Publisher's Department.

GLYCO-THYMOLINE

AN EYE bath fashioned from a single piece of aluminum has been introduced by the Kress & Owen Company. That this little device will be well received by the medical profession is not to be questioned when one considers the many points of advantage this metal cup has over the old style glass contrivance. It is cleanly, unbreakable and can be sterilized instantly by dropping into boiling water. The surgical bag in the future will hardly be complete without one of these cups, which will give happy results in many an emergency. It will be found invaluable for treating ophthalmia, conjunctivitis, eye strain, ulceration and all inflammatory conditions affecting the eye.

EYE BATH

Directions.-Drop into the eye bath ten to thirty drops of GlycoThymoline, fill with warm water; holding the head forward, place the filled eye bath over the eye, then open and close the eye frequently in the Glyco-Thymoline solution.

No pain or discomfort follows the use of Glyco-Thymoline. It is soothing, non-irritating, and reduces inflammation rapidly.

AN EFFICIENT MEANS OF RELIEVING PAIN.-The pain which accompanies the intestinal diseases resulting from grippe colds is often severe and requires the use of an effective anodyne. Papine is peculiarly adapted to such needs, as it represents all of the painrelieving properties of opium without its narcotic and nauseating effects. It is apparent that such a remedy has a wide range of usefulness, and that Papine is well appreciated by the medical profession is shown by the place it has occupied in the medical armamentarium for so many years.-International Journal of Surgery.

"Salicylates act at least in two ways in the body. In the case of acute articular rheumatism, in which they are supposed to exercise a specific influence, they probably act deleteriously upon the microorganism which is responsible for the malady, whereas in the case of chronic rheumatism or gouty conditions depending upon diathetic states they produce some influence upon metabolism or the oxidation processes in the body which we do not understand, but of which we are therapeutically certain."

It is of the greatest importance, therefore, that the salicylic acid administered should be from natural sources and not the synthetic produce. Physicians can rely on the fact that all the salicylic acid in Tongaline is made from the pure natural oil of wintergreen and that it does not possess the disturbing effects of the salicylic acid made from coal tar.

M. M. Foy & Co., St. Louis, Mo.-I find, after trying same, that no remedy or combination, will produce as good results in intestinal

indigestion, especially where there is auto-intoxication, as your Digestets. F. M. MOORE, M. D.

Franklin Junction, Mo.

A PHYSICIAN makes the following statement:

"I consider Tongaline far superior to any preparation for rheumatism, neuralgia, grippe, gout and similar complaints, and it has given me such uniform satisfaction that I rely upon its action most implicitly.

"I was first impressed with the unusual merits of Tongaline by the great benefit which my wife derived from its use, and this was all the more remarkable because she tolerates salicylates in any other form very poorly, but whenever she feels the first symptoms of rheumatism, the attack is at once controlled by taking Tongaline for a very short time."

A Reconstructive Tonic.

For more than twelve years "Bronchiline," advertisement of which appears in this issue, has been recognized as a valuable expectorant. While its action is prompt and reliable in the treatment of conditions indicating its use, there has been a demand and constant inquiry for a reliable reconstructive tonic to be used in connection with it: a remedy not only to stop the waste of tissue, but to give tone to the functions of nutrition, assimilation and excretion, and cause an accumulation of flesh and increase in weight. After consultation with leading physicians in different sections, careful laboratory experiments with the various formulae submitted, and observation of the results attending their use in actual practice, we believe that in the preparation we have named "Nutrivine," we present the most elegant and meritorious remedy that has been offered to the profession for wasting diseases, such as phthisis, nervous debility, anemia, chronic diarrhea, bronchitis, nervous or flatulent dyspepsia, chlorosis, and prostration following fever, diphtheria, etc., or any exhausted condition of the system.

Each teaspoonful represents 33 per cent pure Norwegian cod liver oil with three grains hypophosphite lime, 1 grains hypophosphite soda, combined into an excellent and palatable preparation with malt, wild cherry and sherry wine, so that it will not disagree with the most delicate stomach.

Samples on request to Peter-Neat-Richardson Co., Louisville, Ky.

PEACOCK'S BROMIDES. Peacock's Bromides is made to meet every possible and exact requirement of the bromides. It is a combination of the five bromides of the alkalies and alkaline earths— potassium, sodium, calcium, ammonium and lithium. The salts empolyed in its manufacture are made specially for Peacock's Bromides and are purer and better than the commercial salts. The preparation will give the best possible results with the least danger of bromism disturbances.

PUBLISHED MONTHLY.-SUBSCRIPTION $1.00 A YEAR.

VOL. XXII.

AUSTIN, MARCH, 1907.

No. 9.

The publisher is not responsible for the views of contributors.

For Texas Medical Journal.

Laryngeal Diphtheria, With Special Reference to Intubation.

names:

BY T. J. DODSON, M. D., MANGUM, OKLA.

Laryngeal diphtheria may be considered under the following Pseudo-membranous laryngitis, membranous croup, true diphtheria, true croup, and laryngeal stenosis. For nearly a halfcentury the identity of membranous croup and laryngeal diphtheria has been contended for by some and denied by others equally as good. Bacteriology has settled many questions along this line; statistics showing that 80 per cent of these cases are true diphtheria; i. e., it is due to the Klebs-Loeffler bacillus.

In cases of primary laryngeal diphtheria, there are wanting many of the characteristic features which distinguish diphtheria of the pharynx. There are two reasons for this: one is the rapid course of the disease, often producing death from local causes before the constitutional symptoms resulting from the absorption of toxin have developed. The second reason is, that the absorption of poison by the laryngeal mucous membrane is very slow and feeble as compared with that which takes place from the pharynx.

It is unnecessary for me to enter into the differential diagnosis between the different forms of laryngeal stenosis, for as has already been stated, 80 per cent of all cases show the Klebs-Loeffler bacillus; we will, therefore, consider them as laryngeal diphtheria. Neither will I consume your time by going over the long list of symptoms which characterize this disease, as it is the intention of this paper to deal with those cases only which have advanced to that stage where operative measures must be considered. I am

sure that any one who has ever seen a case of this kind once, would hardly make a mistake in his diagnosis.

That there are cases, whether it be diphtheria or not, where nothing but operative measures promise relief, none will deny. Opinions will differ as to the time when operative interference is called for. One should never wait for general cyanosis, for often this does not occur until just before death; it is better to operate too early than too late.

After a fair trial has been made of other remedies, and if, in spite of all this, the dyspnea continues to increase steadily and the temperature begins to rise, operation should not be deferred longer. When this has been decided upon, the physician has his choice between intubation and tracheotomy. During the last ten years intubation has grown steadily in favor, and since the introduction of antitoxin, tracheotomy has been practically abandoned, it being resorted to only in rare cases, after intubation has failed to give relief.

A report of the American Pediatric Society says: "Before the use of antitoxin 27 per cent of intubation cases recovered, now 73 per cent recover; and an early use of antitoxin will lower this mortality still more. Sixty per cent of stenosis cases do not require operation if antitoxin is in time. My personal experience with intubation has been very satisfactory, indeed, a report of which I will give later. In combination with antitoxin I consider intubation one of the greatest blessings at the disposal of the physician. The operation of intubation and extubation is not in itself difficult, the latter being more difficult than the former. Only two assistants are necessary, neither of whom need necessarily be a physician, and proceed as follows: Remove all clothing from the child except the underclothing, and wrap the child securely in a sheet from shoulders down, secured by safety pins. Place the child upright, facing the operator, in the lap of one assistant, who sits upright in a common straight-backed chair; the arms of the patient should be firmly held below the elbows; the child's legs are clasped between the knees of the assistant. The second assistant stands behind the chair and when the gag is introduced, includes it within the firm grasp. The position of the child should be as though it hung from the top of its head. The operator should have the tube properly prepared, and armed with a small string; this is necessary in case the tube should become blocked or be turned loose in the esophagus, it can be immediately removed. The operator now stands in front of the patient and inserts the index