Professor Lashkevitch, of St. Petersburg, reiterates this assertion, and at his suggestion, Dr. Favr, of Kharkov (reported in Vratch, November 13, 1885), resorted to oxygen inhalations in two cases of puerperal eclampsia, and his efforts were followed by prompt and brilliant results. Cough and vomiting of reflex origin have been promptly arrested by inhalation of oxygen with an admixture of nitrogen monoxide. Eczema.-Dr. Wallian reports the following: Mrs. W. M. A—, æt. 55. An extremely severe case of chronic eczema, complicated with hay-fever and an undoubted specific taint. The true nature of the case having been disguised in the beginning, treatment was undertaken and pressed for six weeks, when only moderate benefit being apparent, beyond the relief of the hay-fever and accompanying indigestion, further treatment was refused, the patient being advised to go to the Hot Springs of Arkansas. Dyspepsia.-Dr. Wallian, of New York, reports the following: Mrs. H. A. E, æt. 30. Case of unusually severe chronic constipation of ten years' standing. Family history shows phthisis, which has been both predicted and feared. Result of six weeks' treatment, marked general benefit, which continues to date. Dr. A. M..., æt. 55. Came to me suffering from aggravated dyspepsia, with persistent constipation and distressing insomnia. Weight, one hundred and thirty pounds. Has had inflammatory rheumatism, and one sister died of phthisis. Was placed on active oxygen treatment with nourishing diet-no drugs whatever -and in three weeks gained five pounds in weight, and had an excellent appetite. Constipation relieved and digestion good. Sleeps soundly, and has climbed to the summit of a neighboring mountain, nearly five thousand feet above the sea-level. Is to continue the treatment at home. Dr. K. J-, æt. 40. Has been a chronic sufferer from indigestion and "neurasthenia." In one month the indigestion is a thing of the past. He eats the miscellaneous fare of a wellkept hotel with impunity. Has gained five pounds in weight, and says he feels "rested," and much stronger. Can hunt, fish, and climb mountains without great fatigue. Says he feels physically renovated," and returns to his practice with zest. distressing dyspepsia, insomnia, and decline of virile power. After four weeks of active, but somewhat interrupted treatment, he declares himself a "new man.” Was able to sleep soundly all night for the first time in two months after a single treatment-six inspirations. Now sleeps, eats, and digests well, and asserts that his virile powers are all that he could desire! In respect to this latter result, it was a surprise to me, but I have since noted the same revival in a very marked manner in a number of additional cases. The treatment has proved a prompt restorative to this function in every case since observed, in which loss of sexual appetite and power, in either sex, had been a marked feature. Case of S. A. C-, merchant, æt. 59. chronic rheumatism, severe dyspepsia, and slowly progressive locomotor ataxia. Oxygen treatment undertaken by means of a portable rubber bag, patient being confined to his bed, and completely helpless. Result of six weeks' treatment, gradual amelioration of all the symptoms. Locomotion became possible by the aid of a cane, and so remains at this writing. Mrs. S. A. M—, æt. 26. Disease: severe, chronic, gastric catarrh. Complete recovery, and a gain of fifteen pounds in body-weight in six weeks. In the severer forms of the indigestions the results have been scarcely less brilliant. Scanty or suppressed secretions are gradually restored, absorption and assimilation resume normal activity, and the functions of depuration and defecation, long deranged, obstructed, or interrupted, are surely, normally, and, in a medical sense, permanently restored. It may be asserted, in general, on rational as well as experimental grounds, in connection with this treatment, that those chronic cases show most marked and striking results which are selected from the great army of house-prisoners, "delicate" people who, from necessity, habit, preoccupation, or negligence, have been long deprived of wholesome air and everything like active out-door life; or who have long suffered from miasmatic location, sedentary occupations or unsanitary surroundings; or from those who have been too tenderly reared-overcoddled (and this virtually includes every close resident of a populous city). To these may be added the phlegmatic, the lymph albuminous," and the lazy-of whom every commu S. C. H, æt. 37; married; suffering from nity shows numerous examples-patients with sluggish circulation, small respiratory apparatus, | an hour. She asked for food, particularly for torpid or enlarged livers, fatty heart or kidneys, vegetables. Trousseau and Oxygen Inhalation.--You have seen in our clinical wards the successful results of this treatment, results which have not astonished you less than they have astonished me. The results were as remarkable when looked at from a therapeutic point of view, as they were physiologically unexpected and paradoxical. The woman, whose case I am now going to describe, was admitted on the 1st of April, 1864, and is now a patient, occupying bed No. 7, St. Bernard Ward. She is twenty-two years of age. She has been, like the other woman whose case I have just described, recently confined; like her, also, she was anæmic, and exhausted by lactation. Her face was exactly like that of a dead person. The first step in the treatment was to separate the child from the mother. There was, however, no improvement between the first and 14th of April, that is to say, during the first fourteen days in which she did not give suck. On the contrary, there was a continuance of the fever; the pulse ranged between 120° and 130° Fahr.; the skin was dry and hot, and the debility went on increasing. So great was this debility, that the patient could not sit up in bed without fainting, and on this account auscultation was almost impossible. Nevertheless, it was ascertained with certainty that the lungs were healthy. As there was no tubercular disease, as tonics and ferruginous remedies had failed, and as there was complete anorexia, I resolved to try the effects of inhaling oxygen, with a view to restore appetite and promote digestion. The patient commenced this new treatment upon the 14th, but was so weak that after the second inspiration of this gas she became insensible from the effort made in inhalation. However, I recommended her to persist, and to inhale during the day, at intervals, a quantity amounting to five or six litres. For three days she inhaled much less than that quantity, and during that period the amelioration was not very perceptible. But from the 19th the patient could sit up in bed with impunity, and could eat a little. The pulse was not more than 104 in the minute. On the 21st, she was able to leave her bed for The pulse was not more than ninety-two. The skin was cool. Upon the 24th, the pulse was eighty. On that day the patient went down into the garden and ate voraciously. To-day, April 30th, and for the four preceding days, the pulse has ranged between seventy-two and eighty. The young woman feels herself so well that she wishes to leave the hospital. I have, however, asked her to remain, telling her that her cure is not yet complete. In fact, she still continues pale, and the fibre has evidently regained its tonicity to a greater extent than the blood has regained its normal constitution. One strange and unexpected phenomenon which accompanies the inspiration of oxygen is the production within the chest of an agreeable sensation of coolness by each inspiration of the gas. The pulse being eighty-four on the 30th of April, when the patient began to inhale the ten litres of gas, had fallen to seventy-six by the time the inhalation was completed, and remained at that point during the remainder of the hospital visit. The pulse becomes thready after three inspirations of oxygen, and so continues for two or three minutes of the duration of the operation. These facts prove-were proof required that hæmatosis is not accomplished in the lungs, but in the general capillaries—that during the inspiratory act there is a simple exchange of gas in the organs called the organs of hæmatosis, and that, finally, the oxygen acts almost immediately upon the vaso-motor nervous system producing contraction of the vessels. How shall oxygen be administered? Ist. Direct inhalation will probably always stand at the head of all methods. 2d. Cutaneous absorption has been resorted to in Europe, and may be found advantageous in certain cases. 3d. Oxygenated water is a feasible and pleasant medium for stomachal administration. It is prepared by saturating steam with the gas, at high pressure, and afterward condensing the steam. M. Brochin reported some experiments made by MM. Paul Bert and Becquard at a recent meeting of the Société de Médicine Pratique (British Medical Journal). Oxygenated water was used with great success in the treatment of purulent cystitis, ozæna, and ringworm; also internally in uremia and diabetes.-C. C. V. 4th. Oxygenated bread has been used to some extent in England, and there is no reason why the "aërated bread" of our cities should not be easily transformed into oxygenated bread at will. Of this bread Dr. Birch says: "Its relative effect on the appetite is singular. Thus on the one hand (as might be expected) it stimulates the appetite when absent or capricious, while, on the other hand, it tends to produce such a feeling of epigastric fulness, when sufficient food has been taken, as to effectually suspend (if not satisfy) some morbidly craving appetites.. "In some cases it will be found advantageously to supersede artificial pepsin, pancreatin, and even quinine and the mineral acids. . . It is particularly indicated in cases of delicate children with continually recurring ascarides, functional derangement of the stomach and bowels, and mesenteric weakness." In the matter of proportions and combinations, and as respects the quantity to be exhibited in a given case, there is a wide latitude for the exercise of professional discretion, as in the compounding and selection of ordinary drugs.-DR. WALLIAN. Time and Frequency of Administration.Except in emergencies, the treatment should not be given either on an empty stomach or after a prolonged fast. In a majority of cases the mid-meal hours between breakfast and dinner are most favorable. It is well to avoid giving any active treatment within an hour of any principal meal, or at any time when there is present an unusual degree of fatigue. Mere weakness or nervous prostration do not, however, contra-indicate, but are usually relieved by oxygen. As a rule, in ordinary chronic cases one treat ment per diem is all that is advisable; in many cases it is all that is allowable. This should be carefully borne in mind by the inexperienced, since it is quite easy, and I had almost said natural, in the anxiety of both physician and patient to see palpable signs of immediate improvement to overdo in the matter of dosage. Dosage and Intervals.—When feasible, let the patient stand erect, throwing the shoulders well back and as thoroughly as possible expelling the residual air from the lungs before inspiring the gas; then with a steady effort slowly inspire from the mouth-piece until the lungs are as full as can be readily filled. Let the inspired gas be retained as long as convenient without discomfort, then slowly and deliberately expired. There should be an interval of from five to twenty minutes, according to the nature of the case, before a second inspiration is given, and during this interval the patient may walk about, sit or recline, as he seems most inclined. It is well to hold the nose while inspiring. In ordinary non-critical cases, accompanied with venous stasis and general functional torpidity, from four to ten inspirations, comprehending two to six gallons, may be given at each daily séance; but this limit should seldom be exceeded. Some cases will present in which two full inspirations will be all that should be exhibited during the twenty-four hours. In this regard the practitioner must be constantly on the alert, and must use the most careful discretion. A systematic record should be kept of each case treated, beginning with a summarized history, a thorough physical examination, an examination of the urine, noting pulse- and respiration-rates, capacity of lungs, etc. The quantity per diem and specific gravity of the urine, as observed at stated intervals; daily, in critical or important cases, and at least weekly in all during treatment, will furnish suggestive data from which to regulate the quality and quantity of gas to be exhibited. In acute cases, as of asphyxia from any cause, alarming dyspnoea, cyanosis, suspended animation, narcosis, severe paroxysms of asthma, etc., no definite rules can be formulated. The indications must be gathered in each instance from the nature and progress of the case, and the judgment of the practitioner must in all cases supersede all rules. In cyanosis and asphyxia there is little danger of pushing the treatment too rapidly or too far, short of positively relieving the patient. The immediate demand is for oxygen, and it may be given, freely and constantly, until the imminent crisis has been passed and the urgent symptoms are relieved.—WALLIAN. torpid states of the digestive organs, hot water drinking are useful adjuvants. Morbid products are set free by the treatment, and these should be washed away. ORIGINAL COMMUNICATIONS. THE PRINCIPLES OF HEALTHY CLOTHING. BY ALFRED S. GUBB, L.R.C.P., M.R.C.S. THE Black of such substances as eider-down, or furs, or plumage of any sort, the interstices of each. being filled with air, which is, in itself, a bad conductor of heat. Many experiments have been made since those first conducted by Rumford, in 1736, to determine the delays. which occurred in the cooling of a thermometer heated to a certain degree, when enveloped in hemp, flax, cotton, silk, and wool respectively. Since this observer, Senebier and Boeckmann have both recorded numerous experiments with a similar object in view. flannel was found to allow of the absorption HE choice of materials for clothing has and dispersion of heat more rapidly than lighter been dependent, hitherto, far more on shades, but it is difficult to say how much of the facilities which they offer for manufacture, this is attributable to the difference in the or self-decoration, than on any preconceived texture from the chemical changes involved in idea of their suitability, although here, as else- dyeing. In any case, the differences found to where, we find, on examination, that the con-exist between textures of various hues, are only sensus of opinion of succeeding generations, appreciable as regards solar heat, obscure heat generally leads in the right direction. The best method, therefore, of arriving at the truth is to reason backwards, and to endeavor to ascertain why certain materials have invariably been chosen, under certain circumstances, as clothing material, and this may enable us to understand the laws which underlie this apparent hazard in the matter of choice. The value of clothing consists, as we all know, in promoting the maintenance of our bodies at an equable temperature, and in shielding the surface from the effect of sudden and violent changes in the temperature of the surrounding atmosphere. Now the value of any particular substance as an article of clothing is in inverse proportion to its capacity as a conductor of heat. But this is not the only quality to be considered in the selection of such materials, for while we wish to protect our bodies from undue loss of heat by radiation, we have to provide or allow for ventilation, and the escape of watery vapor and gases, and here the ma terials vary within wide limits. It should be borne in mind that radiation takes place, not only in proportion to the relatively low temperature of the ambient air, but also, and more markedly, towards bodies which are possessed of a lower temperature than ourselves. not exhibiting the same preferences. In some more recent investigations, by Pettenkofer, on a cylinder of sheet-iron filled with hot water, and enveloped successively in different textures, the variations only represented some one or two per cent., and this irrespective of color, but when the cylinder was exposed to the rays of the sun, the absorption of heat varied between linen and silk as much as 90 to 108. The effect of color was even more striking, and was as follows: white, 100; yellow, 140; green, 160; red, 168; blue (light), 198; black, 208. The figures readily explain why a black garment is unsuitable to wear in the sun. It is worthy of note that, on enveloping the cylinders with a double layer of satin, cotton, or fine linen, the loss was only diminished by some two to six per cent., whereas, with chamois leather, flannel, or woolen cloths, the diminution amounted to from twenty to thirty per cent. The inference is evident, viz., that the resistance to the passage of heat depends less upon the individual conductivity of the textile fibres than upon the thickness, the volume, and the texture of the materials. conductivity of wadding, for instance, increases some forty per cent. when strongly compressed. Although the radiation which goes on is not A great factor in protecting our bodies from notably diminished by doubling the thickness thermometric changes, lies in the different of the investing texture, if it be tightly drawn strata of air which intervene between the differ-round the cylinder, it is quite otherwise if an ent layers or garments, and permeate the air space is allowed to intervene between the fabrics themselves. two layers. With such an interspace, of only The It is to this that we owe the extreme warmth one third of an inch, the radiation is dimin ished (exclusive of the diminution due to the layers themselves) to the extent of some thirtyfive per cent. This, however, is based on the assumption that the intervening column of air is motionless, but as loose garments tend to favor the circulation of the air, they are, notwithstanding this fact, preferred in hot climates. The essential point, indeed, is, that the greatest obstacle to the dissemination of heat is found in a discontinuity or want of homogeneity, in its elements. Heat, like sound, is but a form of molecular vibrations, and is governed by the same laws. Then, again, the permeability of the various textures to air, is a point of capital importance, and this varies from one in glazed kid to one hundred in flannel. It is essential that our garments should allow of such ventilation, but it is also necessary that this should not take place so rapidly as to affect the sensory elements of the skin, hence the more slowly it takes place, the more conducive is it to our health and comfort. the pores of the tissue to become blocked, the fibres of wool, in virtue of their native elasticity, tend to keep the pores open, and so favor evaporation, while the air contained in the pores checks, to some extent, undue radiation. It has been remarked that vegetable fibre is less suited to purposes of clothing than substances which are of their very nature destined for this purpose. Take the fibres of flax or hemp for example; they form an integral part of the plant, and are not called upon to possess any isolating or protective properties against cold. Now as to cotton, this indeed serves to envelop the seed of a plant, and is, therefore, to some extent protective; but silk, wool, eider down, and fur are, par excellence, the materials furnished by nature for the express purpose of protection. As to the shapes of our garments, they are now probably definitive in all essential particulars. Ladies' dress doubtless calls for reform, reasons of taste and æsthetics dominating too largely in their choice, both of texture and of shape. One is apt to call to mind the profound and amusing speculations of Darwin, on contemplating the rich plumage and often cumbersome ornamentations by means of which animals are enabled to place themselves in evidence, and so unconsciously aid in the designs of nature in the matters of natural selection. TEREBENE. BY ALFRED S. GUBB, L.R.C.P., M.R.C.S., THIS HIS substance has lately been employed by Dr. William Murrell, of London, Another important property of textile fabrics is their capacity of absorbing and retaining moisture; the nearer the air is to its saturation point, the more moisture do they absorb, owing to diminished evaporation. This is accentuated when the temperature, from any cause, falls. The water contained in textures may be divided into two categories, one part not appreciable to the touch and which cannot be squeezed out; the hygrometric water, properly so called; and a second part which blocks the pores, and which may be expelled by compression, the interposed water. According to the experiments of Mr. Coulvier, wool is more hygroscopic than hemp, and linen than cotton. The quantity of water that these textures can absorb is much greater than is generally sup-in the treatment of winter cough, and he posed. A woolen garment weighing ten to published a series of one hundred and twelve pounds will take up about a quart of fourteen cases, in which great benefit had water, to evaporate which, completely, will been derived from its use. Expectoration withdraw from the body from 500 to 600 units is facilitated, and the shortness of breath is of heat. More moisture is absorbed at a low relieved. It is a colorless fluid, with a faint temperature than when it approaches 70° terebinthinate odor, which is by no means disFahr., further, since wet garments are better agreeable. The remedy may be inhaled as a conductors of heat than dry ones, they protect vapor with the ordinary "respirator," or it us far less efficiently against the cold, hence the may be atomized by means of one of the puldanger to health of damp and cold combined. verizateurs, several forms of which are in use, This effect, however, is less marked in the case and the fine spray so produced inspired by the of woolen textures than in those of cotton, silk, patient. For internal administration by the and wool, and this is probably owing to the fact mouth, it may be given as an emulsion with that, while the fibres of the latter all become gum tragacanth. Another, and possibly a softened on contact with water, and so allow preferable manner, is to give it dropped on |