or three grains to the ounce. This should be used for three or four weeks, and then substituted by some similar remedy, as ferric alum or chloride of below, over the head-board and foot-board. | for most cases. After the inflammation has subThe patient, wrapped in a sheet, is then slipped sided, I direct the patient to continue the use of on to the cot; of course, the canvas sags down, the mild, stimulating spray two or three times a and when water is poured over the sheet the day for many months, in order to toughen the man lies half immersed in a pool. If the attend- membrane so that it may not be so easily affected ant is provided with two tubs, one containing by exposure. For this purpose I usually recomwater and one empty, and also with a large bath-mend a solution of sulphate of zinc in water, two ing sponge, the water in this pool, heated by the body, can be removed by means of this sponge, and fresh cold water soused over the body enveloped in the sheet. In this way the water-zinc, for about the same time, after which the orilying continually between the sheet and the body, as well as saturating the sheet-so envelops the person that the effect of the cold bath can be achieved, and I have seen very rapid reduction of obstinate high temperatures. If the bed upon which the patient lies be a very wide one, instead of a cot being used the mattress can be so arranged on one side as to sag down sufficiently to form a hollow for the pool, and in this way the bath can be given. ginal spray may be again employed. Frequently, I combine with these solutions small quantities of carbolic acid, for its sedative effect, and often I add to them the distilled extract of hamamelis, eucalyptol, or Listerine. At the same time, owing to the pharyngeal trouble, troches of krameria, or Hancock's compound troches of krameria, or benzoic acid, may be beneficially employed four or five times a day. By this process, eventually, nearly all these cases will be cured, if the patient is faithful in the use of his home remedies. The vapor inhalations which were much in vogue a few years ago, are not generally beneficial, except during the first few days of the attack; on the contrary, they are often hurtful by reason of the increased tendency to inflammation in I notice that Stephan, of St. Petersburg, affirms that the application of ice-bags over the superclavicular regions is sufficient to control the temperature in fever, owing to the fact that the cold is brought into close contact with much of the blood of the body by the large superficial veins of the neck. I have had no experience, how-duced by the frequent applications of warmth ever, of this method of reducing temperature, but it is worthy of a trial; especially as it seems to be safer to reduce temperature in a low fever by external cold, than by our at present known depressant antipyretic drugs. RECURRENT LARYNGITIS.-Dr. E. Fletcher Ingalls (Journal of American Medical Associaation) says the treatment of recurrent laryngitis must be varied according to the cause of the disease. In cases in which the affection occurs in a person predisposed to inflammation of the mucous surfaces, and in which there is no obstruction in the upper air passages to account for it, we adopt the ordinary treatment recommended for chronic laryngitis, i.e., local applications of astringents and stimulants, together with proper attention to any constitutional symptoms. We must make every effort to ascertain the true cause of the frequent colds from which these patients suffer, and they must be advised accordingly. During the heighth of the attack, I prefer applications of sulphate or chloride of zinc, in strength varying from gr. ij to xxx in f3j, according to the effect, the weaker solutions during the heighth of the affection, and the strong ones later on. These are made with the atomizer, if possible, but in a large number of cases, the patient cannot hold the throat in position long enough to permit a thorough application; and then either a brush or a pledget of cotton must be employed. I prefer the latter and moisture. As a matter of course, the patient must not use the voice when hoarse, and he must be careful in recommencing its use after a period of rest. The condition of the digestive and secretory organs must be carefully attended to in all these dartrous diathesis, if present, must receive proper cases, and the rheumatic, gouty, syphilitic, or consideration. In a considerable number of cases, the inflammation is caused and maintained by the use of tobacco. I have found the condition most frequently among smokers, though I believe that chewing is almost as injurious in some individuals. In such cases, tobacco must be discontinued before we can hope for a complete cure. THE INTERNATIONAL CONGRESS.-We have received a circular containing the preliminary organization of the International Congress, which we publish elsewhere, and which looks very much as though the meeting was destined to be a great success. In this connection, it seems to us to be our plain duty to call attention to and to censure in very severe terms the unpatriotic course that has been hitherto pursued by the two prominent weekly medical journals, that, we are almost ashamed to say, have made every effort in their power to doom the Congress to failure. With remarkable persistency, that would call only for the highest praise were it expended in a worthy direction, the Medical Record of New York, and the Medical News, of Philadelphia, have, by repeated editorials and by the republication of extracts unfavorable to the Congress from interested foreign journals (such as those published in Berlin, which city was the great rival of the United States at Copenhagen for the honor of the Congress in 1887), used their utmost endeavors to cultivate the seeds of discontent that had been cast abroad by the disappointed clique. The editor of the Medical News is one of this select circle, and it is with sorrow that we witness his exhibition of weakness in prostituting the great mission of medical journalism to the gratification of a jealous coterie. The Medical Record is the organ of the New York circle, and its great mission has been submerged by (to say the least) an exceedingly unpatriotic course. oring ludicrously to gracefully retire from a position which they evidently regret. Now, that those who would have taken pleasure in ruining the Congress, realize that the fœtus has great vitality and gives ample promise of a vigorous maturity, they hesitate in their unpatriotic course, and since success always assures success, commence to think that they would like to do homage to its shrine, and since, with a commendable spirit, the present authorities seem inclined to extend the hand of fellowship to those among the revolters whose coöperation is universally desirable, we doubt not that the chasm will be bridged.-Medical and Surgical Reporter. WHEN A PATIENT DIES OF EXHAUSTION, FROM WHAT DOES HE DIE?-Dr. J. Milner all know what is meant by death from exhausFothergill (British Medical Journal) says: We tion. It is "failing power." The patient sinks before our eyes, slipping away because we cannot "keep up the strength," or "husband the powers," or "maintain life," as we variously phrase it. We know well that, when the sick man declines food, in a limited time he will sink. We give him the readily oxidizable alcohol, but he cannot long survive on that alone. What is amiss, that we fail to keep him alive? How different in a similar situation would be, and indeed how dissimilar in the present case is the course pursued by the great independent London weekly, the Lancet; this enormously influential journal, published in a country that would be perfectly excusable for hostility to an American Congress, has been much more loyal to our good name and our good fame than have our own journals. The scurrilous imputation has been made that the Lancet has been bought over, and as we write the words, we can see the If a shipwrecked sailor be deprived of food smile that will illumine the face of Mr. Wakeley for a certain time, he will die of starvation. He when he reads that any one could for a moment grows weaker and weaker, till, at last, he dies of suppose that his absolute independence, that has exhaustion. Just like the sick man, he sinks. made his journal the most influential medical We know, too, that, while a man so deprived of publication in the world, could be bought at any food in a cool locality will die in about ten days, price. From the beginning, Mr. Wakeley's pene- he will die in less time in a cold locality; while tration enabled him to recognize the true inward-life will be maintained for a longer period of ness of this revolt, and rightly reasoning that justice, truth, and journalistic independence were to be placed high above all personal aims, he has accorded to the Congress a hearty support. That our visitors will not see men worth seeing, and hear men worth hearing, because some of the leading lights of our large cities will "sulk in their tents," is not true. We venture to say that the distinguished physicians of Europe would consider it well worth their while to have traveled many miles to have heard and seen McDowell, Atlee, or Jenner; to see and hear Koch, and many others whose names we could mention who did not, when they became famous, belong to city cliques. It is not always those who themselves think so, who are the most worth hearing and seeing. time, even to seventeen days, in the tropics. (It is assumed that he has access to water.) Starvation is a slow form of burning up. But what is burnt up? The fuel-food of the body, clearly. The fuel of the body is glycogen and fat-the stored form of fuel. Glycogen is burnt, we believe, as lactic acid in union with soda-lactate of soda. From the carbohydrates of our food, glycogen or animal starch is stored mainly in the liver. This glycogen is stored up from each meal, and given off, as grape-sugar, as the body requires it. Disturbance in the glycogenic function of the liver gives us diabetes, a wasting disease. In the diabetic person the combustible portions of the body are burnt up, just as in death by starvation. The liver gives off grape-sugar as long as Besides, we are not so sure that these shining it has any to give; and, when its store (and the lights will not be found at the feast. It is a sig- spare store, the body-fat) is exhausted, then the nificant fact, that the two journals already al- lamp of life dies out, just as the lamp on our luded to have, for some little time, dropped their study-table dies out when the oil is exhausted. former aggressive form and stand only on the de- Now how does all this bear on our patient fensive, editorially noticing the Congress only sinking from failure of the powers, otherwise when their policy in the past is attacked, and│“dying of exhaustion"? It bears very matethen lamely defending their course, and endeav-rially upon his case. Virtually, the patient is dying of starvation. How do we feed that | Practical Surgery, Including Surgical Dressings, Bandaging Fractures, Dislocations, Ligation of Arteries, Amputations, and Excisions of Bones and Joints. By J. EWING MEARS, M.D., Lecturer on Practical Surgery and Demonstrator of Surgery, Jefferson Medical College, etc. With four hundred and ninety illustrations. Second edition. Revised and enlarged. Philadelphia: P. Blakiston, Son & Co., 1885. perishing patient? We give him beef-tea, calf'sfoot jelly, alcohol, and milk, and seltzer-water or other effervescing water. He may get a small quantity of other foods; but that just given is the staple of his regimen. Now, let me ask, in all seriousness, how much of the body-fuel (grape-sugar) is contained in the list? A small quantity of milk-sugar there is certainly; also, a small quantity of fat in the milk; some oxidizable alcohol certainly. But are we not mocking the famishing man by giving him a stone when he asks for bread? Do we not stand around his dying bedside, and, with the best intentions in the world, let him die by inches before our eyes, unsuccored, unfed? Fashion prescribes the food of the sick-room to a large extent. Veal-broth had given way to calf's-foot jelly when my professional experience first began. Then a patient who had not had calf's-foot jelly had been neglected. Now it is beef tea which holds the place of honor in the sick-room. Beef-tea is valuable as a stimulant, as a pleasant vehicle of something else, but its food-value is so small, that it can scarcely be classed as a food. What that beef-tea needs is grape-sugar. How can this be added? In our prepared foods, known generally as "baby food," starch has been converted into the soluble dextrine, or maltose; the one grape-sugar, the other only requiring a touch of saliva to complete its conversion. Add some of this material to the beeftea, and then food is supplied to the famishing system. Starch that has long been exposed to heat (either by the baking process or the malting process) is converted, more or less completely, into grape-sugar. The saliva of a sick person is enfeebled, and so carbohydrates should be provided which do not require insalivation for their solution, being already soluble. This demand is met by the various malt extracts which contain not only soluble carbohydrates, but also some soluble albuminoids, and phosphatic salts, ground malt of like composition, also grape-sugar itself. The latter is not too sweet to pall upon the palate when added to beef-tea or other meat-broth. Much new and important matter has been incorporated in the second edition of this valuable work. It now contains a clear and concise description of all the operative procedures of every-day surgical life, and will be of inestimable assistance to the busy practitioner, as well as to the student when preparing for examination. Inebrism; a Pathological and Physiological Study. By T. L. WRIGHT, M.D., Bellefontaine, Ohio. Published by the author. This instructive treatise is devoted to a consideration of the causes of inebriety, and the pathological changes which are developed in the organs and tissues of inebriates. It contains much important information and many valuable suggestions, and should be read by every lover of humanity. Post-Mortem Examination, with especial rej- and Pharmaceutical Students and Practi- This work is the result of the author's experience as a teacher of chemistry during the past twelve years, and corresponds in subject matter and general arrangement with the course of lectures given by him for several years in the Long Island College Hospital. It was written especially for the use of medical and pharmaceutical students, but will also be of value to the practising physician as a book of ready reference. Official Formula of American Hospitals. Collected and arranged by C. F. TAYLOR, M.D., editor of The Medical World. Published by The Medical World, Philadelphia. This little volume contains the formula which are most frequently employed in the principal American hospitals. It has been carefully compiled by Dr. C. F. Taylor, and will be found to be a useful pocket companion. A Treatise on Nervous Diseases; their Symptoms and Treatment. A Text-Book for Students and Practitioners. By SAMUEL G. WEBBER, M.D., Clinical Instructor on Nervous Diseases Harvard Medical School, etc. New York: D. Appleton & Co., 1885. This volume contains a concise but comprehensive description of the etiology, pathology, diagnosis, prognosis, and therapeutics of the functional and organic diseases of the nervous system. It is written in an attractive style, and will prove a valuable addition to the working library of every practitioner of medicine. The Physician Himself, and what he should add to his Scientific Acquirements in order to secure Success. By D. W. CAHILL, M.D., late Professor of Pathology in the College of Physicians and Surgeons, of Baltimore. Fifth edition. Revised and enlarged. Baltimore: Cushing & Bailey, 1885. The success of this admirable book is as un paralleled as it is well deserved. Over fifteen thousand copies were sold within two years from its first publication, and the fifth edition, which has been recently printed, will soon be exhausted also. We cordially advise those of our readers who have not yet procured a copy of it, to send for one at once. It is full of practical suggestions, from which every young practitioner, and many old ones, can derive both pleasure and benefit. Milk Analysis and Infant Feeding: a Practical Treatise on the Examination of Human and Cow's Milk, Cream, Condensed Milk, etc., and Directions as to the Diet of Young Infants. By ARTHUR V. MEIGS, M.D., Physician to the Pennsylvania Hospital, and to the Children's Hospital, etc. Philadelphia: P. Blakiston, Son & Co., 1885. This little book is a valuable contribution to our knowledge of infantile dietetics. The author, after long and careful investigation, is convinced that human milk contains a much smaller percentage of casein than is ordinarily believed to be present in it; and that the failure of the various substitutes which are used for it is due to the fact that they usually contain more casein than can be digested by the infantile stomach. Experience has shown that these views are correct. The Use of the Microscope in Clinical and Pathological Examination. By DR. Carl FriedLANDER, Private Docent in Pathological Anatomy, Berlin. Translated by HENRY C. COE, M.D., Pathologist to the Woman's Hospital. New York. Second edition. Enlarged and improved. New York: D. Appleton & Co., 1885. This volume contains a concise description of the best methods of making microscopic examinations for diagnostic and pathological purposes, and will be found to render invaluable aid in many obscure cases. Its author is well known as one of the most expert anatomists and microscopists of the famous Berlin school. Aids to Gynecology. By ALFRED S. GUBB, L.R.C.P., M.R.C.S. New York and London: G. P. Putnam's Sons, 1885. lids to Surgery. By GEORGE BROWN, M.R.C.Ş., L.S.A. New York and London: G. P. Putnam's Sons, 1885. Aids to Obstetrics. By SAMUEL NALL, B.A., M.B. New York and London: G. P. Putnam's Sons, 1885. Aids to Medicine. By Dr. C. E. ARmand SemPLE, B.A., M.B., etc. New York and London: G. P. Putnam's Sons, 1885. This valuable series of compends has been written for the use of students while preparing for examination. Each volume presents in a clear and concise manner all the important facts connected with the subject of which it treats. The volume on gynecology is especially worthy résumé of all the salient features of that departof commendation, as containing a complete ment of medicine. Leonard's Physician's Pocket Day-Book. Published annually by the Illustrated Medical Journal Company, Detroit, Mich. This popular day-book is now in its ninth year of publication. It is good for thirteen months, from the first of any month that it may be begun, and accommodates daily charges for fifty patients, besides having a cash department, and complete obstetric records. columns for the diagnosis of the case, or for brief record of the treatment adopted, following each name space. It also contains Modern Therapeutics of the Diseases of Children. By J. F. EDWARDS, M.D. Philadelphia: D. G. Brinton, M.D., 1886. This valuable book presents in a concise form a summary of the most approved modern methods of treatment of diseases of children. The sections on diphtheria, croup, and bronchitis are especially instructive. Every page, however, contains valuable suggestions, and will well repay careful perusal. DANIEL E. HUGHES, M.D., Demonstrator of Clinical Medicine, Jefferson Medical College, etc. Philadelphia: P. Blakiston, Son & Co., 1886. This valuable work is one of the most complete handbooks of the practice of medicine that has yet been published. It is based upon the popular quiz compends written by the author some years ago, but contains much new and original matter, and has been further enlarged and improved by the addition of a complete section upon diseases of the skin. A Practical Treatise on the Diseases of Children. By ALFRED VOGEL, M.D., Professor of Clinical Medicine in the University of Dorpat, Russia. Translated and edited by H. RAPHAEL, M.D., New York. Third American edition, from the eighth German edition. Revised and enlarged. New York: D. Appleton & Co., 1885. The value of Professor Vogel's interesting and instructive treatise on the diseases of children is sufficiently attested by the fact that it has been translated into four languages, and the present edition is the third that has been issued in America within a few years. It contains a complete summary of the etiology, pathology, prognosis, and therapeutics of the varied diseases of infantile life. It is evidently the result of years of personal experience, as well as of extensive reading, and is well entitled to a first place in the field of modern medical literature. NEW PUBLICATIONS RECEIVED. Puerperal Mania, by T. K. Holmes, M.D., Chatham, Ont. Reprint from Canadian Practitioner. Contributions to the Philosophy of Color, by William C. Cahall, M.D., Philadelphia. Reprint from Popular Science Monthly. Rectal Medication, by D. W. Cathell, M.D. Reprint from the Transactions of the Medical and Chirurgical Faculty of Maryland. The Surgical Treatment of Cystis of the Pancreas, by N. Senn, M.D., Chicago, Ills. Reprint from Journal of American Medical Association. Mechanical Dilatation of the Uterus, by Charles Meigs Wilson, M.D., Philadelphia. Extract from Transactions of Pennsylvania State Medical Society. A Case of Laparotomy for Gunshot Wound, by John R. Hamilton, M.D., Washington, D. C. Reprint from the Journal of the American Medical Association. Iritis: Its Relation to the Rheumatic Diathesis and Its Treatment, by Charles J. Lundy, A.M., M.D., Detroit, Mich. Reprint from the Physician and Surgeon. Abnormal Positions of the Head: What do they Indicate? by Edward Borck, A.M., M.D., St. Louis, Mo. Reprint from The Medical and Surgical Reporter. In Memoriam, John L. Atlee, M.D., LL.D. An Address delivered before the Lancaster City and County Medical Society, by J. L. Ziegler, A.M., M.D., of Mount Joy, Pa. Hydrobromic Ether, or Bromide of Ethyl as an Anæsthetic, by Laurence Turnbull, M.D., Ph.G., Philadelphia, Pa. Reprint from the Journal of the American Medical Association. The Practice of Artificial Anæsthesia, Local and General, with especial reference to the Modes of Production and their Physiological Significance, by Dudley W. Buxton, A.M., M.D. Reprint from British Medical Journal. A Case of Fatal Ear Disease, beginning as a Circumscribed Inflammation in the outer half of the External Auditory Canal, by Charles J. Kipp, M.D., Newark, N. J. Reprint from Transactions of American Otological Society. Résumé of Dr. J. Mortimer Granville's Book on Nerve Vibration and Excitation, with Notes of Clinical Experience with the Percuteur, by Asa F. Pattee, M.D., Boston, Mass. Reprint from the Journal of the American Medical Association. Observations upon the Mutual Relations of the Medical Profession and the State. An Address by Donald Maclean, M.D., President of the Michigan State Medical Society. Delivered before the Society at Port Huron, Mich. Published by order of the Society. Ninth International Medical Congress, to be held in Washington, D. C., in September, 1887. Preliminary Organization. Rules and General Officers. Published by order of the Executive Committee, Henry H. Smith, M.D., Chairman, Philadelphia; Nathan S. Davis, M.D., LL.D., Secretary-General, Chicago, Ills. On the Necessity of an International Pharmacopoeia. An Address delivered in French before the International Pharmaceutical Congress, at its meeting in Brussels, September 1, 1885, by F. J. B. Quinlan, M.D., Professor of Materia Medica and Therapeutics, Catholic University Medical College, etc. Reprint from the Dublin Journal of Medical Science. Subscribe for THE MEDICAL BULLETIN; the largest and best journal issued for $1.00 a year. |