indulgence. The glycosuria here results from imperfect nutrition. In many of these cases some hepatic change, increase or decrease in size, may be found. In others cardiac valvular disease may be detected. Some irregularity in arterial tension is generally present in these cases. Some cases of granular kidney are associated with glycosuria. Tertiary syphilis is also frequently found as a cause. Again, in tissue imperfection the storing of sugar in the muscles must be considered, and the author considers it highly probable that muscular degeneration, in and of itself, may result in glycosuria. Several interesting cases are recorded where glycosuria was found in patients suffering from angina pectoris. In his remarks on this disease the author has failed to associate arterial change with muscular degeneration.

Six instances are given where the sudden stopping of the secretion of milk was followed by a temporary glycosuria, being due to the backward flow into the vessels of a large quantity of lactose.

No definition of glycosuria is given, but it is evidently regarded as a condition and not a disease. The author concludes by saying that as albuminuria is not conclusive evidence of Bright's, so glycosuria should not be regarded as always indicating diabetes.

amount.

LACTOSE AS A DIURETIC.

Germain Sée (Semaine Medicale) makes the statement that lactose is a powerful diuretic, increasing the watery flow to an enormous It is recommended by him in dropsical conditions. Only the uncomplicated dropsy of cardiac disease can be successfully treated by lactose. Its action is not so certain where the kidneys are involved. Diarrhoea or perspiration, if excessive, will modify its action. Its use may be continued for eight or ten days. The author asserts that one hundred grammes of lactose will produce enormous diuresis; and will not cause the appearance of sugar in the urine. Milk alone is a diuretic, but it causes a glycosuria. The theory as to the action of lactose is a strange one, and if it be true does not bear out the relation of cause and effect. It is to be used only in dropsies of cardiac origin, and it acts not by increasing blood pressure, but by having a direct action on the renal secreting elements.

PREVENTIVE MEDICINE.

BY E. H. BARTLEY, M. D.,

Professor of Chemistry and Toxicology, and Lecturer on Diseases of Children, Long Island College Hospital.

THE EASY DETECTION OF ADULTERATED BUTTER.

P. Bockairy, in the Bull. de Soc. Chem., 1888, p. 249, describes an easy way of detecting foreign fats in butter. The results are said to be

very satisfactory, and the presence of foreign fats can easily be stated to within ten per cent.

The process is as follows: 15 c. c. (fl.z ss.) of toluol (or benzole) are put into a test-tube, and 15 c. c. of the butter to be examined are added, taking care to melt and filter, or melt and thoroughly settle it beforehand so as to get rid of salt, water, etc. 40 c. c. (fl.3 xj) of ninety-five per cent. alcohol are now added. At the temperature of 18° C. (64.4° F.) the toluol in which the fat is dissolved will be found in a clear layer at the bottom, while the alcohol forms a layer above. Warm the tube to 50° C. (122° F.) by immersing it in warm water, and shake to mix the two layers. Foreign fats immediately produce a turbidity, whereas if the butter be genuine there is no turbidity.

To ascertain whether the butter is pure, it is sufficient to keep it for half an hour at about a temperature of 40° C. (104° F.), after having shaken it well. If the butter is pure, no turbidity, or scarcely any, will be perceived, whereas, when foreign fats are present, there is at first a turbidity, followed by a separation of the liquids. Samples which show a precipitate of about 2 to 3 c. c. in volume are probably adulterated. This is certainly the case when the precipitate is more than 2 to 3 c. c. or more than one-half drachm.

THE DISINFECTION OF FECES.

Dr. C. J. Foote, of Yale Medical School, has recently published (Am. Jour, of the Med. Sci., Oct., 1889) the results of his experimental studies in the sterilizing of fæces.

The object of the experiments was to determine the value of corrosive sublimate as a disinfectant for fæces, and also the value of other disinfectants. The method employed was to mix the fæces with a solution of the disinfectant of definite strength, and after a definite duration of contact, to inoculate culture media with the mixture. The conclusions drawn from the experiments were as follows: The best disinfectants to use are the bichloride of mercury with hydrochloric acid, bichloride with potassium permanganate, and chloride of lime.

Corrosive sublimate alone, even in two-tenths per cent. solution, is unreliable when even as much as a pint to every one hundred cubic centimetres (31⁄2 oz.) of dejection is used. Five per cent. solutions of carbolic acid are unreliable.

The author emphasizes the necessity of thoroughly stirring the fæces with the disinfectant, so as to disintegrate every part of them, and the necessity of allowing the mixture to stand at least four hours before emptying.

For long-continued use, where the dejections are to be thrown into a water-closet, chloride of lime is the most available disinfectant. Solutions of chloride of lime lose their efficacy after a week, and

A freshly made solution is

should be kept in tightly corked bottles. the best.

LIME AS A DISINFECTANT FOR FÆCES.

In 1887, Dr. Liborius, of Kronstadt, Russia, communicated to the "Zeitschrift f. Hygiene" a paper on the above subject. He reached the conclusion that an aqueous solution of caustic lime, of the strength of 0.0074 per cent. of lime, suffices, in a few hours, to permanently destroy the typhoid bacillus, and 0.0246 per cent. kills the cholera

bacillus.

Cholera bouillon-cultures, containing an abundance of fragments of coagulated albumen, were completely disinfected by the action of 0.4 per cent. of pure caustic lime in fragments. Under these unfavorable conditions, the most effective form of the lime was pulverized caustic lime, or a 20 per cent. milk of lime.

In 1888, in the same journal, Dr. Kitasato, of Tokio, Japan, gave the results of experiments in the same direction, performed by him upon the typhoid and cholera bacilli. He states that he found the addition of 0.18 per cent. of lime destroyed the typhoid bacillus in neutral bouillon-cultures. He concludes that caustic lime is a very suitable disinfectant for typhoid and cholera bacilli, as it is cheap and to be found everywhere.

In 1889, in the same journal, Dr. Pfuhl, of Berlin, published the results of his experiments to determine the best form of lime to use in the disinfection of typhoid and cholera stools. He found lime in lumps too slow in its action. He then prepared a milk of lime by slaking fresh lime in four parts of water. This 20 per cent. milk of lime, when added in the proportion of 2 per cent. to typhoid and cholera stools, disinfected them completely.

He recommends the addition of enough of the milk to render the mixture decidedly alkaline to test papers.

In the "Revue D'Hygiene" for 1889, Drs. Richard and Chantemesse publish their results in repeating the experiments of Pfuhl. They confirm his results that 2 per cent. of the 20 per cent. milk of lime was sufficient to disinfect typhoid, cholera or dysenteric stools. It would appear, then, from these experiments that milk of lime is a valuable disinfectant for typhoid stools, and Richard and Chantemesse, in comparing its action with that of corrosive sublimate and chloride of lime, found it much more effective than the former, and more so than even the latter.

Fresh unslaked lime must be used in preparing the milk of lime, and it must be freshly prepared or kept in tightly stoppered bottles. It may thus be kept two or three days without losing its efficacy. "Sanitary Inspector," Aug., 1889.

BY JOSHUA M. VAN COTT, JR., M. D.,

Pathologist and Lecturer on Histology and Pathological Anatomy, Long Island College Hospital; Associate Director of the Department of Histology and Pathology, Hoagland Laboratory; Pathologist to the Brooklyn Throat and Nose Hospital.

ETIOLOGY, MODE OF ORIGIN, AND FORMS OF ACUTE PERITONITIS.

Pawlowsky (Virch. Archiv, cxvii., p. 469), after critically examining the investigations of von Wegener, Grawitz, and Mikulicz, conducted a series of 110 experiments in 13 series. These he divided into four principal groups, as follows:

1. The action on the peritonæum of various chemical substances: (a) ol. crotonis, (b) the digestive ferment trypsin, (c) the chemical products of staphylococcus aureus and streptococcus erysipelatis. In no case did he induce suppuration; either no serious effect was produced, or the animals had hæmorrhagic peritonitis.

2. The action on the peritonæum of various microbes: (d) nonpathogenic, a staphylococcus somewhat resembling S. aureus, and yellow sarcina: these alone and in combination with chemical substances did not induce purulent peritonitis; (e) pathogenic, staphylococcus aureus, bacillus pyocaneus induced fatal purulent peritonitis regularly, the animals only surviving inoculations with exceedingly small quantities of the germs. The purulence of the inflammation was always in direct ratio to the length of the animal's life after the inoculation. In cases running a very short course scarcely any changes in the peritonæum could be noticed; only microscopically was the peritonæum seen thickly covered with microbes, which also had invaded the superficial lymph-channels. P. here remarks the resemblance of the autopsyfindings to those of patients dead of "shock after laparotomy," perforation, etc.

3. Action of the intestinal contents on the peritonæum: deadly when injected unfiltered, harmless when injected after filtration, deadly after six days' sterilization by Tyndall's method.

4. Mixed action of microbes and chemicals on the peritoneum : a bouillon-culture of a pilz which is fatal to rabbits, which had been obtained pure on agar-agar, induced fatal fibrino-purulent peritonitis. Finally (g) staphylococcus aureus in quantity which had alone proved harmless with agar-agar, croton-oil, or trypsin, always proved fatal, and nearly always produced swelling of the spleen and commonly pleuritic effusion. The author believes his experiments indicate, as their practical outcome, the necessity for laparotomy at the earliest possible moment in these cases.

ETIOLOGY OF PERNICIOUS ANEMIA.

F. Müller (Charité-Annalen, xiv., 1889, p. 253) publishes four grave cases of pernicious anæmia, in which examination of the blood showed very significant reduction in the number of red blood-corpuscles (as low as a half million to the c. mm.), while the lessening in amount of hæmoglobin was not proportionally great, so that the corpuscles were all more highly colored than normal. Further, under poikilocy

tosis and microcytosis, the appearance of unusually large nucleated red blood-corpuscles (megoblasts and gigantoblasts), and no increase of white corpuscles. Fever and capillary hæmorrhages were also noted. in these cases. In the first case was found, as in the cases of Reyher, Runeberg, and Schapino, botriocephalus balticus, the expulsion of which, however, came too late to be connected with the eventual consequences.

The other three cases presented undoubted constitutional syphilis, and the author concludes that syphilis may occasionally lead to pernicious anæmia.

TWO FORMS OF AORTIC INSUFFICIENCY.

Hampeln (Petersburger med. Wochenschr., 1889, No. 20) observes the necessity for distinguishing two forms of aortic insufficiency— 1. Primary, following endocarditis.

2. Secondary, occasioned by arteriosclerosis.

The importance of making the two distinct relates to the prognosis which in the first case is favorable, in the second unfavorable, namely, when associated with syphilis or alcoholismus. The differential diagnosis, according to H., is not difficult.

URÆMIA, CEREBRAL ŒDEMA, AND ARTERIOSCLEROSIS IN AN EIGHT-YEAR-OLD

CHILD.

Girode (Rev. mens. d. malad. de l'enfance, 1889, Juin) reports the case of an eight-year-old child, hitherto in good health, who caught cold and was seized with headache, vertigo, colic, and cramps, followed in a few hours by coma, trismus, opisthotonos, tonic spasms, irresponsive pupils, marked salivation, irregular respiration, pulse 66, temperature 41.2° C. Death in twelve hours. The autopsy revealed advanced hypertrophy of left ventricle, mitral valve normal, chronic endocarditis of left ventricle, slight atheroma of aorta at its commencement, nephritis, marked albuminuria, serous intra-meningeal effusion, oedema cerebri.

Microscopically the kidneys showed recent widespread degeneration of the parenchymatous cells in the convoluted tubules, with exudation. into the glomeruli, and chronic changes in the same. The renal vessels and those of the thickened endocardium are in the early stages of arterial sclerosis.