Achison, Nashville. Discussion by E. A. Cobleigh, M. B. Hutchins. President's Address: The Doctor of Medicine. J. B. Murfree, Murfreesboro, Tenn. Permanent Drainage of the Peritoneal Cavity in Ascites. Dr. Nalty (Sem. Méd., 1896) performed an abdominal paracentesis by means of a small trocar on a patient of sixty-five years. After about two litres of serosity had been removed he introduced a capillary tube through the trocar, which was then taken away and the small tube left fixed with diachylon. After ten days, during which twentyfive litres of serosity ran out, the ascites and edema of the inferior members disappeared completely. Then Dr. Nalty took away the drainage-tube and obturated the orifice of the puncture with diachylon. The recovery has been complete.-Indian Lancet. system. On page 341 of Prof. Schmiedeberg's "Arzneimitellehre" (latest edition) this eminent pharmacologist states: "The fact and effect of a craving for iron (Eisen-Hunger) can be experimentally proved on animals. A strong, frisky dog, after a moderate loss of blood, was fed for five months on pure milk only, and gradually became so weak that he refused further nourishment, became reduced in body weight, tottered when on his legs, and finally was at the point of death. At this stage 1 gramme of ferratin was added to the milk per day; the dog ate this with ravenous appetite, and within fourteen days had regained his weight and general condition to nearly equal the normal strength and activity possessed before commencement of the experiment." Ferratin in 8-grain doses three times daily was recommended by Germain Sée, the late distinguished French therapeutist, for "those suffering from anemia from hard work, though apparently in good health; those, of both sexes, affected with chlorosis; those weakened by too rapid growth and puberty; those fatigued by study; and, in short, all in whom a diminution of red blood-corpuscles had ensued, due no matter to what causes." Selections. FROM CURRENT MEDICAL LITERATURE. The Operative Treatment of Dilatation of the Stomach. Ewart and Bennett describe in the Lancet, London, 1896, vol. ii, No. 1, an operation for dilatation of the stomach which they believe to be new. The abdomen having been opened by a median incision about five inches long, commencing above at a point an inch below the ensiform appendix, the stomach was thoroughly examined by the hand introduced through the wound. No adhesions were detected and the pylorus was normal. The viscus was then drawn out of the abdomen and laid upon the parietes, where it presented a large balloon-like bag distended with A fold on the anterior aspect of gas. the stomach was then turned in by the fingers of the assistant. The length of this fold, which followed the direction of the long axis of the stomach, was about twelve inches, its greatest depth being about three inches. While this fold was held involuted by the assistant's fingers the peritoneal surfaces on the opposite sides of its base were brought together by numerous sutures made to transfix the peritoneal and muscular coats, the fingers of the assistant being gradually withdrawn from the fold before the tightening up of the final stitches. After the stitches had all been fastened off the size of the stomach was greatly lessened. Mr. Bennett had intended to make a small secondary involution at the great end of the stomach to prevent the otherwise inevitable dependent tendency of that part; but as the patient was in a very unsatisfactory condition generally, it was thought wiser to be content with what had already been done. The altered viscus was then returned into the abdomen, the wound in the parietes being closed by fish-gut sutures in the usual way. The patient presented the ordinary symptoms of dilatation of the stomach in a marked degree. He had had the benefit of the various forms of palliative | way on a second, third and fourth slip. treatment without any relief. The pa- When exhausted, the paper may be retient, after leaving the hospital, was charged. The slides are then stored able to resume his work, which was away to await convenience. Before that of a carpenter. proceeding to stain, the blood is fixed by dropping a little absolute alcohol on the films. The slides are then dried and stained with borax (5 per cent.), methylene blue ( per cent.), a few drops of the solution being applied for about a half minute. After drying the cover-glasses xylol-balsam is applied. If crescents are to be sought for, a good plan is to make the films fairly thick, to fix with alcohol, and then to wash out the hemoglobin with very weak acetic acid-two or three drops to an ounce of water. The now colorless film is washed with water, stained with methylene blue, and mounted in xylol-balsam in the usual way. The field not being obscured with blood-corpuscles, the large amount of blood which this method of preparation enables us to pass rapidly in review greatly favors the quick finding of any crescents that may be present. The same method of preparing blood films is equally applicable for the demonstration of other blood parasites. MANSON, British Med. Journal. Under the title of "Gastropexy," Duret describes in the Revue de Chirurgie, June 10, 1896, an operation for the condition of dilatation and downward displacement of the stomach, which is known as gastroptosis or Glenard's disease. The operation is performed as follows: An incision four inches in length is made in the middle line of the abdomen, beginning at the ensiform cartilage. The peritoneum is divided only in the lower half of the wound, the upper portion being left undivided to receive the sutures which hold the stomach in place. The pylorus and lesser curvature are then fixed to the anterior abdominal wall as follows: The stomach having been raised and placed in his normal position, a silk suture is made to include the serous and muscular coats of the pyloric extremity, and is then passed through the overlying portion of exposed peritoneum from within outward. The suture is carried backward and forward in this way until the stomach has been well anchored. The external wound is closed layer by layer. - American Journal Med. Sciences. A Rapid and Convenient Method of Pre paring Malarial Blood Films. As many microscopic slips as are likely to be required are cleansed with ether and placed in rows on a table near the patient. Three or four oblong strips of very fine, clean tissue-paper, one and a half inches by five-eighths of an inch, are also prepared. The patient's finger is cleansed and pricked in the usual way. A droplet of blood is then taken up by touching it with one of the papers about one-half inch from the end of the paper. The charged surface of the paper is then placed upon a glass slip. rather towards one end. In a second or two the blood will have run out in a thin film between the paper and slip. When this has taken place, the paper is drawn across the slip. The same paper, without recharging, is placed in a similar The Auscultation and Percussion of the Larger Arteries. Litten (Centralblatt f. innere Med., 1896, Bd. xxii) calls attention to a matter not generally recognized. It is well known that on pressing a stethoscope over an artery a murmur may be heard. This corresponds to a thrill which can best be felt just below the compressed part of the vessel. These phenomena can be brought out over all arteries larger than the radial. They are marked in proportion to the straightness of the artery and the possibility of compressing it against the deep tissues. So they are most distinct over the femorals and the abdominal aorta. Litten finds that these signs are intensified in certain diseases, such as aortic insufficiency and pseudo-aortic insufficiency, Basedow's disease, and circumscribed arterio-sclerosis. The latter is important, because easy to recognize in peripheral arteries; it is difficult when Suicide and Longevity and Climate and Poverty. the aorta alone is affected. Symptoms | tures, and for printing the dissertation, of sclerosis of the abdominal aorta are and the cost of books and instruments, especially pain in the abdomen, greatly amount altogether to about £100 or increased by pressure over the aorta; £120. The cost of board, lodging and increased hardness and abnormal width clothing is about £400 for four and a of the vessel on palpation, so much so half years.—British Med. Journal. that the inexperienced often mistake it for aneurism. From the great increase in the strength of the thrill in sclerosis, however, the diagnosis can be made. Litten mentions a case in which three were characteristic symptoms of pseudoaortic insufficiency with pain in the abdomen latter. Gradually a pulsating tumor formed in the abdomen, but as there was vomiting of blood the physician was in doubt as to whether the case was one of aneurism or cancer of the stomach. From the signs just described Litten diagnosticated aneurism, which was confirmed post-mortemAmerican Journal Med. Sciences. Cost of Medical Education in Official information has been supplied to the Italian government in regard to the cost of university study in Germany. To obtain the degree of doctor of medicine at Berlin involves about double the expense incurred in obtaining the doctorship of law at the same university. The following are the details: Fee for matriculation, 18 marks (I mark=1 shilling); fee for examination for the medical faculty, 242 marks; diploma fees for the faculty of medicine, 440 marks; fee for lectures necessary to pass the various examinations in the medical schools, 800 to 1,200 marks; charge for printing of the candidate's dissertation, 150 marks; and cost of books and instruments for a medical student, 500 marks. Then as to the cost of living. For a medical student who studies in a town where his parents do not live, 7,600 to 8,000 marks must be allowed for board, lodging and clothing during his four and a half years' course. At other German universities the cost would be somewhat less, but the difference, it is stated, would not be great, for the main item-the cost of livingis very much the same in all university towns. In other words, the fees for all examinations, for the diploma, for lec Northern latitudes produce stalwart frames, and mountainous regions develop men of deep chests and of sturdy limbs, but for compact, long-lasting, fatigue and weather-resisting and easygoing properties, no region can compete with the mild climate of the south of Europe. Spain, France and Italy, and boggy but even-climated Ireland, are the nations most favored as to longevity. It should be said, however, that this favoritism only exists in parts of those countries. The valley of the Po in northern Italy and the adjacent regions of the Apennines, the southerly parts of France, from the Alps to the Bay of Biscay, and the lower lying regions of Spain, are those wherein longevity thrives the best. To obtain these results requires a peculiar combination of climatic, racial and social factors. Agricultural pursuits, a mild climate, even if moist, an easily-satisfied and not-over-ambitious disposition, not being over-burdened with wealth, and temperance in enjoying the good things of this life as they come in one's way, all favor longevity. In Napoleon's campaigns, whether in that of 1806-7, or the later disastrous one of 1812, it was remarked that the contingent from southern France, along with those of northern Italy and Spain, were those who stood the best against the severity of the Polish and Russian winters. Late statistics, gathered by a German statistician, gives Germany only 78 centenarians, France 213, while Spain, with a population much less than that of Germany, has 401. Belgium has only 6. The Belgians are a hardy, strongly. constituted and muscular people, but do not seem to endure cold, privation or fatigue-or the general wear and tear of life-on an equal degree with their slighter physiqued and not so stubborn Rabuteau's Dragees of Iron Laureate of the Institute of France. The studies made by the Physicians of the Hospitals have demonstrated that the Genuine Dragees of Iron of Rabuteau are superior to all other preparations of Iron in cases of Chlorosis, Anæmia, Leucorrhoea, Debility, Exhaustion, Convalescence, Weakness of Children and the maladies caused by the Impoverishment and Alteration of the Blood after periods of fatigue, watching and excesses of any kind. TAKE 4 to 6 DRAGEES DAILY. Rabuteau's Elixir of Iron is recommended to those persons who may be unable to swallow the Dragees. Dose-a small wineglassful with meals. Rabuteau's Syrup of Iron is specially designed for children. Chalybeate medication by means of Rabuteau's Iron is the most economical and the most rational known to therapeutics. No constipation, no diarrhea, complete assimilation. TAKE ONLY THE CENUINE IRON OF RABUTEAU OF CLIN & CO., Paris. CAPSULES Mathey-Caylus With Thin Envelope of Gluten. Containing Copaiba and Essence of Santal; Copaiba, Cubebs, and the Essence of Santal; Copaiba, Iron, and the Essence of Sanal. "The Mathey-Caylus Capsules, of the "Essence of Santal, associated with the Bal"sams, possess an incontestable efficacious"ness and are employed with the greatest "success for the rapid cure of old or recent "Discharges, Gonorrhoea, Blenorrhoea, Leucor"Thoa, Cystitis of the Neck, Urethritis, Catarrh, "and other diseases of the bladder, together "with all affections of the Urinary Passsages. "Thanks to their thin envelope of "Gluten, which is essentially assimilable, "the Mathey-Caylus Capsules are digested "by the most delicate persons and never "weary the stomach."— PARIS (Gazette des Hopitaux de Paris.) - CLIN & CO. — PARIS AND OF ALL DRUGGISTS. "The Salicylate of Soda used by Clin is "of perfect purity, and is prepared with "the greatest care; it is a medicament in "which we may have every confidence."(Paris Society of Medicine, Meeting of Feb. 8th, 1879.) Clin's Soludon, very exactly mixed, contains: 2 grammes of Salicylate of Soda per tablespoonful, 50 centigrammes of Salicylate of Soda per teaspoonful. PARIS - CLIN & CO. - PARIS AND BY ALL DRUGGISTS. NEURALGIAS PILLS OF DR. MOUSSETTE. The Moussette Pills of aconitine and quinium, calm or cure Gastralgia, Hemicrania, Headache, Sciatica and the most obstinate Neuralgias. "The sedative action exerted by the "Moussette Pills upon the apparatus of the "sanguineous circulation by the intermedi"ation of the vaso-motor nerves, indicates "their use in neuralgias of the trigemini "nerves (fifth pair), congestive neuralgias, "and painful and inflammatory Rheumatismal "affections. "Aconitine produces marvelous effects "in the treatment of facial neuralgias when "they are not symptomatic of intracanial "tumor.". (Society of Biology of Paris, meeting of the 28th Feb. 1880.) DOSE: Take 3 to 6 pills during the twenty-four hours. ACCEPT ONLY THE GENUINE MOUSSETTE PILLS OF CLIN & CO., Paris. E. FOUCERA & CO., Agents for the U. 8., NEW YORK. When corresponding with Advertisers, kindly mention LANCET-Clinic. ANHEUSER-BUSCH BREWING ASS'N, St Louis, U. S. A. Send for handsomely illustrated colored booklets and other reading matter. Uniformly Effective, Agreeable and Lasting,-the FORMULA: The concentrated extract -the aromatic principle of the fresh Coca Leaf, blended with a special quality of grape juice of southern France. DOSE: Wine-glassful three times a day, or more or less at Physician's discretion. Nourishes - Fortifies Refreshes AIDS DIGESTION = STRENGTHENS THE SYSTEM AGREEABLE TONIC-STIMULANT WITHOUT UNPLEASANT REACTION. SOLD AT ALL PHARMACIES. PARIS: 41 Boulevard Haussmann. A MARIANI & CO., 52 W. 15th St., New York. |