at once and becoming blooming and robust without a sign of syphilis. In neither case could arsenic be detected in the milk, hence the cure of the children could not have been due to a direct passage of the 606 into the milk. It is necessary to assume that some other anti-spirochaetic substance was contained in the milk. On account of the enormous number of spirochaetes which syphilitic infants are known to harbor, there would be great danger of auto-poisoning by the dead germs if 606 were given to the child; hence both authors conclude that the best remedy for syphilis in the new born is the milk of a syphilitic woman who has been injected with 606; and in case the mother can not nurse the child, a syphilitic, 606-injected wet-nurse should be engaged.--Gifford (Omaha).

Syphilis of the Nose.

Translated from Die Syphilis, der Nose, des Halses und des Ohres von Dr. P. H. Gerber a. o. Professor a. d. Universität und Direktor d. Königl, Universitätspoliklinik f. Hals-und Nosenkranke zu Königsberg. 1910 Mongraph.

In 1739 Hoffman published the first account of intranasal chancre, the next was by McCarthy in 1844, then followed Ricard, Fournier, Rollet, Nettleship, Watson and Rosori. Since 1885 the reports have been more frequent.

The infection is indirect by the fingers, instruments and articles in general.

Löb under the direction of Seifert collected from the literature 249 Cases of Chancre of the nose, which he tabulates as follows:

Chanere of the external Nose causes great swelling of the

soft parts and the surrounding region of the nose, in the center of the swelling is found the indurated, crust covered ulcus elevatum.

The symptoms of the intranasal chancre become quite important to the patient when he experiences, for some time both a cold and plugging of the nose. The secretion takes on a bloody pus, dirty brown, excoriating character which finally causes the patient much uneasiness over his trouble.

The chancre appears in one of the two primary forms, either the large crusted, indurated characteristic ulcer, or the small, flat, slightly or not at all indurated sore.

On the septum where the chancre mostly occurs, it is generally the type of the true ulcus elevatum which does not completely obstruct the nasal passage, nor cause much swelling of the nose.

Accarding to Dupont, the sclerosis forms a fungous, greyredish mass on the nasal mucous membrane and many authorities speak of a mushroom proliferation. Nearly always is the surrounding or the whole mucous membrane affected.

The induration of the submaxillary, submental and praeoricular glands helps to establish a diagnosis where the local signs are not clear. Some hold that the enlargement of the gland at the greater corner of the hyoid bone is pathognomonic.

The remaining subjective symptoms are small, though nasal breathing and speech may be considerably changed.

Many patients experience a severe neuralgia of the first and second branches of the fifth nerve, also fever and a general complaining may be observed.

The intranasal chancre must be differentiated from the different growths of the septum and difficulty may be encountered as the following will show:-from the so-called bleeding septal polypi, Granulomata, Fibromata and especially the Sarcomata and Tuberculoma, which are the first to be met with; less frequently occur Carcinomata, Scleromata, Leprosy and Glanders.

The characteristic signs of the chancre are not always present; the wall-like undermined border, the induration, and the sharp border line from the surrounding healthy tissue, then we must look to the accompanying symptoms, the secondary phenomena, the histological and parasitological examination. The importance of looking for enlargement of the glands cannot be too often repeated. The author sights two cases, one infected from a nephew, the other by using snuff.

H. L. ARNOLD, (Omaha.)

The Induction of Labor.

Little (Jour. Obst. and Gyn. Brittish Empire, Sept., 1910, Am. J. of Med. Sciences, Feb., 1911) reports 46 inductions of labor in 3,000 cases of pregnancy. The method employed was the introduction through a bivalve speculum of a medium sized rectal tube through the cervix by a flexible metal director. The average time from the introduction of the bougie to the onset of labor was six and one-half hours; the shortest time about half an hour; the longest about twenty-four hours. Twice the membrances ruptured prematurely, but at the onset of labor, and not as a result of the introduction of the bougie. In 2 cases there was slight hemorrhage after the introduction of the bougie, but in no case was this alarming, as it was easily controlled. A general anesthetic was given in but 2 of the 46 cases. The indications were: toxemia, 14; disproportion between head and pelvis, 8; protracted pregnancy, 8; tuberculosis, 3; pyelitis, 2; cardiac lesions, 2; foetal death, 2; syphilis, 2; typhoid fever, 2; diabetes, 1; fever during labor, 1; and persistent vomiting, 1. In half the cases spontaneous labor occurred, and in the other half it was necessary to perform some obstetric operation to complete labor. These operations were all those of delivery through the vagina by various methods. Four of the mothers so treated died; in one case of persistent vomiting a small quantity of chloroform was given during delivery, and at autopsy extensive necrosis of the liver was found. A second case of severe toxemia had eclampsia after the bougie had been inserted and pains had started. The patient died on the third day and autopsy showed thrombosis of the cerebral veins with necrosis in the uterine wall. One other patient died with marked oedema of the lungs, and one from general anasarca with chronic nephritis.

In commenting upon the series, the author believes that the method used for the induction of labor has proved more satisfactory than any of the other means suggested for the purpose. Harris' method of dilation is satisfactory when the application of the forceps must be preceded by the obliteration of the last rim of the cervix. Its dangers are obvious in cases in which the cervix is unusually vascular. The use of the dilating bag is limited to cases in which there is no objection to rupturing the membranes. The bag displaces the head, if already in the pelvis, and anyone who has tried to insert a bag into a cervix admitting but two or three fingers will appreciate the inadvisability of recommending its use in general practice. The necessity for emergency measures in obstetrics, the author thinks,

varies inversely with the care given to the patient during pregnancy. Many complications of labor can be anticipated and avoided by the timely induction of labor. Pelvic contraction is not to be considered as an indication for the induction of labor. Prolongation of pregnancy, on the other hand, is more frequently an indication.

The passage of the bougie and the introduction of the gauze pack will usually bring on pains within a few hours. Labor may be spontaneous or may be terminated artificially. When the cervical canal is obliterated, its dilation by the hand is usually easy and with care reasonably safe. Hemorrhage and infection can be avoided; lacerations of the cervix will frequently occur, and such lacerations should be immediately repaired.

This method can be employed without assistance other than the anesthetizer and a trained nurse. It is simple, applicable to many cases; the force used is limited to the fingers of one hand, and the fingers can recognize and estimate the resistance to be overcome.-Palmer Findley (Omaha).

He was a professional politician, and knew more about "grafting" than Luther Burbank himself. As he was walking from the City Hall to the bank, an automobile struck him amidships. He was rushed to the nearest hospital, and three surgeons stopped playing pinochle and tried to locate the liver, which had been driven up under his right lung.

"Compound fracture of one rib, and we'll have to probe for the splinters," said the Head Dissector.

"All right, as long as it isn't a grand jury probe," groaned the sufferer.

A half-hour later the politician came out of the ether.
"Where am I?" he asked dazedly.

"In the City Relief Hospital, Ward 9," answered the nurse pleasantly.

"Gimme my clothes!" he screamed. "The Ninth Ward is Republican." -Lippincott's.

A tender-hearted little girl was looking at a picture of Daniel in the lions' den. She suddenly began to cry, whereupon her mother said:

"Are you crying for the poor man, dearie?"

"No; I'm crying for the little lion over there in the corner. He isn't going to get any at all.”

Neb.

NOTES AND NEWS.

Dr. Slusser of Norman, Neb., has changed his location to Polk, Neb.

Dr. J. F. Neal of Peru, Neb., is reported to be removing to Auburn,

Dr. C. Gunderson is a new physician in Gordon, Neb., coming recently from Chicago.

Dr. S. A. Swanson of Wausa, Neb., has disposed of his practice there and located in Oakland, Neb.

Dr. L. A. Lansing of Wakefield, Neb., has purchased the practice of Dr. Swanson in Wausa, Neb.

Dr. Cameron of Spalding, Neb., has located in Kearney, where he will engage in medical practice.

Dr. J. N. Stoops, is a new physician, recently located in Mitchell, Neb., coming from Lubbock, Texas.

A nurses' training school has been founded at Seward, Neb., by the leading physicians of that town.

Drs. Johnson and Smithheisler of Creighton, Neb., have formed a partnership for practicing medicine.

Dr. H. J. Sloss, who was located for a short time in Nebraska City, has returned to his former home in Wyoming.

Dr. L. W. Bowman of Alliance, Neb., has removed to Stanton, Neb., where he will make his home in the future.

Dr. D. F. Smith of Wauneta, Neb., has removed to Bartley, where he will continue in the practice of medicine.

Dr. Mace of Glenville, has purchased the practice of Dr. Fox of Roseland, Neb., and will make that his future home.

Aberdeen, S. D., will get the German Baptist hospital which several cities have been after. The building will cost $50,000.

Drs. Allen and Humphrey of Clark, Neb., have dissolved partnership, and Dr. Humphrey has removed to Council Bluffs, Ia.

Dr. E. O. Weber of Lincoln, Nebr., formerly of Valpariso, Neb., has located in Wahoo, Neb., where he will practice his profession.

Dr. W. L. Bowman, a pioneer physician of Stanton, Neb., and the father of Dr. L. W. Bowman, is recovering from a very serious illness.

Dr. J. Whitridge Williams has been appointed dean of the Johns Hopkins Medical School, succeeding Dr. William H. Howell, resigned.

The cholera situation in Madeira is growning worse. Up to January 15th 1,646 cases of the disease had been reported, with 535 deaths.

Dr. W. H. Ramsey of Omaha, chief surgeon of the Missouri Pacific, and contract surgeon of the Aramy, died suddenly in the Paxton hotel, Jan. 14.

R. R. Hollister, M. D. of Omaha, has been appointed contract surgeon of the department of Missouri, U. S. A., to succeed Dr. Ramsey, deceased.

Dr. S. Wier Mitchell of Philadelphia, has tendered his resignation as trustee of the University of Pennsylvania, after serving 35 consecutive years. The physicians of Cumberland, Md., on December 20, resolved "to abolish all contract practice as applied to medical service of every sort in the city."