PUBLISHERS' DEPARTMENT. SALOPHEN.-When the preparations of salicylic acid were first used in medical practice, it was thought a specific had been discovered for the treatment of rheumatism. As time passed, it was found that the salicylates failed to meet all the requirements of an anti-rheumatic; they frequently caused disturbances of the stomach, nervous disorders, irritation of the kidneys, and weakness of the heart. Accordingly when salol, the phenol-ether of salicylic acid, was brought forward by Sahli as a substitute devoid of these disagreeable effects, it met with ready acceptance by the profession; but it was soon found that owing to the quantity of carbolic acid in its composition, salol gave rise to carbolic acid poisoning in some cases, if employed in large doses. To obviate these toxic effects a new body was constructed in which the phenol element of salol was replaced by an innocuous substance, and to this resulting compound the name Salophen has been applied. Although only recently introduced, Salophen has already demonstrated its value as an anti-rheumatic in many hands. Dr. W. H. Flint [N. Y. Med. Jour., July 30, 1892] has employed the remedy in six cases of acute articular rheumatism, and concludes that we possess in Salophen a remedy equally as effective as the other salicylates to control the symptoms of acute rheumatic arthritis, but devoid of their tendency to weaken the heart's action, to disturb the stomach, and to produce albuminuria and smoky urine. Prof. Hobart A. Hare, of Philadelphia [Therapeutic Gazette, Jan., 1893], speaks very favorably of the action of Salophen in cases of severe neuralgia and myalgia of rheumatic origin, and considers the drug an important addition to the materia medica. Prof. Guttmann, of Berlin [Berlin Klin. Woch.] has employed it in cases of acute articular rheumatism, and found that it exerted very beneficial effects, especially in recent cases, the pains and swelling of the joint being rapidly relieved. Dr. Frolich [Wien. Med. Wochenschr., July, 1892] states that the remedy did not fail in one out of thirty cases of acute rheumatism, and prefers Salophen to the salicylates because (1) being decomposed in the intestine, it does not irritate the stomach; (2) it can be given in large doses and for a long period without unpleasant effects; (3) it is tasteless. Dr. Edmund Koch [Inaugural Dissertation] has recently reported a large number of cases of acute rheumatism treated with Salophen, and comments upon the rapidity with which it removed the pains, fever, and swelling. In various nervous affections, headache, migraine, sciatica, it proved very efficient, rapidly removing or at least relieving the pains, and this without disagreeable after-effect. These remarkable analgesic properties of Salophen are also confirmed by Dr. Caminer [Therap. Monatshefte, Oct., 1892], who obtained excellent results from its use in cephalalgia, hemicrania, trigeminal neuralgia, and sciatica. SULFONAL.-The British Medical Journal published the following respecting Sulfonal. Sulfonal is a drug which, with others of similar character, like anti-febrine, anti-pyrine, etc., is now-a-days so much abused. We are glad indeed to see the danger and evil on this subject pointed out: "Prof. Kast (Arch. f. axp. Path. u. Pharm. 31, I) from a study of the published cases in which poisonous effects have followed the use of Sulfonal for a prolonged period, gives the following as characteristics of the condition of chronic poisoning by the drug: 1. Disturbances of digestion, as vomiting, diarrhoea, or constipation; 2. Of the nervous system, as ataxy and feebleness of the limbs, ptosis, and ascending paralysis; 3. Ischuria, oliguria, sometimes albuminuria, or the presence of hæmatoporphyriu. These are the chief signs. Kast is of the opinion that a cumulative action of the drug produces, instead of a transitory diminution of the nervous excitability, a permanent depression thereof, just similar to that caused by a single large dose. He finds that the dose best calculated to produce a hypnotic effect is about 30 [?] grains for a man, and half the quantity for a woman. These quantities should be the maximal daily doses. He advises also that an interruption should be made from time to time in the use of the drug, so as to ensure its elimination. Loss of appetite, vomiting, or pains in the stomach, he regards as indications for the immediate discontinuance of the remedy." HORLICK'S MALTED MILK FOR INFANTS.When you have occasion to prescribe a food for an infant patient, whose mother cannot properly provide for it, or when the child is being weaned, or for a child suffering from malnutrition through any cause, or from cholera infantum, marasmus, or other troubles which affect its power to digest and assimilate nourishment, remember that Horlick's Malted Milk is provided especially for the use of physicians in such cases. This preparation consists of pure, rich, sterilized cow's milk obtained in one of the choicest of dairy districts and combined with an extract of malted grain, then evaporated to dryness in vacuo, and put up in the form of a powder in sealed glass packages. It contains all the elements of nutrition in milk and the cereals in a perfectly soluble and easily assimilable form. Infants thrive better on it than on raw cow's milk, owing to the partial digestion of the casein of the milk by plant pepsin obtained from the grain which is malted by a special process. It contains no starch, and requires neither cooking to make it digestible nor the addition of milk to make it nutritious, being prepared for use by simply dissolving in warm water. Try it in your next case, and you will not be disappointed. Packages for trial sent on application to the manufacturers. Malted Milk Co., Racine, Wis. BY W. H. RILEY, M. D. Sanitarium, Battle Creek, Mich. (Concluded.) CASE II. Mr. B., aged American by birth, a grocery and saloon keeper by occupation, came to the Sanitarium for treatment for "paralysis," and gave the following history: The patient had been addicted to the use of alcoholic liquors for some years; but during the last two or three years, had been drinking whisky rather excessively, being in the habit of drinking daily, but was seldom intoxicated. For some time previous to his present trouble, he had been working out of doors in the sun, and was exposed a great deal. About four months before coming under my observation, he noticed a numbness and sometimes a burning and prickling sensation in his hands and feet. These sensory symptoms continued for several weeks before the disease manifested itself by more decided symptoms. About twelve weeks ago, after overwork and exposure to heat and sun, he was taken sick with dizziness and vomiting, and could not see well. At times, things appeared black before his eyes. He also suffered from mental weakness and confusion and loss of memory. The numbness, burning, and prickling sensations, which had appeared several weeks previously in his hands and feet, had continued to this time, and were now even more prominently present than before. The muscles soon became very sore. Muscular weakness increased. He was soon unable to stand on his feet or use his hands, and was obliged to take his bed. He remained in bed ten weeks previous to his arrival at the Sanitarium, with no improvement. His condition on entrance is indicated in the following report of EXAMINATION. The 1. Motor Symptoms. The patient is totally helpless; cannot stand at all on his feet; is unable to move his hands; cannot feed himself; remains in bed all the time; unable to get out of bed even to evacuate the bowels and bladder. paralysis of certain muscles in the arms and legs, the contraction of unopposed antagonistic muscles, the severe pains and soreness of muscles, have all contributed to cause the patient to occupy a certain position while lying, illustrated in the accompanying cut taken from a photograph. (See Fig. 6, frontispiece.) The patient maintains this position constantly. He cannot straighten his legs himself, nor can they be straightened by applied force; he holds his hands in the position shown in the photograph, on account of the paralysis and soreness of the muscles. He can do nothing for himself. The flexors of the legs are contractured, which keeps the limbs in the position shown in Fig. 6. The weakness of the muscles in the extremities is greatest below the elbows and below the knees. The kneejerk is absent in both legs; the abdominal and cremasteric reflexes are present. The faradic irritability of the muscles is very much decreased, no contractions at all being produced in some of the muscles with a very strong current. The galvanic irritability of the nerve is also decreased, and the galvanic irritability of the muscles in front of the leg and the smaller muscles of the hand and forearm is increased. It requires a weaker galvanic current to produce contractions in these muscles than in health. With the galvanic current, the anodal closure contraction approaches the cathodal closure contraction in these muscles. The reaction of degeneration is present. Sensory Symptoms. There is anæsthesia to touch and temperature in the feet. Hands and feet are clammy, and perspire freely. The fingers are pointed, and the finger nails glossy. Vasomotor symptoms are prominently present in this case. The hands and arms below the elbows, and the feet and legs below the knees, have a decided cyanotic appearance, and the extent to which the disease has affected the vasomotor nerves can be clearly seen on the limbs by the discoloration of the skin. There is also a slight eruption over the anesthetic area. Mental Symptoms. The mental symptoms in this case are very prominent, and form an important part of the picture of the disease. The patient is very talkative; his mind is wandering and weak; he talks incoherently; is extremely forgetful, especially of things that have happened recently. He forgets that his physician has seen him five minutes after the physician has left the room. At times he is irritable and delirious; is constantly asking his nurse to remove something from his feet and hands when and extent of the anesthesia is indicated by the shading in Figs. 7 and 8. In that part of the figures where the shading is deepest, the anesthesia is complete. The lighter portion of the shading indicates a partial loss to the sensation of touch and temperature. (This case differs from the foregoing in that all the nerves of the skin in the periphery of the extremities are the seat of marked sensory disturbance, as is shown in Figs. 7 and 8. In Case I, the disease selected some nerves and left others.) The muscles are extremely tender and sore. The limbs cannot be manipulated without producing severe pain, and any movement of the limbs has to be done with the greatest care in order to avoid severe pain. Trophic and Vasomotor Symptoms.— The muscles of the upper and lower extremities are wasted and flabby, and have lost their natural tone. The wasting of the muscles is greatest in the hands and Fig. 8. Areas of Anesthesia Behind in Case II. Degree of anesthesia indicated by the degree of shading. there is nothing on them. He often thinks he has socks on his feet and |