39

wing of the Middlesex Hospital on Thursday afternoon,July 15th, at 5 P.M.

-

THERE is no foundation for the statement that Mr. MayoRobson contemplates resigning his hospital appointment atLeeds and removing to London.

Pharmacology and Therapeutics.THE ELECTRIC LIGHT IN RHEUMATISM.

DR. KOZLOVSKI, a St. Petersburg physician, publishes in theVrach (No. 14, 1897) an account of his method of treatmentof rheumatism and neuralgia by means of exposure to theelectric arc. He was induced to make these observations bythe statement of Dr. Ewald, who is medical officer to somelarge ironworks, that he had noticed that since the intro-duction of the system of electric welding there had been anotable diminution in the number of cases of rheumatism,neuralgia, migraine, and other nervous diseases among theworkmen, which he attributed to the beneficial effect of theelectric light. In order to bring this therapeutic agent withinthe reach of ordinary patients Dr. Kozlovski has fitted upconsulting - rooms with a suitable plant for producingthe electric arc, which consists of a six-horse-poweroil engine, a dynamo, thirty-five Tudor accumulators, arheostat, ampere-meter, and electric arc lamp with reflector.With these he obtains an electromotive force of 50 or 60volts and a current of from 250 to 300 amperes. The patientis placed at a, distance of one and a half metres from the lightand protected by blue spectacles and also by a screen ofcardboard in which an aperture is cut to allow the light tofall on the affected region of the body. To this it is exposedfor from three-quarters of a minute to two minutes. At thetime the patient feels a slight sensation of heat, though thetemperature is never raised more than 4° F. where the lightfalls on the skin, but nothing more until six or eighthours afterwards, when itching and tingling are felt andthe skin becomes reddened. Some forty-eight hourslater desquamation occurs, which lasts for two or three days.In the course of three months Dr. Kozlovski has treatedthirty-eight patients, varying in age from thirteen to seventyyears, by the electric light. There were eight cases ofsciatica, all of which recovered; four of neuritis (locality notstated), two of which recovered ; eighteen of chronicrheumatism, fourteen of which recovered ; three of lumbago,all of which recovered ; three of occipital neuralgia, ofwhich two recovered ; and two of trigeminal neuralgia, oneof which was greatly benefited. In most cases three or foursittings produced an amelioration of the pain. They werecontinued at intervals of three or four days, according to theamount of cutaneous irritation, but the total number ofsittings never exceeded a dozen.

PICRIC ACID IN ECZEMA.

Picric acid, which, as is now known, is a very useful appli-cation in burns, has also been employed with success ineczema by M. Grange and by Dr. W. Maclennan. In a recentcommunication to the Paris Societe Médicale des -U6 p ita?tx,Dr. Gaucher reports very favourably of it. He employs a 1per cent. solution to paint the affected spots, which he thencovers with a compress soaked in the same solution, leavingthis on for two days at a time. He finds that the irritation isrelieved and that the surface becomes more healthy. Thismethod is applicable only to moist varieties, not to acute orto chronic lichenoid eczemas. He thinks also it would bevery suitable in many other moist affections of the skin, suchas pemphigus. It should be observed that Dr. Maclennandealt with acute cases, and employed a saturated solution.

AIROL IN LEPROSY.

An Italian physician, Dr. Fornara, of Taggia, reportla remarkable improvement in a case of typical leprosy o:

five years’ standing, consequent on the use of airol duste<on the ulcers and open abscesses, together with s10 per cent. vaseline ointment applied to the conjunctiveand injected into localities where softening had commenced. Tonics were also prescribed and general massagwas practised, and at the end of a couple of months thnodules disappeared or diminished considerably in size, thconjunctive regained their normal appearance, the hai

reappeared, and the cutaneous sensation returned. Th

drug was well borne, but the gums became discoloured b,

the bismuth in the airol, and when very large doses weregiven a certain degree of prostration was observed.

EUCAINB B IN OPHTHALMIC PRACTICE.

According to Dr. Silex, of Professor Schweigger’s oph-thalmic clinic, Berlin, the so-called eucaine B, which is, ofcourse, closely allied to the older eucaine or eucaine A, hassome advantages over the latter as well as over cocaine andtropacocaine-to which it is also closely allied-in oph-thalmic practice. First of all, it is very much less toxic thanany of these substances. Its hydrochlorate stands boilingmuch better than that of cocaine, thus rendering sterilisation,more simple. The hydrochlorate is soluble in water to theextent of 5 per cent. at ordinary temperatures, and it doesnot irritate the eye as eucaine A often does. Two drops of a1 per cent. solution induce in from one to three minutesanaesthesia of the cornea which lasts for a quarter of anhour. In about half the cases examined hyperaemia.was observed in the conjunctiva, which, however, didnot distress the patients at all, and which was inmarked contrast to the an&aelig;mia usually caused bycocaine. The pupil was unaffected in diameter, the sphincterreacting promptly ; the power of accommodation, too,remained intact. No diminution of tension in the eye-ball as sometimes noticed with eucaine A could be detected.In the treatment of foreign bodies in the cornea, corneal,

ulcers, interstitial keratitis with great irritation, episcleritisand iritis, cocaine appears as suitable as eucaine B ; indeed, -more so in affections such as iritis in which there is hyper-&aelig;mia of the anterior half of the eye. In cataract operationseucaine B is perhaps better than cocaine, as it is often ofadvantage to have a normal pupil during the operation. Six

drops of the solution are instilled about ten minutes beforethe operator is ready. It may be remarked also that,eucaine B is cheaper than cocaine, so that in hospital practiceit is not unlikely to be preferred in suitable cases.

INJECTIONS OF IODINE IN TUBERCULOSIS.

Campanini gives an account of several cases of Durante’smethod of treatment in cases of surgical tuberculosis. Twocases of joint disease in which cures were obtained are espe-cially mentioned. In one of these fifty-three and in theother forty-five injections were given, some of which wereintra-muscular and some intra-articular. Good results werealso obtained in cases of tuberculous glands, especially thosewhich were not associated with any suppurative periadenitis.Lupus, tuberculous orchitis, and epididymitis have all beentreated with this method, and two cases of tuberculous peri-tonitis are also said to have improved under it.

EUCHININ AS A SUBSTITUTE FOR QUININE.This substance, which is said to have the therapeutical

qualities of quinine, occurs in fine white needles which meltat 95&deg; C. and are easily dissolved by alcohol, chloroform, andether, but dissolve with difficulty in water. It forms salts,of which the muriate is easily soluble in water, whilethe sulphate and tannate are much less so. The advantageswhich this drug is said to have over quinine consist in thefacts that it is almost tasteless and that it does not produceany headache, noises in the ears, &c., which quinine is aptto do. Clinically it has been used in the same classes ofcases in which quinine would be applicable, and it is statedthat healthy persons can usually tolerate from fifteen tothirty grains without any ill effects. Chemically the drug is

, closely allied to quinine, and it is prepared by the action of, chlor-ethyl carbonate upon quinine.

LYCETOL AS A SOLVENT OF URIC ACID.

. Since the discovery of the all-important part which the

: presence of uric acid plays in health and disease there hasbeen a constant endeavour to find a drug which will

promote excretion of this substance when its presencein the body is causing unpleasant symptoms. Oneof the last of these solvents is named "lycetol."

9 Lycetol is the tartrate of dimethyl-piperazine, andf as such it will be seen that it is closely allied to

1 piperazine, which is also claimed to have a definiteisolvent action on uric acid. It is a white powder, easily soluble in water, and possessing a pleasant acid taste. The- administration of this drug is said to be immediatelye followed by an increase of the amount of uric acid in thee urine, while the actual quantity of the urine is increasede and the specific gravity lowered. Dr. R. de Jollenaerer reviews the action of this drug in La Belgique M&eacute;dicale,e and he considers that without being considered a specific,lycetol none the less must be regarded as a valuable help

40

in the treatment of chronic gout and rheumatism ; for underits influence there is often a rapid diminution of pain,accompanied by an increased flow of urine.

AMYLOFOBM AND DEXTROFORM.

A new substitute for iodoform has recently been preparedby Professor Classen, of Aix-la-Chapelle, which he names"amyloform," and which consists of a combination of

formaldehyde with starch. It occurs as an almost impalpablewhite powder, devoid of all smell and insoluble in ordinarymenstrua. In contact with the tissues of the living body,however, it breaks up, and when it was applied to extensivesuppurating wounds formaldehyde could be detected in thepurulent discharge. At the same time the urine was provedto be quite free from it by distillation with dilute sulphuricacid and the addition of fuchsin sulphurous acid, so thatwhatever formaldehyde enters the system must be fullyoxidised therein. However much amyloform is applied notoxic symptoms are produced, though a slight and transientsmarting sensation is sometimes complained of locally. Theclinical effect of the substance is very similar to that ofiodoform, only it is frequently more pronounced. In a num-ber of cases of deep wounds with suppuration of bonefrom osteomyelitis or tubercle a quantity of the powdervery liberally applied caused the suppuration to cease in avery short time-in some instances where iodoform hadpreviously been tried without much result. In varicoseulcers of the leg and in the primary sore of syphilis, amylo-form also proved useful. The above clinical observationswere made by Dr. Bongartz in the Mariahilf Hospital, Aix-la-Chapelle. It has been mentioned that amyloform is in-soluble, but a very similar substance has been prepared fromdextrin instead of starch, which Professor Classen calls"dextroform," and this is dissolved without much difficultyby both water and glycerine. Its five, ten, or even twenty percent. solution has proved very useful, as in injection in

gonorrhoea, and the two former of these solutions have beenemployed with success for washing out the cavity of anempyema. Internally the solution has been prescribed withadvantage in a case of cystitis.

The Lancet Special CommissionON

SICILYAS A HEALTH RESORT.

III.1

Comparative Meteorology and Olintatologn nf Sicily -Contrastbetween Sicily and (1) Bournemouth, Ventnor, and Torquay ;(2) Nice, Mentone, and San Remo ; (3) Cairo ; and (4)Orotava, Canary Islands.-Tke Sicilian Flora and itsRelation to Climate.--Experiments in Acclimatisation atPalermo.

To complete the survey of the meteorology and climatologyof Sicily it will be instructive to institute a comparisonbetween that island and some of the most favourite healthresorts of the world. For the purposes of this comparisonthree of the best-known British resorts will be selected-viz.,Bournemouth, Ventnor, and Torquay; three of the best-knownRivieran resorts-viz., Nice, Mentone, and San Remo ; Cairo,as representative of the North African sanatoria ; and Puertode Orotava, Teneriffe, as representative of the CanaryIslands. It would be easy to enlarge this list, but the

exigencies of space place a limit to the range of the survey.As differences, usually slight, but some’imes material, exist inthe figures of the meteorological tables furnished by differentauthorities, it may be well to indicate the writers who havebeen chiefly relied upon to furnish the data for the followingcomparisons. For the British resorts "The Climates andBaths of Great Britain," being the report of a committee ofthe Royal Medical and Chirurgical Society of London, 1895,has been exclusively relied on. For the Riviera the well-known works of Sparks, Marcet, Bennett, and Hassall have

1 Nos. I. and II. were published in THE LANCET of June 5th and 12th,1897, respectively.

been consulted. Sand with has supplied the figures for Cairoand Samler Brown those for Orotava. The authorities forSicily have already been fully indicated. Before entering uponthe following comparative survey it should be rememberedthat comparisons between different health-resorts are difu-cult, and unless made with great caution may be entirelymisleading. Climate is a very complex affair, and twosanatoria cannot be fairly compared with regard to oneclimatological factor without having regard to the others.Thus, if two localities are compared with regard simply toconsiderations of temperature, the comparison will possessa certain value, but that value will be very limited becausethe comparison will ignore such vitally important points to theinvalid as amount of sunshine, proportion of fine days, amountof rainfall, and character of the prevailing winds’. Again, acertain locality may be pre-eminent from one point of view, butquite deficient from another. The island of Monacb, in theHebrides, has one of the most equable climates in the world;but the amount of rain and cloud and the deficiency insunshine render it useless as a health resort. At Luxor, inUpper Egypt, there is practically no rain, and the sky duringwinter is usually cloudless; but as a set-off to these greatadvantages the daily range of temperature is very high anddust-storms from the desert are a serious annoyance.Syracuse has a bright, sunny, equable climate, but thefrequency of high winds mars its utility as a health-resort.In fact, as Fonssagrives remarks,2 "Les climats, commeles caract&egrave;res, ont les qualites de leurs d&eacute;fauts, et lesd6fauts de leurs qualit&eacute;s." In other words, the value of ahealth resort must be gauged, not only by its merits, but byits defects and by a judicious appraisement of its toittensemble of meteorological characteristics.

1. Sicily as compared reitlt the cliief Britisit resorts.-Themean temperature for the whole year at Bonrnemouth is49 7&deg; F. ( = 9 83&deg; C.) ; at Catania 644&deg; F. ( = 18&deg; C.) ;the mean at Ventnor 50 8&deg; F. (== 10 44&deg; C.) ; at Palermo64 6&deg; F. ( = 181&deg; C.) ; and at Torquay 49.4&deg; F. ( = 9 66&deg; C.).The temperatures for the winter months at the three Britishresorts and at Catania and Palermo appear in the followingtable :-

Dr. Sparks, in his work on " The Riviera," says (p. 2) : Onthe whole, it may be stated without much want of accuracythat the mean temperature of the Riviera in the winter andspring is from eight to ten degrees higher than that ofEngland." It would appear from the above table that themean temperature of the Sicilian resorts in the winter andspring is from eleven to fifteen degrees higher than that ofEngland, and consequently from three to five degrees higherthan that of the Rtviera. The contrast between the Britishand the Sicilian resorts with regard to the relative humidityof the air is, as might have been expected, great. The

figures are as follows :-Torquay ......... 82-3 per cent.Ventnor ......... 81-0 "

Bournemouth ... 77 7 " Saturation = 100 per cent.Palermo ......... 654 4 "

Catania ......... 610

Not less striking is the contrast between the British andthe Sicilian resorts as regards the proportion of rainy daysin the year. The following are the figures: Torquay, 187rainy days per annum ; Ventnor, 164 ; Bournemouth, 158’3 ;Palermo, 116 ; and Catania, 86.The returns from the British resorts do not state the

number of days of frost, fog, or high winds, so that anycomparison under these heads is impossible. It may, how-ever, be borne in mind with advantage that at Palermo thethermometer touches freezing point about two or three times

2 Article, Climat in the Dictionnaire Encyclop&eacute;dique des SciencesM&eacute;dicales. Paris, 1878.