aminations of the urine are desirable, as both salvarsan and mercury may exert an untoward effect upon the kidneys. 4. It is believed that syphilis is curable in a certain percentage of cases. A tentative standard has been proposed. Further investigation is desirable along these lines. 5. The results obtained from spinal fluid examinations are of great value. These examinations should be more generally practiced than is now customary. 6. The provocative Wassermann reaction is a refinement of the ordinary reaction. Information may be obtained from this reaction which can be secured in no other manner. 7. Rubber gloves are a desirable protection to the operator in handling syphilitics. 8. In positive cases, further information may Such antiserum contains agglutinins, opsonins, and complement fixation bodies, at the same time exhibiting certain antibactericidal properties. It would seem fair to conclude, he adds, that with potent polyvalent antiserum prepared in this manner, some definite therapeutic value might be anticipated in human cases of the dis ease. Vomiting of Pregnancy.-Johnson (Amer. Jour. of Clin. Med., June, '17), advises painting the os uteri with tincture of iodine. One application generally is all that is required and in most instances it acts like magic. One of his patients, who had been vomiting for over six weeks and was literally worn out, was com stage, will give a chronic gastritis or gastroptosis as a complication. Acute appendicitis, treated properly, does not need to be operated on much of the time. When we find a severe gastritis, do we use gastrotomy? Certainly not. And then, why not exercise an appropriate treatment to save the appendix in the same way we do to save the stomach? Here is the author's treatment: When the appendix shows only hardness and congestion, my treatment can be successfully applied, which consists of a colon injection to reach the cecum, every twenty-four hours, of the following solution: Ichthyol, xx drops; glycerine, dr. vi; tincture belladonna, x drops; aqua camphor, ad. oz. iii; to be injected all at once. The solution is for an adult, children in proportion. This aforesaid treatment shall be used for one week from the beginning of the attack, once a day, and associated by the internal use of the following powders: Benzonaphthol, dr. ss; magnesia oxide, heavy dr. i; asafetida, gr. x; aromatic powder, gr. xv; make 10 charts. One every four hours, five a day in wafers. Diet to be strictly of spring water and milk. After one week a soft diet can be used, and continuing the powders for fifteen more days, with saline solution, one pint a day, for colon irrigation. When my treatment is given in time we can save nearly all patients from the knife; but when we find a very large distention of the organ, a danger of perforation, or an abscess formed, then the best thing to do is to take the appendix out immediately to save the patient discomfort, time, money and danger of life. We kill many and many people without knowing it, as we advise our patients suffering from acute appendicitis to use the ice-bag and sedatives, and, after the pain has been subdued, we say the patient is cured. But alas, we should tell the poor unfortunate that he is not cured at all, only relieved from the pain from which he was suffering, and to be really cured he should use a long treatment. Tommasello has come to the conclusion that so far as he has learned from his practice, 90 per cent. of the cases of acute or chronic appendicitis come from school children, college students, shop workers and from all other classes doing indoor work, dissipation and meat eaters. Tommasello found with certainty that the causes of appendicitis are as follows: 1. School frequenters are refused the time by their teachers to go to the toilet when the desire to evacuate appears, and, not passing the fecal matters at the time of the stimulus, the feces become hardened and atonia sets up. 2. Shop girls or other indoor workers abstain from evacuations for fear of losing their positions or a desire to finish the work they have in hand. 3. Dissipating people comprise another category of patients, as they do not masticate their meals and take them at irregular hours, being occupied with women, cards, dances, etc. 4. The last category is given up to the meat a Increased Cost of Food Handicap to Health. The monthly bulletin of the Health Department of the City of Boston calls attention to the fact that while the high cost of living has been a serious handicap to most people, in general it is the poor that suffer most from the prohibitive prices that prevail. It sounds well to say "cut out" all luxuries from your table. but the table of the poor man never contained luxuries. The poor have been accustomed to eating beans, stews, fruits, vegetables, bread, milk, butter, eggs, fish, etc., all of which contain proper food values. These articles of food have now become luxuries if prices are to be considered. The proportionate increase in these edibles has been greater than in the ordinary high priced food. Carbohydrates, proteins, and fats we all know are essential for the proper nourishment of the body, but to administer them in tabloid form to the average man instead of meals would be repulsive to him. As a matter of fact, a balanced ration in regular form is preferred and bulky foods, altho some are of but little importance in food value, are necessary. In consequence of high prices there is bound to be a lack of proper food for people, from a health standpoint, particularly, mothers, infants, and invalids. Everything possible is being done to reduce infant mortality, but prohibitive prices will give us a serious setback in such a campaign. Increased cost of food will in no wise help, and while the young and strong go to war, many to be killed, there are many others that will suffer in their peaceful pursuits at home because of conditions that prevail. The Use of Onions.-Onions, says a writer in the Med. Summary (June, 1917) are being supplied raw to the troops in France, for the scientific world is coming to recognize in the lowly onion a thing of great food value, and that in it are found some of the most valuable and tonic mineral salts in the vegetable kingdom. Onions are perhaps best known as a cure for insomnia. They also oppose the rather nondescript condition known as rheumatism. Except in cases of idiosyncrasy, onions are easily digested, nourish, stimulate the appetite, soothe the nerves and act as a mild diuretic. They contain sulphur and other elements which act as intestinal antiseptics. Without especial rhyme or reason, people have always been inclined to eat onions with a view to breaking up a cold. Cooked onions are both sedative and laxative and would naturally be indicated in colds. And perhaps nothing in the voluminous pharmacopeia will relieve acute bronchitis and dyspnea so quickly as the old-fashioned onion poultice. It is no doubt the offensiveness of the breath after eating them which makes most people shy of the nutritive onion. By chewing a coffee bean, however, or drinking milk after a meal of onions, this pungent aroma can be removed. Since it has been shown that diabetic coma is caused by ketone bodies destroying the alkalinity of the blood, the rational treatment would consist of supplying the blood with alkalis in an effort to correct the acidosis. Soda bicarbonate by the stomach, supplemented by rectal medication by the Murphy drop method, and intravenous injections are to be employed. Sterilized normal salt solution will aid materially in eliminating the poison by stimulating diuresis. A diet of vegetables containing 5 per cent. carbohydrates is allowed. They emphasize the importance of boiling the vegetables three times with change of water. This will reduce the carbohydrates. Butter may be given with the Diabetes. Crain writes in the Medical Herald (July, '17) that the treatment of diabetes is principally dietary. There is no disease known to man where the regulation of the diet is of such tremendous importance as in diabetes. Medicinal treatment accomplishes little or nothing, except in its application for relief of complications and distressing symptoms. At one time opium was considered as having a favorable influence in regulating the output of sugar. Codeine is the preparation most usually employed. It is questionable whether opium possesses any real merit along this line. Dermatitis and skin complications usually disappear with proper dieting. Diabetic gangrene should be treated surgically. vegetables. Carbohydrate intake should be raised gradually. Proteins should also be gradually raised, alternating with the carbohydrates, keeping within the limits of sugar non-production. The degree of tolerance of sugar-producing diet will gradually raise until the patient is able to take a sufficient amount to maintain a normal state of health. They emphasize the importance of taking exercise during this treatment. It is all important that a patient cured of diabetes mellitus should thoroly understand the importance of frequently consulting his physician, and submitting to an examination to ascertain whether the old trouble is returning. Important Medical Matters of Today.Semple in his paper on Medical Matters of Today, (Northwest Medicine, July, 1917) says: A year ago the eastern hemisphere was engaged in the most terrific war in history and since then, after long submission to repeated deeds of barbarism and insult, the western hemisphere has been drawn into it. The call to the colors has been sounded and every profession, occupation and trade has responded with enthusiasm, and none with more spirit and selfsacrifice than the medical profession. Nor did our profession wait for our country's call, for years before a cry of distress was heard from the bloodstained fields of Europe and hundreds of American physicians crossed the ocean to render help. Of our profession supreme duties are expected, yea demanded, for not only are the health and strength of the troops placed in our hands to get them ready for action, but in. rebuilding of shattered bodies, which inevitably will come after action. Will the medical profession meet the duties required of it? If history repeats itself it will. A Study of the Menopause.-Culbertson, in his comprehensive paper in the Surgery, Gynecology and Obstetrics (Dec., 1916), says that the menopause is a functional derangement on the part of the various glands of the endocrine system subsequent to the cessation of the ovarian secretion. On this basis may be explained the psychic and somatic manifestations of the menopause. The vasomotor disturbances represent an instability of arterial tension. In the majority of cases this takes the form of a vacillating hypertension, both systolic and diastolic. The diastolic pressure is not elevated proportionately to the systolic. This produces an increased pulse-pressure. Hot flushes, sweating and other vasomotor symptoms are directly created by the vacillations in arterial tension. In a minority of cases there is arterial hypotension, and here also the systolic and diastolic pressures are out of proportion. Hypertension is apparently due to a relative oversufficiency on the part of the hypophysis or the adrenals. The psychic symptoms are apparently influenced by thyroid dysfunction-in the majority of cases a hyperthyroidism, in the minority a hypothyroidism. The administration of the missing hormone, represented by the extract of corpora lutea from animals in early gestation, brings about a gradual restoration to normal of the blood-pressure with disappearance of the mental symptoms. This reduction of blood-pressure by organotherapy, together with the disproportionate systolic and diastolic rise, is offered as evidence that the hypertension is a functional one and not due to organic changes. Blood-pressure estimation is essential as a means both of measuring the degree of menopause disturbance and of controlling its therapy. An occasional pressure reading is of little or no value. Tension must be determined at frequent intervals, preferably daily until improvement is well under way. The significance of functional hypertension as a factor in uterine hemorrhage is obvious and will be made the subject of a subsequent report. Hexamethylene Tetramine ("Urotropin") as a Fuel.-Frost, in a recent issue of the Medical Record, says there are many times when the physician needs a small, hot, sootless flame such as produced by an alcohol lamp, when he is out of reach of any such article. It is not generally known, I believe, that hexamethylene tetramine will give exactly this kind of flame when ignited. Two five-grain tablets such as are often carried in the physician's medicine case will give a clean flame of sufficient heat to boil 5 c.c. of water in a test-tube within 30 seconds, and of sufficient duration to keep it boiling for two minutes. For boiling needles or small instruments, sterilizing water for hypodermic injections, testing for albumin by the heat-and-acid method, and many other similar purposes, this "extemporaneous technic" may be found useful. |