THE WEEKLY MEDICAL REVIEW.

VOL. XI. No. 15.

MEDICINE AND SURGERY.

CHICAGO AND ST. LOUIS, APRIL 11, 1885. TERMS: $3.50 A YEAR.

TREATMENT OF TENESMUS.-The Med. and Surg. Rep. comments: There are two symptoms which, though occasionally accompanying grave diseases, are often met with in mild affections, but exceedingly annoying to patients. These symptoms are tenesmus of the rectum and tenesmus of the bladder (recti et vesica). In many cases of diarrhea, especially during the warmer season of the year, the symptom, of which the patient really complains, is the frequent desire to evacuate the bowels, accompanied by a peculiar spasmodic condition of the sphincter ani. Again, in catarrhal conditions of the bladder, also mostly prevalent during the summer, when the main symptoms are a frequent desire to micturate and a painful smarting sensation during the act, a very similar tenesmus seizes the neck of the bladder, and often is almost unbearable to the patient. Happily these symptoms-the tenesmus in both cases-are not apt to endure long, but as long as they do last they are a torment to the individual suffering from them.

Heretofore we had to be satisfied either with the causal treatment of the underlying disease the diarrhea or dysentery in the one, the catarrhal inflammation or the specific urethritis in the other case-or with the local application of heat or of anodynes, the latter in the form of suppositories if the bowels were the seat of the lesion, or in that of injections if the bladder was the organ affected.

tioned, where the tenesmus forms the symptom for which the patient consults the physician, a transient action would be all that is necessary to insure success; and if the action of the cocaine in such cases can always be relied upon, on that one account alone the addition of the drug to our pharmacopeia would be a boon to many a sufferer. The solution employed in B's case was the usual 2 per cent one.

F. TH. VON FRERICHS.-The foremost of German pathologists and clinicians died in his 66th year, on March 14, at Berlin. He is especially well known for his writings on diseases of the kidneys and the liver. He completed his twenty-fifth year as a clinical teacher at the Berlin University only last year and on that occasion gave to the world an exhaustive treatise on diabetes. Frerichs was a representative of the exact methods in medical investigation and was eminent alike as student and teacher.

ANTIPYRINE. We commend the paper of Dr. James E. Newcomb, that is published in this and the preceding number to the especial attention of our readers.

OF

SYPHILIS AND THE DEPOPULATION FRANCE.-The members of the Académie de Médecine have recently held several long debates upon the subject of the depopulation of France. The depopulation of France, Recently Dr. J. Bettelheim (Wiener Med. M. Fournier said, was due to two causes: a Presse, 1884, 45,) has tried the new local low birth-rate and a high death-rate among anesthetic, muriate of cocaine, in a severe infants. Physicians could do little to affect case of tenesmus of both rectum and blad- the former, but in lessening infant mortality der, and the result was very favorable and there was an opportunity for work. M. Fourprompt, though not of more than a few hours' nier thought that there was a large and induration. Still, in the milder cases men-creasing amount of syphilis in France, partic

ularly in Paris. The result of this was sterility or high infant mortality. Among one hundred children born of syphilitic parents sixty-eight died. M. Fournier urges renewed efforts in the prevention of syphilis, and the adoption of some measures to prevent the marriage of syphilitics.

CARL THEODOR ERNST VON SIEBOLD.This eminent representative of a celebrated family of medical men died a few days ago, aged 80 years. He occupied academic chairs at the universities of Wurzburg, his native city, of Erlangen, Freiburg, Breslau and Munich. He was an authority in comparative anatomy.

yielded. This they ultimately did, but not by the 'gentle pressure' Dr. Stewart speaks of. An attack of peritonitis followed the reductior, but the patient made a speedy and happy recovery. Two similar cases treated by the same simple method, with no untoward symptoms following, warrant me in underscoring this 'simple expedient.' The first case occurred five years ago, and I do not report it with a view of establishing any priority of claim, but rather as a confirmation of the practice or plan recommended."

ILLINOIS STATE SANITARY SURVEY.-In connection with the Sanitary Survey of the State and the House-to-House Inspection, now being prosecuted under direction of the State A SIMPLE EXPEDIENT IN THE MANAGE- Board of Health with reference to the probMENE OF STRANGULATED HERNIA.-Dr. S. H. able appearance of Asiatic cholera in this Hurd, of Long Branch, N. J., writes the Med-country the Board has just issued a circularical Record: "Under the above caption Dr. C. A. Stewart, of Chicago, calls attention in the Record to a simple expedient he has resorted to successfully in five cases of strangulated hernia after taxis had failed. It consisted in dilatation of the constriction which produces the strangulation at the abdominal ring, by passing the finger along the inguinal canal, carrying the integument before it, until the constricting ring is felt. The finger is then gently insinuated into the opening, and, if the band of opposing fibres does not yield readily, gentle pressure is made against the upper border of the ring until it is felt to give way, when a resort to taxis again will ordinarily result successfully. Last year I called the attention of the members of our County Society to this plan and its happy results in several cases.

"One of my patients referred to was sixtyeight years of age, and several unsuccessful attempts had been made to reduce the hernia. I had made every preparation for surgical interference, and the patient was anesthetized, when Dr. Green, of this city, attempted it by the above method and succeeded. The effort, though, was prolonged, and much patient and persistent pressure was made upon the fibres of the constricted ring before they

letter No. VI, addressed to County Clerks, and requesting that the work of getting the public institutions into sanitary condition be completed with as litte delay as possible. Much work of this character was done during the past summer and fall, in response to the circular-letter of the Board issued in July last. But, in addition to what remained to be done when cold weather suspended operations, there must since have accrued, in many cases, accumulations of filth and refuse which should now be promptly removed; defects in plumbing, drainage and sewerage, disclosed during the winter, should be repaired; and the effects of the occupancy of dormitories, workshops, wards, cells and other apartments should be remedied by a thorough spring cleansing.

The officers in charge of almshouses, jails, and all other public buildings under control of the County Board, are notified to commence this work at once. Very much that requires to be done-scrubbing, whitewashing, removal of garbage and refuse, the emptying and disinfection of vaults and cesspools, the opening up and cleaning out of drains, sewers and ditches-can be performed by the employes and inmates of the institutions.

one cause. There is no commoner mode of such pollution than through foul, badly constructed and improperly located privies and waterclosets. The disease, in this country, being always due to importation, and its spread being, most commonly, by persons traveling from place to place, it follows that railway privies and water-closets are especially exposed to the danger of cholera infection. In view of these facts it is requested that all such places in connection with stations, freight-houses, shops and round-houses be at once inspected and put in good sanitary condition.

Especial attention should be given to the tion of the water-supply than to any other location and condition of privies and waterclosets at these places, as also at court houses and elsewhere. Vaults should be emptied before warm weather makes such work dangerous, and then be thoroughly disinfected with sulphate of iron (copperas). Where these vaults are within fifty feet of any source of water-supply-well, spring, pond, lake, or running stream-their further use should be abandoned, and, after being emptied, they should be disinfected and filled up with clean, dry earth-one of the best disinfectants. The new vault should not be less than fifty feet from the [nearest water-supply; should be water-tight; ventilated by a four-inch shaft, opening above the roof; the contents should be kept inoffensive by the use of some cheap disinfectant; and the building and its sur roundings should be kept in the cleanest attainable condition. Where practicable the substitution of the earth-closet system for the subterranean vault-storage is recommended. In either case the frequent removal of the contents, and their safe disposal, by use as fertilizers, are necessary sanitary measures.

The source of the water-supply, and its storage and distribution, should be carefully inquired into; and all possible causes of pollution should be removed. A pure watersupply is of the first importance to health under all circumstances; but among numbers of persons living under the conditions which obtain in county institutions, its importance is increased. Epidemics of diarrhea and dysentery may be caused by impure water; while typhoid fever and Asiatic cholera are spread more commonly through the water-supply than in any other way.

These remarks and suggestions will indicate the character of the work which the Board considers it desirable should be accomplished before warm weather sets in, not alone through fear of cholera, but in the interest of public health, and, consequently, of

true economy.

A similar circular was recently issued to railroad managers setting forth that the spread of Asiatic cholera is due oftener to the pollu

Responses have been received from nearly all the roads, and one of the most important lines has already completed the work indicated along the entire extent of its road.

ALVELOZ FOR CANCER.-The Washington correspondent of the New York Medical Journal writes to this paper under date of January 26, 1885. that a new, and perhaps, not an indifferent successor to cundurango has sprung up in alveloz, a new South American plant recommended as a cancer cure. Our consul at Pernambuco forwarded to the State Department a sample of the drug, with the statement that several cases of alleged cancer had been cured by its application. Unlike cundurango, which was an alleged internal remedy for cancer, and syphilis, alveloz is an external application. Its mode of operation is similar to that of jequirity. A profuse suppuration follows its application to a granular surface. On receipt of the medicine, it was turned over to the Marine Hospital Bureau for trial. A portion of [the drug was given to Dr. Smith Townshend by the Surgeon-Genéral, for use in a case of lupus of the nose, near the angle of the eye. This case was of nearly forty years' standing, and had resisted all previous treatment. The ulcer was cured within a few days, and the patient was exhibited by Dr. Hamilton at a recent meeting of the medical society. Dr. Hamilton stated that he had under observation an undoubted case of epithelioma of the