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mended in poisoning hy other agents of this class, would be indicated in a case of poisoning by Gelsemin. It is a matter of regret that its physiological action has not been more definitely determined; were such the case, the treatment for the toxic effects of an overdose could be conducted on rational and perhaps successful, grounds. Whether it acts as a cerebral stimulant by increasing the quantity of blood sent to the brain, or as a direct sedative to the great nerve centres, as have been variously supposed, we do not positively know. We rather incline to the belief that it acts as a nervous sedative, paralyzing the whole reflex functional activity of the spinal cord and sympathetic, as shown in tRe inability to coordinate muscular movements, and finally in the complete obliteration of all muscular motion.
The most important question which presents itself in connection with this case, is, whether this patient, from some idiosyncrasy or from depression of the vital powers, consequent upon a long continued illness, was unusually susceptible to the action of this drug, or whether the dose usually recommended in our medical works is not altogether too large. In the American Dispensatory, and Coe's work on Concentrated Medicines, the ordinary dose is stated to be from onehalf to one grain, to be repeated, if necessary, every few hours. In some conditions a dose of two grains is recommended. Few physicians, practically familiar with the properties and action of Gelsemin, would venture to prescribe such a large dose. They would regard one-half or even one-fourth that quantity unsafe in the case of a weak or delicate patient, and absolutely dangerous if frequently repeated. One-eighth of a grain of Gelsemin produces decided effects, and in our practice we prescribe this quantity as the medium dose.
We should like to have the experience of some of our readers in the use of Gelsemin, especially as regards the maximum dose which can be used with safety, also any well digested theories they may entertain of its physiological action.
Concentrated Medicines. All the various forms of concentrated medicines, “ Resinoids," “ Active Principles," “ Concentrations,” Alcoholic Fluid Extracts," - Essential Tinctures,” &c., &c., are now being more carefully tested by practitioners of the different schools of medicine, than at any other period of their history. The use of heat in manufacturing, and the degree in which it affects the stability and value of the resulting preparations, is now being thoroughly examined.
All such investigations have our most hearty sanction, it is the right kind of labor in the right direction. It is the real active medi. cinal principle, the certain quantity, the exact and uniform strength, that the practitioner wants. If the preparations can be made so that one-eighth of af a grain will take the place of one or more grains or drachms of crude material, let us have them. If the drastic property of the Podophyllin can be obviated without destroying the action of this remedy and its value as a cholagogue, let it be done. The products of opium are now found to be some ten or more, and yet they differ materially in their action. The products of the Peruvian Bark are also numerous, each one impressing the animal economy in a man. ner peculiar to itself. Why not, from this standpoint, begin an in. vestigation of many of our leading remedies.
Sanguinaria Canadensis and Hydrastis Canadensis have been found to contain several distinct products, all of which differ somewhat in their therapeutic action. We hope to see many improvements made in every field of this worthy investigation. Yet we hope to be kept clear of competition among manufacturers, which will fill the market with cheap and worthless medicines.
Stillingia in Syphilis.“ Dr. J. C. M'Mechan, of Cincinnati, Ohio, contributes the following to the Western Journal of Medicine.
“We have used the drug in a certain form of syphilis, and with the finest results, and have seen Dr. Dawson, Surgeon to the Cincinnati Hospital, prescribe it frequently with the most market effect, wben other remedies had failed.
The form of syphilis in which it is most useful, is secondary, where the symptoms of tertiary are just beginning to manifest themselves, but it is also useful later in the tertiary form, in combination with iodide of potassium.
In secondary syphilis, in broken down subjects, mercury is, of course, objectionable, and if administered, cannot be carried to the point where it would have a marked effect upon the syphilitic eruption. If mercury cannot be administered, there are but few remedies left to prescribe, and the principal ones, perhaps, are sarsaparilla and iodide of potassium. The latter remedy is very good in the tertiary form, but in the secondary it has been found almost inert, having but very little, if any, effect upon the eruption. Sarsaparilla, at one time, had
quite a reputation, and it was thought next to impossible for a patient to recover without its administration. It is now seldom administered, except for its moral effect, unless outside of the regular profession. Now, in primary, we have iodide of mercury (and in healthy subjects it is the proper remedy in secondary), and in tertiary, the iodide of potassium. But here is a vacancy. What is the remedy in secondary when the patient is broken down in health, or when mercury has been used without effect? There is but one remedy in the materia medica that can fill the vacancy properly, and that one is stil. lingia. For broken down patients with the syphilitic eruption, to patients on whom mercury has had no effect, and to patients in whom the bones have become affected and the secondary manifestations still continue, let this remedy be given."
We copy from the Med. f. Surg. Reporter the above remarks, not because they contain anything new to Ecclectics as they have for years past recognized the good effect of Stillingia in the treatment of secondary syphilis, and availed themselves of it in practice, but because it affords an illustration of the fact that our remedies and peculiar ideas of practice are being gradually adopted by our Allopathic brethrer.
REVIEWS AND BIBLIOGRAPHICAL NOTICES.
PRACTICAL OBSERVATIONS ON THE AETIOLOGY, PATHOLOGY, Diagnosis
AND TREATMENT OF ANAL FISSURE. By WILLIAM BODENHAMMER,
Few affections are more obscure in their origin, more exquisitely painful to the patient or more obstinate in treatment than fissure of the anus. Notwithstanding the exceedingly practical importance of the subject, until the appearance of this monograph no complete and systematic treatise upon Anal Fissure has been offered to the profession. The author of this work bas been long and favorably known to the profession by his work on "Congenital Malformations of the Rectum and Anus." During the many years in which he has made a specialty of diseases of the rectum and anus he has enjoyed extensive and peculiarly fine advantages of study and observation, and the character and practical utility of the work before us afford satisfactory evidence that he has made good use of his opportunities.
The first chapter of this work is devoted to the history of Anal
Fissure, the views entertained by different surgical writers of its causes and varieties, the confusion to which its frequent concomitant, spasmodic contraction of the anus gave rise to, and the precise nature of the disease to which the term Anal Fissure is at present applied.
In Chapter II the author endeavors to remove some of the confusion and obscurities which surround the subject, and defines the characteristic lesions of the affection to which the term Fissure of the Anus truly and legitimately belongs. In the physiology of the complaint, he considers the physiological relation between the sphinctores ani and the voluntary and involuntary system of nerves.
Chapter III treats of the Aetiology of the disease. Prominent among the causes of Fissure of the Anus is constipation of the bowels. He also cites mechanical injury, external violence, irritating discharges in dysentery, cholera and other visceral diseases, as frequent causes.
Chapter IV is devoted to the classification and description of Anal Fissure, its anatomical and pathological characters, the symptoms and signs, diagnosis and prognosis.
Chapter V gives the different methods of treatment, included under the following heads: 1, topical application; 2, cauterization; 3, dilatation; 4, incision of the mucous membrane; 5, excision of the sphincters of the anus. The authors treatment consists of topi. cal medication combined with dilatation, and sometimes scarification, or incision of the mucous membrane.
In Chapter VI are presented a large number of illustrative cases with treatment. A short bibliography is appended. We can commend the work as the most complete and exhaustive treatise yet pre. sented on the subject.
NEWS AND MISCELLANY.
CARBOLIC ACID in SCARLATINA.—Dr. Carpenter, of Keokuk, Iowa, (Physician and Pharmacist,) is highly laudatory of the use of this acid in the anginose variety of scarlet fever. He says that it not only materially lessens the inflammatory process in the fauces, but prevents septic poisoning, heals the ulcerated spots, and prevents the accumulation of the viscid faucial secretions. He says that within the past five wecks he has treated nineteen cases between one and three years, withont a single fatal result. In eleven the febrile movement reached its maximum intensity. Delirium, with restlessness and stupor, obtained in all these cases—the range of the pulse 140 to 155 to the minute. The heat of skin was lessened by constant sponging with cool or tepid water and vinegar, and lemonade, ad libitum, to allay thirst and soften the parched and swollen tongue, with occasional laxatives, and a solution of chlorate of potassa, two drachms to a pint, as a drink, together with the following topical application to the tonsils thrice daily, (acid carbol. f. 3 ss; glycerine, aq. distil. aa. 3 jss,) constitute the treatment. To combat renal congestion, spt. nit. dulc. in ten drop doses was
Milk punch and animal essences were freely used when the heat of the skin had subsided.—Medical Archives.
TRAUMATIC TETANUS CURED BY PROFUSE SWEATING.–L'Union Medicale contains the report of two cases of traumatic tetanus cured by profuse sweating induced by the gradual slacking of quicklime under the bed-clothes, the progress being kept up by replacing the lime as occasion required. In both cases the disease was cured in five days, but in one, the trismus, which was the last symptom to disappear in both, lasted until the tenth day.
GAZEOLE IN W100ping Cougi, a volatile ammoniacal product, obtained from the distillation of coal tar, seems to enjoy quite a reputation in France in the organs. The treatment consists in placing a teaspoonful of gazeole in a saucer at some distance from the patient, and renewing the liquid every two hours, until the sick chamber becomes impregnated with its odor.
TREATMENT OF FERMENTATION IN TIIE STOMACH.—“In cases of fermentation," Dr. Fenwick says, "the diet should be carefully regulated. Tea, coffee, milk, arrowroot, rice and similar fluids, so often forced upon the patient during a' bilious attack,' should be forbidden; and iced water, soda water, Seltzer water, and beef-tea should be substituted.
“As regards remedies, I have generally prescribed creasote in doses of one drop, combined with magnesia; but if there be much subacute inflammation of the mucous membrane, the hyposulphite of soda will be found more useful. For some time after the attack has subsided, vegetable tonics in combination with acids or alkalies are required."
Excessive SWEATING OF The Hands or FEET. For the relief of this troublesome affection Dr. Donilt recommends the thorough application of the hottest water that can be borne without pain to the offending parts until they are red hot and tingling as if scalded. This treatment the author states, sometimes appears to aggravate the affection. Hebra recommends the frequent local use of a solution containing one drachm of tannic acid mixed in six ounces of alcohol; this liquid should be rubbed into the parts several times a day, and the skin must not be wiped afterwards; a little powdered asbestos is to be sprinkled on it while still wet, and with this the part is to be rubbed till it is dry.