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The vagus irritation plays a most important clusions: An early diagnosis is the most im. role in the cause and symptoms of broncbial portant step to the successful treatment of asthma. The catarrbal affections play a sec. tuberculosis. Tuberculosis may be arrested ondary role, which can easily be demon. by proper treatment, with a fair certainty of strated in many cases by the almost complete a permanent cure. Tuberculin is a valuable absence of catarrbal symptoms. One mg. adjuvant in the treatment of tuberculosis, as atropin, hypodermio, relieves many cases of evidenced by the recovery of twenty-eight out asthma in a very short time, and the lunge of thirty cases tbat were treated with practi. oontraot to their normal size. Since hysteric cally nothing but tuberoulin, while they con. individuals bear atropin very badly we must tinued to follow their ordinary occupations use it caustiously in these cases, or combine during the treatment. Cases of tuberculosis it with morpbine. Many nostrums which treated with the addition of tuberculin showed are advertised for the cure or relief of asthma far less tendency to recur than did similar contain atropin, but it is far preferable to use oases treated without tuberculin. Tuberoulin the drug bypodermio, and regulate the dose in small doses (0.1 to .5 mg.) seems to bave a more accurately.

more curative action than when given in large Nervous Liver Colic.—(Ewald, Berlin, Ther

and increasing doses. No ill effects follow the

administration of small ones of tuberculin. der Gegenwart.)—The severity of the attack,

bi Purely incipient cases improve very rapidly

P, the seat of pain and the recurrence of the at.

under the use of small doses of tuberoulin, taoks of nervous liver colio cannot be differ.

both as to tbe arrest of the disease and the entiated from those due to gall.stones or or.

clearing up of the diseased area. Tuberculin ganic liver diseases. In females these attacks

sbould never be given to a patient who has are apt to occur during menstruation, and other

ferer or who is suffering from mixed infec. nervous, hysterical or neurasthenic symp

tion. Third stage cases, especially advanoed toms accompany them. The abuse of alcohol,

cases, receive litile or po benefit from the use tobacco aud spicy foods often bring on an at

of tuberoulin. taok. Jaundice, bepatic enlargement or en. largement of the gall bladder very rarely ex

Ethyl Chlorid as a General Anesthetic.ist. The treatment of the nervous condition frequently relieves the patient of the colic.

Hawley (Juur. A. M. A., Aug. 18, 1906) dis.

cusses the merits of ethyl chlorid as a general Frequently the diagnosis is not made until

anesthetio. He reviews 'briefly the literature the surgeon makes an exploratory laparot.

on the subject and finds that various writers omy, or the case terminates fatally, and the

give diametrically different opinions. Hawley autopsy reveals the exact condition. The

states that after several years of more or less author reports several cases that he diagnosed

constant use of ethyl chlorid both in clinical gallstones, and the following operation failed

and in private practice, he bas still to see the to show any abnormality about liver, gall.

first case to cause him the slightest fear of bladder or ducts.

uneasiness. He declares tbat when used with Dietetic Treatment of Basedow's Disease.

care and understanding he prefers ethyl Alt (Münob. Med. Wochenschrift, No. 24, chlorid to any other anesthetic, in sbort oper. 1906) obtained splendid results in the treat. ations, except, perbaps, nitrous oxid gas. He ment of myxedema and Basedow's disease by states tbat the following precautions should paying close attention to the diet. The food be observed: (1) The patient should be preshould contain very little salt, especially if pared as for obloroform or ether; (2) wbatedema is present, or if the heart beat is greatly ever mask is used it huold fit the face snugaccelerated. Carbohydrates are not well ly; (3) a graduated tube with a large aperture tolerated and are not well absorbed, and, there should be used; (4) the anesthetic should be fore, it is better tu reduce them in the diet well supplied with air and as little given as Albuminous substances and fat in the form possible; (5) care should be taken not to preot milk, cream, butter, ice, meat, eggs and sent it at first in too large a quantity, frefisb are very beneficial. Phosphorus should quently a diam is sufficient for short opera. be administered to balance that lost in the tions; (6) the patient should rest a while after rapid metabolism and eliminated by the kid. its administration, as faintness sometimes neys. He reports twelve cases, of whch all supervenes; (7) a mask should be used which showed a decided improvement in the sub- does not receive the drug close to the pajective and objective symptoms.

tient's face; otherwise one is liable either

to freeze the face of the patient, or to Tuberculin in the Treatment of Tuberculo- cause asphyxia by the moisture from the ex. sis—with the Report of 167 Cases.- Pogue pired air freezing on the ganze in the mask, M ed. Rec., Aug. 4, 1906) from a study of and thus preventing the free passage of air to bis series of cases draws the followpg oon. the patient.

Teter Cathone poc., oct uretere wire, at

Infectediving Three night Life

ewis (Medine

GENITO-URINARY.

mately lead to stricture formation. Rarely is

the fold of mucous membrane so extensive as T. A. HOPKINS, M. D.

to require ablation or removal in toto. The Three Ureters Demonstrated During Life;

During Life: two lateral bands become eventually atrophied Ureter Catheterization Giving Three Different

and at a level with the urethral oanal. An. Urines. One Infected with Gonococci.

other method tbut may be utilized consists in Lewis (Med. Rec., Oct., 1906) reports a re.

the dilatation of the urethra either by means markable case of three ureters in one patient:

of a urethral dilator or what is still simpler Three catheters, armed with wire, were suc

with a pair of ordinary dressing forceps cessively introduced into the three ureter

gently introduced and expanded to its utmost openings and pushed up toward the reval re

limit, provided, however, that the cul-de-sac gions, after which two X-ray photographs

is not situated too far posteriorly, severing were taken, with very satisfactory results.

the band by means of a small scissor, and This skiagranh made it evident that the then proceeding in the manner already de. ureter on the right side of the body bad no lineated. connection with the two on the left side. Vesical Tuberculosis.-In a recent address Those of the left side, after leaving their re on the subjeot of vesical tuberculosis before speotive openings at the angle of the trigone, the New York Academy, Pedersen stated (N. run parallel with one another in following the Y. Med. Jour., Oct. 6, 1906) that this was a direction of the pelvio hexagon, and ascended disease of early adult and middle life, more in the manner usually followed by the left frequent in men than in women, and almost ureter. Whether because he did not push it invariably secondary. It was a disputed as far as possible or not, one of the catheters question whether it was secondary to dis. ended at a point something like three inches ease of the kidney or of the genital organs. lower than the other. The two ureters instead It was also a mooted point whether infecof maintaining their relative positions, tion generally took place through the blood crossed one another in making their ascent. or the lymph vessels. No weight was at. The one starting from the median vesical tached to infection by tuberculous urine or opening led to the outer side when it reached semen. Some authorities stated that the the flank, while the ureter that started from urine maintained its acidity, others that it the outer opening crossed and obtained tbe became alkaline. Pus in the urine denoted a median position in the flank. This one was mixed infection. The presence of tubercle infected with gonococci, the other two . hav. bacilli in the urine was the one pathogno. ing been perfectly healthy.

monio sign, but failure to find them was not Urethral Diverticula and Cul-de-Sacs. –

conclusive negative evidence. The diagnosis

was difficult in the early stages, but not so Aaronstamm (N. Y. Med. Jour., Oct. 13.

later. Pain, frequenoy of urination, and 1906) after emphasizing the importance of

hematuria were the cardinal symptoms. Cys. detecting defects of this class states tbat the

toscopy would show patoby byperemia, erotreatment thereof is decidedly simple. It

sions, or ulcerations. Search should be made consists in first discovering the precise loca

for tuberculosis of other organs. A sign of tion of the sao or canaliculus by means of the

some value was the fact that the bladder was uretbroscope, or if this be not available with

intolerant of mild solutions of silver nitrate, a small sound or probe; or a very fine olivary

but this was also true of some cases of vesi. bougie may be used. With the former in

cal calculus. Strong solutions acted favor. position, the lacunar fold is then slit open

ably. It was the consensus that in the with a small knife or tenotome throughout

early stages the treatment should be mainly its entire extent to the very bottom of the

hygienic and dietetio. Creosote and guaiacol urethral mucosa. Or, after the site of the

were good. Instillations were preferred to obannel or sac has been located, a uretbro.

irrigations as a general thing. When the tome may be introduced, and by a sweep of

frequency of urination and the tenesmus the delicate blade the pocket divided Local

could be controlled no longer, the bladder anesthesia usually suffices to accomplish this

should be drained. Kelly exoised the ulresult. As soon as the fold of mucous mem.

cers. The prognosis of vesical tuberculobrane has been severed, this should be fol.

sis was universally conceded to be bad. lowed by the insertion of sounds in ascending sizes until the largest can be conveniently Hypospadias.—Stinson (Jour. A.M.A., Vol. passed, and left in situ for at least ten minutes xlv, No. 23) describes his method of operating each time. This must be continued for a week for hypospadias anterior to the scrotum in or ten days to prevent the too premature clos. the following steps: First, he performs an ure or healing of the divided edges or subse. external perineal urethrotomy and insurts & quent fibrous contraction, which may ulti. large tube into the bladder so that all the

urine will be drained away, permitting the MEDICAL MISCELLANY later plastio operations to heal primarily.. Next he corrects the incurration by dissect. THE RECENTLY ENACTED PURE FOOD ing up the uretbra and dividing all constrict.

BILL. ing fibrous bands by transverse incisions so as tborougbly to straighten the organ. The

The profession is so intimately interested tbird step is to form a new urethra by taking

in the Pure Food Bill and its enforcement flaps from the mucous membrane and submu.

that its reproduction seems desirable. cous tissues of the glands, and if necessary

The following is the full text of the “Act from the skin and subcutaneous tissues also. for preventing the manufacture, sale or transTo cover raw surfaces thug left on the glands portation of adulterated or misbranded or and body, the hood is utilized. Lastly, the poisonous or deleterious foods, drugs, medibump and transverse' constriction on the

cines and liquors, and for regulating traffic upper surface of the body is corrected by

therein, and for other purposes”': making an inch long incision backward Be it enacted by the Senate and House of Repretbrough the skin and subcutaneous tissues sentatives of the United States of America, in in tbe median line. This incision is at right

Congress assembled :

“ Sec. 1. That it shall be unlawful for any perangles to the transverse one made in separat.

son to manufacture within any Territory or the ing the hood and is made long enough so that

District of Columbia any article of food or drug when its angle is dissected it can be drawn which is adulterated or misbranded, within the proforward and sutured in the same line and visions of this act; and any person who shall viocontinuous with the stitching of the prepu.

late any of the provisions of this section shall be

guilty of a misdemeanor, and for each offense shall, tial or transverse incision. This eliminates

upon conviction thereof, be fined not to exceed the convexity by diminishing the antero. $500 or shall be sentenced to one year's imprisonposterior measurement of the penis and over- ment, in the discretion of the court, and for each comes the existing lateral constriction in this

subsequent offense and conviction thereof shall be

fined not less than $1,000 or sentenced to one region by increasing the transverse measure.

year's imprisonment, or both such fine and imprisment to the normal condition. Each of these onment, in the discretion of the court. steps is described in detail, and tbe advan. “ Sec. 2. That the introduction into any State or tages claimed are: the surgery is done at one

Territory or the District of Columbia from any

other State or Territory or the District of Columbia, sitting, and takes but a short time, healing is

or from any foreign country, or shipment to any durable in two to four weeks, the new canal foreign country of any article of food or drugs retains its normal caliber and its coverings which is adulterated or misbranded, within the remain in their new positions. The prelim.

meaning of this act, is hereby prohibited; and any

person who shall ship or deliver for shipment from inary urethrotomy and bladder drainage allow

any State or Territory or the District of Columbia, the plastic surgery to heal without the least to any other State or Territory, or the District of trouble and the results, Stinson claims, are Columbia, or foreign country, and having so rebetter than those of any operation hitherto

ceived, shall deliver, in original unbroken packages,

for pay or otherwise, or offer to deliver to any other described. The deeper structures are sutured

person, any such article so adulterated or misseparately and accurately with buried absorb. branded within the meaning of this act, or any perable sutures so as to get perfect union. Ster son who shall sell or offer for sale in the District of ilized catgut issued for the buried sutures. Columbia or the Territories of the United States

and such adulterated or misbranded foods or drugs, A short account is given of the first operation

or export or offer to export the same to any foreign thus performed and each step is illustrated. country, shall be guilty of a misdemeanor, and for

such offense be fined not exceeding $200 for the first

offense, and upon conviction for each subsequent Anal FISSURE IN INFANTS. — Marfan, ac.

offense not exceeding $300, or be imprisoned not cording to Nouveaux remedes, recommends

exceeding one year, or both, in the discretion of the

court; Provided, That no article shall be deemed that before forcible dilatation of the anus is

misbranded or adulterated within the provisions of resorted to, one of the two following oint. this act when intended for export to any foreign ments should be tried :

country and prepared or packed according to the

specifications or direction of the foreign purchaser (1)

when no substance is used in the preparation or B Petrolatum.......... ... 3j

packing thereof in conflict with the laws of the forExt. belladonna............ gr. viiss eign country to which said article is intended to be Ext. rbatany............... gr. XXX

shipped; but if said article shall be in fact sold or M. For rectal application.

offered for sale for domestic use or consumption,

then this proviso shall not exempt said article from (8)

the operation of any of the other provisions of this B Petrolatum ........

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act. Tannic acid.

.. gr. xxiiss Sec. 3. That the Secretary of the Treasury, the

Secretary of Agriculture, and the Secretary of Com... gr. ivss

merce and Labor shall make uniform rules and reg. _M. For reotal application.- N. Y

ulations for carrying out the provisions of this act, Jour.

including the collection and examination of speci.

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mens of foods and drugs manufactured or offered for test laid down in the United States Pharmacopeia sale in the District of Columbia, or in any Territory, or National Formulary. of the United States, or which shall be offered for “Second. If its strength or purity fall below the sale in unbroken packages in any State other than professed standard or quality under which it is than that it which they shall have been respectively sold. manufactured or produced, or which shall be re "In the case of confectionery: ceived from any foreign country, or intended for "If it contains terra alba, barytes, talc, chrome shipment to any foreign country, or which may be yellow, or other mineral substance or poisonous submitted for examination by the chief health, food color or flavor, or other ingredient deleterious or or drug officer of any State, Territory, or the Disdetrimental to health, or any vinous, malt, or spirittrict of Columbia, or at any domestic or foreign uous liquor or compound or narcotic drug. port through which such product is offered for interstate commerce, or for export or import between “First. If any substance has been mixed and the United States and any foreign port or country. packed with it so as to reduce or lower or injuri.

"Sec. 4. That the examination of specimens of ously affect its quality or strength. foods and drugs shall be made in the Bureau of “Second. If any substance has been substituted Chemistry of the Department of Agriculture, or wholly or in part for the article. under the direction or supervision of such bu “Third. If any valuable constituent of the artireau, for the purpose of determining from such cle has been wholly or in part abstracted. examinations whether such articles are adul- “Fourth. If it be mixed, colored, powdered, terated or misbranded within the meaning of coated, or stained in a manner whereby damage this act; and if it shall appear from any such ex or inferiority is concealed. amination that any of such specimens is adul- “Fifth. If it contain any added poisonous or terated or misbranded within the meaning of other added deleterious ingredient which may renthis act, the Secretary of Agriculture shall cause no der such article injurious to health: Provided, tice thereof to be given to the party from whom

That when in the preparation of food products for such sample was obtained. Any party so notified shipment they are preserved by an external applishall be given an opportunity to be heard, under cation applied in such manner that the preserva. such rules and regulations as may be prescribed tive is necessarily removed mechanically, or by as aforesaid, and if it appears that any of the pro. maceration in water, or otherwise, and directions visions of this act has been violated by such party, for the removal of said preservative shall be printed then the Secretary of Agriculture shall at once cer on the covering or the package, the provisions of tify the facts to the proper United States district this act shall be construed as applying only when attorney, with a copy of the results of the analy- said products are ready for consumption. sis or the examination of such article duly authen. "Sixth. If it consist in whole or in part of a ticated by the analyst or officer making such exam filthy, decomposed, or putrid animal or vegetable ination under the oath of such officer. After judg substance, or any portion of an animal unfit for ment of the court, notice shall be given by publica food, whether manufactured or not, or if it is the tion in such manner as may be prescribed by the pro luct of a diseased animal, or one that has died rules and regulations aforesaid

Otherwise than by slaughter. "Sec. 5. That it shall be the duty of each dis- "Sec. 8. That the term 'misbran trict attorney to whom the Secretary of Agriculture herein, shall apply to all drugs, or articles of food, shall report any violation of this act, or to whom or articles which enter into the composition of food, any health or food or drug officer or agent of any the package or label of which shall bear any stateState, Territory, or the District of Columbia shall ment, design, or device regarding such article or the present satisfactory evidence of any such violation, ingredients or substances contained therein which to cause appropriate proceedings to be commenced shall be false or misleading in any particular, and and prosecuted in the proper courts of the United to any food or drug product which is falsely branded States, without delay, for the enforcement of the as to the State, Territory, or country in which it is penalties as in such case herein provided.

manufactured or produced. "Sec. 6. That the term 'drug' as used in this That for the purposes of this act an article act shall include all medicines and preparations shall also be deemed to be misbranded. recognized in the United States Pharmacopeia or

in the United States Pharmacopeia or "In case of drugs : National Formulary for internal or external "First. If it be an imitation of or offered for use, and any substance or mixture of substances sale under the name of another article. intended to be used for the cure, mitigation, or pre “Second. If the contents of the package as orig. vention of disease of either man or other animals. inally put up shall have been removed, in whole or The term 'food,' as used herein, shall include all ar in part, and other contents shall have been placed ticles used for food, drink, confectionery, or condi in such package, or if the package fail to bear a ment by man or other animals, whether simple, statement on the label of the quantity or propor, mixed, or compound

tion of any alcohol,morphine,opium, cocaine, heroin, 'Sec. 7. That for the purposes of this act an alpha or beta eucaine, chloroform, cannabis, indicaarticle shall be deemed to be ad ulterated

chloral hydrate, or acetanilid, or any derivative or "In case of drugs:

preparation of any such substances contained "First. If, when a drug is sold under or by a name recognized in the United States Pharmaco. "In the case of food : peia or National Formulary, it differs from the “First If it be an imitation of or offered for standard of strength, quality, or purity, as deter sale under the distinctive name of another article. mined by the test laid down in the United States "Second. If it be labeled or branded so as to de. Pharmacopeia or National Formulary official at the ceive or mislead the purchaser, or purport to be a time of inves:igation; Provided, That no drug de foreign product when not so, or if the contents of fined in the United States Pharmacopeia or Nation the package as originally put up shall have been al Formulary shall be deemed to be adullerated removed in whole or in part and other contents under this provision if the standard of strength, shall have been placed in such package, or if it fail quality, or purity, be plainly stated upon the bot to bear a statement on the label of the quantity or tle, box, or other container thereof, although the proportion of any morphine, opium, cocaine, heroin, standard may differ from that determined by the alpha or beta eucaine, chloroform, cannabis indica,

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chloral hydrate, or acetanilid, or any derivative or preparation of any such substance contained therein.

“Third. If in package form, and the contents are stated in terms of weight or measure, they are not plainly and correctly stated on the outside of the package.

"Fourth. If the package containing it or its label shall bear any statement, design, or device regarding the ingredients or the substances contained therein, which statement, design, or device shall be false or misleading in any particular : Provided, That an article of food which does not contain any added poisonous or deleterious ingredients shall not be deemed to be adulterated or misbranded in. the following cases :

“First. In the case of mixtures or compounds which may be now or from time to time hereinafter known as articles of food, under their own distinctive names, and not an imitation of or offered for sale under the distinctive name of another article, if the name be accompanied on the same label or brand with a statement of the place where said article has been manufactured or produced.

"Second. In the case of articles labeled, branded, or tagged so as to plainly indicate that they are compounds, imitations, or blends, and the word 'compound,' 'imitation,' or 'blend,' as the case may be, is plainly stated on the package in which it is offered for sale : Provided, that the term 'blend' as used herein shall be construed to mean a mixture of like substances, not including harmless colorings or flavoring ingredients used for the purpose of coloring and flavoring only : And provided further, That nothing in this act shall be construed as requiring or compelling proprietors or manufacturers of proprietary foods which contain no unwholesome added ingredient to disclose their trade formulas, except in so far as the provisions of this act may require to secure freedom from adulteration or misbranding.

"Sec. 9. That no dealer shall be prosecuted under the provisions of this act when he can establish a guaranty signed by the wholesaler, jobber, manufacturer, or other party residing in the United States from whom he purchases such articles, to the effect that the same is not adulterated or misbranded within the meaning of this act, designating it. Said guaranty, to afford protection, shall contain the name and address o the party or parties making the sale of such article to such dealer, and in such case said party or parties shall be amenable to the prosecutions, fines, and other penalties which would attach, in due course, to the dealer under the provisions of this act.

"Sec. 10. That any article of food, drug, or liquor that is adulterated or misbranded within the meaning of this act, and is being transported from one State, Territory, District, or Insular Possession to another for sale, or, having been transported, remains unloaded, unsold. or in original' unbroken packages, or if it be sold or offered for sale in the District of Columbia, or the Territories, or Insular Possession of the United States, or if it be im. ported from a foreign country, for sale, or if it is intended for export to a foreign country, shall be liable to be proceeded against in any district court of the United States within the district where the same is found, and seized for confiscation by a process of libel for condemnation. And if such article is condemned as being adulterated or misbranded, or of a poisonous or deleterious character, within the meaning of this act, the same shall be disposed of by destruction or sale, as the said court may direct, and the proceeds thereof, if sold, ess the legal costs and charges, shall be paid into

the Treasury of the United States, but such goods shall not be sold in any jurisdiction contrary to the provisions of this act or the laws of that jur. isdiction : Provided, however, That upon the payment of the costs of such libel proceedings and the execution and delivery of a good and sufficient bond to the effect that such articles shall not be sold or otherwise disposed of contrary to the provisions of this act, or the laws of any State, Territory, District, or Insular Possession, the court may by order direct that such articles be delivered to the owner thereof. The proceedings of such libel cases shall conform, as near as may be, to the proceedings in admiralty, except that either party may demand trial by jury of any issue of fact joined in any such case, and all such proceedings shall be at the suit of and in the name of the United States.

Sec. 11. The Secretary of the Treasury shall deliver to the Secretary of Agriculture, upon his request from time to time, samples of foods and drugs which are being imported into the United States or offered for import, giving notice thereof to the owner or consignee, who may appear before the Secretary of Agriculture, and have the right to introduce testimony, and if it appear from the examination of such samples that any article of food or drug offered to be imported into the United States is adulterated or misbranded within the meaning of this act, or is otherwise dangerous to the health of the people of the United States, or is a kind forbidden entry into, or forbidden to be sold or restricted in sale in the country in which it is made or from which it is exported, or is otherwise falsely labeled in any respect, the said article shall be refused admission, and the Secretary of the Treasury shall refuse delivery to the consignee and shall cause the destruction of any goods refused delivery which shall not be exported by the consignee within three months from the date of notice of such refusal under such regulations as the Secretary of the Treasury may prescribe : Provided, That the Secretary of the Treasury may deliver to the consignee such goods pending examination and decision in the matter on execution of a penal bond for the amount of the full invoice value of such goods, together with the duty thereon, and on refusal to return such goods, for any cause to the custody of the Secretary of the Treasury, when demanded, for the purpose of excluding them from the country.or for any other purpose, said consignee shall forfeit the full amount of the bond : And provided further, That all charges for storage, cartage, and labor on goods which are refused admission or delivery shall be paid by the owner or consignee, and in default of such payment shall constitute a lien against any future importation made by such owner or consignee.

"Sec. 12. That the term 'territory' as used in this act shall include the insular possessions of the United States. The word 'person' as used in this act shall be construed to import both the plural and the singular, as the case demands, and shall include corporations, companies, societies, and associations. When construing and enforcing the provisions of this act, the act, omission, or failure of any officer, agent, or other person acting for or employed by any corporation. company, society, or association, within the scope of his employment or office, shall in every case be also deemed to be the act, omission, or failure of such corporation, company, society, or association as well as that of the

"Sec. 13. That this act shall be in force and effect from and after the first day of January, nineteen hundred and seven.

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