Josserand, in Germany by the younger Erb, and in Warsaw by Kzentkowski. The histological examination of the suprarenal capsules of three cases of atheroma revealed evidence of functional overactivity in those organs. All the facts are in favor of the suprarenal origin of arterial atheroma by reason of excessive functional activity, which throws into the blood too large a quantity of adrenalin.

How do these new facts agree with the older theories? 1. In contradiction to the classical opinion, atheroma and arteriosclerosis ought to be separated; the animals attacked by experimental atheroma never exhibited arteriosclerosis. 2. There were no lesions of the vasa vasorum of the atheromatous patches, which is in opposition to the theory of Hippolyte Martin. 3. Infections and intoxications may produce atheroma; these act indirectly by first determining an excessive activity of the suprarenal capsules which produce too much adrenalin and an auto-intoxication which places them under the influence of lowered arterial tension and atheroma.

Will increased tension produce atheroma, as some have thought? Is it by virtue of its power to augment tension that adrenalin gives rise to atheroma? Or does adrenalin possess in addition to its vasoconstrictor and hypertensive properties, a special ability to cause arterial atheroma? These are the questions which the speaker sought to solve by the injections into the veins, during a long period, of a substance which decidedly increases tension, viz.: nicotine. None of the animals became atheromatous. therefore appears that adrenalin exerts a specific influence upon the walls of arteries. Experiment and pathological anatomy agree in proving the suprarenal origin of arterial atheroma.-La Tribune Médicale.

Hypertensive Glands.

At the French Congress of Medicine M. P. Mulon drew attention to a series of organs disseminated along the nervous system

and demonstrated that they secrete adrenalin. He has studied them in various species of animals and in man. Injecting the rabbit with extracts from one of these organs, the glomus caroticum of the horse, he obtained arterial tracings absolutely comparable to those due to the injection of adrenalin.

All along the ganglionic sympathetic chain (vasomotor nervous system) hypertensive glands are found in close relation with the nervous elements.

This fact may throw light upon certain points still obscure in the pathogenesis of increased arterial tension. La Tribune Médicale.

Late Jaundice and Enlargement of the Spleen in Syphilis.

At a meeting of the Medical Society of the Hospitals M. Léon Bernard spoke of the case of a man, 35 years of age, who was attacked by gastralgia with fever, followed immediately by icterus. The discoloration was intense, and there was a diminution of the coloring matter in the fæces. There was a slight swelling of the liver and marked enlargement of the spleen. After a month of milk diet no change had been effected except a slight increase of the fæcal coloring matter. On account of the former existence of a chancre contracted ten years previously and the absence of any other pathogenic cause the subcutaneous injection of Gaucher's solution of the benzoate of mercury was adopted. The jaundice rapidly lessened, the hepatic hypertrophy disappeared, and the spleen diminished considerably in size. After six weeks of treatment. the cure seemed complete. Nine months later there was recurrence of the same manifestations, beginning with gastric pain and fever, jaundice, a little enlargement of the liver, and great hypertrophy of the spleen. Antisyphilitic management was at once. instituted, and the same result was obtained after the same time of treatment.

The syphilitic nature of the icterus ap

peared demonstrated by the efficacy of the treatment, which twice caused rapid improvement while other measures had no effect. It was not a jaundice of the secondary stage, since ten years divided it from the chancre. The physiognomy and evolution of the case bore no resemblance to those of icterus caused by obstruction due to a gumma. On the contrary, the color of the fæces, the enlargement of the spleen, the initial and ephemeral fever, the recurrence, rather recall the characters of infectious jaundice.

It is probable that the syphilis acted in this case by determining a slight infectious hepatitis, which gave place to the picture of infectious jaundice accompanied by enlargement of the spleen. This case, which has not previously been reported, belongs undoubtedly in the same series as those of syphilitic hepatitis with chronic jaundice. described by Hanot. We have the right to suppose that, if the patient had not been under proper treatment, the infectious icterus would gradually have passed into chronic cirrhosis. It is interesting to remark that within the domain of syphilitic infection the general laws of hepatic pathology are observed and that, as in trivial infections, we may recognize infectious icterus as the cause of biliary cirrhosis. Both belong to the same natural family of facts as has been shown by the researches of Gilbert and his pupils.-La Tribune Médicale.

Cold Abscess of the Tongue.

M. S. Mercadé has placed upon record the case of a child, 8 years of age, who had upon the left side of the tongue a small, whitish tumor covered by an attenuated mucous membrane. Fluctuation was decided. The

tumor was situated near the middle line at an equal distance from the base and tip of the tongue. It was the size of a large pea and of round contour, the mucous membrane in its neighborhood being healthy. It developed without pain or fever. There were no glandular enlargements. The hereditary

antecedents were excellent.

There was no tuberculous manifestation. The abscess was opened and scraped. The pus contained no pathogenic microbe.Revue Hebdomadaire de Laryngologie, etc.

Rare Localizations of Nasal Syphilis.

M. C. Chauveau writes that in the study of syphilis of the nose and its annexes not

At a meeting of the Medical Society of the Hospitals MM. Dufour and Brelet described the case of a man attacked by general paralysis of the melancholic form, with amnesia and intellectual decay. There were exaggeration of the patellar reflex and Babinski's sign in both feet. The encephalorachidian fluid contained a large quantity of lymphocytes. Syphilitic infection dated five years back, but for six months there had been complete inability to work. The first

ment of the root of the nose, the frontal sinus, and intermaxillary bone. The author cites three cases in which syphilis was limited to the base of the nose, which appeared to be hypertrophied in its bony portion. There was no lesion of the nasal fossæ or sinuses, but in two of the cases there was slight frontal headache and in the other redness confined to the skin upon the left side. The peculiarity of these three cases is that the thickening of the root of the nose was not accompanied by any other manifesta

tion of syphilis. As regards frontal sinusitis Chauveau believes that the influence of syphilis has not been appreciated, and, without exaggerating its pathological rôle, he thinks that the physician is warranted more often than has been thought necessary in cases of doubtful history in prescribing mercury before undertaking surgical intervention.

As an instance of syphilitic necrosis almost limited to the intermaxillary bones, he cites the case of a patient who denied. all specific taint, in whom the floor of the nasal fossæ was swollen upon the right side. Three incisors were absent, the fourth was loose in its socket, and the bone all around was denuded. There was a movable sequestrum, rather large, firm at its lower part. This was extracted after three weeks of specific treatment. The sequestrum was in the form of a trapezoid, 21/2 centimeters long and 1/2 centimeters broad. palatine mucous membrane was not impli

The

cated.-Revue Hebdomadaire de Laryngologie, etc.

Vegetative Rhinitis.

Dr. R. Lulle defines vegetative rhinitis as a chronic inflammatory disease of the mucous membrane of the nose, having definite characteristics, as indicated by Broeckaert, differentiated from primary lupus of the nasal mucosa and from chronic tuberculosis of the nose.

Its symptoms are: a secretion of thick mucus, nasal voice, without crusts, ozæna, or epistaxis. Examination of the nasal fossæ shows small nodosities, which cause. the surface of the mucous membrane to project and assume the form of yellowish granulations the size of a grain of hemp, indolent, and having little tendency to bleed. There are no ulcers.

From the anatomo-pathological point of view the swelling is constituted by firm connective tissue containing leucocytes and lymphocytes of granulated aspect. There are no epithelioid or giant cells.

The treatment is local: ablation or curettage after anæsthetization. In order to prevent return the surface is touched with lactic acid.- Revue Hebdomadaire de Laryngologie, etc.

The Relation Between Stuttering and Hypertrophy of the Pharyngeal Tonsil.

Dr. Zwillinger, of Budapest, admits that often ablation of adenoid vegetations produces cure or amelioration of stuttering. Grossard has recently reported three cases in which cures were thus obtained.

According to Zwillinger, the pharyngeal tonsil is hypertrophied in about one-third of the cases of stuttering. He does not, however, look upon these two processes as cause and effect. Although he cannot be sure that operation for the removal of the vegetations will be followed by cure or amelioration, he thinks that intervention should

always be practiced.-Revue Hebdomadaire

de Laryngologie, etc.

The Abdominal Cutaneous Reflex in Typhoid Fever and Appendicitis in the Child.

At the French Congress of Medicine M. Sicard stated that the abdominal cutaneous reflex is always easily obtained in the child. and adolescent, but is modified in the course of typhoid fever and appendicitis. It disappears with the establishment of typhoid fever or appendicitis, the disappearance. often being unilateral in the latter disease, and reappears with the cure of the intestinal lesions.

These modes of reaction do not constitute a sign of differential diagnosis from other intestinal diseases, but a sign of the evolution of the malady which may furnish useful information as regards the subjacent lesions.

M. Cruchet said that he had found in acute gastro-enteritis of childhood the abdominal reflexes are frequently abolished, in subacute gastro-enteritis they are exaggerated or normal, and in chronic enteritis

dicale.

Syphilitic Phlebitis.

Jullien writes that syphilitic phlebitis is sometimes extremely precocious. The author had observed one case in which the patient was attacked by fever and went to bed with severe pain in one of the saphenous veins, and in examining them there was found a roseola. The phlebitis was the first. sign of syphilis. In another case the beginning of the infection coincided with a fracture of the leg, which occupied all the attention. Furthermore, a phlebitis developing upon the other side was not until long afterward interpreted as a syphilitic manifestation. It is true that when attention was awakened to this point it served as a valuable aid in determining the date of contamination.

The author thinks that very often this accident passes unperceived or is at least misinterpreted.-La Tribune Médicale.

Therapeutic Notes.

Poplar (Populus Monilifera) in Malarial Toxemia.

Dr. W. M. Alter, of England, Ark., says in the Medical Council:

"It is the ideal antimalarial for the pregnant. It seems to have a soothing effect on the uterus. Abortion and premature birth are often caused by malarial toxæmia, and in quite a percentage of women here the administration of quinine will bring on abortion or premature labor. In cases of threatened abortion I generally give the following with fine results:

"R Fl. ext. populus monilifera, 3ij.

Fl. ext. passiflora inc., 3v.

Fl. ext. viburn. prun., 3iij.

"M. Sig.: A teaspoonful. Repeat every hour till half an ounce is taken, then two hours apart till another ounce is taken, then

three hours. After that I prescribe three ounces of fluid extract of populus monilifera to be taken every three hours.

"I have often stopped obstinate vomiting by giving from 3 to 10 drop doses every five minutes to children. To older patients I do not give much more for checking vomiting."

Medical Treatment of Deep-Seated
Hæmorrhage.

F. Hare urges the use of amyl nitrite in hæmoptysis. In 13 attacks of hæmoptysis, 12 tuberculous and 1 cardiac, the bleeding ceased in all but 1 in three minutes. The writer thinks that the sudden fall of the blood-pressure permits some coagulation and plugging of the leak, and that this is usually adequate to resist successfully the subsequent rise. The rationale of the treatment is evidently identical with that in which the administration of nitroglycerin is the central feature. Interstate Medical Journal.

Rheumatoid Arthritis.

A. Malbec gives during twenty days out of the month:

R Sodium arseniate, gr. iss.
Strontium iodide, 5iiss.

Distilled water, 3iij.

M. Teaspoonful at each meal.-Le Progrès Médical.

Hæmoptysis.

The best treatment of hæmoptysis requires: (1) absolute physical rest; (2) mental quiet and relief from fear and anx-iety; (3) morphine and atropine in sufficient dosage to insure both the preceding; (4) control of cough, fever, and pleuritic pain, and careful attention to diet; (5) suggestive measures, as icecaps over the heart, salt and cracked ice by mouth, etc.; (6) free use of bromides and nerve sedatives in the nervous; (7) nitrites or veratrum when high blood-pressure persists; (8)

care in not overdrugging or in placing reliance on specifics, as ergot or adrenalin; (9) hypodermoclysis with normal saline when indicated. Dr. Guy H. Fitzgerald, Albuquerque, N. M., in Cleveland Medical Journal.

Effects of Hypodermoclysis with Sodium

Chloride Solutions in Nephritis.

Ferrannini points out that, although the modern theories of the renal function regard the introduction of an excess of chlorides into the organism as apt to aggravate an existing nephritis, the use of hypodermoclysis with solutions of sodium chloride is still a favorite method of treating certain forms of nephritis in which the eliminative functions of the kidneys are greatly impaired. An extensive experimental research brought him to the conclusion that all the harm that can come from the limited use of sodium chloride in the form of hypodermoclysis in nephritis is that the albuminuria may be slightly increased for a short time, and that the renal elements in the urine may be present in larger numbers for a while. This increase, however, is followed almost immediately by a considerable diminution in the amount of albumin and in the number of renal elements eliminated, together with a general improvement in the condition of the patient. During an access of uræmia hypodermoclyses of salt solution are also beneficial, as they increase the renal function; but they should not be used as a systematic treatment of Bright's disease, because, in the long run, if used often, without proper caution, they may interfere with the action of the kidneys. This method of treatment is therefore only to be used temporarily, and in emergencies.-New York and Philadelphia Medical Journal.

The

might be syphilitic, the patient having been treated for syphilis ten years previously, injections of cyanide and biniodide of mercury were given, but with no result. eye gradually became worse and was enucleated in April, 1902. Examination showed no evidence of sarcoma. A few months later the other eye became affected with optic neuritis, and injections of cyanide and biniodide of mercury were again tried with no effect. The patient then came under the hands of the author, who commenced weekly injections of 0.05 gram of calomel. After twenty-nine injections (1.45 grams of calomel) the eye was completely recovered. The author draws attention to the success of calomel injections after the failure of soluble preparations.British Medical Journal.

Epilepsy.

In the Therapeutic Gazette Dana recommends:

R Aq. sol. sodii glycerophos. (50 per cent.), 3ij.

Sodii bromidi, ziij. Aquæ, q. s. ad 3vj.

M. Sig. One teaspoonful twice a day in water, six days in the week.

After each meal an acid tonic is given as follows:

B Tinct. ferri chloridi (1 year old), 3j.
Acidi sulphurici dil., 3iv.
Aquæ, 3x.

Olei menth. pip., mv.

M. Sig. From 15 to 25 drops well diluted or dropped in capsule after each meal.

The Treatment of Nævi without Operation.

A. Frattini describes his method, based on the principle of Monteggia and resuscitated by Piorani. He employs a 6 per cent. solution of corrosive sublimate in flexible collodion and, after shaking the solution, applies it so that it just encroaches upon the healthy skin surrounding the nævus: a current of air is blown over the