DIABETES. — This condition may be suggested by the facies of a case, but the degree of wasting is far greater in ano rexia, and the urine does not contain sugar.
death the body weighed but forty-nine pounds. The brain and other organs found normal. Lockhart Stephens (Lon don Lancet, Jan. 5, '95).
Treatment. — Isolation, hypnotic sug gestion, hydrotherapy, gastric electriza tion,—intra and extra,—gavage, and lay age of the stomach have all proved useful in some cases. But occasionally means fail. In these cases Debove in sists on the necessity of compelling the patient to eat, by whatever means, the appetite returning as the case improves.
Anorexia nervosa in a man, aged 2a years, whose weight was seventy pounds,. in which compulsory feeding was em ployed. The patient, who had been in bed five years, gained fourteen pounds after a month's treatment. Drummond (London Lancet, Oct. 19, '95).
Hypodermic injections of morphine have been recommended, but the danger of producing morphinomania in such cases is very great. This method should, therefore, be used with the greatest of care, and only after all other means have failed.
Prognosis. — Anorexia nervosa but rarely proves fatal. When great debility is reached, manifested by a dry, wrinkled, cold skin; a small, rapid pulse; and a dry, sooty tongue, the likelihood is that death will ensue unless forcible means are utilized.
Two cases ending in death. The dis ease is rarely fatal of itself, death coming on through some other disease. Tuber culosis has been known to supervene in these cases. Nothing prepares the soil better for tuberculosis than anorexia. Debove (Le Progres Med., Oct. 19, '95).
Fatal case, in a girl of 16 years, simu lating diabetes. Urine normal. Up to eleven months before death the patient was a fine healthy-looking girl. After Three cases successfully treated in the following manner, after all other means. had failed: Morphine, about grain, was injected at four-hour intervals, until' three doses had been given, or until was paralysis of the stomach-wall (in two cases three doses accomplished this result). Each patient was told that she would become numb, that her pains would diminish, and that she would he to take and retain the food that would be given to her a half-hour after the injection. The injection should be
given at the same hour each day, and be followed in a half-hour by the admin istration of food, either with gavage or without gavage. The patient should also be assured thLt the food will be retained, and that it will not give rise to pain. After having used morphine in the man ner indicated, these patients become hypnotizable and suggestionab]e in a few days. The diminution of the dose of morphine should be made progressively as soon as alimentation and assimilation have been sufficient to augment the body-weight. S. Dubois (Le Progres Med., Feb. 22, '96).
ANTHRAX.—Gr., eirOput;, a coal. Definition.—A malignant pustule due to infection by the bacillus anthracis, by which, from an infected centre, it may spread over the body or attack the intes tinal tract, resulting in a general infec tion. It is also known as "wool-sorters' disease" in man and "splenic fever" in animals.
Danger lurks particularly in the manes of Russian horses; so notorious is the risk that manufacturers refuse to have anything to do with them. The stuffing for chairs and sofas is another source of infection. When the material has been washed it is usually found to have di minished by 40 per cent. Editorial (Indian Lancet, Aug. 16, '97).
Death of five men in Jefferson County, Pa., due to anthrax derived from hand ling infected hides imported from Asia. The hides had been treated with arsenic and had been washed in a neighboring creek. The trouble may have been due to drinking the water. Several cattle which drank of the water suddenly died. Editorial (Med. News, Sept. 4, '97).
Seventy-two eases of anthrax met with in a factory near Paris where skins are tanned and wool prepared. Skins and fleeces coming from Turkey, Russia, Bul garia, and Argentine are infectious. Of the 72 cases, 62 were cured, giving a death-rate of 14 per 100. Among the hands employed in treating skins there were 57 cases among 560, 15 among 160 workers engaged in preparing wool and tails. Prophylactic measures are of the greatest importance. M. le Roy des Barres (Brit. Med. Jour., Sept. 25. '97).