We know we echo the sentiment of every physician who enjoys the acquaintance of Dr. Boisliniere (and who in the West and South doesn't know him and love him?) when we say that we hope he may retain his renewed health and long remain among us to work and cheer us by his presence. He can rest assured in these, his declining years, that the doctors all around him in this great cityall who have been one time or another classed among the young doctors, particularly indulge the fond hope that he who was ever their friend in deed as well as word, may long be with them, and, as the years come and go and age creeps more and more upon him surely but gracefully, he can rest happy in the knowledge that he has fought the good fight, he has kept the faith, and attached his professional brothers to him with hooks of steel. And now in the fulness of his intellectual powers in these, his closing years, may each and every kind, cheering and sympathetic word he has ever uttered come back to him multiplied and intensified, and cheer him when his spirit is weary, and every generous and kindly act of his life come up before him and brighten his path and strengthen him on his way. I. N. L. THE REMOTE EFFECTS OF REMEDIES. This is the subject chosen by Dr. Broadbent, President of the Section of Medicine, for his annual address at the late meeting of the British Medical Association. The doctor handles his subject with great earnestness. He presented to the Association a few illustrations of the desirabiliiy of looking beyond the immediate results of treatment, and of the necessity of exercising forethought in the employment of remedial measures. As glaring examples of injurious remote effects, he briefly refers to alcohol and opium, merely, however, to show the drift of his thoughts. The injuries that he discusses are the result, most frequently, of unauthorized abuse and of weak and vicious self indulgence on the part of patients with real or imaginary ills. Gout and some of the remedies employed in its treatment are first considered. The paroxysm of the acute attack may be cut short by the free use of colchicum or veratria. But they should not be habitually employed or disastrous consequences, great prostration, must follow. The secretory and excretory organs should be placed into a state of greatest functional efficiency in order to clear the economy of the gout poison. This can only be attained by aperients, alkalies, iodides and careful regulation of diet, by baths and waters, measures requiring great self-denial. Instead of subjecting themselves to such a vigorous course of true remedial treatment patients resort again and again to the so-called "specifics." The consequences of imperfect elimination must manifest themselves. High arterial tension, with all its varied danger of arterial degeneration, cerebral hemorrhage, aneurism, dilatation of the left vertricle, is thus promoted. As a striking illustration of injuous remote effects of gout specifics the author points to plumbers and painters; through absorption of lead these artisans are, from imperfect oxydation and metabolism, extremely subject to gout. Gout pills, etc., are in common use among them. The consequences of the imperfect elimination and assimilation of imperfectly oxydized matter are enormous deposits of urate of soda in hands and feet, and marked arterial degenerative changes. The "Banting" treatment of obesity, as understood and practiced by the public is a source of high arterial tension and consequent danger. Under the highly nitrogenized diet of this "cure" together with the limitation of fluid ingesta, active metabolism and elimination are reduced. The amount of fat may be reduced, but a surplus of imperfectly oxydized nitrogenous waste remains in the circulation, especially, if exercise in the open air, so essential in this treatment, is neglected, as is generally the case. Such cases, and also the cases of glycosuria in stout, elderly, gouty subjects never do well on a strict nitrogenous diet. The eliminating action of large quantities of water with saline matters, such as are found in the waters of Carlsbad, Mari enbad and Vichy, are highly beneficial in such cases, while dietary restriction and measures checking the excretion of sugar may prove positively harmful. For diabetics of the above description Dr. Broadbent would allow a modified mixed diet and an eliminant treatment of a blue and colocynth pill, once or twice a week, followed up by salicylates and alkalies. He very justly says: "Our object is not the removal of the last trace of sugar from the urine, but the comfort, happiness, and long life of the patient." In asthma, too, much injury is worked by "pecifics." The powders, of which "Himrod's" is the most popular, whose fumes relieve the paroxysm, are largely composed of solanaceous drugs, the powerful alkaloids of which obtain direct access to the blood through the pulmonary capillaries. In cases that have a catarrhal element these powders are especially injurious. Paralysis of the arterial walls is their immediate effect; the right ventricle also loses its tone, and under immoderate use, is gradually dilated, giving rise to systemic venous stasis and dropsy. In migraine or sick-headache, much harm may be ultimately worked by a course of treatment looking to a radical cure, from the point of view of cerebral congestion or gastro-hepatic derangement. Great mischief results in these cases from rigorous diet and depletive measures. Careful feeding up, and arsenic with quinine and nux vomica have given Dr. Broadbent far better, more satisfactory results. Another illustration of present relief, purchased at the expense of subsequent injury to health, is the treatment by too careful and restricted a diet of certain forms of so-called indigestion. In such cases, says the doctor, the list of permissible foods is often cut down, till starvation point is almost reached. The winter indigestion of women and weakly men is such a form of dyspepsia. In all such cases, the principle of functional rest should not be lost sight of. But, generally, "it is not the food that disagrees with the stomach, but the stomach which disagrees with the food." The functional energy of that organ should be brought up by food of a stimulating character, such as beef-tea, egg-flip, tonics, stimulants at meals, etc. We should not starve those who are suffering from inadequate nourishment, or employ treatment for catarrh, or ulcer, or organic disease, when nothing of the kind is present. The injudicious use of purgatives is also discussed by the doctor. J. Milner Fothergill in commenting on the address in a letter to the British Medical Journal, speaks of a large class of patients as follows: "They do not care to look beyond the immediate present, or to subordinate it to the future; nor do they give their medical men any encouragement to look to the remoter consequences of the remedial agents employed, provided they act immediately." Dr. Broadbent's address strongly points to the evils of self-quackery, and ought to encourage the profession in its opposition to the tendency on the part of a majority of the sick to trim and modify or persist in lines of treatment, that must eventually work harm. PERIARTICULAR FRACTURES.-In the Société de Chirurgie not long since, M. Trélat stated that he thought his colleagues had perhaps gone a little too far in opposing immobiliza tion in the treatment of periarticular frac tures. Each fracture, in fact, possesses a number of indications, and no treatment addressed solely to one of these can help but be imperfect. In regard to fracture of the patella, Richelot was correct in insisting upon the importance of the muscular atrophy which takes place, but Tilanus was wrong in recommending massage as the sole treatment. It seems as if surgeons were falling into the same error regarding the fibula. It is true that massage can render some service, but none the less it ought not to make us lose sight of the fracture. Immobilization is good, but should not be prolonged beyond certain limits, as was done by surgeons at the beginning of this century. For, in trying to do too well, one is liable to have stiff joints, and thus for the fibula the apparatus should be left in position four weeks and not six. CHRONIC ZONA. Chronic zona presents itself under three forms: 1. Chronic, local, extensive zona ; 2. Zona by propagation from one nervous branch to the other; 3. Successive or distant zona. The lesions of herpes zoster are too well known to need repetition. There are alterations of the intervertebral ganglia and of the peripheral nerves, sometimes as far as in the skin. Dr. Leudet, of Rouen, has lately observed two cases of chronic zona (France Medicale). They were in tuberculous patients. and there c existed a new tuberculous growth. The cutaneous lesion brought about new ulcerations, scars, with or without pseudo-phlegmon. This state may continue during three or even six months and leads to the development of keloidal tumors, and is accompanied by a neuritis. Pulmonary tuberculosis or the irritation caused by a pleural fistula after empyema may call into action the development of a remote zona. Zona, when it occurs in the same individual, may recur in the same or in different regions, and it is this constant recurrence due to internal irritation that constitutes chronic zona or zoster. RESISTANCE OF THE VIRUS OF GLANders. MM. Cadéac and Malet have studied the resistance of the virus of glanders, to the destructive action of atmospheric agents and of heat and their results are communicated to the Paris Academy of Sciences, Aug. 9, They conclude that this virus loses its virulence in the liquids exposed to the free air after complete dessication. It is also rapidly destroyed by warm and dry weather; more slowly during cold and damp weather. If the virus is rapidly dried in a vessel, in about four hours, it retains its virulence much longer than if slowly dried. This last fact estab lishes, in a certain degree, that in this mode of destruction of the virus, the important factor is not the suppression of the water, but the action rather of the oxygen of the air. The experiments which have been made, also establish the fact that the bacteria of glanders resist putrefaction for a long time, and the matter thrown off by glandered animals M. Rohnner has written a good paper upon this subject, his conclusions being that this artificial maturation may be employed in senile cataract which is incompletely ripe, in which, on this account, a too hasty extraction is contra-indicated. A simple discission with massage of the eye suffices in the majority of cases. If the result remains incomplete, it can be finished by performing an iridectomy that will complete the maturation and be preventive for extraction. Finally, if after extraction is made under such conditions, there exist in the pupillary field any shreds. or pieces of cortical substance subsequently opacified, adjuvant means, such as aspiration (suggested by Redard), and intra-ocular washing will correct this in a short time, and a pupil, entirely black in appearance, will result. PROGRESSIVE ATROPHIC MYOPATIA. - M. Ladame, of Geneva, after recalling the history of progressive muscular atrophy, considered as a disease of the muscles, then as a disease of the marrow, then with Erb subdividing itself into two types, the one myelopathic and the other myopathic, attaches himself (Journal des Sociétés Scientifiques) to the type described by Déjerine and Landouzy who confirm the labors of Erb, more particularly in regard to the absence of fibrillary contractions in. myopathic atrophy, and in the atrophy of degenerative reaction. But, according to him, these authors go too far in trying to make of myopathy an affection entirely distinct from and having no relation to pseudo-hypertrophic paralysis, the juvenile form of Erb and hereditary atrophy of Leyden. Erb has proven the connection between these forms, and Charcot has brought his extensive experience in support of this opinion. Whilst according a large importance to the facio-scapulo-humeral type of Déjerine and Landouzy, the author cannot go as far as to make a special disease of it. It is perhaps the classic type of progressive muscular dystrophy, in respect to which the juvenile form of Erb, the pseudo-hypertrophic paralysis and hereditary atrophy of Leyden, only occupy a secondary position. subject of International Quarantine is to be raised by the president of the Section, Joseph Jones, M. D., of New Orleans. We could send to the discussion of such a subject no greater authority than Mr. John Simon. We are glad to be able to report a very general desire among leaders in London to be present at Washington in 1887. Whatever hesitation they felt some time ago in view of the divided state of feeling in America, is now steadily Ladame cites a case of the Déjerine Landouzy type, in a young man of twenty, having a grand-father who died of a muscular atro-giving place to a desire for the success of the phy. At the age of fourteen the patient had Congress, and a wish to do anything they can an atrophy marked at the right shoulder and to further it. We feel quite justified in say arm, and also involving the right thigh, and ing that our best men in England and Scotcommencing to spread to the left side. Some land are preparing to go if they get any indiatrophy of the face also existed. The mus- cation that their presence will be acceptable. cles of the tongue, larynx, jaw, eye, dia- Sir Andrew Clark, Sir Spencer Wells, Prophragm and thorax (intercostals) were un- fessor John Chiene, Professor Fraser, and we affected. No fibrillary contraction; the believe Sir William Turner, are all, according electrical excitability was simply diminished to our information likely to go. in the diseased muscles. There was a loss of the tendon reflexes, conservation of the cutaneous reflexes, integrity of the sphincters and no sensory troubles. The most efficacious treatment is galvano-faradization of the muscles according to a precise method and using only moderate currents. INTERNATIONAL CONGRESS.-The London Lancet, Aug. 7, says: The subject of public and international hygiene is likely to occupy an important place in the discussions of the Ninth International Medical Congress, or rather of its fourteenth section. We are glad to see that Mr. Simon is anxious to attend the Congress and take Vice-Presidentship of the Section. Mr. Simon, indeed, speaks in his letter responding to the invitation with some doubt as to his power to attend, but with a clear intimation of his desire to do so. Mr. B. W. Richardson and Dr. Thudichum both reply in most cordial terms to similar invitations, and accept a similar office. To those who know the imperfect health which Dr. Simon has lately enjoyed, the significance of his conditional acceptance is very great. The promoters of the Congress will take this as a sign of British good-will towards their great and responsible undertaking. The important It is not America alone that is interested in the success of the meeting at Washington, but the profession throughout the whole world, and we might add the world itself. When our profession meets internationally it is of good omen. We not only stimulate fraternity and scientific rivalry amongst ourselves, but every thought in advance and ev ery medical discovery is a great boon for the human race and for all nations. We urge on members of our profession in the empire to strain a point to be at Washington on or be fore September, 1887, where, if report is to be trusted, a very hospitable reception awaits them. BACTERIOTHERAPY IN PHTHISIS. Since Cantani's first publication setting forth the efficacy of the bacterium termo in combating the bacillus tuberculosis and advising a therapeutic application by means of the spray of cure cultures of the bacterium to tubercular lungs, several reports by clinicians have appeared, both favorable and unfavor able as to the actual value of the proceeding. The readers of the REVIEW have been informed of these reports. The great biological interest that attaches to this matter prompts us to day to give the results obtained by Luigi de Blasi, Giornale internazionale delle scienze medicine. The inhalations were conducted twice a day upon eight tuberculous patients, about an ounce of a broth culture of bacterium termo being used each time. The reporter arrived at the following conclusions: 1. No bad effects resulted in any of the patients. 2. The sputa showed a very marked diminution of tubercle bacilli; however, they did not entirely disappear in any of the cases. 3. In six patients the cough and the expectoration diminished in intensity and amount. 4. In only two patients was an increase of weight an evident result. 5. The course of the fever was not modi fied. The physical examination of the chest showed no improvement in the signs. In Progress we read of a pronounced case treated by this spray; the patient also took a pill containing 1.40 gr. of the bichloride before each meal and at night and at the same time a pill composed of asafetida, gr. iii., and ext. nuc. vom. gr. for six weeks. The result was a most happy one. We do not find any statement respecting syphilis in the case. If such existed, the efficacy of the bichloride would have a significance entirely different from the one intended to be conveyed. DR. NATHAN S. DAVIS-The British Medical Journal says: "The leading position assigned to Dr. N. S. Davis, of Chicago, by his countrymen as president-elect of the approaching International Medical Congress at 6. The patients all declared that they felt Washington, and the prominent position of better subjectively. honor assigned to him at the meeting of the British Medical Association at Brighton, will make many of our readers desire to know more of the professional life-history of this venerable and respected physician. Dr. Da received the degree of Doctor of Medicine from the Regents of the University of New York in 1837, and has been engaged in the practical duties of the profession from that time until the present. In 1844, while a member of the New York State Medical CHLORAL HYDRATE AS A VESICANT.-Dr. Ivanowski, of Charkow, says that chloral hy-vis drate is a vesicant of great reliability. He cuts a piece of adhesive plaster of the desired size and sprinkles it freely with powdered chloral leaving the edges free. Thereupon the back of the adhesive plaster is warmed over a gentle heat until the chloral is molten. The strip is then applied to the skin which previously is well oiled. After ten to fifteen minutes a large blister is formed. The pain experienced by the patient is inconsiderable. The application should not be continued. longer than fifteen minutes, otherwise, ulceration may result. Society, he originated the movement that resulted in the permanent organization of the American Medical Association in 1847. At the annual meeting of that Association in 1851 he read a valuable paper, giving the results of original investigation in regard to the effects of different kinds of food and of alcoholic liquors on the temperature of the human body, etc. His contributions to medical literature since have been valuable and In 1859 he was elected Profesnumerous. sor of Principles and Practice of Medicine in the Medical College in Chicago, and Professor of Clinical Medicine in the Mercy Hospital, which positions he continues to hold at the present time. He was president of the American Medical Association during the years 1864 and 1865. In 1879 he received |