Report of Committee on Diseases of Children.

JAY OWENS, M. D., CHAIRMAN.

Your Committee have decided to say a few words concerning the treatment of that most fatal disease of childhood, diphtheria.

This disease has existed in epidemic form, in certain localities in St. Paul, for the past two years; a large percentage of the cases being of the malignant type. At times only a few cases would exist in the city, when suddenly a large number of cases would occur, scattered over different sections of the city, but more thickly over the low and damp districts than the high and dry portions. of the town. In several instances the disease appeared shortly after the overturning of the surface earth for the purpose of paving streets and building sewers. During the paving of Fort street a large number of cases occurred on this street and in the adjoining neighborhoods.

The disturbance of the surface of the street and the exposure of lower layers of the street bed to the action of the rain and hot sun, produced a large crop of diphtheria cases when the Fourteenth street sewer was built.

Owing to the unsettled state of the pathology of diphtheria, the treatment is much diversified. Many of our physicians still adhering to the chlorate of potassa and quinia treatment, while others, believing in the parasitic nature of the disease, adopt measures which seem to them more in accord with their theory.

Among the antiseptics and antiparasitics now employed, carbolic acid and iodine stand prominently in the foreground. It is believed that carbolic acid given internally

in one-half drop doses in combination with the tincture of iodine in from two to ten drop doses, depending on the age of the patient, will very much diminish the danger of septic poisoning in most cases. During the administration of the acid the urine is to be carefully watched, and if it becomes cloudy the acid is to be discontinued and the iodine given alone.

The internal administration of the sulpho-carbolate of sodium is practiced by some with apparent good results.

Dr. Gauthier, late of St. Paul, but now of Grand Forks, Dakota, strongly advocates the administration of Lugol's solution of iodine in doses varying from three drops each hour or two to a child three years of age, to ten or twelve drops every one or two hours to an adult. The medicine to be largely diluted with sweetened water; at the same time giving as large an amount of alcoholic stimulants as the patient will bear.

This treatment is exceptionally successful in the hands of its advocate, but has only given fair results in the hands of some of its adopters. If given freely, this is excellent treatment.

Perhaps one of the very best remedies "to give on general principles" is the oil of turpentine; the dose being two or more drams, in emulsion, for an adult, and a proportionally smaller dose for children; the medicine to be given twice daily. Alcoholic stimulants are conceded by all physicians as being of inestimable value in this disease. Whisky is the one most frequently given. When whisky is not well borne by the patient, a change to brandy or to pure alcohol and water is often found advantageous, the patient sometimes after refusing one form of alcoholic stimulant will take uncomplainingly another form. When the heart shows signs of weakness, the prompt administration of digitalis and strychnia will often enable this organ to recover itself and to change the termination of the case. As much as a dram of the tincture of digitalis

and the one-twelfth of a grain of the sulphate of strychnia have been given at a dose, and repeated every three hours until several doses have been taken in the case of a young adult, with the result of bringing the heart's beats down from one hundred and thirty-eight in a minute to ninety-six in a minute, in the space of twenty-four hours, the patient making a good recovery.

This mixture is best ap

In many cases the mem

As a local application to the false membrane, carbolic acid and glycerine, in the proportion of one to seven, will be found generally satisfactory. plied with a camel's hair brush. brane rapidly becomes white and shrivels under this application when the mixture is used every half hour or hour during the day and at intervals not exceeding two hours during the night.

Tincture of iodine is a good application, as is also the oil of turpentine. Blowing sulphur into the patient's throat will serve to keep the friends of the patient busy, and do the latter no harm.

In cases where the throat is much involved a diet of three parts of milk and one of water, taken in as large quantities as the patient will swallow, is probably the best. Small pieces of ice placed in the patient's mouth frequently, are grateful to the patient, when the throat is much inflamed and the tonsils much swollen.

The preceding is a synopsis of the treatment of the disease considered, and is respectfully offered as the Committee's report.

Report of Committee on Materia Medica

C. G. SLAGLE, M.D., CHAIRMAN.

Mr. President and Gentlemen of the State Medical Society: Your Committee on Materia Medica respectfully submit their report with an expression of regret that it could not be made more full and replete with matter of interest to you. The responses to circulars sent out by the Chairman have been few and brief, and it is much to be regretted that we could not succeed better in awakening more interest among our members in this important field.

That it is a department of our profession somewhat tedious and difficult to explore without time and patient experimentation all will admit, and the ingress of so much new and strange material as has been presented to us within the last few years renders it still more complicated and important; and while we have not succeeded to a very great extent in eliciting an expression from the members in regard to the value of the manifold "New Remedies" which have been recently presented for our investigation, whatever expression we have secured reflects the conservative views of our medical brethren in accepting these new agents cautiously and without an undue enthusiasm.

The few papers which we have been able to secure are hereby respectfully submitted. By your Committee,

C. G. SLAGLE, Chairman.

T. F. QUINBY,

WM. FRISBEE,

D. A. STEWART,
JAMES DAVENPORT.

THE EMPLOYMENT OF ASTRINGENTS IN THE TREATMENT OF ACUTE BOWEL AFFECTIONS OF

INFANTS AND YOUNG CHILDREN.

This seems to be a not uncommon error committed by medical men generally, and appears to be an empiricism or routinism which has been in vogue with many for ages past, and has not yet entirely yielded to the advanced lights of a more rational therapeutics.

If we reflect a moment on the true nature and more common causes of the bowel fluxes of the very young, whether it be any of the forms of diarrhoea or dysentery, and then consider what is really the mode of action of these agents when introduced into the stomach, we will not wonder that any such internal medication must necessarily fall far short of satisfactory results as a rule.

The prime factors of most bowel troubles of the very young are either some form of indigestion or (as a result) morbid and irritating secretions in the alimentary canal.

Will any one contend that "astringents" are capable of either correcting indigestion to any very great extent or alter morbid secretions only so far as some of them happen to possess also some secondary tonic or alterative virtues? Does it not seem reasonable that we can generally better accomplish a cure by mild, soothing laxatives conjoined with carminatives, tonics and antacids, often alternated by mild alteratives, thereby fulfilling the rational indications of treatment predicated on a rational pathology by endeavoring to clear out the irritating matter from the prima via (i. e., laxative); change the secretions to normal (i. e., alterative) and restore the tone to stomach (tonics), correct acidity and quiet pain (opiates and carminatives), and calm nervous irritation (sedatives and nervines). Does not this seem to fulfill the requisites for a rational and successful treatment? Verily, and experience will surely attest it well.