On Cephalization, and on Megasthenes and on Microsthenes. By James D. Dana. (Amer. Journal of Science and of Arts, vol. xxxvi. ser. ii. 1863, pp. 1-11.)

Physiological Researches on Optics. By A. W. Volkmann, Prof. in Halle. (Part 1, with 21 Woodcuts. Leipzig, 1863.)

On the Nerves of the Liver, Biliary Ducts, and Gall-bladder. By Rob. Lee. (Proceedings of the Royal Society, vol. xii. p. 246.)

Further Contributions to our Knowledge of the Bile. By R. Heidenhain. (Studien des Physiologischen Instituts zu Breslau, 1863, Heft ii. p. 69.)

On Animal Dextrine, or Amyloid Substance, its History and Physiological Properties. By R. McDonnell, M.D. (Natural History Review, 1863, p. 538.)

On the Amyloïd Substance of the Liver, and its ultimate Destination in the Animal Economy. By R. McDonnell, M.D. (Proceedings of the Royal Society, vol. xii. p. 476.)

On the Effect of Temperature on the Excretion of Urea, as observed on a Voyage to China and at Hong Kong. By E. Becher, M.D. (Proceedings of the Royal Society, vol. xii. p. 440.)

On the Appearance of Albumen in the Urine after Interruption of the Circulation. By R. Overbeck. (Sitzungsberichte du Kais. Akad. d. Wissenschaft zu Wien, 1863, p. 189.)

HALF-YEARLY REPORT ON MATERIA MEDICA AND
THERAPEUTICS.

By ROBERT HUNTER SEMPLE, M.D.

Member of the Royal College of Physicians, Physician to the St. Pancras and Northern Dispensary, London.

I. On Glycerine, and its Applications to Medical and Surgical Treatment. By Dr. DÉMARQUAY.

DR. DÉMARQUAY has lately published a book on the therapeutical applications of glycerine. This substance has been used internally as a laxative, but its aperient effects are more evident when employed as an enema, in the proportion of two ounces of glycerine to sixteen of water. Fetid and gangrenous ulcers are modified by glycerine, and rapidly assume a healthy aspect, if the dressings are changed two or three times a day. It forms a good dressing for malignant carbuncle, and in cases of burns it imparts to the injured surfaces a permanent sensation of coolness, due to its hygrometric properties. It is also a useful adjunct in the treatment of scorbutic, scrofulous, and syphilitic ulcers, and a valuable palliative in cancer. It possesses the property of dissolving iodine, and an injection of an ounce of iodine and three ounces and a half of glycerine has been found very efficacious in cases of deep-seated abscess, sinuses, scrofulous wounds, syphilitic bubo, &c. In diseases of the skin, glycerine is often more successful than pommades, as for instance in vulvular hyperæsthesia; in pityriasis capitis a combination of hydrochlorate of ammonia, glycerine, and rose-water, as prescribed by Dr. Gueneau de Mussy, has been found very efficacious; and a sulphur pommade for scabies, made with glycerine instead of lard, possesses the advantages of not staining the linen and being free from offensive odour. Dr. Démarquay gives numerous formula, containing glycerine, applicable to the treatment of diseases of the eyes, ear, mouth, fauces, and larynx. In thrush, stomatitis, and ulcerative sore throat, M. Blache prescribes an application consisting of two drachms of biborate of soda and one ounce of glycerine.

II. On the Treatment of Tendinous Rheumatism by the External Employment of Sulphur. By Dr. RENARD. (L'Union Médicale, April 21st, 1863.) Tendinous rheumatism, according to Dr. Renard, differs from acute rheumatism by the absence of the general symptoms, and from the chronic by the presence of local inflammatory symptoms. Dr. Renard suffered from this complaint himself after an attack of acute rheumatism, for which he was copiously bled. The parts affected were the tendons of the hamstring muscles, and no improvement resulted after a long course of diaphoretics, camphor, terebinthinate and other liniments, and the administration of the solanaceæ. At last Dr. Renard saw a passage in an English medical journal, stating that persons suffering from rheumatism in the legs had only to dust the inside of their stockings with sulphur. He immediately employed this simple remedy, the sulphur being the commercial flowers of brimstone, which contain some sulphurous acid. The curative effect was very well marked, for Dr. Renard walked in the evening, then renewed the sulphur in the stockings before sleeping in them, found himself very much relieved the next morning, and nearly quite cured on the morning after. A few days later, he left off the brimstone, and the pain reappeared in the soles of the feet, but yielded very soon to the reapplication of sulphur. Since the year 1857, when he was first attacked, the same experiment was repeated every winter when he was suffering from chronic tenodynia, either in the hams, the heels, or the elbows. He felt, under the influence of the contact of the flowers of brimstone, the skin becoming hotter, slightly excited, and more disposed to sweating; and as soon as this effect was produced, the relief of the pain seemed to be immediately marked. Whatever may be the explanation of the manner in which sulphur exerts its curative agency, Dr. Renard affirms that it has a beneficial effect upon the rheumatic pains of the tendons, and that this action is the more rapid and certain in proportion as the tendons are more superficial and the sulphur is kept more closely over the painful parts.

III. On the Use of Nitrate of Silver in the Paraplegia of Children. By Dr. BOUCHUт. (Bull. Gén. de Thérap., Jan. 30th, 1863.)

Dr. Bouchut employed the nitrate of silver internally in the case of a child, aged seven years, in the Hospital of Sainte Eugénie. The patient had had a fall from a height of a few feet, and immediately complained of acute pain in the dorsal region. From this time the child was unable to walk, and when she was placed upright the legs bent and sank down under the weight of the body. The speech became slow, difficult, and indistinct, and the food partly escaped from the mouth during mastication. For nearly a month, only the expectant treatment was adopted; but Dr. Bouchut then conceived the idea of treating the paralysis with nitrate of silver, according to the views of Wunderlich, and Charcot and Vulpian. He therefore prescribed one centigramme of the nitrate, divided into two pills, to be taken every day; and this treatment (occasionally varying the dose) was continued for more than a month with success, for at the end of this time the child left the hospital perfectly cured. Dr. Bouchut remarks that this was a case of paraplegia from direct violence, depending apparently upon a state of commotion of the spinal cord, and that the use of nitrate of silver was attended with manifest advantage. The expectant treatment had been tried without any avail, but as soon as the nitrate was employed the improvement became apparent: in twelve days the child began to walk alone, and at the end of six weeks of the treatment the cure was complete: Although the nitrate of silver was successful in the present case, Dr. Bouchut thinks that it would not be a suitable medicine for cases of paraplegia in which there are symptoms of acute inflammation of the spinal cord or its membranes.

65-XXXIII.

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IV. On the Employment of Tannin in the Affections of the Respiratory Organs, and principally in Pulmonary Phthisis. By Dr. WOILLEZ. (Bulletin Général de Thérapeutique, January 15th, 1863.)

Dr. Woillez has employed tannin in pulmonary phthisis, and also in some other affections of the respiratory organs, accompanied with hyper-secretion from the bronchial tubes. He believes that in the former case it occasionally exercises an undoubted influence, not only in the diminution of the mucous secretions obstructing the air-passages, but also in the evolution of the local tubercular lesion, as well as in improving the general health. In bronchorrhoea it apparently acts only on one element of the disease-namely, the abnormal hyper

secretion.

In selecting his cases of bronchitis, Dr. Woillez has admitted only those which were well marked, and characterized by the principal distinctive sign of a subcrepitant rhonchus, occupying at least the base of both lungs behind. In such instances, the bronchial secretion becomes the prevailing feature as soon as the most acute phenomena are relieved, and the greater or less abundance of this secretion may account for the greater or less dyspnoea, and the frequency of the cough and expectoration. The first indication of treatment, therefore, is to diminish this catarrhal element, and thereby to relieve the functional symptoms, and to restrict the extent of the humid rhonchi heard on auscultation. Dr. Woillez administers tannin in the daily dose of four pills, each containing the 15 or 20 of a gramme, two to be taken twice a day at meals.

When

In reference to the efficacy of tannin in pulmonary consumption, Dr. Woillez considers that this drug has an undoubted influence in improving the general condition of the patient, and in inducing a favourable change in nutrition, and that its tonic action is comparable to that of cinchona. But he admits that this favourable action on the nutrition, and its reparative influence on the pulmonary lesion, are not constant, and he cannot accurately state the proportion of successful and unsuccessful cases which he has observed. Even in the advanced period of pulmonary consumption, Dr. Woillez has known the tannin produce a favourable result by arresting the symptoms in their progress, and in modifying them to such a degree as to produce an apparent cure. tannin is given in the dose already described, to patients who have cavities in their lungs, not amounting to large excavations, it generally happens that the local signs are sensibly improved at the end of from eight to fifteen days. This amelioration is characterized by a marked diminution of the humid rhonchi. The blowing or cavernous respiration is afterwards clearer, as well as the bronchophony, and the rhonchi, sometimes less numerous, are perceived principally at the end of inspiration, or only at the moment of coughing. The principal conditions in which the treatment by tannin has seemed to fail in phthisis, are the continuance of fever, the rapidity of the course of the disease, and the existence of recent delivery in women: these circumstances seem to Dr. Woillez to make phthisis almost necessarily fatal.

V. On the Simultaneous Employment of Perchloride of Iron and Ergot of Rye in Albuminuria. (Gazette Médicale de Lyons, Oct. and Nov. 1862.)

Dr. Socquet, in the first instance, and afterwards Dr. Chatin, both physicians of the Hôtel Dieu of Lyons, have employed the perchloride of iron and ergot of rye for the prevention of the loss of albumen in the urine, and the results they have obtained are deserving of notice. The cases observed were some men of bad constitution, weakened by former unfavourable hygienic conditions, such as insufficient food, and dwelling in damp and badly-ventilated localities. The dropsy, in all the cases, at first confined to the face, had successively attacked the limbs and the peritoneum. The urine was pale and

inodorous, and contained large quantities of albumen, and in one case microscopic examination revealed the presence of the remains of renal epithelium. Immediately on their admission into the hospital these men were subjected to diaphoretics, alkaline diuretics, uva ursi, and digitalis, though without any good result; but at last they took the ergot of rye and perchloride of iron. These medicines were given in progressive doses, beginning with 20 drops of tincture of the perchloride and 50 centigrammes of ergot of rye. Every two or three days these doses were methodically increased, and carried successively to 30, 40, 50, 60, 70 drops of tincture of the perchloride, and to 75 centigrammes, 1 gramme (about 15 grains), and 3 grammes of the ergot. Under this treatment the albumen in the urine rapidly began to diminish; in ten days it disappeared completely, and in ten days afterwards the different dropsical effusions disappeared also. In one of the cases, the treatment having been suspended a little too soon, the albumen again appeared in the urine. In order to judge comparatively of the effects of the perchloride and the ergot, the perchloride was administered alone, when the albumen diminished; but this diminution, although rapid at first, was afterwards very slow. The ergot being added to the prescription, accelerated the cure, and four days after its administration there was no more albumen in the urine. M. Perrond, in making some remarks on these cases, observes that the ergot and the perchloride of iron appear to have a beneficial effect on the albuminuria, but that their use constituted the treatment of a symptom rather than that of a disease, and that they are not therefore calculated to supersede the use of other mea. sures intended to remove the original malady.

VI. On the Employment of Large Doses of Digitalis. By Dr. W. E. BOWMAN. (Canada Lancet, April 15th, 1863.)

Dr. Bowman doubts the correctness of the generally-received opinion as to the poisonous effects of digitalis, and he attributes many of the sudden deaths said to occur in dropsy to the accompanying disease, and not to the remedy. Dr. Bowman records two cases of delirium tremens in which he gave large doses of digitalis with good effects. The first was a man of fifty years of age, who had been a hard drinker for many years. Morphia was first administered, but it did not produce sleep. Digitalis was given, with the result of reducing the pulse from 100 to 56, of diminishing the tremor, and of calming agitation, and he recovered without any bad symptoms remaining. The second case was that of a man of forty-five years of age, who had frightful visions, and attempted to destroy himself by throwing himself out of a window. The treatment was begun by the administration of half an ounce of tincture of digitalis, which soon brought down the pulse from 80 to 64; and the same dose was repeated at short intervals for eleven hours and a half, and in eight days he recovered. This patient took two and a half fluid ounces of the tincture of digitalis in eleven hours and a half, the tincture being made from fresh and fine leaves. The first dose lowered the pulse eight beats, but it was again raised by the second dose, and the second, third, and fourth doses had no effect on the number of beats, but rendered them occasionally irregular. The 5th dose, however, brought down the pulse at once to 48, at which it remained most of the time for several days, producing no ill effects whatever, and merely rendering the patient languid.

[These cases show, what has long been believed, that persons may take large doses of digitalis without any bad effects; but from the manner in which the cases are related, it is doubtful whether they were cases of true delirium tremens.-REPORTER.]

VII. On the Internal Exhibition of Atropia and Strychnia. By ALEXANDER FLEMING, M.D., F.R.C.P. Lond. (Edin. Medical Journal, Jan. 1863.)

Dr. Fleming has for several years employed solutions of atropia and strychnia for internal use, and he prefers them to the ordinary preparations of belladonna and nux vomica, on account of their greater safety and efficiency. The solutions of both alkaloids employed by Dr. Fleming are so proportioned in strength that ten minims is the ordinary commencing dose, which easily admits of increase for the adult, and of diminution for the child. The solution of atropia is prepared from 1 grain of atropia, and 5 drachms of distilled water. The alkaloid is to be thoroughly dissolved with the aid of a few drops of hydrochloric acid, and sufficient rectified spirit is to be added to make 10 drachms. This solution keeps well and is of uniform strength, and 10 minims of it, containing 1-60th of a grain of atropia, is the commencing dose for an adult. It should be given in a little water, once daily, at bedtime, and on an empty stomach. For children of one year, and all ages under one year, the commencing dose is 1 minim; of two years, 2 minims; of three years, 3 minims, and so on up to ten years, when 10 minims may be given. The diseases in which Dr. Fleming uses atropia are epilepsy, asthma, constipation, and hooping cough. He uses it once a day, because the action of one dose does not subside completely for sixteen or eighteen hours; and if a second is given before the effects of the first have passed away, there is a risk of producing cumulative action. It should be given on an empty stomach, because the dose of atropia requires, for its due action, to be promptly absorbed ; and when mixed with the contents of a full stomach it enters the system very gradually, and manifests its usual effects very imperfectly, or not at all. This is one reason why the drug, when taken into the stomach of the rabbit, has no action, for it always meets there a large quantity of food, and mixing with it, enters the system very gradually. Several experiments made by Dr. Fleming have satisfied him that this explanation accounts in some measure for the immunity of grass-feeding brutes from the effects of certain poisons, for their stomachs are always full. Atropia should never be given in pill, which may undergo solution very slowly or not at all, lest when two or three pills accumulate in the stomach or bowels, they may, from some change in the gastrointestinal fluids, be suddenly dissolved and excite severe atropism.

The solution of strychnia is made with 2 grains of strychnia and 5 drachms of distilled water: the strychnia is to be thoroughly dissolved by means of a little diluted hydrochloric acid, and rectified spirit is to be added to make 10 drachms. This solution, like that of atropia, is uniform in strength, passes readily into the circulation, and the dose can be apportioned with accuracy. The commencing dose is 10 minims, and contains 1-30th of a grain of strychnia. When employed for its tetanic action, the solution should be taken in the morning, half an hour before breakfast, and in half an ounce of water, and the dose increased 2 or 4 minims daily until a slight degree of its physiological action, such as stiffness about the jaws or neck, or spasmodic movements in the paralysed muscles, is manifested, when no further increase should be made. It should be given only once daily, to avoid the risk of cumulative action; it should be taken in the morning, so that its action may be over before bedtime and the sleep be not disturbed; and it should be given on an empty stomach and diluted with water, to ensure its prompt and easy absorption. Strychnia should never be given in pill, for it is hard of solution in the weak acids of the stomach, and several pills may remain unchanged and accumulate there, or in the bowels. When the strychnia is employed as a tonic, the dose of the solution is 5 minims, and it may then be exhibited twice daily with safety and advantage.