1408

Two days more of the treatment. served to effect a morepermanent cure. Notwithstanding the observations ofMM. Hayem and Lesage on the value of lactic acid in thediarrhoea, with green stools of young children (see TnELANCET, voL i. 1887, p. 1149, and vol. ii. 1887, p. J020),according to whom lactic acid destroys the bacillus on whichthe condition depends, this medicament is rarely used, and,indeed, is not generally known tJ have any effect on

infantile or other diarrhoea..

WIRING THE SPINOUS PROCESSES INPOTT’S DISEASE.

Ttirs procedure is recommended by Dr. Hadra of Chicagoas a means of securing immobility of the spine in diseasedcondition!’. Dr. Hadra used it once as a means of fixing afractured spine, and he now recommends it as worthy of atrial in other diseased conditions in which it is desirable tosecure the spinal column in a condition of rest. In this wayhe thinks the vertebral bodies will be prevented from press-ing on each other, and so it may possibly prevent permanentdeformity. If, however, an abscess cavity has alreadyformed, the surgeon will have to decide whether it is toolarge to be filled up by new bone formation. If it is, it hadbetter be left alone. Of course the difficulty will be notonly to discover whether there is a large abscess cavity,but whether there is one at all. The operation, how.ever, seems to be a simple one, and it does notexclude other and subsequent means of relief. Itis carried out as follows: A median skin incision ismade over the prominent spinous processes; the longmuscles on either side are incised longitudinally, and re-tracted su fliciently to allow of a good view of the outlines ofthe spines; then the silver wire is carried on a strong needlethrough the interspinous spaces above and below the pro-cesses as often as is deemed necessary, and the ends of thewue twisted. In lumbar operations, simple instead of

figure-of-eight loops are sufficient, as the processes standout almost horizontally. The operation is not difficult, andwith careful asepsis should be without -danger, and it maybe found to be an important aid in securing the physio.logical rest so necessary in these cases.

THE TREATMENT OF SCLEROSIS OF THEMIDDLE EAR.

DR. LOEWENBERG publishes in the Deutsche MediciniseheWochenschrift a contribution to the treatment of sclerosisof the middle ear. While fully acknowledging the goodeffect of inflating the drum with air or vapours in catarrh orpuriform inflammation of the middle ear, though denyingthe importance of occasional distensions of the sound con-ducting apparatus during the treatment, he advises theavoidance of immoderate pressure or of undue interferencewith the proper balance of the various parts of the organin the treatment of sclerosis. He recommends the exclusiveuse of the catheter, which admits of a free regulation ofpressure. The patient must at the same time hermeticallyclose the ear with his finger, and so decrease the tension ofthe drum outwards. In cases where it is necessary to

allow the patient to treat himself, he should also himselfapply Pulitzer’s method, as he can best obtain by practicea knowledge of the necessary pressure. He must, however,get another person to close his ears during the inflation, unlessan apparatus is used which Dr. Loewenberg himself con-structed in the year 1884. It consists of a ball, with one ortwo tubes having olive-shaped ends, which fit tightly into oneor both meatu?. In discussing the choice of remedies to beintroduced by means of the catheter, he utters a warningboth against the moist vapours of water and other fluids, andagainst the dry vapour of iodine. He considers the coldvapour of iodine, mixed with atmospheric air, valuable.

This may be guided into the ball by aspiration from abottle containing crystals of iodine. Dr. Loewenberg alsofound the vapour of bromide of ethyl especially useful incases of subjective noises. In conclusion, be calls attentionto a symptom which he observed so regularly that he dependson its diagnostic and prognostic value. Patients sufferingfrom sclerosis have a sense of warmth, and even complainof a feeling of burning during the inflation of the vapours ofether, chloroform, or bromide of ethyl ; while those whosuffer from other diseases of the ear have, on the contrary,a sense of cold during the administration of these remedies.

ENTERIC FEVER IN ROTHERHAM ANDRAWMARSH.

IN the interests of the consumers of the water supplied toRawmarsh and other places as well as to their own boroughby the Rotherham corporation, we very much regret theattitude adopted by the chairman of the Health Committeein dealing with the recent serious prevalence of enteriefever which has had its special incidence on consumers ofthat water-supply. Dr. Picken performed his obvious dutywhen he pointed to the relation existing between theuse of that water and the prevalence of the disease;he served Rotherbam, equally with Rawmarsh, whenhe pointed out the grave defects attaching to that.water-service by reason cf the sewage and excrementalfilth to which it was exposed ; and even chemical analysis,which can admittedly not speak of safety and wholesome-ness as to water, bore out his views, for the results obtained!by the county analyst were suspicious in the extreme. Andyet the chairman refers to all this as "trailing a red herring,across the path in order that he [Dr. Picken] might detract.from ’what was the real cause." One of the most significant,points in the reports and speeches of thoe who profess not,to believe in water pollution as a cause of this epidemic has.been their utter inability to suggest any other intelligent ex-planation of the marked peculiarities of its incidence. It is

nothing that one chemist should find no chemical evidenceof pollution of an individual sample, especially when itis remembered that the albuminoid process, when applied towater deliberately polluted with a nitrate of typhoidevacuations, once led te the sample being classed as of 11 ex-traordinary organic purity." Even if chemistry had the powerof detecting disease organisms, many a sample might betaken from a reservoir in which the typhoid poison waspresent without any morbid particles being included, butthat would be no proof that other samples might not containthem. For the credic of Rotherham, and in the interests ofthe consumers of this water, it is sincerely to be hoped that,whatever may be said on the subject, the action taken wilLbe on the lines indicated by Dr. Picken.

CEREBRO-SPINAL SCLEROSIS AND THE ACUTESPECIFIC FEVERS.

I IN an article in the CorrespondenzBlatt fiir Schweizer’Aerzte, of which an abstract appears in a recent number ofthe Centralblatt fur Klinische Medizin, Dr. Nolda directe.attention to the occurrence of cerebro-spinal sclerosis inchildren and the relation which it bears to acute infectiousdisease. The disease as it appears in children does notdiffer materially from that in adults, except that symptomscome on more quickly and that it runs a more rapid course.Out of seven cases to which he refers, in six the onset ofthe condition was preceded by an acute infectiousdisease, and in five of them the first symptoms hadmanifested themselves so soon after the acute illnessthat it is reasonable to conclude that they dependedupon it. In the sixth case the onset of the symptoms ofsclerosis was not Evident until several months after theacute illness. In only one case of the seven did the onset