ACUTE GENERAL MILIARY TUBERCULOSIS.
Little can be done for this fatal malady, which usually pursues its course in a few weeks. The treatment must be entirely symptomatic. Fever will call for repeated cold sponging. as the action of the newer antipyretic drugs is too dangerously to the heart to admit of their routine administration. when profuse must be met by Quinine in full doses, which sometimes also checks the rise of temperature liable to follow after the skin action passes off. Dyspncea may be sometimes considerably relieved in the pulmonary form of miliary tuberculosis by the inhalation of Oxygen. Cardiac failure should be corn hated by Strychnine administered hypodermically, and Alcohol may be freely given by the mouth. Vaccine treatment is clearly contra-indicated; it can only hasten the fatal issue. The futility of pouring in antiseptic drugs with the view of destroying the bacilli in the blood or tissues is obvious. Creosote, however, often affords measurable relief by its power
of neutralising the toxins, and it may with advantage be resorted to.
The important consideration of prevention of the attack should never he lost sight of. The general invasion being always the result of the breaking down of an old caseous deposit in some part of the body which causes perforation of a bloodvessel, the importance of dealing surgically ith such foci is obvious, but their removal must be radical, as partial attempts, as in the case of scraping or gouging bone, are liable to cause a fatal general infection. For the same reason a caseating testicle should be promptly removed by radical operation, whilst as a rule indolent lymphatic glands are hest left alone owing to the difficulty of the entire removal of the diseased tissues. These foci are nearly always of bovine origin.