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To-day the nurse noticed some egg which patient had eaten come out through the tube, Otherwise patient is doing well.

Percentage of albumen in urine somewhat less.

28th.-Milk and food taken escapes through the tube freely. A drink of milk excites a fit of coughiug, and then the milk streams out through the tube. Introduced to-day a new tube with a fenestrum in it. Opening of tube was closed by a cork, and the patient breathed through the natural passages, but with great diffculty, for about 15 seconds. Urine high coloured. Albumen almost disappeared. No casts to be seen with the microscope.

Temperature suddenly went up yesterday evening, from 98° to 100° F. Pulse 124 ; respirations 36.

29th.-Ordered to be fed in the recumbent posture, and it is found that not so much food escapes through the tube in this way. After several successful trials of the power of breathing, per

vias naturales, the tube was removed and left out. Patient speaks now more distinctly, but still in a whisper. A rather copious eruption of varicella came out to-day all over the body, explaining the sudden rise of temperature. Urine contains about 25 per cent. albumen. Temperature 101.2° F. Pulse 125; respirations 40.

February 1st.- About 4 p.m. yesterday patient was suddenly seized with vomiting, became very faint, surface and extremities grew cold, the breathing became hurried, and the face livid. By applying warmth to the body, and giving stimulants internally, he rallied in about 45 minutes.

He had a tolerably fair night after this attack. He is not so well this morning, and has had a spell of rapid breathing, (80 per minute), again.

2.00 p.m.—Breathes nicely now, and is much better. As the food taken by mouth still continues to escape through the tube in considerable quantities, enemata of beef-tea and brandy every four hours were ordered in addition. The enemata are well retained. Has some retention. Has only passed 4 ounces of urine during the last twenty-four hours. It contains about 10 per cent. of albumen. Some of the varicellar vesicles are matur


ating while others are coming out. Temperature 101° F. Pulse 120. Respirations 40. From this time until complete convalescence was established, the temperature was normal (989 F.) Pulse ranged from 110 to 120, and the respirations from 36 to 40.

5th.Complains of pain in the back of the head, and for the last few days has had pain in the lower limbs, and some numb

Still suffers from some retention. Eruption of varicella has disappeared. Takes food by mouth much better, it does not excite so moch coughiny. To have an enemata only every six hours. Wound healthy-looking.

10th.—The patient is doing very well, no more food passes through the opening in the trachea. Wound doing nicely, and is strapped with adhesive plaster.

Retention has passed off, urine still contains a small percentage of albumen. 18th.-Allowed to sit up. Wound healing nicely. 25th.- Patient was taken home by his parents to-day.

30th. After he left the hospital the wound healed rapidly, but for a long time the little fellow suffered from a hoarse barking cough, which was much worse at night. Loud rhonchi were heard over the root of both lungs behind during this time. The voice continued husky for a long time after the external wound had completely closed. For the first four weeks after he left the Hospital he improved in general health but slowly, but after that he picked up wonderfully, and is now quite fat and well in every respect

This adds one more case to those already published of the success attending the performance of tracheotomy in laryngeal Diphtheria. The case was most urgent, the symptoms at the outset were severe and pronounced, the results most gratifying. As it is the rule in practice, one closely followed in this Hospital, to open the trachea whenever, from extension of the disease, implicating the larynx, the life of the patient is threatened, we may reasonably hope that ere long other successful cases will be chronicled.

Reviews and Potices of Books.

The Physicians' Visiting List for 1879.—Twenty-eigbth year

of its publication, well bound in leather, with tucks, pocket and pencil, Philadelphia : LINDSAY & BLAKISTON.

We have received a copy of the Physicians' Visiting List for the

year 1879. It comes to us in the same familiar form like an old friend with a new garment, and as full as ever, with all the requirements needed by a physician in a work of this kind.

We have seen many other somewhat similar lists, but this, “ The Physicians' Visiting List " is the parent of them all, we have become accustomed to its use and could ill be without it. These lists can be had of any bookseller to supply space for 25, 50, 75 or 100 patients a week. The book is convenient in form, not too bulky, and in every respect the very best visiting list published.

Elementary Quantitative Analysis. — By ALEXANDER CLAS

SEN, Professor in the Royal Polytechnic School, Aix la-
Chapelle. Translated with additions by EDGAR F. SMITH,
A.M., M.D., &c., &c., with thirty-six illustrations. 8vo.

pp. 328. Philadelphia : Henry C. LEA, 1878. We hail with satisfaction the translation of this little work. We have been acquainted with it for some time as a practical and concise guide, and we believe it will be found to fill an important niche in the library of the real practical chemist. It is a compact and useful manual of quantitative analysis. The author has sought in these pages to illustrate his subject by examples, beginning with simple determinations, following on with a number of alloys, and then proceeding to the analysis of minerals and other products which are submitted in the various departments of applied chemistry. It is sufficient to mention the fact that this book has been adopted as a class book in nearly all the laboratories of continental schools, and has taken rank by the side of larger and more voluminous works on this subject, and even in Great Britain and the United States, it has been most favorably received as a thoroughly reliable guide. This is the opinion of those who have used it in the original, but their work will be greatly facilitated, at least, we refer to Englishspeaking students, since they have now an excellent translation, and one which has received at the hands of the translator such additions as the advance of scientific facts rendered necessary.

A Guide to the Practical Examination of Urine. For the

use of Physicians and Students.-By JAMES Tyson, M.D., Professor of General Pathology, &c., &c. Second edition,

8vo. pp. 172. Philadelphia : LINDSAY & BLAKISTON, '78. In this the second edition of this little work, the author has carefully corrected and revised it, and has incorporated into its pages such additional facts as were deemed consistent with the original purpose in its publication. This has been done without increasing the size of the volume. The author at the outset mentions the theory of Ludwig, of the method of secretion of urine He then mentions the reagents and apparatus required for quantitative as well as approximate analysis. The selection of a specimen of urine for examination is then referred to, and in making the selection the necessity for obtaining a part of the total amount of urine passed in the twenty-four hours is mentioned. The general physical and chemical characters of the urine are next given. He then passes on to the study of the different constituents of urine in health and disease, taking upfirst the organic constituents and then the inorganic. Urinary deposits forms the subject of the next section, the closing sections being on the differential diagnosis of renal diseases, and urinary calculi. The directions given throughout the work are clear and distinct. Those who desire more elaborate information on the chemistry of the urine will have to consult larger treatises on the subject, but we regard this little work as containing all that is really essential in a concise form. It is just such a treatise as the busy practitioner will find of the greatest service, and we can, without hesitation, commend it to our readers.

The Antagonism of Therapeutic Agents and what it teaches.

The essay to which was awarded the Fothergillian Gold
Medal of the Medical Society of London for 1878. By
C. Milner Fothergill, M.D. Edin., &c., &c. 8vo. pp. 160.
Philadelphia : HENRY C. LEA, 1878.

The author in this essay gives a short and pithy view of the subject of the antagonism of toxic agents. He divides the subject into two departments, experimental and practical. That is he gives the results of experiments which he and others have made with various substances, keeping in view throughout the work the practical bearing of these experiments.

It is quite recently that the subject has demanded attention prominently. Formerly chemical antidotes were those only known, or those giving mechanical results. We knew that an alkali would neutralize an acid. That tannin in any form would form an insoluble compound with tartar emetic, and that sesquioxide of iron would throw down arsenic, provided it was in sufficient quantity. These effects were observed alone when the poison was in the alimentary canal but if a deleterious substance had entered the blood nothing could be done, but wait patiently with the hope that it would be eliminated.

This little work consists of seven chapters. The first two are described as being upon experimental inquiry and practical inquiry, the one being a continuation of the other. The third chapter treats on the effects of drugs on the nerve centres. Chapters IV and V are on the action of drugs on the circulation and on the respiration respectively. In the sixth chapter we are taught the practical use of a knowledge of the antagonism of drugs, in cases of actual poisoning. And in the last chapter, we have a concise but lucid description of the uses of a knowledge of antagonism of drugs in ordinary practice. This is really a most interesting little work, and the contents should be familiar to all, as its practical bearing and teaching is quite indispensable to the physician who desires to follow his art with ordinary


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