NO CYANOSIS, NO EXCITATION, NO EVIL AFTER-EFFECTS THE AMERICAN Analgesic, ANTIPYRETIC AND Anodyne. Follow the Exhibition of Antikamnia. A New Combination of Coal Tar Derivatives of the Series C-H2n—6 Further Information and Samples sent Free to any reputable Physician on Application. ANTIKAMNIA CHEMICAL CO., ST. LOUIS, Mo CAREFUL, continued testing by upward of seven thousand practitioners in America, whose written opinions over their signatures (in our possession) are fully in accord and clearly prove the efficacy and merits of VIN MARIANI, may thus be summarized ; As a diffusable stimulant in anæmia, nervous depression,. sequelae of childbirth, lymphatism, tardy convalescence. general "Malaise," and after wasting fevers. As a stimulant, with special reference to the nervous system. As a tonic in laryngeal and gastric complications. And in all those cases where a general toning or strengthening VIN MARIANI has been before the Medical Profession almost thirty years and invariably given uniform satis..... Physicians desiring to use our preparation, are requested to specify VIN MARIANI. To familiarize physicians with our Bottle and Label, we present fac simile herewith, to avoid errors. MIN MARIANI CAPSULE perler la signature de M'MARIANI DOSE: postnanis REGULAR BOTTLE CONTAINS FRENCH HALF-LITRE -17 Ounces. BISMUTH SALTS AND THE ODOR OF GARLIC.The cause of the odor of garlic, occasionally communicated to the breath of patients who are taking preparations of bismuth, is said to be the presence of the metal tellurium as an impurity. The fact that tellurium gives this odor to the breath was first noticed by Sir James Simpson, who, when making trials of the salts of cerium, also experimented upon tellurium. He reports a case of a divinity student who inadvertently got a dose of tellurium, which was followed by the evolution of such a persistent odor of garlic that for the remainder of the season the patient had to sit apart from his fellows. That specimens of bismuth preparations which caused this peculiar odor of breath contained tellurium was established in 1875. The British Pharmacopoeia guards against this impurity by giving a special test for its detection in bismuthum purificatum. -British Med Journal: Indiana Med. Journal JUDGE THAYER, of Philadelphia, says that no person can be legally compelled to leave his home and be treated in a hospital, even if he have small-pox or other contagious disease; it is the right of the patient to stay in his home, if he so desires. It is reported that, through ignorance, physicians sometimes aid in compelling patients to leave their homes. TRIONAL AND TETRONAL are chemically related to sulphonal. The former represents sulphonal (dolthyl-sulphon-dionethyl-methane) in which one of the methyl radicals is substituted by one of ethyl; in tetronal both radicals of methyl are replaced by ethyl. The maximum doses used by Drs. Barth and Rumpel (Deutsch Med. Wockenschrift) was 60 grains of the former and 45 grains of the latter; and they conclude that they are both useful drugs, though not superior to sulphonal, except in certain nervous conditions (delirium, etc.), in which they were effective after failure with that drug. They also appear to have fewer after-effects than the sulphonal. THE DIETETIC GAZETTE and The Doctor, the last a monthly publication devoted to physical education, food, sanitation and hygiene, will be sent together, to any address in the United States, or Canada for one year, for ONE DOLLAR. Send all remittances to THE DIETETIC GAZETTE. IMPROVED RECTAL CASE. Instruments and Painless System of Treatment. Please mention The Die:etic Gazette. DIMENSIONS.-Length 11 inches; width 6 inches; height 2 inches. Each case contains fourteen separate instruments made of best material. Full and complete instructions with formulæ all given. The manner of treatment is all easy; it requires but little skill to become an expert in our new method of treating rectal diseases. The practice in this line will increase rapidly, and you will be astonished at the number of these cases coming to your office through your success in handling them. There is no necessity for soliciting patronage, it will come without; neither is it necessary for you to make this an exclusive specialty; work it with your general practice; nor is there any reason for not being strictly ethical in this practice. The Improved Rational Treatment makes its possessor master of the situation. It makes the treatment of rectal diseases the most lucrative and the most satisfactory department of his practice. No physician can possibly do justice to himself and patients without it. The fee from a single patient is frequently more thin enough to pay for the entire system and all its privileges. It pays largely to secure territory to operate with this treatment. Can you afford to be without it. Prof. G.W. Van Vleck, A.M., M.D., of Cincinnati, Ohio, says: "It is by far the Best, Safest and the most reliable now known, as we have scores of other systems to compare with." Remember the treatment is comparatively painless from first to last. Your patients lose no time with this treatment. Our complete Case of Instruments with full instructions and all formulæ given and sent to any address at greatly reduced prices. Sent C. O. D. if desired. An Circulars giving full particulars mailed free. Essay on Diseases of the Rectum mailed for 15c. Address G. W. POWELL, M.D., Moriah, N. Y. DIPHTHERIA; CROUP; SORE THROAT, AND ALL INFLAMMATORY DISEASES OF THE THROAT. OPINION OF THE PROFESSION. Dr. Geo. B. Hope, Surgeon Metropolitan Throat Hospital, Professor Diseases of Throat, University of Vermont, writes in an article headed "Some Clinical Features of Diphtheria, and the treatment by Peroxide of Hydrogen" (N. Y. Medical Record, October 13, 1888). Extract: On account of their poisonous or irritant nature the active germicides have a utility limited particularly to surface or open wound applications, and their free use in reaching diphtheritic formations in the mouth or throat, particularly in children, is, unfortunately, not within the range of systematic treatment. In Peroxide of Hydrogen, however, it is confidently believed will be found, if not a specific, at least the most efficient topical agent in destroying the contagious element and limiting the spread of its formation, and at the same time a remedy which may be employed in the most thorough manner without dread of producing any vicious constitutional effect. "In all the cases treated (at the Metropolitan Throat Hospital), a fresh, standard Marchand preparation of fifteen volumes was that on which the experience of the writer has been based. "A steady, coarse spray, with an air pressure of twenty pounds or more, will in a few moments' time produce a more positive action than prolonged efforts to reach the fauces by means of cotton applicators. The force of the spray should be sufficient to cleanse at once the surface accumulations, as it destroys the necrosial elements with which it comes in contact. In this manner the removal of the débris and the action on the deeper structures go hand in hand. How frequently the treatment is to be followed up depends to a considerable extent on the density as well as the area of the surface involved. It may be said, however, that two applications a day, in the great majority of cases, should be sufficient, if thoroughly performed, to arrest all danger of extension and accomplish the gradual resolution of the local formation. Dr. E. R. Squibb, of Brooklyn, writes as follows in an article headed On the Medical Uses of Hydrogen Peroxide” (Gaillard's Medical Journal, March, 1889, p. 267), read before the Kings County Medical Association, February 5, 1889 :— Throughout the discussion upon diphtheria very little has been said of the use of the Peroxide of Hydrogen, or hydrogen dioxide; yet it is perhaps the most powerful of all disinfectants and antiseptics, acting both chemically and mechanically upon all excretions and secretions, so as to thoroughly change their character and reactions instantly. The few physicians who have used it in such diseases as diphtheria, scarlatina, small-pox, and upon all diseased surfaces, whether of skin or mucous membrane, have uniformly spoken well of it so far as this writer knows, and perhaps the reason why it is not more used is that it is so little knows and its nature and action so little understood. "For example, some albuminoids are instantly changed by contact with hydrogen dioxide, as is shown by rinsing the mouth with a dilute solution, when the albuminoid matters of the secretions are at once coagulated. Then, as all virus is albuminoid, whether propagative or not, it is destroyed or by coagulation rendered inert by simple contact with this agent, just as it is by contact with corrosive sublimate. simple experiment of rinsing the mouth with a dilute solution of hydrogen dioxide and examining the discharged liquid can hardly fail to convince any one of the destructive potency of this active oxygen on some albuminoids, and of its thoroughly cleansing effects upon the mucous surfaces. This Now, if diphtheria be at first a local disease, and be autoinfectious; that is, if it be propagated to the general organism by a contagious virus located about the tonsils, and if this virus be, as it really is, an albuminoid substance, it may and will be destroyed by this agent upon a sufficient and a sufficiently repeated contact. "A child's nostrils, pharynx and mouth may be flooded every two or three hours, or oftener, from a proper spray apparatus with a two volume solution without force, and with very little discomfort; and any solution which finds its way into the larynx or stomach is beneficial rather than harmful, and thus the effect of corrosive sublimate is obtained without its risks or dangers. Further on Dr. Squibb mentions that Charles Marchand is one of the oldest and best makers of Peroxide of Hydrogen, and one who supplies it to all parts of the country. CAUTION.-I would earnestly impress upon the profession the very great importance of prescribing only my Peroxide of Hydrogen (Medicinal), from which all hurtful chemicals have been eliminated. By specifying in your prescriptions "Ch. Marchand's Peroxide of Hydrogen (Medicinal)," which is sold only in 14-lb., 1⁄2-lb., and 1 lb. bottles, bearing my label and signature, you will never be imposed upon. Never sold in bulk. PREPARED ONLY BY A book containing full explanations concerning the therapeutical applications of both CH. MARCHAND'S PEROXIDE OF HYDrogen (Medicinal) and GLYCOZONE, with opinions of the profession, will be mailed to physicians free of charge on application. Mention this publication. Chemist and Graduate of the " Ecole Centrale des Arts et Manufactures de Paris (France). SOLD BY LEADING DRUGGISTS. Laboratory, 10 West Fourth Street, New York. The Dietetic Gazette MONTHLY JOURNAL OF PHYSIOLOGICAL MEDICINE. NEW YORK, DECEMBER, 1890. Clinical Lecture. THE TREATMENT OF PULMONARY CONSUMPTION. BY WILLIAM PEPPER, M. D., LL. D., Professor of Theory and Practice of Medicine and of Clinical Medicine in the University of Pennsylvania. W I E discussed, at our last meeting, the question of change of climate for patients suffering with pulmonary consumption. You remember that we decided that we must be governed in the matter by the place from which the patient comes; the state of his finances, his sex and age, the stage of the disease and the place to which he or she is to be sent. The latter consideration, we remember, varies with the condition of the patient. We studied the character of life to be followed at these places of resort and the care which was to be insisted upon. believe that the only time in the course of the disease when a change of climate is inadmissible is in the last stages of the disease. Even then we see most remarkable results in cases in which we are led, from a careful study of the condition, to expect but little. There is one consideration which we must not overlook in advising a change in a patient late in the disease. Ill-natured persons may say that we have kept the patient home until we have squeezed all the money we can from him, and then when the failure to produce a cure is palpable we send him away, to die far from home and friends. Hence in discussing this matter with a patient well along in consumption, explain the position; it is not your duty to deny the chance of improvement which exists; if the patient elects to take the chance, unless far advanced, allow him to go. Once started he should follow out every detail of hygienic care as fully as if at home. If the patient decides to fight the disease out at home, do not neglect the slightest feature of the case; inquire into and regulate every cir cumstance and condition of the patient's life. No point is so small that you can afford to neglect it. First, in ordering more rest for the patient, determine if he is actually obliged to work for his living; many cases that cannot afford to go away, can lay off from work. If he need not work, have him take his breakfast in bed; not allowing him to expose himself to the cold air of a house in the early morning, when his own powers of resistance are lessened. Then he need not go down stairs until the house has been nicely warmed. He should dress leisurely, and should take as much out-door exercise as his strength permits and the weather allows; but do not allow him to become fatigued or depressed. He should lie down and rest both before and after his dinner, going out again after that meal. Do not simply tell your patient to live out-of-doors; then he is apt to over-exert himself by staying out too much. He should rest and sleep, if possible, in the middle of the day. Promote the circulation and increase the tone of the muscular system by aiding and correcting digestion. Order food that will increase the resisting power of the body; so that he will cease to be so much affected by changes in the weather. He should retire early and sleep in a room which has not been used for a sittingroom; the air must be pure. If it is pure in the bedroom the window had better be kept nearly, if not wholly, closed. The cold air of a sleeping room may cause considerable irritation. Allow the patient to undress quickly, using candle light. Dress him carefully, in good pure woolens. The skin should be kept in good condition by baths and friction. A rapid sponge bath in salt water, followed by brisk rubbing, may be used; if this is too severe, rubbing oil over the body and removing it once a week, may prove beneficial. Make these details the principal “business" of the patient's life. Pulmonary gymnastics, in bringing in play the remaining healthy tissue and strengthening pulmonary muscles, is an excellent exercise. These must be advised whether the patient is at home or abroad. At all stages the digestion must be most carefully watched; hence make the rule never to give any drug which lessens appetite or weakens the digestive powers. Such a drug does more harm than it can possibly do corresponding good. There are so many signs and symptoms in pulmonary consumption that to attempt to prescribe for each one would soon develop polypharmacy. Try to grasp the most prominent and most urgent symptoms and attack them. There are from twelve to fifteen symptoms in this disease: cough, coated tongue, the pulse, the temperature, night-sweats, sleep, the condition of bowels, loss of flesh, pain in the chest, etc. Remember tha no one remedy is in the slightest degree a specific. Since the discovery of bacillus tuberculosis and its close relation to this disease, there has been no discovery of a mode of treatment which is more efficient in its results than was possessed before. We cannot destroy or even weaken the vitality or virulence of the bacillus, except by increasing the resisting power of the patient, producing more healthy cellular action, restricting the seat of the disease and restoring tone. In considering the use of antiseptics or parasiticides, we know that if we could catch the bacillus and dose him well with bichloride or arsenic, we might do him extensive harm; but situated in the lungs of an ordinary patient, he can well defy us to attempt to drive him from that position. Inhalations do not go deep enough nor are they concentrated enough to effect much change. Experiments are being constantly made with this or that agent which kills or injures the bacillus, in the attenuated vapor to which it becomes reduced before it reaches his locality, with impunity of further effect upon the patient; but as yet we have no such drug on which we can rely. Remembering that unfortunately there exists no specific curative remedy, we naturally seek for further means of prevention of the spread of this dread disease. I will only speak of two points in this connection. One is the importOne is the importance of destroying the sputa, or at least its infectious properties, immediately upon expectoration. Have the material received in some vessel which contains a powerful parasiticide; or have it burned or buried at once. The second question is one which fascinates the medical profession; it is the endeavor to utilize our knowledge of the bacillus to render the system less sus ceptible to its deposition. Possibly this is to be accomplished by inoculation with attenuated tuberculous virus; on the principle that this would produce the same result that the virus of vaccine disease does in relation to small-pox. It is going to be a serious business if the future parent is to have his child inoculated with the virus of all infectious diseases, to preserve him from the course of disease to which our present children are exposed. But if it be proven that each disease has its preventive inoculation, similar to small-pox, this may become a question which the parent of the future may be called upon to decide. At present we have no direct evidence that attenuated tuberculous virus will make the human species less susceptible; nor do I have much hope of such a possibility. Small-pox and phthisis are such different diseases that analogy between them is not striking, still many observers throughout the medical world are working over this point, on the lower animals, and we shall probably hear their con-clusions in the future. Undoubtedly there is a preparation of the system before the successful deposition of the bacillus takes place. Depressing influences have been at work; possibly some local catarrhal affection exists in the lung. The disease attacks only those who are not at the best state of resistance, while small-pox on the other hand attacks the strong and weak alike, another point of difference in analogy. Prevent this susceptible condition by increasing the vigor and resisting power, first by hygiene, secondly by attention to the digestion and assimilation. Often the remedies or treatment for atonic or irritative dyspepsia may be indicated. Keep this thought uppermost; that the digestion must be kept in the best possible state; if you do not injure it by the use of additional nutrients, try such things as fat, in cod-liver oil, plain or emulsified; but the oil will do no good unless it is well borne. At least as much food must be taken during its continuance as before its commencement. The amount must be decided by the patient; a teaspoonful that is pleasant is better than two teaspoonfuls that nauseate. But if a tablespoonful can be well borne at a dose so much the better. If other preparations prove offensive, try the oil in combination with an alkaline salt, as the hypophosphites or lactophosphate of calcium; this introduces an element of nutrition which also favors the liquefaction of expectoration. Again cod-liver oil with wildcherry bark suits many delicate or fastidious |