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olive oil 50, crude petroleum 100. Sig.: scaly and without much apparent loss of hair. Apply twice daily; or the following ointment, There is, also, a sharply defined and marginrecommended by Lassar: B Hydrargyri sul. ated eruption, occurring on the upper or furati rubri 1.00, sulfuris' sublimati 24.00, lower lip, or both, in school children. It is olei bergamottae gr. xxv, vaselini favi ad caused by lip sucking, or by the intermittent 100.0. Sig. : Apply twice daily. A condi- protrusion of the tongue, and its excursion tion of the eyelids is occasionally met with in over the upper and lower lip. A constant school ohildren wbich is apt to be considered source of irritation is thus afforded, and a a blepharitis marginalis. It is really a pedi. suitable soil for fungus growth. Diluted oulosis of the eyelids due to the pubic louse, white precipitate ointment will cure the and is readily cured by soaking with olive condition, provided the lip sucking habit is oil, and then applying the well known Pa- discontinued. In the treatment of scabies, gensteoher's yellow ointment. Of course, it is he has abandoned the usual sulphur ointwith the nits, in pediculosis capitis that the ment. Instead, after the preliminary bath great obstacle to a cure is encountered, and the with green soap and hot water, the patient is author's experience leads him to say that there furnished with powdered sulphur, and told is no one drug which will hold out any hope to rub this thoroughly into the affected reof rapid removal. With boys, the hair should gions twice daily, and to dust a quantity be clipped short, while, with girls, clipping into the bed sheets before retiring.

It is the hair should be the last resort. "Tight more cleanly than the usual ointment treatbraiding in the class-room and unbraiding ment, and, he claims, less irritating and at home for care and treatment should be in. more rapid in its results. After the itching sisted upon." The only plan for pronounced is controlled, the following ointment, reccases is the patient, persistent, painstaking, omended by Kaposi, is applied twice daily: removal of the nits, strand by strand, with the B Beta naphtholi

, cretae albae aa 10.0, sahand or fine comb. Education of the parents ponis viridis 50.0, axungiae porci 100.0. He to the nature and cure of the trouble is of the oloses with a plea for the more careful epilautmost importance. For the associated, or tion and treatment of cases of tinea tonsurindependent, impetigo contagiosa, he recom- ans, and the necessity of such patients being mends the usual white precipitate ointment required to keep their hats, books, pencils, (5%) in unguentum diachyli. (The editor eto., separate from those of other scholars, if bas always found wbite precipitate 2% in they are not excluded from school until oured. vaseline sufficiently strong.) For localized

For localized They should, of course, have individual spots a protective dressing of iobthyol collo towels, soap, combs and brushes. dion (10%) is excellent. The individual lesions heal and dissemination is guarded The Erythema Group of Skin Diseases.against. This remedy, however, may be ob- Brayton (Indiana Med. Jour., Nov., 1905) jected to on the face near the scalp, and, of calls attention especially to the visceral and course, cannot be used in the hair.

nephritic lesions so often associated with this sidering tinea corporis be warns against a con- interesting group of troubles whose correct dition which is often diagnosed as eczema, diagnosis is often so difficult, and the nobut which, he says, is due to the trichophyton. menclature of which is so confused. PurIt consists of more or less irregular, scaly, pura, angio-neurotic edema, urticaria and ill-defined, eczematous looking patohes on the simple erythema are often quoted as the skin face, and sometimes three or four cases are manifestations in these cases, whioh are ad. found in one class-room. They yield usually mitted to hospitals suffering, also, with arth. to sulphur or white precipitate ointment. ritis, severe, and often paroxysmal

, attacks of For ring worm of the body, he reports excel. abdominal pain, albuminuria, hematuria, and lent results from the use of formalin, 40% vomiting of blood. Of course, not all of these solution diluted two or three times. Several are present in each case. Sometimes only one applications are frequently sufficient. In a is, sometimes several. In several oases oper. sensitive skin, it is well to avoid vigorous ated on, the findings were, dark patches in rubbing, and, if the smarting or burning is the intestinal walls, due to extravasated serum intense, the application of ammonia water and blood. In one case, which ended fatally, will give relief. He has had the usual dis- there was hemorrhage into the wall of the couraging results with tinea tonsurans, but colon, leading to paralysis of the affected part, has found the 40% formalin solution useful and to increased muscular contraotion, with beje, too. A form of ring worm of the scalp colio, in the adjoining part of the bowel, and that is often mistaken for eczema, with cor- a consequent intussusception of the cecum responding rebelliousness to treatinent and and adjoining portion of the ileum into the danger of spreading, is evidenced by many colon. Gangrene and acute general peritoni. disseminated, small areas, which are dry and tis were the immediate cause of death. Osler

In con

says that the subjects of the erythemas, with the seven deaths in Osler's 29 cases, fire were visceral manifestations, are usually by young: from uremia. The poisons, whatever they Twenty-one out of twenty-nine cases collected are, that cause the erythema cause also by him were under twenty years.

Seven of the nephritis, which comes on, as a rule, the twenty-nine died, proving the condition at the height of the skin lesions, or even to be a serious one. As regards the causes as late as a week thereafter. Of a series of these affections, certain diseases are known of 14 cases in which nephritis developed, five to be frequently associated secondarily with died of uremia. In four, purpura alone, as a definite skin lesions. Severe purpura goes

skin inanifestation, was present; others had with Bright's disease; urticaria and purpura mixed types, edema and urticaria, but pur. with cirrhosis of the liver; urticaria with pura also occurred in thirteen of the fourteen asthma; and all forms of erythema with cases. Arthritis is, of course, a frequent comchronic valvular heart lesions of children. plication, but is often quite independent of Urticarias are usually due to autotoxins of the rheumatic poison. There is undoubtedly gastrointestinal origin, wbich Osler says may a toxic, or blood factor in the causation of be bacterial, protozoal, vegetable, or ineta- these serous and sero sanguineous effusions bolio in character. To quote the same au- such as urticaria, erythema, erythromelalgia, thor, "It is not likely that the poison in it. and even purpura, but they may be caused self, of whatever kind, is of less intrinsio im. by the same factors that determine undoubted portance than certain transient aspects of nervous manifestations, the effusions being cell metabolism, for there is no constancy of due certainly in part, and perhaps sometimes action of the same poison in different per- entirely, to the neuro-vascular irritability and sons, or even in the same person at different irregularity which form the essential element times. The chronic forms of urticaria prob. of nervous (hysterical) conditions. “The hy. ably illustrate a morbid and persistent sensi. sterical patient in this sense) has lost his tiveness of the cutaneous vessels to poisons vasomotor equilibrium, and is the victim of of either intestinal or tissue origin.” The lo- a vasomotor ataxia.” “It is, then, a ques. cal status is also important, and a peculiarity tion of dual causation, and both the toxio and may be transmitted through several genera- the neuro-vascular factors are met with in tions, as in angioneurotio edema, which is diferent proportions in different cases, just only urticaria “writ large." Here there must as they are met with in epilepsy and other be either a morbid susceptibility of tissue, or neuroses in varying quantities. an inherited peculiarity of metabolism, or both combined. “The relation of the ery- Some Practical Points in X-Ray Therapy.thema to infective processes is interesting. Gray (Southern Medicine and Surgery, Dec., Certain types of exudative erythema behave 1905) suggests, as an explanation of the occalike an acute, febrile disease, there may be sional failure of the X-ray in cases of super. symptomatic erythemas. Many of the graver ficial epitheliomata, in the aged, that, in such cases of purpura have followed an acute in. cases, the tissues offer such low resisting fection, puerperal fever, gonorrhea, otitis power that the invading element, be what it media, eto. The rheumatic poison is respon- may, finds little difficulty in spreading to the sible for many cases. But in the large group adjacent structures and deeply infiltrating of cases persisting for years, an infective pro- them with the process of disease, and that the cess is out of the question." The complica- insufficient administration of the X-ray tions of the erythema group fall under two (which loses to a degree its destructive effects classes: (1) the angioneurotic, (2) the inflam- in passing through the superficial tissues) matory. To the former belong the swelling acts only as a stimulant on the disease-proof the fauces, edema of the glottis, changes ducing factor, and, so far from a cure, an inin the bronchial mucosa causing asthma, and crease in the rapidity of the growth will the colic, which is due to the localized edema be the result, just as heat, in a moderate deof the gastro-intestinal walls. To the in gree, acts as stimulant to cell growth. "In flammatory group belong the more serious these cases, treatment should be begun with complications, endocarditis, pericarditis,

pericarditis, energy, and penetrating, prolonged exposures pleurisy, pneumonia, and nephritis. The should be given, at frequent intervals, in oredema of the glottis may cause death. Both der to speedily produce the desired destructcroupous and lobar pneumonia have followed ive action on the disease-producing elean exudative erythema. Endocarditis and ment." However, the inability of the tis. pericarditis have occurred in connection with sues to repair, in the aged, when a destruct. intense arthritic purpura.

As would be ex. ive effect has been produced, causes often a pected gastro-intestinal symptoms are the tedious recovery, and the physician is formost common features of the group, but the tunate if pyogenic infection does not complirenal complications are the most fatal. Of cate the field, and further retard the healthy

repair aimed at

He believes that the occa. 2d and 3d lumbar vertebra by first removing sional failure in persons of middle age is due about 7 com. of cerebro-spinal fluid, in wbich to lack of an accurate estimation of the con. is dissolved 0.07 gram of tropococaine, and dition, and a failure to properly administer then injected. Nausea and vomiting, collapse the doses. He bas had unusual success in and incontinuence of stools and urine at the treatment of lupus vulgaris, psoriasis and times oocur during the operation.

Not all obronio eczema with this form of therapy. patients will respond to the injections. The

analgesia is most pronounced in the lower ex

tremities. At times a slight rise of temperaTHERAPEUTICS.

ture occurs after the injection. Better re

sults are obtained if cerebro-spinal Auid is W. T. HIRSCHI, M.D.

used for a solvent than if normal saline so.

lution is used. Ovoferrin.-Dr. Schram (Die Therapie der

The Treatment of Incarcerated Hernia.Gegenwart, Dec., 1905) administered ovofer

Dr. Boix (Deutsche Med. Wochens., No. 27, rin to 100 patients in the polyclinics of Professors Litten and Klemperer, Berlin. Sixty. 1905) uses ethyl chloride spray locally in two cases of chlorosis varying from mild to preference to ether on account of its more severe forms, received from one-half to one

rapid and intense action, producing a local ounce ovoferrin from two to nine weeks, de.

anemia and diminution in the size of the

tumor and a dilation of the ring. Tbis pending on the severity of the case, and in almost every one a decided increase of hem- method is to be used in cases before resorting oglobin was observed. Thirty-five cases of

to an operation or where an operation is re

This anemia, partly primary, and some occurring fused, or impossible to perform. in tuberculosis and gastric ulcer showed a

method may be entrusted to the patient to be decided improvement in hemoglobin and red

used until the arrival of a physician. blood corpuscles under the use of ovoferrin.

The Prevention of Vomiting in the Use of Two cases of pernicious anemia and one of

Anthelmintics.- Apolant (Deutsche Med. leukemia were not benefited by ovoferrin.

Wooh., No. 44, 1905) administers one to two The majority of patients could easily take powders of menthol and sacch. lactic aa 0.3 ovoferrin, their appetite improved and consti.

from one-fourth to one-half hours before the pation never occurred as a result of ovoferrin.

anthelmintics are given, and he has rarely Remarks about Orthostatic Albuminuria. observed any nausea or vomiting, even if (Dr. Loeb, Therapie der Gegenwart, Dec., niale fern or pomegranate were used. Other1905.)–Edel concludes from numerous ex.

wise the same precautions and directione

should be followed as is usual with these periments made in healthy individuals, that sodium chloride is more rapidly eliminated

remedies. by the kidneys in the horizontal than the up- Edema of the Feet and Legs as a Result of right position, and the writer proves that the Excessive Use of Sodium Chloride.—(Brythe opposite is the rule, however some excep. ant, Practitioner, No. 8, 1905). -- An appar, tions occur. Edel believes less chlorides are ently healthy individual complained of eliminated in the upright position on ac. edema of the feet and legs, and the writer count of the poorer renal circulation. So- after a thorough examination of the urine dium chloride and water are eliminated in found nothing abnormal except a large in. the glomeruli, while some water, urates, phos- crease of sodium

hloride. All other organs pbates and a small amount of chlorides are

were normal. As the patient consumed eliminated in the tubules. Decreased blood

about four times the usual amount of salt in pressure affects the glomerular secretion more his food, the writer advised him to use much than tubular secretion. Glomerular secre- less salt, with the belief that this caused the tion usually is alkaline, and tubular acid. edema. After three weeks the edema entirely The author believes vascular renal circulation disappeared and the urine contained a nor. is better in the upright than in the horizontal mal amount of sodium chloride. position.

Thiosinamin in Scar-Contractions. (Dr. Spinal Analgesia. Tuster (Beitr zur klin. Mellin (Deutsch Med. Woch., No. 5, 1905) Chirurgie, Vol. XLVI, No. 1) reports 235 pa- reports a patient with extensive scar-contractients anesthetized with spinal injections of tions of the face and arms as a result of burns tropococaine. The full physiologic effect oc. which was decidedly benefited by the use of curs from forty-five minutes to one and one. thiosinamin injections. Thiosinamin is used half hours. They should not be made in sep- in 15 to 20% alcoholio solutions, begininng tio patients on account of the autointoxica. with one-third syringe and increasing it to tion. The injections are made between the one, or if these produce pain a 10% aqueous or glycerine solution may be used. The in- SOCIETY PROCEEDINGS jections should not be made in the area of the cicatrix, or while there is any inflamma

MEDICAL SOCIETY OF THE NEW YORK tion, as they would exaggerate the trouble.

POLYCLINIC MEDICAL SCHOOL AND The writer has used twenty-five injections in HOSPITAL. a single individual.

The Treatment of Gastric Ulcers and Gas- Stated meeting held January 8, 1906. tric Hyperacidity.-(Kohler Vienna Med. The President, Dr. J. J. MacPhee, in the Woch., No. 21, 1905.)–Pylorio spasms due chair. to ulcers or fissures are quickly relieved by

URETHRAL FISTULA AND PROLAPSED KIDNEY. the administration of olive oil. The oil has a soothing action on ulcer or fissure, thereby

Dr. Charles H. Chetwood showed a patient overcoming the spasm und pain, and indirectly

ou wbom he had operated two years ago for reducing the secretion. On carcinomatous

urethritis and who at the present time had ulcers oil acts as an anesthetic, and is also

an incomplete fistula. When first examined somewbat nourishing. To patients who ob

his symptoms seemed to point toward the ject to the taste and smell of olive oil, it may

urethra and prostate, the latter being about be administered in gelatine capsules, or with

the size of a small orange and very hard. some more palatable substance.

The history indicated a gonorrheal infection,

and, apparently, a syphilitic abscess of the The Present Method of Treating Fractures. prostate. The patient urinates every balf -(Martens, Therapie der Gegenwart, No. 12, hour,day and night, and the bladder contains 1906.)--A correct diagnosis is most essential about twelve ounces of residual urine. The for the successful treatment of fraotures, and appearance of the urine is indicative of kidafter a careful consideration of the classical pey pns. Both kidneys are prolapsed and the symptoms of fractures, i.e., deformity, ab. right one is very palpable, enlarged and normal motility, crepitation, extravasation tender. The interesting feature of the case of blood, pain and impaired function an is the prolapse of both kidneys without any X-ray picture will be of great assistance. apparent explanation. There is no tubercu. The X-ray also should be used after the bones lous history and none suggestive of kidney are placed in proper position. The fracture disease. The speaker's intention was to should be set as soon as possible and an anes; drain the prostatio abscess through a perineal thestio used if necessary.

The limbs are incision, examine the bladder thrcugh the placed in such a position that if ankylosis opening, and possibly oatheterize one of the occurs the patient can derive the greatest ureters. benefit from the limb. Plaster of Paris or splints are usually preferable to any other

SYRINGEMYELIA OR LEPROSY ? means of fixation. Cotton padding is gener- Dr. A. J. Budine presented this patient. ally applied over the skin, but frequently this She was 21 years of age, and her family is unnecessary, and is not advisable in hot history was negative. About six years ago weather. Limbs which are encased should she dirst noticed that she was unable to be elevated to prevent swelling, and if nec- distinguish the impact of the soles of her essary the cast is loosened. The first cast re- feet against the sidewalk and began to have mains from one to tbree weeks depending on aching pains in her feet and legs. Later, circumstances, and massage and passive mo. pus formed beneath callous spots on the tion used as early as possible to prevent mus. feet and discharged, leaving sinuses leading cular atrophy and ankylosis. At times ex. down to the metatarsal bones. Rest in bed tension is necessary (especially in fractures healed the sinuses, but on resumption of her of the femur). At times the fractured ends occupation they reopened. Three years ago must be sutured in order to hold them in her feet began to pain in the axillae and in position, e.g., patellar fractures, and olecra. both groins. Pain was also present in her non fractures and pseudoarthrosis. Great spine from the neck to the cocoyx. She care must be exercised in suturing to prevent was operated on for the contractures of the infection. In compound fractures all foreign feet in 1902. Her general health is now material and bone splinters are removed, and fair. The soles of her feet are covered with the wound is well drained. The complica- multiple perforating uloers. The discharge tions of fractures, e.g., shock, fat emboli, de. is tbick, brown in color, and has a peculiar lirium tremens, thrombosis, injury to nerves sickening, penetrating, odor. There is an and blood vessels must receive close atten. abscess under the skin in one thigh and tion. The after-treatment is very important, another over the saorum. There are marked and cunsists of proper massage, active and motor and sensory disturbances of the feet passive motion, baths, electricity, eto.

and legs. The oase was presented for diagnosis, which the speaker thought lay be. toxins from the fetus. Under these circumtween syringem yelia and leprosy.

stances the amount of toxins passing to the Dr. W.B. Pritchard said that, he considered mother must be small in quantity, and there. this patient an example of syringemyelia pre- fore the immune condition is acquired in a senting the exception in a distribution of comparatively short period as compared with symptom in the lower rather than tbe upper the time necessary in aoquired syphilis. extremities, though both were involved. The Syphilis is a serious disease, not only on trophic disturbances in the feet, with bladder account of the liability to fatal parasyphilisymptoms, scoliosis, and, finally, dissociation tic affections, as locomotor ataxia, but also on sensory phenomena, indicated with fair clear- account of its destructive action of the progness the diagnosis. It was not leprous neu- eny of syphilitic parents when produced durritis, as the nerves showed no bulbous en- ing the active stage of the disease, hence the largements and the skin was quite free from shorter this period exists the fewer syphilitic the characteristic plaques. Tabes had been children are produced. suggested, but there was little in the symp- If the tertiary and parasyphilides depend ton picture to sustain such a suggestion. very greatly, or principally upon the severity Absence of the Arygl-Robertson pupil, the of the dyscrasia, and this condition upon the persistence of one knee jerk, with absence of amount of intoxication, that is, the amount true ataxic gait and characteristic pains of toxins produced, and this upon the number were collectively conclusive in negation. and activity of the syphilitio organisms in

The paper of the evening was read by Dr. the system, it follows that in this special par. Andrew R. Robinson, and was entitled asitio affection the treatment of sypbilis must

be based upon the microbes, the toxins preTHE TREATMENT OF SYPHILIS.

duced, and the ground of the individual affecHe referred to the different views held on tion. Proper consideration of these three the subject of the treatment of syphilis, and points constitutes the fundamental basis for stated that he would endeavor to show that the best treatment of the disease until the syphilis is a serious disease in a considerable last microbe is gone; hence the division of percentage of oases, and especially on account the disease into stages is not scientifically of the tendency after immunity is reached to correct, although for clinical description it fatal parasyphilitio affections; that the tend- is of some value. ency to these parasyphilides depends as a In the period between the appearance of special predisposing factor upon the dys. the primary sore and the so-called secondary crasio condition accruing in the active con- stage, represented by cutaneous lesions, the tagion stage; that the intoxication producing general nutrition of the person is lowered, the dyscrasia and leading to immunity often fever is present in varying degree, the red. is most severe in the period between the rec. blood corpuscles are diminished in number, ognition of the primary gore and the appear- the lymph glands throughout the body may ance of lesions upon the cutaneous surface, be affected, the spleen swollen and tender, and, there, that syphilis should be treated liver enlarged and the nervous system injured, actively as soon as a positive diagnosis of the as shown by the presence of neuralgia, headdisease is made.

ache, lassitude, pains in the joints, bones The object of such treatment is to inbibit and periosteum, and occasionally by an exthe life action of the organism, so that only tensive multiform erythematous eruption. a small amount, comparatively, of toxin is This shows that before secondary lesions ocproduced, giving immunity with only a mild cur upon the skin there may be intoxication dyscrasia, and producing a minimum amount of the general system, which leaves its imof injury to the tissues, and consequently a press on the tissues and acts as the main discomparatively slight tendency to parasyphil. posing factor in the causation of parasyphides, or even tertiary lesions. He maintained, ilides. If this be true, it follows that treatalso, that in the acute infectious stage it is a ment should be commenced in every case rule that the less toxin produced in a given as soon as a positive diagnosis is made, and if case, the earlier the system acquires the con- this is done at a stage before cutaneous dition of immunity; and in syphilis this is lesions appear, so much the better for the important not only for the individual affected, patient. but also from social standpoint, as the sooner Existing lesions in the secondary stage immunity is obtained the less danger of con- are treated to lessen danger of contagion, tagion to others.

remove deformity and save tissue, but surely An example of early iminunity is that ac- it is better, more philosophical, to prevent quired by a mother in a case of parental the formation of lesions, especially as they syphilis, when she is not invaded by the syph- are hot-beds for tosin formations than to ilitio organisms, but acquires immunity by wait until they are formed and damage bas

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