For the same reason, we give aconitine to prevent absorptive fever:

Five or six granules a day.

After the operation, the patient must be sustained by albuminous foods and wine, so as to prevent impoverishment of the blood and intravascular void, which would have the effect of forwarding the re-absorption of ichorous matters.

This, therefore, is quite different from the arbitrary regimen which some surgeons extol.

In order to stimulate digestion, quassine, and even arseniate of strychnine must be given :—

Three to four granules a day, at meal times.

By this treatment, the blood and the tissues are kept up to the desired degree of tone, and reabsorption, or rather infiltration, either intra or extravascular, is prevented.

At the least appearance of shivering or horripilation, hydroferrocyanate or arseniate of quinine should be administered, sometimes the two together, especially when a very intense poisoning is foreseen:

A granule of each every half-hour.

The nature of septicemia may now be considered as determined. It is not laudable pus which produces fever, but the ichorous matter or septic virus which vitiates the blood and depresses the vitality. Therefore, the wounded must not be debilitated but strengthened. In a word, their vitality must be sustained. Fixed or diffusible stimulants are totally unable of themselves to produce such a result. Virginian serpentary irritates the digestive mucous membrane, and cinchona tans it, and increases the thirst and dryness of the tongue. Thus, the elimination of the ichorous virus is prevented, for the diarrhoea in that case arises solely from indigestion. The dosimetric granules must, therefore, be had recourse to, for these being very soluble, are easily absorbed, and do not produce any irritation or additional trouble.

The chief point is, the close observation of the animal temperature, or the degree of intravascular pressure, in the same manner as the engineer consults the manometer. As soon as the temperature rises above 40°c., it must be made to fall to 39° or 38°c., by means of aconitine and veratrine :--

A granule of each, together, every half-hour;

and if the heart beats with too great impetuosity (120 pulsations a minute), it must be moderated by digitaline :—

A granule every hour.

For if Cullen, a celebrated English physician,-called digitalis "the opium of the heart," it must not be forgotten that it stupefies like opium, and that, consequently, it is dangerous to employ it in substance, when the arterial pulsations are weakened, as happens in miasmatic poisoning. In that case, it is advisable to make choice of digitaline, and to associate it with a fixed substance, such as arseniate of iron or strychnine:-

A granule of each, together or separately, every half-hour.

DIPHTHERITIC AFFECTIONS.

THE diphtherias are characterised by buff exudations, which were formerly considered as inflammatory products, but which are now known to be parasitic organisms, which attach themselves to the mucous membranes. These diseases are, therefore, looked upon as parasitic affections, like the oidium of the vine.

As these maladies present, generally, an epidemic and contagious character, it must consequently be admitted that the parasitic germs being diffused through the atmosphere, and attaching themselves to the mucous membranes by their pencil-shaped prolongations or suckers, produce there those exudations or buff-like membranes, which thus serve as the

receptacles or nests, where they are evolved and multiplied in such a manner as to extend the area of contagion.*

It is necessary, therefore, to destroy the parasitic germs, and to attack the disorders which they have produced.

The first indication will be fulfilled by the administration of sulphide of calcium, the parasiticide par excellence, as is proved in the treatment of the vine:-

Eight or ten granules a day,

and undiluted lemon-juice to destroy the false membranes.

As to the general poisoning (these infinitely small particles being usually venomous), it will be neutralised by the emetics, -emetic or emetine, according as the patients are adults or children ::

A granule every quarter-of-an-hour until the effect is produced; and Seidlitz salt to cleanse the intestine : :-

A teaspoonful in a glass of water.

The fever must be combated by arseniate of strychnine and quinine (arseniate or hydroferrocyanate); the first, for the prostration, the second, against the accession :

A granule of each, together, every quarter-of-an-hour until sedation.

If spasmodic symptoms manifest themselves, especially such as affect respiration and deglutition, they must be combated by hyosciamine and aconitine :-

A granule of each, together, every half-hour. Among the diphtherias must be classed

:

1. Glanders (La rhinite jettatoire).—This disease is rarely

*The parasitic nature of the diphtherias can now no longer be contested, since it has been demonstrated by the microscope. What the ancients called monads, are those infinitely-small particles which float in space, and which, entering the lower atmospheric strata, that is to say, our respiratory field, invade us through all our pores. There, if they encounter vital resistance, they are repulsed or die, like the noxious weed in a well-tilled field. This proves that in epidemics the system should be strengthened and not weakened.

spontaneous or primitive in man, who generally contracts it from glandered horses. The pituitary membrane is of a red brown colour, and looks wrinkled on account of the development of the muciparous follicles which secrete a viscous liquid, at first of a whitish and afterwards of a yellowish tint, which is very contagious. There is lachrymation arising from the extension of the irritation along the nasal canal. The surrounding lymphatic glands are engorged (mumps).

Glanders must not be confounded with coryza, in which the discharge is serous, although, indeed, it acquires sometimes an acrity which attacks the nostrils and lips.

Coryza arises generally in the frontal or maxillary sinuses, the membranes of which are almost serous. Glanders attacks, on the contrary, the mucous follicles. Sometimes it reaches the lungs, in cases where the infection of the glanders has been introduced through the respiration (pulmonary glanders). The accompanying fever is very intense, and should be combated from the commencement by arseniate of strychnine and arseniate of quinine, so as to ward off symptoms of prostration and periodicity; for, like as in every absorptive fever, there is accession or increase :—

A granule of each, together, every half-hour, and then every hour, according to the diminution of the fever.

The patient should sniff up chlorine-water,* and the Seidlitz salt must be given as a refrigerant.

2. The stomato-exudatives: aphthous, pultaceous, pseudomembranous or buff-like, all arise from the same cause, and require the same treatment. In order that this class of diphtherias may take place, it need not necessarily be always epidemic, since the zymogenic organisms are formed in the exudations, which result from local irritations or neglect of cleanliness. In the case of infants at the breast, the nurse

* Chlorine-water and other antiseptic solutions might be inhaled in the form of fine spray by employing a steam-atomizer.-H.A.A.

must take the internal remedies, and the treatment of the former must be limited to external measures.

3. True diphtheria is characterised by the formation of plates, polypous concretions, and false membranes due to parasites (micrococci), which cause an occlusion of the principal passages, and threaten suffocation. The treatment, therefore, cannot be too sufficiently active. The back of the throat must be painted with pure lemon-juice, and sulphide of calcium administered until the intestinal gas emits an odour of sulphuretted hydrogen. Not only is this gas innoxious, but it has the property of preventing the formation of ammoniacal compounds (carbonate), which induce a typhoid condition by decomposing the blood.

Seidlitz salt must be used to cleanse the intestine, and fever should be combated by arseniate of quinine, the accessions being cut short by aconitine and veratrine :

A granule of each, together, every half-hour until sedation.

The

4. Croup. There are two kinds of croup, one primary, and the other caused by the extension of diphtheria. first variety is the most dangerous, on account of the difficulty in getting at the false membranes or skins which spread themselves sometimes throughout the whole tracheal tree. Emetic or emetine must, therefore, be administered from the commencement:—

A granule of either every quarter-of-an-hour until the desired effect; and on the production of vomiting, sulphide of calcium should be administered until sulphuretted hydrogen gas begins to be emitted.

Paroxysms of fever will be best combated by hydroferrocyanate of quinine :

A granule every half-hour until the paroxysm ceases.

5. Hooping-Cough.-I class the hooping-cough among the diphtherias because it attacks the respiratory passages and is essentially contagious. The disease is of a paroxysmal