Pilocarpin in Eclampsia-Alcohol.

Pilocarpin in Eclampsia.

561

Pilocarpin may be said to be on trial as a remedy in the dreaded convulsions of puerperal eclampsia, and it is important to note the results which are from time to time reported by competent observers. On the whole, the reports are decidedly favorable, and a case recently published in a French contemporary shows clearly enough that in certain cases the drug may be relied upon to conjure the attack. In this particular case the attack had come on during labor, and was not relieved on the evacuation of the contents of the uterus; indeed, the condition of the patient on the following day was simply desperate. The injection of a third of a grain of pilocarpin at the critical moment is reported to have produced a most remarkable effect. After an abundant diaphoresis lasting over half an hour, the pulse returned in the radial arteries and the surface temperature was restored. No further convulsions occurred, and in the course of a day or two the injections continued night and morning, albumin disappeared from the urine, the patient becoming convalescent. The effects were too clear and too prompt for the results to be attributed to any other influence, and the remedy is one which should always form part of the armamentarium of the obstetric physician. Med. Press and Circular.

Recent Signatures to Medical Declarations on Alcohol.

Three leading declarations on the subject of intoxicants have been published, with the signatures of many leading members of the medical profession. The first of these was issued in 1839, and was to the effect that intoxicating liquors were unnecessary in health in any quantity, while excessive quantities were injurious. This was signed by, among others, Sir Benjamin Brodie, Sir James Clarke and Dr. Marshall Hall. The second declaration appeared in 1847, and was mainly to the effect that perfect health was compatible with abstinence from all intoxicants, which might safely be discontinued at once or gradually, and that universal abstinence would conduce to the health, prosperity, morality and happiness of the human race. Sir John Forbes, Sir Risdon Bennett, Sir J. McGregor, Sir B. Brodie and 2000 other well-known physicians and surgeons VOL. X-36

appended their names. The third declaration appeared in 1871, Mr. Earnest Hart and Dr. Parkes having initiated it; it was designed to call attention to the inconsiderate prescription of large quantities of alcoholic drinks in disease as a grave danger, and to suggest a careful prescription, as in the case of any powerful drug, for the occasion only. This was largely and influentially signed by consulting and hospital physicians and surgeons. Within the last year and a half the British Medical Temperance Association has secured 622 additional signatures. Of this number no fewer than 561 have been affixed to all three manifestoes; among the names appended to the last document are those of Prof McKendrick and Sir George Macleod, of Glasgow, Prof. Simpson, of Edinburgh, Sir Henry Pittman and Dr. W. S. Playfair. Among the signatories to one or other of the declarations have also been Dr. Bristowe, Dr. Matthews Duncan, Sir George Paget and Dr. Bridges (of the local Government Board). Such a body of testimony from the medical profession is the best answer to the aspersion so frequently indulged in by irresponsible agitators that medical men are generally opposed to the temperance reformation. This great and growing movement has no truer friends than the many within the ranks of the medical profession. Brit. Med. Jour. Feb. 1, '90.

Treatment of Enuresis Nocturna in Children.

Dr. Van Tienhoven, Director of the Krankenhaus, in Haag, advances an enlightening theory on the cause of this troublesome condition appearing in otherwise perfectly healthy children; as a result of his deductions, he recommends the following successful therapeutic measure. The bladder, performing its functions well during the day, has no power to hold the urine during the night, consequently relieves itself of it. The question now is, is it the musc. detrusor urinæ or the musc. sphincter vesica, or both, the one perhaps less, the other more involved? Dr. Van Tienhoven believes that the sphincter muscle is not strong enough to retain the urine that has collected during the first part of the night; that it permits the urine collected before the orifice of the urethra to pass into the pars prostatica urethræ and at this point, through reflex

Bromoform in Whooping cough.

563

action, the musc. detrusor is stimulated, and under its action the entire contents of the bladder are expelled.

This conviction suggested to Dr. Van Tienhoven the idea that children suffering from enuresis should sleep with the pelvis elevated. Experiments on the cadaver prove that after elevation of the pelvis the bladder will hold a considerable amount of urine before the hight of the orifice of the urethra is reached. Fourteen cases, treated according to this theory, without other therapeutic means, were cured in a short time. The necessary elevation is obtained by raising the foot of the bed to a plane of 45 degrees. The children must go to bed with an empty bladder and without having taken liquids for some time before retiring. They sleep well in the elevated position and awake without complaint of any kind.-Correspondenz-Blatt fuer Schweizer Aerzte.

Bromoform in Whoopingcough.

Dr. Stepp has treated one hundred children with this drug, and his results have been successful in every instance. The bromoform is administered in a pure form and dropped into a teaspoonful of water. On account of its greater specific gravity it sinks to the bottom, and collects in a mass which is readily swallowed. The dosage is as follows: In infants three or four weeks old, one drop three or four times daily; in older infants two or three drops three times daily, according to the intensity of the disease; in children between the ages of two and four years, four or five drops three or four times daily, and up to the seventh year six or seven drops three or four times a day. No disagreeable after-effects were observed, the cough was at once relieved, and a cure effected in from two to four weeks. No more than two grams of the liquid should be prescribed at a time, on account of the ready decompositiou of the bromoform, and it should also be protected from the sunlight, which sets free the bromine.—Deut. Med. Worch.

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KOCH'S REMEDY FOR TUBERCULOSIS.-The very remarkable paper read by Prof. Robert Koch, M.D., at the recent International Medical Congress, held in Berlin, the home of the author, has created enthusiasm in the breasts of, not only the laity, but of the most unimpassioned men of science. The time, however, for accepting or rejecting his methods and theories is not yet, for none outside of his laboratories know the character of the agent used. We cannot but regard the secrecy, with which the professor has clouded his epoch-making experiments and research, as unfortunate. Albeit, greater homage could not have been paid to the genius of a great scientific worker than that evidenced by the headlong rush to Berlin, of medical men from all nations, many of them experts in bacteriologic research and in the treatment of tuberculosis. From our own country we notice a number of medical men have either gone or are going. Dr. Guiteras, the Professor of Pathology in the University of Pennsylvania, Dr. Dixon of the Jefferson Medical College, and Dr. Herring of New York have already registered in Berlin. The medical profession is inclined to look for results from the scientific attenuation of the virulence of microbic disease factors, by Pasteur and Koch, in much the same light, expecting similar results, and hoping for like benefits as followed the experiments of Jenner. The latter took the lead, Pasteur followed on a much more scientific basis and by a much more circuitous route.

Thus