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The Use of Carbohydrates in Diabetes Mellitus. Lauistzen, (Med. Klinik, No. 39, 1905.) In recent years the use of carbohydrates in diabetes has become more liberal, and it is now for us to decide which of the carbohydrates is most advisable. Some patients tolerate one form of carbohydrates while others do better on another form. Milk, sugar, oatmeal and potatoes do less harm than any other carbohydrates. In complicated cases (renal, cardiac, arterial) a milk diet is of great benefit to the patient. Many patients are unable or unwilling to continue a strict diet for any length of time and here we must select the least injurious food substances.

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The Importance of Anesthetics in Inflammatory Processes. Spies (Munch. Med. Woch., No. 6, 1906) recommends local anesthetics in inflammatory processes, wounds, and in superficial operations. Laryngeal tuberculosis, coryza and similar inflammatory diseases improve decidedly by using anesthetics. Orthcform powders often do much good, but at times more powerful anesthetics are indicated. Opiates should be used cautiously in chronic processes, but in acute cases where little danger of acquiring the habit need be feared it may be used advantageously.

Abdominal Arteriosclerosis. - Rosengart, (Munch. Med. Woch., No. 20.) Very frequently arteriosclerosis first manifests itself by gastro-intestinal disturbances and not until we find other evidences of sclerosis do we recognize the condition. It occurs most frequently between the 30th and 40th years of life. The patients complain of flatulence, slight pains especially in the right hypochondriac region, slight colic, belching, and other vague symptoms. The patients are irritable, sleep is poor, appetite good, usually, and constipation as a rule. Eventually the pulse become more frequent and hard, the heart dullness increases, a slight systolic murmur and accentuated second aortic sound are heard and the diagnosis is easily made. The gastrointestinal symptoms are due to faulty circulation on account of the sclerotic vessels. The treatment is similar to that of arteriosclerosis affecting any organ of the body.

Diet in Tuberculosis.- H. M. King (Med. Rec., July 21, 1906) declares that disturbed metabolism is essential to the development of tuberculosis. If, in all respects, the cell is normally nourished, it will be sufficiently resistant to the invasion of the tuberole bacillus. As a rule, one is able to trace errors in nutrition antedating by months and often by years the probable period of infec

tion in a given case. The diet question in the case of tuberculous invalids is more than one of calories. It cannot be solved merely by arriving at theoretical standard amounts and relations of proteids, fats, and carbohydrates. The tastes, habits, and peculiarities of the patients, and their heredity are important factors. Variety, preparation, and the manner of serving foods are all important. Psychotherapy is more important in diet prescriptions perhaps than anywhere else. In the study of these cases the food requirements should be determined and met, if possible, and the dangerous error of overfeeding should be avoided.

Diet in Nephritis.-F. C. Shattuck, Boston (Journal A.M.A., January 6), lays down the following as the leading principles pertaining to the dietetio treatment of nephritis: 1. Such control as we may have to-day of nephritis lies in diet and mode of life rather than in drugs. 2. Such drugs as are useful are so in their effect on the general organism and the heart rather than on the kidneys directly. 3. In all cases of nephritis the main aim is to spare the kidneys unnecessary work, remembering that the urinary system is but one, of the many, making up the body. 4. In acute nephritis, as well as in the acute exacerbations of the chronic form, doctors, diet and quiet should work together. Starvation for a few days, regulated by the intensity of the process and the strength of the patient, is the keynote here. 5. In the chronic forms the aim is to lighten and to lengthen life. Especially in the contracted form of kidney disease, many years of life and comfort may depend on the physician's skill in adapting sound principles to the particular case and in securing the cooperation of the patient in persistently carrying out the directions given. Dietary restriction should, in the main, be quantitative rather than qualitative. Alcohol in moderation is not necessarily a poison and may be an aid to digestion. 6. The excess of proteid, not proteid itself, is harmful to the chronically sick kidney. 7. A varied diet is more likely, than a monotonous one, to promote the making of good blood and improving the general nutrition, and that of the myocardium in particular. 8. The amount of albumin is in itself no guide as to the extent of dietary restriction. Shattuck remarks the advisability of a relatively dry diet in dropsical cases, proportioned to the degree of dropsy. In cases of contracted kidney, even without dropsy, he thinks physicians have erred in forcing water, and that the main service von Noorden has rendered is in advocating the limitation of liquids.

SOCIETY PROCEEDINGS

MEDICAL SOCIETY OF THE MISSOURI VALLEY.

The nineteenth annual meeting of this society will be held at Council Bluffs, under the presidency of Dr. John E. Summers, ofOmaha, on September 6 and 7. Sessions will be held in the banquet hall of the Grand Hotel.

Following is the preliminary program: John E. Summers, Omaha: President's Address.

Richard C. Moore, Omaha: Oration on Medicine.

S. Grover Burnett, Kansas City: "A Second Case of Dual Personality."

W. L. Kenney, St. Joseph: "Sarcoma of the Optic Nerve-Operation, X-Ray Treatment; Recovery.

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O. B. Campbell, St. Joseph: "Ectopic Pregnancy with Report of Cases."

C. B. Hardin, Kansas City: "The Physical Signs of Disease; their scope and what they reveal to the Modern Physician.

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Harry Everett, Lincoln, Neb.: "A Preliminary Report on a Simplified Method of Preparing Catgut."

W. T. Elam, St. Joseph: Paper.

T. E. Potter, St. Joseph: "Tubercular Joints."

LeRoy Crummer, Omaha: "The Use of Digitalis.

Mary Strong, Omaha: "Heart Disease in Obstetric Cases.'

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A. C. Stokes, Omaha: "Operative Treatment in Chronic Gonorrhea of the Male."

Geo. F. Butler, Chicago: "The Treatment of Chlorosis."

J. P. Lord, Omaha: "A New Retention Suture in Operations for Cleft Palate."

Bernard A. McDermott, Omaha: "Some Notes on Peritoneal Adhesions, Post-Operative."

F. Damour, Bolokow, Mo.: "Old Time Treatment of Typhoid Fever."

. F. E. Coulter, Omaha: Clinic. L. L. Uhls, Ossawatomie, Kan.: "The Relation of the State to the Insane."

Frank P. Norbury, Jacksonville: "The Treatment of Sleep Disorders."

Leo M. Crafts, Minneapolis: "Observations on the Morbid Physiology of the Ductless Glands."

Palmer Findley, Omaha: "The Clinical Significance of Latent Infections of the Pelvis."

Halsey M. Lyle, Kansas City: "Keratosis Follicularis, or Darier's Disease."

D. C. Brockman, Ottumwa, Ia.: "Tumors of the Breast."

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THE HIGHEST HUMAN TEMPERATURE.It is difficult to give a definite answer to your question. The London Lancet (June 2, 1906) reports the case of a woman in Bombay with a temperature of 112.4 deg. F. We believe still higher cases have been reported, with recovery. Patients suffering with sunstroke may have exceedingly high temperatures for a brief time. Departure from the normal temperature above the standard may be much greater, without causing death, than a reduction in temperature.

MORE TROUBLE IN STORE FOR THE RETAIL DRUGGISTS.-It seems that the Department of Internal Revenue of the Government is determined to make life a burden for the drug trade. The next move may class as retail liquor dealers all druggists who sell "non-intoxicating beverages" that contain a trace of alcohol. It is not generally understood that some of the vario us summer drink will show from a fraction of one to nearly two per cent of alcohol. The manufacturer who sells these goods in lots of five gallons or more must also pay the wholesale liquor tax. Some of the St. Louis manufacturers have been notified that they must also pay back license for two or three years.-Meyer Bros. Druggist.

THE MEDICAL FORTNIGHTLY

A Cosmopolitan Biweekly for the General Practitioner

The Medical Fortnightly is devoted to the progress of the Practice and Science of Medicine and Surgery. Its aim is to present topics of interest and importance to physicians, and to this end, in addition to a well-selected corps of Department Editors, it has secured correspondents in the leading medical centers of Europe and America. Contributions of a scientific nature. and original in character, solicited. News of Societies, and of interesting medical topics, cordially invited.

Advertising forms close on the first and fifteenth of each month. Time should be allowed to submit proof for correction Advertising rates on application.

Remittances and business communications should be addressed to the Fortnightly Press Co.

Subscription, $2.00 a year, in advance, including postage to any part of the United States, Mexico and Canada. Postage to foreign countries in the Universal Postal Union, including Newfoundland, $1.00 a year additional. Entered at the St. Joseph post-office as second-class matter.

The Medical Fortnightly will not be discontinued at expiration of subscription, as many of our readers prefer not to have their files broken on account of failure to remit. Unless we receive a distinct request to discontinue, and payment for all arrearages, this magazine will not be discontinued.

Subscriptions may begin at any time: volumes end with June and December.

Contributors should understand that corrected typewritten copy is essential to clean proof and prompt publication, and is much more satisfactory than manuscript. Original articles should be as condensed as justice to the subject will allow.

Editorial offices in St. Louis and St. Joseph, where specimen_copies may be obtained, and subscriptions will be received. Contributions and books for review should be addressed to the Managing Editor, 319 and 320 Century Building, St. Louis, Mo.

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M. Sig. Shake. A teaspoonful every three or four hours for a child one year old.—J. Lewis Smith.

PRICKLY HEAT.-In carrying out the prophylactic treatment of prickly heat, the Cyclopedia of Medicine and Surgery recommends that children be lightly clad in thin woolens and exposed to heat as little as possible. Constipation should be avoided. The following is recommended, to be applied locally:

B Acidi carbolici.. Acidi borici.... Zinci oxidi.

Glycerini

Alcoholis....

Aquae, q. s. ad.

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M. ft. lotio. Sig.: To be applied locally to the skin.

As a dusting powder the following combination is of value:

B Magnesii carb....

Acidi borici... Pulv. amyli.. M. ft. pulvis.

:

..aa 3 ij

Sig. To be dusted over the areas involved. When the entire body is involved the patient should receive bran, starch, or alkaline baths.

Hyde recommends lotions of lead or of lead and opium in some cases, or alcoholic and ethereal solutions containing camphor and glycerine similar to the following: B Acidi carbolici....

Glycerini..... Mentholis... Spts. vini rectif.

3 iss

3 ij

3 j

3 j

3 viij

M. ft. lotio.

Sig. To be applied locally.

Aquae, q. s. ad..

Or the following:

BOlei

Olei lini.....

Liq. petrolati.

Olei bergamii.
Aquae calcis, q. s. ad..

aa 3 ij 388 Oj

M. Sig. To be applied externally to the body.

The foregoing combination makes a creamy solution which often is very grateful to the skin. If desired, zinc oxide or carbolic acid may be added.

The general treatment of the patient, according to Hyde, should consist in withdrawal from light and heat, the use of unstimulating food and drink, unirritating apparel, and rest.

The free use of lemonade or vichy water, or any reliable carbonated water, is of value in aiding elimination and in supplying the fluids demanded by the cutaneous loss through evaporation. Lassar's paste is serviceable in some cases of pruritus. It is composed as follows:

R Resorcini..

Zinci oxidi .

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Aquae...

:

3iij

Oj

M. Sig. Bathe the affected parts every half hour.

Another good lotion that is often employed is one drachm of the fluid extract of grindelia

in four ounces of water.

Decoctions of chestnut leaves, white or black oak-bark, black alder, or geranium will also prove valuable.-Shoemaker.

ACUTE ECZEMA.-In acute eczema-blue mass or compound cathartic pill, followed next morning by a saline laxative. Natural mineral waters are useful, such as the Hathorn, Carlsbad, Hunyadi Janos or Friedrichshall. When both iron and the sulphate of magnesium are indicated, the following may be used:

Magnesii sulph ... Acidi sulphur dil. Ferri sulph....

3ii

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In this formula, when carbolic acid does not act favorably, dilute hydrocyanic acid may be substituted. Tragacanth mucilage may be used instead of glycerin, or both may be omitted and half the amount of lime water may be replaced by an equal quantity of elder-flower water.

Acidi hydrocyanic dil....... 3ss-ii
Zinci oxidi...

Calamin....

aa 3i

Aquae calcis..

Aquae sambuci.

aa Živ

Or:

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CHLOASMA.-Chloasma or liver spots may be caused by disorders of the liver, and also be caused by disorders of other internal organs, as, for instance, the uterus and ovary. This variety is not infrequent during preg. nancy, and is called chloasma uterinum. Diseases of the blood and nervous system may also bring on the trouble. To successfully treat your patient, endeavor to locate the cause and remove it. A solution of five grains of corrosive sublimate to two ounces of water is an efficient local remedy to destroy the pigmentation. The following ointments are also very beneficial local remedies: BOleati hydragyri.

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MEDICAL MEMORANDA.

Have used your resinol soap and ointment with much satisfaction. I have for years suffered at intervals with scalp itching, have used most everything with no avail until I tried a massage with the ointment. The result was great, scalp easy, no dandruff, and hair ceases to fall out. I try to keep it on hand.-C. D. Driscoll, D. D. S., Paoli, Ind.

X-Ray Burns. At the 337th regular meeting of the New York Dermatological Society held November 28, 1905, the subject of X-ray burns was taken up, and Dr. Henry G. Piffard, Emeritus Professor of Dermatology in New York University said, according to the Journal of Cutaneous Diseases, "that he had obtained the most benefit in treating these conditions from antiphlogistine, chloride of zinc, high frequency current and ultra violet rays

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Let It Be Resolved. That we strive to carry to every patient a more pronounced spirit of hopefulness and good cheer; to know more about disease, exhausting, so far as we may, every possibility of relief or cure; to search for medical truths and accept them wherever they may be found, regardless of source; to meet our defeats like men and fight our battles with undiminished courage; to hate evil and have no commerce with hypocrisy nor with those who fatten on the misfortunes, the ignorance and the appetites of the weak; to give every man a square deal and demand the same for ourselves; to be kind to all but especially the unfortunate; and, finally, to dedicate our energies and our talents to the service of our fellow men, aiming to make medicine, as we practice it, so helpful, so efficient, so scientific, that there shall be no abiding place in the communities in which we work, for quackery in any of its many forms. DR. W. C. ABBOTT.

Anedemin (opposed to edema) is urgently indicated in valvular disease, cirrhosis and nephritis, with edema attendant, or inflammation of the peritoneum, pleurae or other serous cavities. It acts upon the circulation, accelerates the flow in the thoracic duct, rapidly returning the serum to the blood by the lymphatic channels, as well as by resorption into the blood by healthy arterial tone, from whence it is readily removed by diuresis and purgation. The collaborative effects of its components (apocynum, strophanthus, scillae, with sambucus as adjuvant) are marvelous. They are so chemically treated and disposed as to form a definite compound, all objectionable features and properties of the components being positively eliminated, yet the full force and virtues, together with their potency, preserved. Anedemin diminishes the pulse frequency, and will hold it at 50 or 60 for months. It reduces dilatation, diminishes regurgitation, increases the arterial output, at the same time increasing the nutrition and power of the heart muscle. It is not a renal irritant. It is non-toxic, not cumulative, and patients have not to be watched nor kept recumbent as in digitalis administration. It will restore and maintain a perfect balance between the arterial and venous systems. It does not cause nausea, nor interfere with nutrition by producing loss of appetite. A box of 75 tablets promptly mailed gratis to any physician upon request.

An Improved Therapeutic Agent in the Treatment of Diarrhea. In the treatment of diarrhea, whether due to inflammation of the large or small intestines or to struc tural lesions, as incident in typhoid fever, tuberculosis of the intestines, or occurring as functional disorders, viz., indigestion, sporadic cholera, certain forms of colic, or whether the diarrhea be transient or chronic, the following is well to be considered. As is well known, each type of diarrhea requires special treatment aimed at eliminating the cause, for example, the use of a cathartic to remove offending substances from the bowels when the diarrhea is due to fermenting food. It is a fact, however, that every severe form of diarrhea invariably requires at some stage of its treatment the use of astringents in addition to anv special treatment used. Tannic acid is universally acknowledged to be the best of all astringents, because it disturbs the stomach less than any other, but it is open to the objections that it constringes the walls of the stomach, therefore precipitating pepsin and interfering seriously with digestion. Our object is to call attention to a new astringent. This substance is a nucleo-proteid tannin, to which the manufacturers have given the distinctive name "protan" as a word-mark. Protan is a new form of tannic acid free from all the objectionable features because it passes through the stomach chemically unchanged and is not dissolved or changed the slightest until it is dissolved or split up in the alkaline secretions of the duodenum. Protan acts happily not only as a local astringent, allaying congestion and inflammation, but as a reliable disinfectant and antiseptic. In diarrhea of all kinds protan has been highly recommended by clinicians, particularly in the gastro-intestinal disorders of children, diarrhea of typhoid fever, phthisis enteritis and dysentery. Where it is advisable to supplement with other drugs, opium, bismuth betanaphthol, salol, zinc sulphocarbolate or calomel can be combined in powder form, or it may be added to cream of bismuth, milk of magnesia or the regular prescriptions ordered in liquid form, provided instructions are given to shake the mixture well before administering. To physicians desiring sufficient protan for clinical test a liberal quantity, with literature, will be forwarded by H. K Mulford Company, manufacturing chemists, Philadelphia, who are introducing this preparation to the medical profession.

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