Issue 10, pp. 753-832, October 1861, SMSJ

1861.] Diphtheria. 701water, to "be applied to the throat by means of a brush.In the United States, opinion appears to he divided as tothe best local application. Dr. Blake, of Sacramento, hasfound the greatest benefit resulting from an application ofstrong hydrochloric acid : a view in which he is sustainedby Dr. Bynum and Dr. Thomas, both of whom have hadmuch experience in the treatment of the disease. f Frof.Comegys, of Cincinnati, is in the habit of applying nitrateof silver, either in substance or strong solution in water.Sometimes when the ulcerations are deep, he touches themwith strong nitric acid, by means of a brush. In somecases he lias employed, with considerable benefit, inhalationsof tannic acid dissolved in sulphuric ether, applied bymeans of a cloth wetted with it, to the mouth. J The formulaisIJ-.—Tannic acid, - - f. 5ij-Sulph. ether, - - f. 5j. M.l>r. Jacobi, of New York, who, as physician to the CanalStreet Dispensary, which treats a large number of Germanchildren, has had a very large experience, says:" The local treatment consists of cauterization of themembranes and surrounding parts with the solid nitrate ofsilver, or with strong or mild solutions of the same salt inwater, (5ss-j.: §j ;) of gargles consisting of solutions of (orapplying in substance,) astringents, such as tannic acid,alum, sulphate of zinc, or claret wine ; in gargling with, orapplying such medicinal agents as are known to have someeffect on the constitution and tissue of the pseudo-membranes,as chloride of potassium, chlorates of potassa andsoda, diluted or concentrated nitric or muriatic acids, liquorof sesquichloride of iron, etc. Astringents will preventmaceration, render the exudation dry and hard, and alterthe consistency of the surrounding hyperaemic and (edematoustissue. It will thus prevent, sometimes, the extensionof pseudo-membranes to the neighborhood of the parts alreadyaffected, and in some cases may accelerate the expulsionof the membrane as a whole. We have thus seen thebest effects from tannic acid, either applied directly to theparts by means of a curved whalebone probaug, or dissolvedRanking on Diphtheria.t Transactions of the Third Session ol" the Medical Society of tin- St;it.-of California, p. 108.*Proceedings Cincinnati Academy of Medicine.