though the methyl-violet test indicated the necessity for the use of this drug. The results of the comparison were equally bad in cases in which an excess of free HCl was indicated by the methyl-violet test. Of 108 cases in which the color reaction was very strongly marked, quantitative analysis showed excess, that is, more than 50 milligrammes in 100 c. c. of stomach fluid, in only 6 cases (5.5 per cent), while free HCl was totally absent in 8 cases. Α It is thus apparent that as an indicator of excess, the methyl-violet reagent fails much more frequently than it succeeds, and hence, if used at all, should be interpreted negatively, the failures being 7.4 per cent of the cases, or one third more frequent than the successes. study of all the cases showed that free HCl was absent in 21 cases in which methyl-violet showed it to be present. Of these, acid fermentation was present to a very marked degree in 8 cases. The reaction for lactic acid was distinctly marked in 9 additional cases, and in the remaining 4 cases in which neither fermentation nor lactic acid was indicated as present, there was a great abundance of peptone. As lactic acid is almost invariably present in connection with fermentation in the stomach, it is probable that this is at least one of the substances which interfere with the color reaction of methyl-violet as an indicator of free HCl. The above facts seem to indicate beyond controversy the unreliable character of methyl-violet as a color indicator, and to condemn its use as a reagent in the examination of stomach fluids. Günzburg's reagent, and the resorcine reagent of Boas, are much more reliable, and, as a rule, may be depended upon as indicators of the presence of free HCl. The reason why Ewald finds so many cases in which free hydrochloric acid is absent, is to be found in the explanation which he himself gives in explaining another anomalous fact, which he says is "due to the incompleteness and coarseness of our present methods." This explains another fact mentioned by the translator of Ewald's work, Dr. Morris Manges, namely, "the surprising number of such cases recently reported in the various medical journals without correspondent constitutional symptoms.” "Such cases" refers to cases in which a diagnosis of atrophy of the stomach has been made. In the study of 700 stomach fluids by the exact methods of determining quantitatively the amount of free hydrochloric acid present in the gastric juice, devised more than half a century ago by the eminent Prof. Golding Bird, of Guy's Hospital, London, Eng., and recently perfected by Hayem and Winter, of Paris, I have found free hydrochloric acid absent in only 52 instances, and in not a single instance has free hydrochloric acid been. found to be absent without very distinct evidence of ill health, in disordered digestion. Examinations of stomach fluid have frequently been made in women during the menstrual period, but in no instance has free hydrochloric acid been found absent. The reason for these numerous errors in observation, which are so misleading in diagnosis, is to be found in the unreliability of the color-tests for free hydrochloric acid, especially the methyl-violet test, which, as already shown, not infrequently fails to indicate the presence of free HCl, although it may be present in a considerable quantity in the fluid examined. Physicians have frequently found themselves in disgrace from basing a diagnosis of atrophy or cancer of the stomach upon the absence of free HCl, as indicated by methyl-violet, and have thereby been led to discredit the value of all chemical methods of investigating stomach disorders. It is safe to say that the colorometric methods are wholly unreliable, except as giving suggestive indica tions, which in a majority of cases are of some value, although not infrequently the indication given is the opposite of the truth. I shall give, at some future time, a more complete account of my investigations in this direction. GRAPHIC STUDIES OF THE SINUSOIDAL AND (Continued from January No.) optic nerve I attribute to its remarkable power of diffusion or penetration. I have found the current of very great service in connection with the application of large currents for the electrolytic treatment of uterine fibroids, as it greatly lessens the pain of the application, and thus enables the patient to tolerate a current of considerable greater strength than could otherwise be borne. When used for this purpose, an additional electrode is placed upon the back, to which one reopore is attached, the other being connected with the intra-uterine electrode. If after the galvanic current has been made as great as the patient can endure, the magnetic current is turned on, the patient is at once relieved, and the galvanic current may then be increased, usually from 20 The usually from 20 to 30 milliamperes. Even when the galvanic current has been increased to such an extent as to lead the patient to beg to have it reduced, the pain usually ceases almost instantly when the sinusoidal current is switched on. THE motor effects are obtained by running the apparatus at a slow rate of speed; that is, a speed giving alternations of the current varying between 50 and 150 per second. nerves Sensory Effects. The sensory effects are obtained by running the machine at a high rate of speed, securing alternations of 100 to 200 per second. The effect of the current upon the sensory With is equally remarkable. sponge electrodes applied to the temples, the machine being run at a high rate of speed and the current controlled by a rheostat, a most remarkable display of light impressions is observed in the vicinity of each pole, the impression being that of moving circles concentrically arranged. The appearance might be not inappropriately compared to a great whirlpool of light. Absolutely no other sensation is perceived with a current of moderate intensity. As the intensity of the current is increased by the adjustment of the rheostat, the display of light increases to a marvelous extent, and finally a light prickling sensation is experienced in the skin, which becomes painful and is accompanied by tonic contraction of the underlying muscles, if a certain strength of current, variable with each individual, is exceeded. studying the effect of the current upon the various divisions of the tactile sense, the sense of taste, the olfactory sense, and the auditory sense, but am not yet prepared to publish my results. The peculiar effects of the current upon the I am As an analgesic, and for the relief of various illy defined sensations to which persons refer under the general term "pain," I know of no mode of electrical application so valuable as the sinusoidal current obtained from the machine when moving very rapidly, the dose, of course, being regulated by means of a suitable rheostat. In a case recently under observation, a patient who had suffered for several years from a peculiar sensation of emptiness in the head, and what she termed a loss of the sense of time, doubtless using this mode of expression for want of a better means of expressing her feelings, complete and permanent relief was obtained by two or three applications. Many patients who seem to have an utter intolerance of any other form of electrical current, are benefited by the application of this current. Indeed, I have never found a case in which any unpleasant effects were produced by it. The fact that such profound motor and sensory effects can be produced without the ordinary shocking, prickling, and other sensations, is a grateful surprise to the patient, and certainly enhances its value as a therapeutic means. I have found no electrical application so valuable as a means of relieving a hyperæsthetic condition of the abdominal sympathetic ganglia, especially the semilunary ganglia, the lumbar ganglia, and the lumbo-aortic plexus of the sympathetic. It is equally efficacious in relieving pains beneath the shoulder blade and in the back, which are often erroneously attributed by patients to a diseased liver, but which are due, in a great majority of cases, to a congested and irritated condition of the abdominal sympathetic ganglia. A rapidly alternating sinusoidal current is one of the most efficacious means with which I am acquainted for the relief of the peculiar sensation known as "heaviness," of which dyspeptic patients often complain. This sensation is due to a perverted condition of the sensory nerves of the stomach. Its relief by a rapidly interrupted current is an evidence of the penetrating power of this current. The rapidly interrupted current may be applied to the stomach either externally by means of a flat sponge electrode, one over the stomach and the other over the spine opposite, or internally by means of a properly formed electrode placed inside a stomach tube, with a flat sponge electrode either over the stomach or the spine opposite the stomach. I have applied the sinusoidal current in this manner in a large number of cases for the relief of stomach symptoms, especially in cases in which examination of the stomach fluid by the method of quantitative analysis, which I have elsewhere described, showed deficiency in that form. of stomach work which consists in the combination of free chlorine with albumen, as shown by the diminished amount of the combined albumen. (To be continued.) THE EFFECTS OF CONDIMENTS UPON STOMACH DIGESTION. AT the present time a series of very interesting experiments is being conducted in the laboratory, the purpose of which is to determine the effects of condiments upon peptic digestion. Five healthy young men whose stomach formulæ have been determined by means of the standdard test breakfast, have been made to take in various quantities, with the test breakfast, black pepper, red pepper, pepper sauce, mustard, and other like substances, and the results upon the chemical processes of the stomach have been carefully noted. A very constant and characteristic effect has been observed in the increase of a certain element of the stomach work, but a notable decrease in another direction. The diminution of stomach work, as will be shown in a more detailed account of these experiments which will be given in a future number, is in the useful work of the stomach, by which the chlorine is made to combine with the albumen; in other words, although condiments of various sorts have the effect to increase the amount of free hydrochloric acid in the gastric juice, and the amount of chlorine liberated from the fixed chlorides, the amount of chlorine which enters into the useful stomach work of digestion is notably diminished. This method of investigating the effects of various substances upon digestion is one which affords an opportunity for the most useful and extended studies in practical dietetics. A large number of observations of various sorts have already been made in the laboratory, and we hope to be able to give at an early date an extended account of the important data collected, some of which are exceedingly interesting from a practical standpoint as well as from scientific and theoretical considerations. ADVERTISEMENTS. EADING RO Not . Y. : 137 from the d H. NEW Pharmaceutical Products of The Farbenfabriken vorm Friedr Bayer & Co. LOSOPHAN LOSOPHAN, a Triiodocresol, is a A 10% ointment may be W. H. Schieffelin & Co., New York, W. H. Schieffelin & Co., New York. Sole Agents and Licensees for the United States. PUBLISHERS' DEPARTMENT. AMERICAN ELECTRO-THERAPEUTIC ASSOCIATION. AT the annual meeting of the American Electro-Therapeutic Association, held in New York City last fall, committees were appointed to make a study of the adoption to medical uses of various electrical appliances, as follows: COMMITTEE ON STANDARD COIL. Dr. W. J. Morton, 19 East 28th St., New York. Dr. A. H. Goelet, 351 West 57th St., New York. Dr. Wm. F. Hutchinson, Providence, R. I. Dr. G. Betton Massey, 212 South 15th St., Philadelphia. Dr. A. E. Kennelly, Chief Electrician Edison Laboratory, Orange, N. J. COMMITTEE ON STANDARD METERS. Dr. Margaret A. Cleaves, 68 Madison Ave., New York. Dr. H. E. Hayd, 78 Niagara St., Buffalo, N. Y. Dr. Wellington Adams, 2741 Olive St., St. Louis, Mo. Dr. W. F. Robinson, 214 State St., Albany, New York. COMMITTEE ON STANDARD ELECTRO-STATIC OR INFLUENCE MACHINES. Dr. W. J. Morton, 19 East 28th St., New York. Dr. J. H. Kellogg, Battle Creek, Mich. Dr. G. Betton Massey, 212 South 15th St., Philadelphia. Dr. Margaret A. Cleaves, 68 Madison Ave., New York. COMMITTEE ON CONSTANT-CURRENT GENERATORS AND CONTROLLERS. Dr. W. J. Herdman, 48 East Huron St., Ann Arbor, Mich., Rheostats and Dynamo Current Controllers. Dr. Robert Newman, 68 West 36th St., New York, Primary Stationary Batteries. Dr. Frederick Peterson, 201 West 54th St., N. Y. Secondary Batteries and Primary Portable Batteries. COMMITTEE ON STANDARD ELECTRODES. Dr. A. Lapthorn Smith, 248 Bishop St., Montreal, Canada. Dr. R. J. Nunn, 119 York St., Savannah, Ga. Dr. Charles R. Dickson, 263 Victoria St., Toronto, Canada. These committees are now at work preparing their respective reports, which will be presented at the meeting of the Association to be held at Chicago next September. All manufacturers of electrical appliances for medical use, who are interested in the reports of these committees, should correspond with the members, placing before them the merits of their several appli ances. TAXING BICYCLES.-The assessors of the city of Lowell, Mass., and, we are informed, those of the city of Paris also, have determined to place a tax on bicycles. Whether the tax is to be regulated by the price of the bicycle, or whether all bicycles are to be taxed alike, we have not learned; but the bicycles of Lowell and Paris are to be taxed. The result will probably be to limit the use of the bicycle in these localities. From our standpoint there is no more reason why the bicycle should be taxed than a wagon, or a wheelbarrow, or a baby cart. It is not simply a luxury, but a means of obtaining needed exercise, and a convenient vehicle for traveling where roads are sufficiently well made to render the use of the machine possible. The bicycle is a labor-saving machine, as much as a mowing machine, a reaper, or a thrasher. Mounted on a bicycle, a man can travel six miles with no greater expenditure of energy than in walking one mile; hence the bicycle is a means by which energy may be saved for us in ways which are more profitable than locomotion. We hope the example of Lowell assessors will not be followed by the tax gatherers of any other city. |