Iehthyol has been personally employed in thirty cases of tuberculosis. In in cipient stages the cough disappears in a few days. If the lesions are more ex tensive it may continue for some weeks or even mouths. Expeetoritions become more liquid and less abundant. All the symptoms are much improved. Twenty to 40 drops of a mixture of equal parts of ichthyol and water should be taken four times daily. A little peppermint may be added. Fraenkel (La Med. Mod.; Med. News, Oct. 30, 97).
Ichthalbin has some properties which make it slightly more acceptable to some few patients than iehthyol.
The large daily doses of ichthyol re quired renders it impossible, on account of the expense, to administer it to some patients, and a good substitute in such instances is kalagua. Kalagua, like ichthyol, changes the character of tuber culous sputa from purulent to mucoid within a short time. It has no dele terious effect on the functions of the stomach. Only small doses, from 4 to S grains, three times a day, are required. After more or less continued use of this drug it becomes necessary to occasionally remit its administration on account of temporary exacerbation of the conges tion in the diseased area, accompanied by pain and ruder respiration.
Codliver-oil and mixed fats are very valuable when they can be assimilated. Milk, referred to under the heading of diet, may also be properly included among the food medicines. Patients should be forced to consume from two to three quarts daily. There need be but few exceptions to this rule.
For the medical treatment of tuber culosis codliver-oil in doses of 1 or 2 teaspoonfuls twice a day, given in ex tract of malt, is recommended. Arsenic is superior to iron. The latter increases the tendency to htemoptysis, and is con tra-indicated in the presence of pyrexia. Zinc oxide, in doses of 5 grains, is of value in night-sweats, and for the cough lozenges of licorice and gum acacia. Dry inhalations arc also useful in check ing cough; a saturated alcoholic solu tion of menthol or a mixture of equal parts of creasote, guaiacol, and spirit of chloroform may be used. Belladonna and codeine may be given for the relief of excessive secretion. Hector Mackenzie (Practitioner, June, TS).
Antitubercle Serum. —For the past eight years investigations have been car ried on looking toward immunizing pa tients against tuberculosis, as well as curing them when once infected. Most
of our experience in this line of treat ment has been with antitubercle serum of the United States Government, from its Biochemic Laboratory at Washing ton. De Schweinitz claims to have pro duced immunity in a few pigs and markedly prolonged the lives of others.
The use of antitubercle serum would seem to be indicated only in incipient eases and in those presenting a pure culture or simple infection. This, of course, refers to those cases which we hope to succeed in curing. In the writers' experience it has seemed, in a few advanced cases, to retard tempo rarily the progress of the disease; it de creased temperature and increased ma terially the strength of the patients.
Generally speaking, the use of anti tubercle serum would seem to be contra indicated in the third stage of tubercu losis, marked cases of softening or ex cavation, those of marked hereditary taint, in cases presenting a very rapid heart-action with relative feebleness of arterial pressure, and in those in whom corpulence, vital capacity, and confor mation of the chest are much below the normal standard; also in cases present ing marked mixed infection.
There is but little, if any, danger at tendant upon the administration of serum if the proper precautions in the way of antisepsis are observed. trrti caria, erythema, and other forms of eruptions; painful swellings at the point of injection; stiffness, pain, and some times swelling in the different joints, especially in patients presenting rheu matic histories; enlargement of the ax illary gland, and myalgia are met with in a small percentage of cases. These symptoms, however, are not dangerous, but annoying, and, even in the small number of cases who present them, are seldom repeated during subsequent treatment.
The advantages of serum treatment are: first, it does not tax the functions of digestion or produce gastritis, diar rhcea, or loss of appetite. Secondly, in cases wherein bacilli have disappeared they have been lost while the sputa were still present. There may be a certain im munity established in patients treated with serum, but it has not yet been proved.