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

REVIEW OF SOUTHERN MEDICAI. LITERATURE. ]71
probably due to the leucocytosis generated
by the horse serum alone that it might be
well to tuni our attention to agents that
have to do with bringing up the white blood
cell number, and then stimulate the white
blood cell, say of the horse, to protection
by injecting dead streptococci—and instead
of trving to get an antitoxin in the serum
of the horse—extract the leucocytes by
centrifugal means, and make an emulsion
of the white cells, for in them we have only
the protective agent against the streptococci.
The same precaution probably would
have to be observed—as in antitoxin, to get
several varieties of streptococci, or probably
by culture media develop ihe streptococci
to its typical long chain-form: all other
varieties being probably lowed in the evolutionary
stage from the sophrophyte to the
obligate micro-parasite.
Mrginia Medical Semi- Monthly, July 9lli,
Treatment oi Consumption.— Dr. W. 11.
Coffman says liiat a patient who is bleeding
freely should be put to bed as soon as
possible, and should be propped straight
up, comfortable, with a bowl or other large
receptacle containing a little water, in his
lap, so that when the gushes of blood come
he may be able to dispose of them with the
least possible exertion. He should be kept
iu bed for at least ten days after the bleeding
is over, because it takes about this
length of time for the organization of the
clot, which is nature's means of stopping
the bleeding. lie should have a small
hypodermic of morphia to control the cough
and the nervousness from which so many
bleeding patients suffer.
Of drugs, nitrite of amyl is probably the
only one that has any immediate effect on
pulmonary hemorrhage. Calcium chloride
is said to be useful in controlling the tendency
to bleed. It may be given in five
grain doses e\ery three hours, until five or
six doses haveVieen given; then, three times
daily for about three days.
Many cases may be controlled by lowering
the blood pressure. This may be done
by giving large doses of epsom salt: also,
by the use of such remedies as veratrum
viride.
In vieiv of the fact that any patient with
an open cavity is liable to bleed, it is well
to have an occasional record of his blood
pressure, so that when he does bleed you
will Ije in a position to know when you
have reduced the blood pressure enough.
Fifteen to twenty points are usually sufficient.
'I'here are, however, a few cases
in which veratrum viride does no good,
that are promptly checked by the use of
adrenalin. It is probably well to restrict
for one or two days after a hemorrhage the
patient's rational food, or, at least, the
fluids.
Etiology and Patbology of Summer
Oiarrbeas ol Children.— Dr. E. P. Torupkins
points out that at one time it was
thought that sterilizing would do away with
most if not all the bad effects of impure'
milk. But sterilized milk is cooked milk,
and Nature never intended babies to live
on cooked food. Heat sufficient to kill
some of the harmful bacteria is sufficient
also to destroy the beneficial ones which
hold in check or destroy the dangerous
ones. Yet this is not all the damage heat
will do, and a lower degree of heat even
than that required to kill the microbes. For
instance, Hippius and Spolverini have
proven the presence, both in mothers' milk
and in cows' milk, of a ferment which is
destroyed or enfeebled by only a moderate
amount of heat. Spolverini says that the
sterilization of milk produces six disadvantageous
changes in it, namely:
First.—It expels the carbonic acid gas
which stimulates the secretion of the gastric
juice.
Second.—Diminishes the amount of lime
and free phosphoric acid, increases the insoluble
calcium phosphate, and precipitates
the anti-scorbutic citric acid.
Third.—Destroys a large part of the lecithin
of the nucleiu.
Fourth.—Coagulates the soluble albumin
and changes and renders unabsorbable the
casein.
Fifth.—Unites the fat globules in larger
masses which are less easily digested and
absorbed.
Sixth.— Destroys or weakens the ferments,
and thus are lost to the child antitoxic
and immunizing compounds of great
value.
Scarlet Fever.— Dr. J. D. Morgan says
that if there is one thing he is positive about
in scarlet fever it is that suitable warmth to
the body and milk diet give the best results.
It was Jaccoud who laid such stress upon
the sole use of milk. There are few or no
cases that do not show a trace or more of
albumin; and time and again the patients
have been given animal broths, eggs, etc.,
only to see the albumin increase. Thompson
regards nephritis as part of the disease,
and urges care in the diet, which should be
milk and cereals for the first three weeks.
K. Oppenheimer warns against allowing
the patient to become chilled. The diet,
he says, is more important than in any
other infectious disease, on account of the
tendency to nephritis. Rubens holds his
patients to strict dietetic measures, avoid-'