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frequent attacks of asthma. Heart and lungs sound. Appetite and digestion good. Suffers more from asthmatic attacks during autumn and winter than any other seasons of the year. Frequently obtains relief by inhaling the fumes of burning nitre of paper. Prescribed the fluid extract of euphorbia pilulifera and glycerine, equal parts, of which the patient was to take a teaspoonful every three hours. Her husband reported that the medicine had no effect on the paroxysms of asthma, and that his wife's asthmatic breathing was relieved by smoking cubeb cigarettes.

Case 4.-Miss R., age 13 years, has suffered from asthma from early childhood, Has received treatment from all sorts of physicians, from the cultured physician as well as the travelling mountebank, and has obtained very little benefit from any of them. No organic disease could be detected of either heart or lungs, upon examination of the chest. No structural changes in the kidneys. Appetite and digestion fair, and the patient well nourished. She was prescribed a mixture of equal parts of the fluid extract of euphorbia pilulifera and glycerine, with directions to take a teaspoonful morning, noon, and night. Her mother reports that the daughter has breathed better, and suffered less from asthma than at any period for several years.

Within the past year thirteen cases of spasmodic asthma have come under treatment, and in each case the fluid extract of euphorbia pilulifera has been prescribed with satisfactory results, except in one or two cases where it failed to relieve, although no cause could be assigned for its failure. There were no complications, but the drug failed, like many others which have a decided influence in the treatment of spasmodic asthma. In one instance, where mitral lesions were present, a pill containing one one-hundredth of a grain each of trinitrin and strophanthin, night and morning, in connection with half a drachm of the fluid extract of euphorbia pilulifera every four hours during the day, gave the patient relief from the paroxysmal attacks of asthma, which were no doubt of neurotic origin.

Finally, permit me to briefly state the conclusions arrived at by Dr. John Aulde, of Philadelphia, who has prescribed euphorbia pilulifera twenty-five cases of spasmodic asthma: "Euphorbia is a remedy of special value in the treatment of all forms of asthma. In the absence of organic changes in the pulmonary and renal structures, and when the atmospheric conditions are favorable, relief will usually be afforded after taking the first dose. Being excreted largely by the liver and kidneys, the condition of these organs must be taken into consideration when estimating the probable effect of the drug. It has no special action in controlling the sudden attacks, but may be depended upon in young and robust individuals to effect a radical cure, providing they will continue to reside in an atmosphere that is dry and bracing, situated in a moderately elevated locality, where there are no, or comparatively few, sudden changes."

A REPORT OF THE EXPERIMENTS WITH

TUBERCULIN AT THE GOOD SA
MARITAN HOSPITAL IN CIN-

CINNATI.

BY S. P. KRAMER, M.D.,

OF CINCINNATI, O.

The following is a report of the experiments with tuberculin in the treatment of tuberculosis, carried on in conjunction with Prof. Whittaker at the Good Samaritan Hospital in Cincinnati.

The work was begun on January 14th and has been continued up to the present time. Fifteen weeks' experience with the remedy is but a short time during which to gather material that shall give us definite results. This is offered as the result of observation during that time, to be taken for what it is worth.

I shall report only those cases in which the remedy was used systematically as treatment, leaving out the cases in which it was used for diagnostic purposes.

The injection of tuberculin, and nutritious diet and alcohol, constituted the only treatment used.

In all, then, there are twenty-nine cases. Two of these were cases of tuberculosis of the lymphatic glands primarily. As they present many points of interest, I shall dwell on them somewhat in detail.

The first is the case of a young man, age 24. Since childhood he had suffered from repeated attacks of quinsy, and chronic inflammation of the tonsils and pharynx. Three years ago he began to be troubled with enlargement of the cervical lymphatics. This continued and led to the formation of three sinuses, which, when he was admitted, were discharging a slight quantity of thin serous fluid. Eighteen months ago he began to notice cough, with mucous expectoration. This was followed by night-sweats, hæmoptysis and loss of weight.

Examination revealed, besides the general enlargement of the cervical lymphatics, dulness on percussion, with rude inspiration and prolonged expiration over the right apex. Tubercle bacilli was found in the sputum.

The result here has been very satisfactory. The glands have diminished in size, cough and expectoration have disappeared, the patient has gained ten pounds in weight and the anæmia has been greatly ameliorated.

The other case is one of four years duration. The trouble began in the lymphatics of the right neck, extended to the left, involving the entire

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