Correspondence. the Above Heading, Dr

1526 measles, five from diarrhoea, four from whooping-cough, two and to time, in the following sequence : cessation of night- from "fever," and one from diphtheria, but none from small- sweats, decrease in frequency of respiration and pulse, pox or scarlet fever. These 20 deaths were equal to an annual improved appetite, increase in strength, decrease in amount rate of 2’ 8 per 1000, the death-rates last week from the of expectoration, lowering of maximum and heightening of principal infectious diseases being 1’ 0 in London and 1’ 1 in minimum temperature, and increase in weight. It is note- Edinburgh. The fatal cases of measles, which had been four, worthy that in several instances patients whose condition six, and seven in the.three preceding weeks, further rose last had greatly improved lost ground on ceasing to take week to eight. The deaths from diarrhoea, which had been anarcotine and promptly regained it upon its resumption. I six, five, and four in the three preceding weeks, rose observe the usual hygienic and dietetic rules and give tonics, again last week to five. The 176 deaths in Dublin last cathartics, &c., where I deem them indicated. I hope that week included 29 of children under one year of age and the above statements may soon be tested and verified in 42 of persons aged 60 years and upwards ; the deaths of hospitals. &;c. I am. Sirs. vours faithfullv. infants slightly exceeded the number in the preceding week, JAS. H. FRAZER, M.R.C.S. Eng. while those of elderly persons showed a decline. Five inquest Forest Gate, London, E., Nov. 15th, 1904. cases and four deaths from violence were registered and 64, or more than a third, of the deaths occurred in public institutions. The causes of 11. or more than 6 per cent., of ON THE ACTION OF PERCHLORIDE OF the deaths registered in Dublin last week were not certified. IRON IN BLOOD POISONING AND OTHER DISORDERS. To the Editors of THE LANCET. SiRS,—In THE LANCET of Nov. 19th, p. 1415, under Correspondence. the above heading, Dr. P. W. Latham suggests that the value of of iron in the conditions dis- " Audi alteram partem." perchloride cussed depends on the presence therein of free chlorine THE NEW SYDENHAM SOCIETY’S and he adds that it may therefore be desirable to give chlorine in other forms also. Permit me to mention CLINICAL ATLAS. that there is a form in which chlorine might be adminis- tered which seems to me more suitable than To the Editors of THE LANCET. that which he suggests. I allude to the direct chlor-albumin bodies SIRS,-A letter which you were good enough to publish which have been and and six months for the loan of prepared analysed by Hopkins ago asking portraits illustrating Brook.l These are sufficiently stable to allow of accurate the of variola and varicella was diagnosis, &c., productive dosage and yet contain as much as 6 per cent. of chlorine of such excellent results that I am to make another tempted which they readily yield up. They would be free from the The committee in of our Atlas is now application. charge of chlorine in solution and be far more other with irritating properties engaged, amongst matters, drug eruptions. likely to introduce this element into the circulation. More- Of the iodide, bromicle. chlorals, and arsenical we eruptions over, it is possible that such bodies are actually formed in have abundant but some additional ones material, illustrating the tissues to protect them from invasion, though of the that due to and some others proof quinine rash, copaiba, this is lacking. In a recent paper2 I have collected some would be Most of these rashes are very acceptable, very evidence in support of the idea, already put forward transitory and thus it becomes very difficult for us to procure by Noël Paton, Dunlop, and Macadam,s that the chlorine the aid of our own artists of them. If a by good portraits retained in fever is combined, not with sodium, as case is sent up for a portrait to be done its features are has been universally believed, but with albumin, and usually gone or much altered before the artist gets to work. that the sodium is retained in the blood in Thus it is when have been separately only exceptional opportunities order to raise its alkalescence, there being much evidence utilised that of this class are secured. of good portraits Any that a rise in the total alkalinity of the blood is the natural readers who or know where can your may possess such, they and beneficial response to bacterial invasion. In order to be will confer a favour with obtained, by communicating assist in this process I have the last three years been either or I that during Dr. Colcott Fox myself. May add any in the habit of sodium citrate in acute fevers. the results of the bites of insects will administering drawings illustrating I have not tried using chlor-albumin but have suggested be valued.--I am, Sirs, yours faithfully, that such bodies would have bactericidal JONATHAN probably properties HUTCHINSON, and be formed for this reason. It is Honorary Secretary, New Sydenham Society. may very noteworthy as Simon chlor-retention is 15, Cavendish-square, Nov. 23rd, 1904. that, long ago pointed out, very marked in those septic fevers for which perchloride of iron has been advocated. Here also, as in pneumonia, wherein ANARCOTINE IN THE TREATMENT OF retention is also conspicuous, leucocytosis is highly developed, PULMONARY TUBERCULOSIS. suggesting a possible connexion between the two phenomena. It may be added that both chlor-retention and leucocytosis To the Editors THE of LANCET. survive the fall of temperature and both may be alike absent SiRS,—Acting upon the suggestion of an American col- in cases rapidly fatal where little reaction occurs. Direct league, Dr. L. W. Sterne, I began six months ago to use haloid-proteid derivatives could easily be prepared on a large .anarcotine in the treatment of cases of pulmonary phthisis. scale and they have already been used therapeutically by The results thus far obtained are highly satisfactory and Blnm:! They are worthy of further trial. seem to indicate that this drug acts as a specific ; they I am, Sirs, yours faithfully, certainly justify the claim that anarcotine is a valuable Nov. 22nd, 1904. G. C. GARRATT. addition to the means at our disposal in combating tuber- I culosis, and hence I beg you will find space for this short INTOLERABLE INGRATITUDE. notice. Where practicable I ascertain the maximum diurnal To the Editors of THE LANCET. temperature of the patient and exhibit anarcotine (crystals) SIRS,-Mr. M. M. McHardy has only himself to thank for his in powders with saccharum album as follows : one powder sufferings in a law court. He should have paid no attention eight hours, and one powder four hours before such maxi- whatever to the subpoena and he would have heard no more mum, and one powder at the time of the maximum tempera- of it. In a civil action there is no power to compel attend- ture. Where for any reason I cannot ascertain the maximum ance of a skilled witness, though the counsel and judge may temperature I am guided by the patient’s subjective say nasty things about him. He is, however, liable to have symptoms and administer the drug accordingly, and where an action brought against him to recover damage caused by there is no hectic fever the doses are given at 9 A.M., 3 P.M., his absence, but practically this is never done. and 9 P.M. The dose is one grain and this is increased every I am, Sirs, yours faithfully, fourth day until amelioration is marked; thereafter the Nov. 22nd, 1904. EXPERTO CREDE. doses then given are maintained. Thus far I have not I exceeded three grains three times a day. Larger experience 1 Journal of Physiology, 1897, vol. xxii., p. 184. will show the most advantageous mode-as regards time and 2 Transactions of the Royal Medical and Chirurgical Society, 1904, administration. vol. lxxxvii., p. 125. dosage-of 3 Journal of Physiology, 1899, vol. xxiv., p. 331. The results observed occur, in regard both to constancy 4 Münchener Medicinische Wochenschrift, 1896, p. 1099..

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