macology, Therapeutics, and Materia Medica," | interference with the secretory functions of the M. Sig. Teaspoonful largely diluted T. I. D. The iodide of potassium to be increased as required. A great objection to some very valuable remedies consists in the disagreeable cerebral symptoms accompanying their administration in large doses, or in cases in which it is necessary to prolong their use for a considerable period. Thus, salicylate of sodium, which is so invaluable in rheumatism, must often be stopped at a critical period in the process of the disease, or the dose reduced on account of the head symptoms developed; cascara cordial will often prevent the development of these toxic symptoms of the drug. The following furnishes a convenient formula for combining the salicylate with cascara cordial :— Ammonii carb. Ammonii chloridi Syr. yerba santa . 3iss. 3ss. M. Sig. Two teaspoonfuls in water every two hours. M. Sig. Teaspooonful every hour and a half. M. Sig.-Teaspoonful every three hours. THE Medical Bulletin. JOHN V. SHOEMAKER, A.M., M.D., Editor. F. A. DAVIS, Att'y, Publisher. A. L. HUMMEL, M.D., Business Manager. Philadelphia, Dec. 1886. A GRIEVOUS ERROR IN INFANTILE DIETETICS. WE E doubt if there be a more grievous error than that which many physicians commit in directing the milk on which infants are nourished to be largely diluted with water. Dr. Taafe, for instance, in an address delivered before the recent meeting of the British Medical Association says: "No infant at the breast, or who is being brought up by hand, should be fed more than once in three hours during the day and twice in the night; after five months old, every four hours during the day and twice in the night. If brought up by hand the food should consist only of milk and water to be sucked from a bottle. For the first day or two after birth the proportion should be milk one-fourth, water three-fourths. After the first day or two and up to two months old, milk one-third, water two-thirds; from two to four months old, milk and water in equal parts; from four to seven months old, milk two-thirds and water one-third. A dessertspoonful of sugar of milk may be added to each bottle." Dr. Taafe's directions are substantially the same as those which are given by numerous other writers and teachers, and, like them, result, in the overwhelming majority of cases, in the gradual emaciation of the unhappy little patients. necessary, and that when it is practised to the extent of two or three hundred per cent., as recommended by Dr. Taafe and other writers, the resulting fluid is grossly deficient in the material necessary to sustain nutrition. An infant to whom such a mixture is administered soon becomes restless, and is continually fretting and crying for more food. In order to pacify it, the bottle is given it at too frequent intervals, and its stomach becomes over-distended with a watery innutritious liquid. Vomiting, diarrhoea, and other gastro-intestinal disturbances follow as a matter of course. The blood becomes thin and impoverished, the child peevish and emaciated, and, in too many cases, finally succumbs from inanition, unless carried off by some intercurrent disorder to which its half-starved condition makes it an easy victim. Opiates, astringents, and tonics are of little avail. Sufficient nourishing food is the one thing necessary, and without which medication is useless. Let the infant be given pure fresh cow's milk containing the full natural proportion of solid constituents, and in a short time it will be fat, quiet, and happy. In some cases it may be found advisable to add a tablespoonful of lime-water to each pint of milk, in order to render it neutral or slightly alkaline in reaction, but any further dilution will be not only useless but positively injurious. SOME COMMON MISTAKES IN THE MANAGEMENT OF THE PUER PERAL PERIOD. T is a mistake to not apply an abdominal I livery Dr. N. S. Davis has shown that the proportion of casein, butter, and salts to water in the milk of healthy nursing mothers is about 1 to 7, and in good cow's milk about 1 to 6.3. In other words, the relative excess of the nutritive material in cow's milk is less than oneand-a-half per cent., or not more than the difference often observed between different specimens of healthy human milk. It is evident, therefore, that little or no dilution is The muscles have been strained to the utmost extent, and require to be supplemented by artificial aid until their normal contractile power is restored. A well-applied bandage not only adds to the immediate comfort of the patient, but, by checking the sagging of the abdominal walls and the consequent formation of a pendulous abdomen, prevents many a future regretful pang. It is a mistake to not administer a laxative to the puerperal woman until the third or fourth day. If constipation is hurtful to a man of active habits, it is certainly not benefi cial to a woman confined to bed in a warm | resignation of Dr. Williams, of Cincinnati, room and surrounded by exhalations of a more or less unpleasant character. Many cases of socalled septicæmia are produced or aggravated by the absorption of putrid material from the intestines, and disappear after a brisk purgative is given. The health and comfort of all puerperal patients would be promoted by the administration of a gentle laxative twenty-four hours after delivery. It is a mistake to use antiseptic vaginal, or uterine injections as a matter of routine practice If the lochial discharges become offensive, or if there be reason to suspect the presence of placental or other débris in the uterus, they may be employed, but not in any other case. Intrauterine injections should always be given by the physician himself and not intrusted to a nurse. It is a mistake to suppose that a rise of temperature in puerperal women is always due to septic infection. She is not exempt from any of the grave diseases which attack humanity. Many slight febrile attacks are due to the irritation of unnecessary injections, others are produced by cold, malaria, and nervous disturb ances. It is a mistake to regard quinine as the antipyretic par excellence in all diseases of the puerperal period. Quinine is invaluable in the treatment of septic and malarial fevers, but in purely inflammatory affections it is much inferior to aconite and veratrum viride. It is a mistake to restrict the diet of a puerperal woman to bread and tea, or gruel and similar articles. Rest for the stomach as well as for the body is imperative during the first few hours succeeding delivery, but after then it is unnecessary, as well as injudicious, to keep the patient upon low diet. Milk, soups, oysters, eggs, beefsteak, and fruit may be freely partaken of. Cool water may also be drank ad libitum. WE IMPOTENT MALICE. from the Presidency of the Ophthalmological Section of the Ninth International Medical Congress. Dr. Williams, who may be justly entitled the father of ophthalmology in the United States, was one of the original appointees of the Congress, but, being misled by the clamor and misrepresentations of the little clique of Eastern specialists who failed to appropriate all the offices, he tendered his resignation to the committee. He soon discovered his error, however, and reaccepted the position with the determination to make his Section second to none in the Congress in practical results. Unfortunately, his health failing him during the summer, he was compelled to relinquish all professional work and seek a new lease of life in the valleys of California. His resignation from the Congress, owing alone to this cause, was duly published in the Journal of the American Medical Association and other journals. The editors of the Medical News and the American Practitioner, who are now alone in their unpatriotic opposition to the Congress, announced the resignation under the flaring headline of "ANOTHER RESIGNATION FROM THE CONGRESS," but deliberately omitted to state that Dr. Williams resigned solely on account of indisposition. Their object evidently was to create an impression abroad that there is still widespread dissension in the profession of this country, and that the Congress will not be a success. But it, however, has proved a miserable failure, and cannot fail to react disastrously upon its unpatriotic projectors. THE JOURNAL OF COMPARATIVE THE MEDICINE AND SURGERY. HE Journal of Comparative Medicine and Surgery, which has been printed in New York for a number of years, will hereafter be published by A. L. Hummel, M.D., of 1217 Filbert Street, Philadelphia. The first number issued by the new publisher gives promise of a brilliant future. It contains a number of orig E have seldom witnessed a more piti-inal communications of great merit and pracable example of impotent malice than tical value. that which was recently exhibited by the Medical News, of Philadelphia, and the American Practitioner, of Louisville, in referring to the The articles on "Avian Tuberculosis," "Barsati, or Atrophic Carcinoma," etc., are alone worth a year's subscription to the journal. CORRESPONDENCE. OUR PARIS LETTER. apparatus invented by M. Stober, which is a modified form of Snellen's, and serves to detect simulated amaurosis. He placed glasses on the patients' eyes which had one glass red and one A NEW METHOD OF TREATING TYPHOID FEVER green, then the patients were told to read from -HYSTERICAL AMAUROSIS-AN INSTRUMENT FOR FUNCTIONAL EXAMINATION OF THE RETINA-PERI-NEPHRITIC PHLEGMON INDEPENDENT OF RENAL AFFECTION-COCAINE IN ULCERATIONS OF THE TONGUE-LOBULAR a frame on which letters were printed on red and green glass alternately. M. Bernheim's patients were made to read with the right eye, the left being shut, and, with the red eye-glass, they could only distinguish the red letters, but with both PNEUMONIA—Puerperal Neuritis IN CASES red and green glass. Patients affected with unieyes open they were able to read the letters on OF TABES-FILARIA Medinensis. Ar a recent meeting of the Société Médicale des Hôpitaux. M. Albert Robin described a new method of treating typhoid conditions. In this morbid evolution the human organism is always overladen with the residue of nutrition incompletely oxidized. This detritus is eliminated with difficulty, from the fact that they are but slightly soluble in the fluids of the human organism. There are certain pharmaceutical | substances, which combine with the nitrogenous residue of the human organism, and render them more soluble, and thus facilitate their elimination. The principal agents which act as dissolvents are benzoic and salicylic acid, which, after combining with nitrogenous substances, such as glycocol, passes into the urine as salicyluric and hippuric acid. M. Robin, in his first experiment, studied the physiological action of benzoic acid on combustible substances. He administered benzoic acid to persons in good health, whom he had previously dieted during a few days under the inAluence of this treatment. The solid constituents of urine were slightly diminished, there was also a smaller proportion of urea, and its relative proportion to solid matter was lower. These results must not be attributed to a moderating action, exercised by benzoic acid on combustion; this phenomenon is not modified, but the acid carries away into urine part of the substances which have entered into combustion. On another occasion, M. Robin administered benzoic acid to five patients with typhoid fever, in whose urine he noticed an increase in the weight of urea and solid matter. Salicylic acid and salts have effected the same results, also substances such as zylene, toluic acid, ethyl, and propyl-benzine, which in passing through the system became transformed into benzoic acid, combining with nitrogen. M. Bernheim read a paper at the recent medical congress at Nancy, on hysterical amaurosis, which he said was purely psychical. In two cases in his wards it was observed that there was complete amaurosis of the left eye, and, as the patients saw nothing when the right eye was closed, it was easy to prove that this cecity was psychical. With this phenomenon in view, M. Bernheim used an lateral hysterical amaurosis generally can only see one object, but those above mentioned saw equally well with the affected eye as with the non-affected. Hysterical achromatopsia is quite as psychical as amaurosis. M. Grenier quoted the following experiment of achromatopsia: The patient was hysterical, and to her left eye all objects appeared gray; a colored card, printed green, appeared green to the right eye, but gray to the left one; but if a prism were placed before the right eye, the patient, instead of seeing a green object and a gray one, saw two green ones. On repeating the experiment with the left eye, two gray objects were seen. M. Bernheim gives another case where the left eye was affected with achromatopsia, a red object seen with that eye appearing gray, but red with the right eye. On making the patient look through a prism she saw double. If, with the affected eye closed, a prism was put before the right eye, only one red object was seen, but if the prism ' was looked through by the left eye, the object appeared double and in its right color. The prism had given the true color, and had removed the illusion by diverting the patient's morbid imagination, thus the patient's diverted imagination suggested a double object. These are clearly cases of unconscious auto-suggestion. The patient being unconscious of what he sees. Bernheim considered that it would be more rational to give the name of visual amnesia to this complaint, and he added that amaurosis and achromatopsia, suggested by a hypnotic state, are of the same nature. In conclusion he stated that hysterical amaurosis has no anatomical localization, that it is neither localized in the retina nor in the optic nerve, nor in the visual cortical centre, and only exists in the patient's imagination. M. At the medical congress at Nancy, M. Charpentier, of that town, showed a new instrument intended for clinical examination of the visual functions. This instrument can be used, first, for examining luminous sensibility by means of the minimum quantity of light; second, for examining the perception of colors by the same method; third, for examining the perception of the differences of light in white or colored light; An operation was made ten days after the patient's entrance to the hospital, by effecting an incision an inch and a half deep, parallel with the vertebral column, and, on reaching the abscess, one and a half pints of thick pus were removed. Relief was immediately obtained, the patient being able to turn and stretch his limbs, which, before the operation, had not been possible. A drainage-tube was introduced into the wound, which was dressed by antiseptic means; cicatrization followed rapidly, and a fortnight afterwards the patient had entirely recovered. fourth, for examining the perception of colors by | from the commencement of the excessive pain. means of a new method, which consists in making appear upon an uncolored ground a colored surface, where the color becomes gradually more and more intense until it is recognized by the eye. This instrument is composed of a horizontal copper tube about five centimetres in diameter, supported by a stem fixed to a wooden slab. This tube is closed at each end by a piece of ground glass, which can be substituted, if necessary, by a translucid paper or china disc. Moreover, owing to the presence of two almost contiguous convergent lenses, the image of the ground glass behind is thrown upon the front disc. A movable screen, with an aperture which can be made smaller or larger, is placed between the two lenses, which enables different sections of the surface to be seen on these lenses, and, consequently, to regulate at will the lighting of the front glass. The light thrown on is in proportion to the free surface of the opening of the diaphragm in question. This free surface is always in the form of a square, the side of which is marked in millimetres upon an external graduation. The front glass is placed at the end of an ocular tube through which one looks, and which constitutes, when the eye rests on the opening, a dark chamber. This ocular tube is united to the first tube with lenses by a square box, of which the left side can be open or shut as desired. When there is a left side, the instrument can be used to ascertain the perceptible minimum of light. An oil lamp gives a constant light, and lights the back part of the instrument. A special appendage placed between that partenza in the pulmonary organs, facts concerning and the source of light, is constructed to hold the colored glasses destined to determine the maximum of perceptible color. In the Gazette des Hôpitaux, M. Mesnet mentions a case of peri-nephritic phlegmon, which occurred under the following circumstances: A young man of twenty-five years of age, was admitted into one of the Paris hospitals on the second of August, who, a fortnight previously, had suddenly been seized with violent pain in the renal regions, rendering dorsal decubitus impossible. There were no feverish symptoms, the temperature remaining at 380 centigrade; pulsation, 80. Digestive organs and urine were in a normal condition; no diarrhoea or sickness ensued. The only perceptible phenomenon was the continued excruciating pain towards the right side of the renal regions. Great difficulty was experienced in making any examination of the affected part, as, on the slightest pressure or touch, the pain was intolerable; no swelling or redness of the skin were visible. M. Mesnet came to the conclusion that peri-nephritic phlegmon had developed itself in the cellular zone surrounding the kidneys, and that an abscess must have formed | In the Gazette des Hôpitaux, M. Tillaux mentions the case of a man suffering for four years from buccal psoriasis. Cauterization had repeatedly been made, but with no good result, and M. Tillaux advised an operation, which was performed with the aid of a fifty per cent. solution of cocaine, applied every six minutes to the part affected. Five applications were made up to the time of operating, and the result was so satisfactory that dissection and ablation of the mucous membrane were effected without the patient feeling the slightest pain. At a recent meeting of the Société Médicale des Hôpitaux, M. Renant read a paper on a case of lobular pneumonia. Crepitating râles and murmurs were heard in the right lung and once in the left one. M. Renant rejected the hypothesis of pulmonary congestion and bronchial pneumonia; the progress of the disease and its suddenness were incompatible with it. M. Rendu suggested that it might be localization of influ serpiginous pneumonia having long been known of. M. Renant replied that he was convinced that there existed distinct areas presenting lesions characteristic of pneumonia. They were separated by a zone of healthy tissue, free from any morbid stethoscopic sounds. At a recent meeting of the Académie des Sciences, M. Charcot read a paper on peripheral neuritis, by M. Pierret. The writer stated that he did not consider these lesions to be absolutely constant, but he believed them to be curable even in cases of tabes, with confirmed posterior spinal sclerosis without complications. In a recent case, M. Pierret observed the restoration of the nerve tubes of nerves innervating the skin. This important statement would suggest the idea that the lesion of peripheral nerves is probably only the distant transfer of inflammatory irritation of sensitive zones of nerve centres, which can never be cured, though remaining susceptible to longer or shorter periods of remission. Painful symptoms, which are imputed to peripheral neuritis are accessible to rational treatment. The beneficial action of certain mineral waters is thus easily explained. |