SUMMER DISEASES OF CHILDHOOD.

Aside from the extreme heat, there is no one factor, perhaps, which contributes so largely to the mortality from these diseases as improper feeding, and as long as there are poverty-stricken parents, ignorant mothers, weakly children, hereditary predispositions-in fact, as long as there are babies to be reared subject to these conditionsthere can be nothing else expected than a high death rate among these children.

It is an easy matter in almost all the so-called cases of cholera infantum, if their history were carefully inquired into, to find that in nearly every instance the starting point of the trouble could be clearly traced to an attack of acute indigestion.

In such cases the stomach is overtaxed and there is increased irritability of the nervous system, which is already showing signs of exhaustion from the effects of high temperature, humid atmosphere, and other depressing influences of the

summer season.

The indications to be met in these cases are to remove the cause and allay irritation. To this end it is best to correct the defective secretion by giving calomel 1-10 gr., bicarb. soda 1-2 gr., sac. lac. I gr., every two hours until the character of the alvine discharges is changed in color or consistency.

When this has been satisfactorily accomplished, it is necessary to allay irritability and restore normal gastro-intestinal secretions, which is best brought about by the following: Maltopepsine (Tilden's) I gr., bismuth salicylate (Merk's) ii grs., given every half-hour until vomiting ceases; then the time may be prolonged to two or three hours, as required.

In view of the large number of antiseptics which modern chemical research has placed at the disposal of the physician-a number which is constantly increasing-the study of this subject is beset with unusual difficulties. As Dr. R. C. Kenner (New Albany Medical Herald, April, 1896) justly says: "To one who surveys the field of therapeutic agents of this class with a pure scientific disinterestedness, the evidence brought forward that any single one is the antiseptic sought for will show that all are wanting in some special quality." It is, therefore, necessary to specialize in the se

lection of an antiseptic; in other words, to choose each antiseptic with particular reference to its special field of utility. On the other hand, before a new remedy of this kind is accepted, it must be shown to possess advantages over the one it is intended to supersede. Thus, for instance, iodoform has enjoyed for many years a prominent place as a local antiseptic, and, in spite of its serious disadvantages, surgeons have been loth to discard it for one of the many substitutes that have been brought forward, until the superiority of the newcomer has been definitely proved. The time has now arrived when it may be confidently asserted that europhen, by reason of its efficiency and freedom from unpleasant or injurious effects, is entitled to occupy the place of iodoform in many conditions in which the latter has been formerly employed. Dr. Kenner testifies to the value of europhen in the following words: "As a local antiseptic it is particularly suited. It has been employed with most satisfaction in the treatment of ulcers, burns, skin affections and venereal sores. This agent belongs to the iodine family, and is akin to iodoform, and applicable in cases in which that agent is usually employed. It is superior to this agent in several respects. It frequently acts as a cicatrizant. It forms a coating by its property of adhering closely to diseased surfaces, which is of especial value. In this way the air is excluded, the surface protected, and healing favored. The use of europhen is not hindered by the very bad odor of iodoform, and then it is not poisonous as the latter frequently proves to be. In many respects it will prove superior to all other antiseptics which have as yet been offered to the profession; but we look upon it only as a local antiseptic having a specific field."

HYGIENIC STOCKING SUPPORTER.

The Comfort Garter is made in fine silk and assorted colors. It is provided on its inner surface with a rubber lining having soft rubber teeth which enter into and engage the meshes of the stocking, and prevent slipping, or stopping the cir culation of the blood, without necessitating the great tension heretofore required in garters. Send for circular to DREYFUS & WATERMAN, 415 Broadway, New York.

A SYSTEM OF CIRCULAR BANDAGING.

BY GEORGE HENRY FOX, M.D.

(Reprint from New York Medical Journal, Nov. 9, 1895.) Sixteen years ago an elastic tubular bandage was first used by the writer and recommended in the treatment of eczema and ulcers of the leg. This was made of pure rubber and drawn over the foot like a stocking leg. Its usefulness was somewhat impaired by the difficulty of applying it, and soon it was found advisable to cut the tube in sections and to make the continuous bandage by allowing each section or broad band to overlap the edge of the adjoining one to the extent of a quarter or half an inch. In many cases of eczema, both acute and chronic, the application of rubber to the affected skin, especially when combined with gentle pressure, will be found to be far more curative in its effect than the ointments commonly em. ployed. This plan of treatment, though an old one, is by no means as frequently employed as its great value would suggest, and it is certain that in an eczema of the leg, for example, a few rubber bands three or four inches wide and of proper calibre are far more readily applied and much more agreeable to the patient than the rubber sheeting or long rubber bandage which is often employed. For patients with leg ulcers who are obliged to be more or less upon their feet, as is the case with the majority seen in dispensary practice, the use of the circular bandage affords a method of treatment which is at once most simple and effective.

In the treatment of leg ulcers the garter bandage will usually insure therapeutic results which are astonishing to those who have pinned their faith to stimulating ointments, dusting powders, and the ordinary roller bandage. The constant pressure exerted lessens the congestion and relieves the pain of an ulcer which is irritable, and quickly flattens out the raised infiltrated margin of a chronic indolent ulcer.

In case of a varicose ulcer healing will often be promoted by the application of a band above or below the knee, thus lessening the downward pressure of the column of blood and consequent congestion of the leg.

But while pure rubber applied to an eczematous surface often produces a most brilliant curative result, it is liable in case of a delicate skin, especially in hot weather, to excite irritation, and hence would be objectionable as a substitute for ordinary bandages. Recently various forms of elastic webbing have been recommended for bandaging purposes and where simple pressure is required; this webbing, being light and porous, has a decided advantage over the pure rubber. The webbing manufactured by the Elastic Surgical Bandage Company (47 Broad Street, New York) is the variety of webbing which I have used with the greatest satisfaction.

Of the use of the elastic webbing in roller form nothing need be said, as the object of this brief paper is to call the attention of the reader to the novel application of this webbing in the form of a circular or "garter" bandage. This can readily be made by cutting the webbing in pieces of varying length and sewing the ends together, thus making elastic bands or broad garters of varying size. With a supply of these at hand almost any part of the body can be quickly, smoothly and continuously bandaged, and any degree of pressure exerted which is likely to be required. The lightness and porosity of the webbing make the circular bandage extremely agreeable to the patient who wears it. Save where the bands overlap at the margin there is but one thickness of bandage, and no ordinary muscular effort

on the part of the patient is likely to cause it to loosen or to move from its proper position.

The accompanying illustration will give a better idea of the circular bandage and its adaptation to various parts of the body than any extended description. Its utility will readily suggest itself, but will be best appreciated after a practical test. In the treatment of skin diseases it will be found of great convenience for the retention of dressings. The steady pressure which it exerts will often greatly enhance the value of an ointment applied to the skin. In varicose conditions of the leg it serves an admirable purpose and is far preferable to the roller bandage or to the ordinary heavy elastic stocking, being readily applied or removed,

In bandaging any portion of the body it is well to have a supply of bands of various sizes at hand. With a tape measure the actual circumference can be ascertained and bands selected of a calibre one or more inches smaller, according to the degree of pressure that is required. They can be quickly removed at any time and readily reapplied by the patient without any special instruction or practice. The sunplicity of this method of bandaging is apparent at a glance. Its therapeutic efficacy can be demonstrated in the conditions already mentioned, and the extent of its application in general surgical practice can only be determined by those who may be led by a suggestion of its use to make a trial of its merits.

A discovery or an invention, no matter how valuable, can only be made beneficial by putting it within the reach of all. With this in view, Messrs. Frei & Co., of Boston, have placed their X-ray apparatus on the market. Amongst them is their Toepler- Holtz machine of a new design, which is claimed to be strongly built and me

chanically perfect in every way. The revolving plate, of hard rubber, is mounted upon ball-bearings, and is easily revolved at a speed of 2,000 revolutions per minute without any perceptible effort. It is said the results obtained with it are really wonderful when compared with the machines used for illustrating lectures in schools, and its practicability for X-ray purposes is demonstrated by the fact that cathodographs of hands have been taken in one minute without the photo screen, and with the screen in a few seconds, fully as good as those taken with high frequency inductive coils costing four or five times as much. Equally good results are obtained with the fluoro

scope.

The Crookes tubes made by the firm are especially designed for their Toepler-Holtz machine, but they also make them for use on inductive coils, and their Bowdoin College type is considered superior to any tube made here or abroad.

"ONE OF THE CERTAINTIES OF MEDICINE."

Belcher Hyde, M. D., of Brooklyn, N. Y., writes: "Antikamnia is an American product, and conspicuous on this account and because of the immense popularity which it has achieved. The literature is voluminous, and clinical reports from prominent medical men, with society proceedings and editorial references, attest its value in actual practice in an endless variety of diseases and symptomatic affections. The fact stands incontrovertible that Antikamnia has proven an excellent and reliable remedy, and when a physician is satisfied with the effects achieved he usually holds fast to the product. Antikamnia is one of the certainties of medicine. This is the secret and mainspring of its success."

VITOGEN

Is a definite and staple compound which, as a local application, is claimed to be unequaled for its curative properties in the following conditions where an aseptic or antiseptic powder is indicated: Lacerated, contused or incised wounds, all forms of skin diseases, cancer, eczema; erysipelas, tineacapitis, porigo, pruritus, lupus, acne, indolent, varicose, granulated and syphilitic ulcers, suppurative wounds, abscesses, chancre and chanchroids syphilitic bubo, fistula, ulcerations of the anus, granular and endocervicitis, simple and specific va

ginitis, leuchorrhoea, and all forms of acute and catarrhal affections of the mucous membranes.

In its wonderful oxidizing powers it is said to be superior to other antiseptic powders.

It is unaffected by light, heat or the alkalies, and is absolutely non-irritating, and is manufactured by the G. F. Harvey Co., Saratoga Springs, N. Y.

THE USES OF PHOSPHOGLYCERATE OF

LIME.

Although discovered by Pelouze in 1846, this salt has not been used therapeutically until last year, when Dr. Robin showed before the Academy of Medicine that it provides the organism with phosphorous in a form identical with that in which it occurs naturally in the organism.

This authority found that it increased the proportion of solids in the urine, giving a powerful stimulus to the functions of nutrition, and from careful clinical observations he deducted that Phosphoglycerate of Lime is useful during Convalescence to restore enfeebled vitality, in Nervous Affections associated with an excessive elimination of phosphates by the urine, and more especially in Neurasthenia.

In Chlorosis, characterized by a lowering of Nitrogenous oxidation, in phosphatic Albuminuria and in the treatment of Cachexia of all kinds. Administered in daily doses of five grains in a case of Addison's disease, it overcame the characteristic debility, and the patient gained seven pounds in weight during twenty days of treatment.

In Ataxia, the Phosphoglycerate markedly diminished the excruciating pains and attenuated the other symptoms, and in Gastric Hyperasthesia, Acute Sciatica and Tic Douloureux it gave most encouraging results.

One of the most remarkable properties of Phosphoglycerate of Lime is its aphrodisiac action on the genital organs, and in debility and decreased vital energy.

This has been especially demonstrated in India, where early marriages and excesses before full development, combined with an exclusively vegetable diet into which very little nitrogenous food can enter, leaves natives of India often almost totally impotent at an age when in temperate climates they would be in their full vigor.

Hydrocyanate of Iron-Tilden is meeting with universal success in the treatment of Epilepsy.

Vol. II. No. 2.

$1.00 a Year. 10c. a Copy.

ANTITOXIN.

We refer editorially to the report of the American Pediatric Society's collective investigation into the use of antitoxin in the treatment of diphtheria in private practice.

The following is a summary of the report:

1. The report includes returns from 615 physicians. Of this number more than 600 have pronounced themselves as strongly in favor of the serum treatment, the great majority being enthusiastic in its advocacy.

2. The cases included have been drawn from localities widely separated from each. other, so that any peculiarity of local conditions to which might be ascribed the favorable reports must be excluded.

3. The report includes the record of every case returned except those in which the evidence of diphtheria was clearly questionable. It will be noted that doubtful cases which recovered have been excluded, while doubtful cases which were fatal have been included.

4. No new cases of sudden death immediately after injection have been returned.

5. The number of cases injected reasonably early in which the serum appeared not to influence the progress of the disease

6. The number of cases in which the patients appeared to have been made worse by serum were three, and among these there is only one new case in which the result may be fairly attributed to the injection.

7. The general mortality in the 5,794 cases reported was 12.3 per cent.; excluding the cases moribund at the time of injection or dying within twenty-four hours, it was 8.8 per cent.

8. The most striking improvement was seen in the cases injected during the first three days. Of 4,120 such cases the mo tality was 7.3 per cent. ; excluding cases moribund at the time of the injection or dying within twenty-four hours, it was 4.8 per cent.

9. The mortality of 1,448 cases injected on or after the fourth day was 27 per cent.

10. The most convincing argument, and to the minds of the Committee an absolutely unanswerable one, in favor of serum therapy is found in the results obtained in the 1,256 laryngeal cases (membranous croup). In one-half of these recovery took place without operation, in a large proportion of which the symptoms of stenosis were severe. Of the 533 cases in which intubation was performed the mortality was 25.9 per cent., or less than half as great as has ever been reported by any other method of treatment.

11. The proportion of cases of bronchopneumonia-5.9 per cent.-is very small and in striking contrast to results published from hospital sources.

12. As against the two or three instances in which the serum is believed to have acted unfavorably upon the heart, might be cited a large number in which there was a distinct improvement in the heart's action after the serum was injected.

13. There is very little, if any, evidence to show that nephritis was caused in any case by the injection of serum. The number of cases of genuine nephritis is remarkably small, the deaths from that source numbering but fifteen.

14. The effect of the serum on the nervous system is less marked than upon any other part of the body; paralytic sequelæ being recorded in 9.7 per cent. of the cases, the reports going to show that the protection afforded by the serum is not great unless injections are made very early.

The Committee feels that this has been such a responsible task that it has thought best to state the principles which have guided it in making up the returns. While it has endeavored to present the favorable results with judicial fairness, it has also tried to give equal or even greater prominence to cases unfavorable to antitoxin.

In conclusion, the Committee desires in behalf of the Society to express its thanks to members of the profession who have cooperated so actively in this investigation, and to Dr. A. R. Guerard for the preparation of the statistical tables.

(Signed)

L. EMMETT HOLT, M.D., W. P. NORTHRUP, M.D., JOSEPH O'DWYER, M.D., SAMUEL S. ADAMS, M.D., Committee.

THE ACTION OF THE SOCIETY UPON THE REPORT.

At the close of its presentation, the Society voted to accept the report of the Committee, and after a full discussion it was decided to embody its conclusions in the following resolutions:

(1) Dosage. For a child over two years old the dosage of antitoxin should be in all laryngeal cases with stenosis, and in all

other severe cases, 1,500 to 2,000 units for the first injection, to be repeated in from eighteen to twenty-four hours if there is no improvement; a third dose after a similar interval if necessary. For severe cases in children under two years, and for mild cases over that age the initial dose should be 1,000 units, to be repeated as above if necessary; a second dose is not usually required. The dosage should always be estimated in antitoxin units and not of the amount of serum.

(2) Quality of antitoxin. The most concentrated strength of an absolutely reliable preparation.

(3) Time of administration. Antitoxin should be administered as early as possible on a clinical diagnosis, not waiting for a bacteriological culture. However late the first observation is made, an injection should be given unless the progress of the case is favorable and satisfactory.