Pruritus of the Skin of the External Auditory Meatus.—Dr. J. Gueber describes under this name, not the itching and eczema of the ear so often left after scabies, but a special affection, first named as above by Hebra, in which the itching is the only symptom. It occurs most frequently in middle age, and in persons who, from one reason or another, have a defective circulation. There are frequently periodical exacerbations of the irritation. Gueber recommends, as a palliative, applications of water and oily matters for radical cure, repeated painting with a strong solution of nitrate of silver, till inflammatory reaction is set up. Along with this, however, there must of course be a suitable rational treatment, according to the special indications which present themselves. (Allgem. Wien. Med. Zeitg. 52, 1869.)
New Remedies.—Dr. G. W. Lawrence, writing to the Philadelphia Medical and Surgical Reporter, states that the following substances, whose qualities he briefly describes, have been recently tried by him in practice:—Quiniæ Iodo-Sulphas. It has proved to be a desirable alterative and tonic, serviceable in consecutive syphilis, scrofula, cachexia, neuralgia, some forms of paralysis, and in debilitated conditions of the general system. Given in pill form, or mixed with syrup of sassafras bark or blended with elixir of Calisaya bark.—Iodide of Antimony. An alterative, used chiefly in skin diseases, those forms arising from constitutional ills and secretory disturbances. Prescribed with aromatic syrup of dulcamara. He has recently used iodide of antimony as an anaphrodisiac with satisfactory results. He combined it with lupulin, and gave it in pills every six hours.—Iodide of Manganese. Alterative, administered generally with the iodide, or some other desirable preparation of iron, or with quiniæ iodo-sulphas, in anæmia and chloro-anæmia, with resin podophyllin, in chronic splenic and hepatic derangements. In the alterative agency of manganese, he fancied that a determined action is exercised on the ganglionic system of nerves.—Glycerole Pyrophosphate of Iron. In the formula pure glycerine is substituted for sugar, or simple syrup; each fluid ounce (with glycerine) contains sixteen grains of pyro-phosphate of iron. This new preparation is unchangeable, and is one of the most palatable of that family of tonics. He employs it usually as an eutrophic in that spanæmic condition of the system so frequently provoked by the protracted use and abuse of iodides and bromides of potassium. He also uses it when indicated, in progressive paralysis, motor ataxia, in threatening a supposed incipient ramollissement of the brain and spinal marrow.
Carbolate of Lime in Pertussis.—Dr. Snow, of Providence, has suggested the use of carbolate of lime in hooping-cough, and in all cases it has apparently produced a marked effect in diminishing the frequency and severity of the paroxysms. Small quantities of the carbolate of lime are placed in saucers in the room where the child sleeps; merely sufficient to make the odour perceptible. (New York Medical Record.)
Bromide of Potassium and Antimony in Puerperal Convulsions.—Dr. T. N. Simmons reports the history of a case of puerperal convulsions, in which the efficacy of these remedies was evident. A primipara, while in labour, with the head of the child in the inferior strait, was seized with a violent convulsion, which was followed by four others, with an interval of about 15 minutes between each. Chloroform proving of no benefit, bromide of potassium was administered, beginning with a dose of 40 grains in combination with half a grain of antimony. In combination with the bromide one-half grain of the antimony was given every hour and a half or two hours, until three grains of the antimony were taken. After the first dose there was a return of four paroxysms. The first occurred within an hour, the second in two hours, the third between three and four hours, and the fourth in eight hours. Their intensity and duration were also diminished in the order of their recurrence. Convalescence was rapid. (N. O. Journal of Medicine.)
An Acidulated Solution of Pepsine as a Solvent for False Membrane in Diphtheria.—Dr. W. H. Doughty has communicated to the Richmond and Louisville Medical Journal an article upon this subject, with a history of a case in which he was entirely satisfied with the efficacy of pepsine in diphtheria. The patient was about 25 years of age, of feeble general health from intermittent fever. He presented himself with sore throat. For the affection cauterization was resorted to, and a gargle of chlorate of potash ordered. The throat became very much inflamed and swollen, and the glands about the neck enlarged. About the fourth day exudation of membrane was observed under the tongue, a portion of which was removed with forceps. The swelling increased, and the membrane continued to re-form. Quinine and stimulants were freely used, with inhalations of lime-water. On the fifth day commenced the application of pepsine to the membrane, keeping up the same general treatment. Pepsine was used in the following proportion: ℞ pepsine ℨj; acid muriatic, dilute, gtt. x; water q. s. ad ℥iij.: M. and filter. This was applied by means of a hair pencil continuously. A few hours from the commencement of the application, “the mouth, as far as visible, is cleaner and better.” On the next day the patient feels better; no appearance of exudation; mouth is clean, but continues to discharge broken-down opaque masses from the throat, and thinks he must have suffocated but for the solution employed. The breathing is comparatively easy and cough less. Patient died on the seventh day, of asthma.
Impermeable Dressings in Eczema.—In an article on this subject in Mr. Erasmus Wilson’s “Journal,” Mr. Alfred Pullar makes the following remarks on the value of this mode of dressing:—“The method of local treatment first brought into notice by Professor Hardy at the Saint Louis Hospital in Paris, consists in covering the diseased parts completely with vulcanized india-rubber cloth (toile caoutchouquée). The material used for this purpose is ordinary cotton cloth covered with a solution of caoutchouc and subsequently vulcanised: by this means it is rendered impermeable to watery fluids, and acquires on one side a smooth surface. The therapeutical effects resulting from a covering such as that described would seem to depend essentially upon two conditions:—First, the exclusion of the air. As it has been proved by experience that the influence of the atmosphere increases the inflammation of the diseased surface, its complete exclusion fulfils an important indication in the treatment: this is accomplished by the india-rubber covering, which also protects the abnormally sensitive skin from variations of temperature. Second, the retention of the secretions of the skin. These—exuded in considerable quantity, and unchanged by the atmosphere—are retained in contact with the skin, and seem to act by relaxing the inflamed structures. Whilst visiting Hardy’s wards at the Saint Louis Hospital, I had the privilege of seeing several cases of eczema treated by this means (these cases being chiefly eczema of the limbs in old people). The impermeable dressing was so applied as to cover completely the affected parts, and was removed, from time to time, in order to be cleaned and re-applied. Under this treatment, the painful symptoms of the disease were greatly relieved; and the morbid surface gradually assumed a more healthy appearance.” (Journal of Cutaneous Medicine, April.)
Tetanus treated with Calabar Bean.—Drs. Boslin and Curron (Chicago Medical Journal) have treated a case of acute traumatic tetanus of violent character with large doses of morphia and calabar bean. For a portion of the time, a grain and a half of morphia and three grains of the powdered bean in glycerine were given every hour, with the manifest effect of quieting the patient and relieving the spasm. The patient recovered.
The Therapeutics of Bismuth.—In the California Medical Gazette, Dr. W. F. Mac Nutt has a paper on “Some of the Uses of Bismuth,” in which he states that he finds this drug more valuable than it is often supposed to be. Some of his ideas on its therapeutics are novel. “I believe,” he says, “that bismuth not only destroys the sulphuretted hydrogen present in the bowels, but is an antiseptic to albuminous matters, preventing their putrid decomposition. That bismuth destroys the sulphuretted hydrogen present in the bowels, is proved by the fact that if administered for a few hours in considerable quantity the flatulence disappears; and if a dose of oil is given, the evacuations are as black as tar, where the evacuations were natural or clay-coloured before the bismuth was given. It is the chemical action of the gas upon the bismuth which gives the evacuations their black colour. But a small portion of bismuth, when given in powder and in doses from gr. v to gr. xx, is dissolved in the stomach and absorbed. The remainder passes undissolved into the bowels, and while it may have some local anæsthetic action on the bowels as on the stomach, it will be comparatively inert unless there be sulphuretted hydrogen present. Its action on the sulphuretted hydrogen is more particularly demonstrated when given for chronic diarrhœa. Some have attributed to bismuth astringent, tonic, and sedative properties, on account of their success with it in chronic diarrhœa. Others have given it for the same disease without the slightest benefit, and consequently have denied that it has astringent, or sedative, or tonic properties. While the fact is, that in cases of diarrhœa that are caused or kept up by the poisonous effect of sulphuretted hydrogen, I have given bismuth, combined with a few grains of Dover’s powder, with more real benefit to the disease than any drug I could administer. Opium alone is useless, or worse. Charcoal, by absorbing the gas, has been, next to bismuth, the most beneficial. Chambers on ‘Indigestions’ says that it is ‘rare to find sulphuretted hydrogen or hydro-sulphate of ammonia excreted without watery or soft pultaceous stools. They appear to be purgative poisons.’ They are not always purgative poisons.”
Physiological Action of Absinthe.—The following are the conclusions which M. Magnan laid before the French Academy of Sciences, and which have given rise to some discussion in the weekly journals:—1. The epileptic or epileptiform accidents in alcoholism—or, in other words, alcoholic epilepsy—are of a radically different nature, according as the alcoholism is acute or chronic. 2. In acute alcoholism the epilepsy is under the complete influence of an external agent, of a poison (absinthe) which of itself alone causes the epileptic attack; it is epilepsy by “intoxication.” 3. The alcoholic epileptics exhibit the ordinary features of simple alcoholic cases, and also superadded phenomena, among which the epileptic attack is dominant. 4. These two groups of symptoms (the alcoholic symptoms and alcoholic convulsions), united in the same subject, have a relation to the twofold nature of the poison (absinthe), whose elements are absinthe and alcohol. 5. In chronic alcoholism the epileptic or epileptiform accidents are under the direct control of organic modifications which take place in the patient. The excess of liquids, in gradually altering the tissues, renders them capable, under the influence of various causes, of producing by themselves convulsive epileptiform phenomena, accidents analogous to those that we see take place in other patients in certain cases of lesions of the nervous centres (general paralysis, tumours of the brain, &c.) (Comptes Rendus, April 5.)