ADDENDA.

102. AN IMPROVED SYRINGE-PIPE FOR HYPODERMIC

INJECTION.

By Dr. THOM AS BUZZARD, Assistant-Physician to the National Hospital for the Epileptic and Paralysed.

Those of us who are most favourably disposed towards the hypodermic injection of drugs are yet obliged to allow that our patients not unfrequently object very strongly to the pain occasioned by the introduction of the syringe-tube. And we sometimes find it as hard to convince such persons that they are not being hurt as the shoemaker did to prove to Lord Foppington that his shoe was not too tight. "Your lordship," he said, "may please to feel what you think fit; but that shoe does not hurt you. I think I understand my trade!" A syringe-tube which I have lately had made will, I hope, do something to extend the hypodermic method by the facility and comparative painlessness of its introduction. The ordinary syringetube, it will be remembered, is, of gold or silver gilt, and is tubular to the very end, which is sharpened as well as the somewhat soft material allows. Steel tubes of the same form are sometimes employed, but they quickly corrode and get choked. It occurred to me that it was quite unnecessary for the syringepipe to be tubular throughout, and that a gold tube might with advantage be fitted with a solid steel spear-point of the best form for penetrating the skin. At my request, Messrs Meyer and Meltzer, of Great Portland-street, have attached a triangular steel prism to the ordinary gold tube, and thus constructed an instrument which pierces the skin as easily as the "glover's" needle, which is preferred to all others, by many surgeons, and which the termination of the tube closely resembles. advantages of incorrodibility in its tubular portion, and sharpness of point, are thus combined. The point is wiped by simply passing it between the thumb and finger. —Lancet, March 20, 1869, p. 397.

103.-HYPODERMIC MEDICATION IN GOITRE.

The

Prof. A. LücKE, of Berne, reports in the Berlinea Klin. Wochenschrift, No. 25, 1868, a very interesting case of this disease cured by the subcutaneous injection of tinct. iodinii

fort. (1:8). He made the injections at several spots, and at intervals of eight days. He began with four to five drops, and at last got up to two Paraz's syringes full. Until the larger quantities were used, no local or general reaction followed; and only then could iodine be detected in the urine. After four months' treatment, the patient was so far improved that only a few very hard small knots could be felt where the tumours had been.

In the October number for 1867 of the Archives Générales, Dr. A. Luton de Oviens publishes the results of a similar treatment; he gives the account of eight cases which were more or less perfectly cured; in one case suppuration occurred.

Luton and Lucke mention two successful cases in which the same treatment was applied for the cure of chronic enlargement of the lymphatic glands.-Medical Press and Circular, Jan. 20, 1869, p. 63.

104. THE SUBCUTANEOUS INJECTION OF ATROPINE. A country practitioner sends the subjoined note :"The following facts, in connexion with the subcutaneous injection of the sulphate of atropia, may be interesting to some of the readers of the Practitioner. Shortly after the practice was introduced, I commenced it with a patient, and for the last eight years have daily used it for the same person. I dissolve three grains in half an ounce of distilled water, and this suffices for exactly fourteen injections. The toxic effects of the drug are confined to a dryness in the throat, a difficulty of swallowing for four or five hours after, if attempted, and dilatation of the pupils; nearly always, however, sleep follows in a few minutes. There is no waste of the atropia solution, except what must adhere to the inside of the barrel of the syringe. Owing to the danger said to exist (in books and periodicals) in giving the atropia, except in very small doses to commence with, I have only used it (and that once) in two other casesdoses the same as in the first instance :-Acute lumbago; pain removed in half an hour; toxic effects well developed; quite cured. Subacute lumbago of some three months' durationtoxic effects very slight; remedial the same.-Practitioner, Feb. 1869, p. 126.

105.-ON DISINFECTION WITH CARBOLIC ACID VAPOUR. By Dr. JAMES B. RUSSELL, Physician to the City of Glasgow Fever Hospital.

[Any agent employed to purify the air in such a place as a fever or cholera hospital, or sick room in a private house, where the

case is one of an infectious nature, should be one which is respirable without injury or irritation to the lungs. Chlorine and sulphurous acid gas are inapplicable as being both very obnoxious. It occurred to Dr. Russell to try carbolic acid, and the method he employed is thus alluded to in the "Report on Cholera Hospitals," incorporated in the "Report of the City of Glasgow Fever Hospital for 1866-7."]

"Having observed how readily carbolic acid distributed itself through the atmosphere of a room along with steam, I placed in each ward a gas-evaporating stand, by means of which the steam of a solution of the acid and water was constantly thrown off.” (p. 35.) The arrangement thus alluded to was simply a stand, supporting a small tin vessel containing carbolic acid and water, having beneath a Bunsen's burner supplied with gas by a flexible tube. This stood on the table in the centre of the ward; and the nurse was instructed to supply water when required, and acid so that a little might always be seen still undissolved. In the temporary hospital at Greendyke, American stoves were used for heating, and the vessel was simply placed in the round aperture provided on the top of each. By this means the moisture so necessary where such stoves are employed was also supplied to the atmosphere. The device thus adopted for cholera hospitals was continued in the City of Glasgow Hospital when it reverted to its original use the treatment of fever. As perceived by the sense of smell, the effect was a mild odour of carbolic acid in all parts of the wards. What benefit accrued to the patients and attendants can hardly be estimated. That the agent was present to a degree sufficient to be obnoxious to animal life was shown by the circumstance that, during the hot summer of 1868, the flies, which were so numerous and annoying in wards not so fumigated, were only occasionally seen in wards furnished with the evaporating apparatus. Flowers placed on the window-sills were not affected, but pendant plants hung from the joists immediately over the table referred to above soon died.

Recently I improved the arrangement by adopting porcelain instead of tin basins, which were soon perforated by the action of the gas-jet externally and the acid internally. I also added a small flat porcelain cup, containing the pure acid, so as to combine with the evaporation of the aqueous solution the evaporating influence of a water-bath. The result has been very greatly to increase the amount of the disinfectant circulating in the atmosphere. It is strongly perceptible in every part of a ward 48 feet long by 20 wide.

As to the practical benefit of this process, I have already stated that I am unable to say this or that has been the result.

In the first place, this much may safely be asserted, that no harm can be done. The odour is aromatic and agreeable to most persons, though not to all. Some find it repugnant. It is in this direction we must look for the benefit-in the cleansing of the air for the use of attendants and patients, not in the "cutting short" of disease in individual cases. By this, and disinfecting powders in the night-stools, with good ventilation, it may be made quite certain that the poisonous effluvia of one patient will not reach another. Dr. Lemaire proves by every variety of experiment that "water containing a hundredth of the acid is sufficient to destroy all the small noxious animals, and that a thousandth will arrest and prevent putrid fermentation" (p. 208.) In particular he shows that the mere vapour of a few drops of the pure acid at the bottom of "a large jar in direct communication with the atmospheric air" will soon cause the mould on a piece of putrid flesh exposed to the air in the jar "to droop and wither" (p. 59.) Although fully alive to the importance of the use, in hospitals, of an agent so inimical to the lower forms of life, Dr. Lamaire does not suggest any method of constantly supplying it to their atmosphere. The simple plan described in this short notice effects this thoroughly. I am induced to make a memorandum of it, because, there being no doubt of the efficiency of carbolic acid as a disinfectant an easy method of disseminating it is alone requisite to ensure its more frequent use in circumstances which so often occur, in which not one isolated act of disinfection is required, but a continuous process. Such circumstances are found in hospitals, we may say all hospitals, but especially those in which lesions of surface exist, such as surgical and lying-in hospitals; and those in which infectious diseases are treated, such as fever, small-pox, &c. In those institutions a permanent apparatus ought to be contrived. Private practitioners also frequently require this perpetual atmospheric disinfection. Fumes from chloride of lime or open vessels of carbolic acid are not very efficient; and the evolution of chlorine or sulphurous acid is both difficult to control and very disagreeable, and in the better class of houses also detrimental to metal surfaces. It would, on the other hand, always be easy to devise some modification of the water-bath method of distributing carbolic acid. A porcelain cup placed on the round aperture of the globe above the gas jet, having afloat in it another much smaller cup containing pure acid, or a large basin of boiling water renewed from time to time, and bearing a common saucer full of pure acid on its surface, suggest themselves as two out of several plans which might be adopted. My friend Dr. Wood Smith lately used a common retort stand and evaporating dish, with flexible tube and gas jet, during the progress of a virulent case of diphtheria in private. I am not

aware that this idea has been systematically carried out in any hospital but that which I attend. It has been partially tried in the Town's Hospital, and in the fever-house, Royal Infirmary. -Glasgow Med. Journal, Feb. 1869, p. 210.

106.-NEW VAPORIZER FOR CARBOLIC ACID.

Messrs. SALT, of Birmingham, have constructed a very ingenious and well-designed apparatus for the vaporization of carbolic acid. It consists of a receptacle for the acid, covered by a finelyperforated lid. Beneath the receptacle is an air chamber, and beneath this chamber is a recess for a spirit-lamp. Two or three tablespoonfuls or more of carbolic acid (if in the liquid form), or a portion of the crystals, having been placed in the proper receptacle, the lamp is lighted, and in few moments the acid begins to evaporate, and the vapour is diffused into the atmosphere of the apartment through the perforated plate. The apparatus (as we have tested) is an excellent addition to the sick room when it is found desirable to use carbolic acid as a disinfecting agent. It can be manipulated so as to keep the atmosphere charged with a distinct and not unpleasant odour of the acid, and will be found particularly handy and useful in private houses.-Lancet, Feb. 20, 1869, p. 262.

107.-ON A METHOD OF CONVERTING THE SKIN INTO LEATHER.

By JOHN MARTIN, Esq., Undergraduate in Medicine, Queen's University, Cork.

It becomes sometimes advisable in surgical practice to render parts of the surface of the body tense, and firmly pressed on to the subjacent tissues. This pressure is generally effected by bandages, strips of plaster tightly applied, direct pressure by weights, &c. But it does not appear that surgeons have hitherto adopted a more convenient and effectual method of applying pressure, when such is required, more uniform than great; namely, that of converting the cuticle into a temporary bandage. This may be done by forming a tannate of gelatine in the skin. Ordinary solutions of tannine applied to living tissues act astringently, by causing contraction of blood-vessels, as is seen by the paleness produced in mucous membrane by such application. A very strong, or a saturated solution of this substance, however, applied to the external surface of the body, combines chemically with the gelatine of the skin, before reaching the vessels, forming a contracted impermeable layer of