937

complication was thrombosis of the lateral sinus. Purulentmeningitis, in some cases by extension from the bone

disease, in others from rupture of the abscess, occurredseventeen times. In ten cases the abscess burst into thelateral ventricle, and in one case into the fourth ventricle.In one case death was preceded by the bursting of a cerebellarabscess into the ear. Disease of the middle ear and mastoidis more likely to lead to temporo-sphenoidal abscess, of thelabyrinth to cerebellar abscess. This fact may aid in

localising the seat of the abscess, for diagnosis is not muchaided by the seat of pain, and but little by that of tender-ness on percussion. Vertigo and optic neuritis may occurin either form, but disorder of speech, with hemiplegia andhemiparesis, may point to implication of the cerebrumrather than of the cerebellum. Two cerebral cases exhibitedcrossed facial paralysis, which, however, also occurred inone case of cerebellar abscess.

HOSPITAL ABUSE AT BIRMINGHAM.

1HE last two witnesses examined were Mr. tienryGriffith, of the Charity Organisation Committee of Bir- rEmingham, and Mr. T. H. Ravenhill. Mr. Griffith advo-cated the establishment of provident dispensaries. He 81condemned the system of giving hospital letters. Heeulogised the system of provident dispensaries in Man- t(

chester, quoting figures to show how they had reduced c.the numbers of unfit cases from 42’32 per cent. to 6’89.He omitted to mention their faults as regards wage limit,and that the abuse of the dispensaries threatens to be 0

almost as bad as that of the hospitals. Mr. T. H. Ravenhill a

in his evidence described the note system of securing s

medical attendance by the payment of 3s. 6d. a week, and c

said that many medical men in Birmingham adopted it. Heagreed that a vast majority of the patients who went to a

hospitals could afford to pay for medical attendance. He tthought medical aid societies greatly on the increase, 0

started often by agents of infant insurance societies, who tmake large commissions. As to provident dispensaries, s

he said they would get the worst cases, and 3s. a year would inot pay for medical attendance. This is very true, and we Iventure to say that it needs to be impressed on all those ‘who are earnestly trying to make honourable arrangements I

for attendance on the poor. -

A VENEZUELAN PHYSICIAN ON THE TREAT-MENT OF YELLOW FEVER.

A MONOGRAPH on yellow lever, by JJr. lYlanUel Dagninoof Maracaibo, Venezuela, has been published at the ex-

pense of the municipal authorities. In this work theauthor describes his usual method of treating the disease.The first thing to do when any suspicion of yellow feverhas arisen is to soothe the patient’s alarm and put himunder as suitable conditions of temperature, ventila-

tion, &c., as possible. The stomach and intestines are

usually best cleared out by an emetic and a purgativedraught or enema, and a stimulant foot bath given, fol-lowed by massage of the body, and especially of the

parts about the waist, practised with oil and spirit.Sinapisms should then be applied, and acetate of ammoniain considerable doses prescribed. Leeches or venesection

may be required. Pain about the waist, which is frequentlymost distressing, may generally be relieved by dry cupping.A quinine, calomel, and rhubarb pill is ordered every two orthree hours, and cold or iced acid drinks, and no food allowedfor at least three days. In order to combat the black vomitsmall and frequent doses of chlorate of potash with bicarbo-nate of soda are very useful. Lime water with a minutequantity of opium is also a valuable remedy, but creasote,which is sometimes recommended, has not seemed to Dr.Dagnino to diminish, but rather to increase, the black vomit.

After graduating in 1860, at the University of Caracas, hehad no definite ideas on the subject of treatment, andtherefore tried for some time various plans as recom-

mended by well-known authorities with most disappointing-results. Subsequently becoming satisfied that the liver wasthe organ mainly affected, he commenced the routine prac-tice of giving quinine to destroy the virus, and calomel andrhubarb to act on the liver, with the result that for manyyears he lost only from 8 to 10 per cent. of his cases. A fewyears after he commenced this plan he heard that an Englishmedical man in the West Indies had adopted somewhatsimilar methods, giving, however, much larger doses of

quinine than Dr. Dagnino considers necessary. Since theintroduction of antipyrin he has given it alone or combinedwith quinine in cases where the temperature has risen to40° C., as he believes that a very high temperature alone isa fruitful source of accidents in this and all other fevers.

PURE SALICYLIC ACID.

IN the Sheriffs Court of Glasgow a very curious case was.recently heard. A chemist was prosecuted for having soldan ounce of salicylic acid which was not of the "nature,substance, and quality demanded," in respect that " it con-tained 2½ per cent. of cresotic acid, and was therefore soldto the prejudice of the purchaser." The case was wellcontested by the counsel for the chemist, who maintainedthat the article sold was that in universal use, and that it was.

fully up to the standard of the Pharmacopoeia. On theother hand, Professor Charteris was called to give evidence,and he detailed the toxic symptoms produced by impure-samples of artificial salicylic acid, and traced them to,

cresotic acid, of which one grain sufficed to kill a rabbit.Professor Charteris also stated that the natural salicylic-acid cost four or five times as much as the artificial, but.that the purrified artificial acid only cost a penny anounce more than the unpurified. Having thoroughly ven-tilated the matter the prosecution very wisely withdrew,and the Sheriff remarked in concluding the proceedings that,it had been a most useful prosecution, as " showing to theprofession and the public the results of Professor Charteris’s.valuable experiments, and that this article really containedpoison." These facts, however, have previously been laidbefore the profession, and there has not yet been time to.remould the Pharmacopoeia in accordance with them. The-

prosecution is difficult to understand. If intended to react

upon chemists, it is somewhat hard to aim at greater puritythan that advocated by the British Pharmacopoeia; if, how-ever, it was merely intended to show certain "results to the.profession and to the public," it appears to be a somewhat’roundabout way of attracting attention.

DESTRUCTION OF THE TUBERCULAR VIRUS.

SOME interesting experiments bearing on the above subject’are recorded by M. Onimus in the Comptes Rendus forOct. 6th. This observer has attempted-with success-to,destroy the tubercular virus by evaporating volatile oils onincandescent spongy platinum. Sputum, which had beenproved to be tubercular, but which had been submitted to-the vapours of essential oils evaporated in this way, andthen inoculated on animals, failed to produce tuberculosis.The oils were mixed with alcohol before evaporating. Some-of the essences-the oil of turpentine, for example—possessthe disadvantage of emitting black smoke when heated,which rapidly obstructs the pores of the spongy platinum.The oils principally employed were those of thyme, lemon,and eucalyptus, of which the first named was decidedly the-most successful. In another series of experiments naphtholwas added to the liquid to be evaporated, but no advantage-was gained from this. It has long been known that the

essential oils possess an antiseptic action, but this is greatly