Vol. 60, 1909 - University of North Carolina at Chapel Hill

114
THE CHARLOTTE MEDICAL JOURNAL
an iuiportaiil bearing upon the resulting drugs, it is far belter to employ the hot. wet
composite. Free nasal respiration is essen- pack as an aid than to press the use of drugs
tial to their normal growth, and more or to the most heroic measures. The latter
less deformity of these structures accompa- course, so often followed, is what threatens
uies nasal obstruction, especially the high- to bring the most valuable remedies into '
arched palate, narrow alveolus and conse- disrepute. J
quent irregular teeth. Deficient chest de- J
velopment is another sequel of nasal ob- The Alabama Medical Journal, June, 1909.
struclion. A Study in Elioicgy of Typhoid Fever.
Scarlet Fever. -Dr. J. A. Owen believes — Ur. H. Johnston believes that if dust or
that the care of the skin is one of the most soil infection is one of the usual dissemiimportant
points in treatment; and here the nators of typhoid fever we would reason- m
author sounds a note of warning against ably expect to find that children were fre- |
the too prolonged use of emolients, which quently attacked. It is probable that the |
fill up the pores of the skin, prevent it from frequent mildness of the attack or atypical I
performing its normal function, and add to features of typhoid in children allow many j
the strain on the kidneys. cases to escape recognition. But without 1
Oiling of the skin should be limited to the considering this, typhoid in children is not |
eorly days of the disease, thereby hastening, at all uncommon. In the Washington in- ^
and not retarding, desquamation. Forthis vestigation one of the things markedly |
purpose, use eucalyptol, 1 dram, to an brought out was the extreme prevalence of 1
ounce of white vaseline or carbolized oil of typhoid amongst children. There it proved I
cocoa butter, as you may elect. largely a children's disease, and being true j
Special efforts at hastening desquamation jn this instance, under the same careful in- ;
by detaching the skin from the general body vestigation it would probably prove true"
surface do not shorten the quarantine, since elsewhere. If thif frequency of typhoid'J.
the soles of the feet are the last to become fever in children is explainable by a dust V
loosened. This process may be hastened by or soil infection, we would reasonably ex- ^
soaking soles once or twice daily in hot soda pect that in early childhood the sexes would \
solution for ten minutes; then in hot soap be attacked in about the same proportion; ';
suds for equal periods; then rubbing briskly but as childhood advances boys and youths ^
wtth a rough towel. should show a preponderance because they 1
A general warm soap and water bath, would be more liable to such infections
followed by a 1 to 5000 bichloride of mer- than girls and young ladies. The Wash- j
cury bath, should be required before the jngton statistics show that from five to nine i
patient is discharged. years girls are little more often attacked; j
Eclampsia.-Dr. J. W. Hiden concludes f'" ^en to fourteen boys lead; from fifteen j
that the use of morphine in moderate doses, ^^ "'"^*^^" n. proportion to population boys ^
given hvpodermically with veratrum, not are twice as often attackec; from twenty to ;
wenty-four the proportion is almost three ,
Snlv makes the latter drug safer, but ma-
teriallv aids in relaxing the vesical spasms, " °"^ '" favor of the girls. I '"ean^hat
three
thus requiring less veratrum than would
boys are attacked to one girl Thisj,
otherwise be the case. This is of no small
^^^'"^ significant,
import, for, though veratrum judiciously Cholecystitis as a Complication and 'i
administered is unquestionably of great Sequel ol Typhoid Fever.— Dr. E. M. '
value, yet it is equally true that when given Prince points out that the most constant j
in heroic doses, it is a drug to be feared; symptoms of cholecystitis are localized pain, ,f
and, with other aids at our command, he tenderness and tumor. Mayo Robson' claims 'I
sees no necessity for the massive doses that in all gall-bladder inflammation there
which some physicians have advocated, is almost invariably a tender spot at the .
It should also be remembered that morphine junction of the upper two-thirds with the i
is contra-indicated in only rare cases of lower third of a line drawn from the ninth
puerperal eclampsia, namely, those due to rib to the umbilicus. The pain tua3^ howan
interstitial nephritis. When the pulse ever, be referred to the epigastrium and
has been reduced within safe bounds by the vermiform appendix. The onset is usually
combination of morphine and veratrum, a sudden and chills and vomiting may be i
mixture containing potassium bromide, present. In febrile cases there may be a ?
chloral and veratrum, given in moderate rise in the temperature. If the fever has j
doses at staled intervals, is better than to already subsided, the temperature may jump 'v
rely on one drug only, especially so when up very suddenly. A leucocytosis of 10,000 \
this is a powerful cardiac depressant. to 15,000 is usually present. Jaundice is j
When we find the convulsions are diffi- seldom present, unless there is an extension J
cult to control with the conservative use of of the inflammation to the cystic and com-