Medical Excerpts.

By JOHN KING, M. D., North Bend, Ohio.

Cramp of the lower limb, or an involuntary contraction of a muscle or muscles of the calf, suddenly manifested upon the limb or foot being extended, or placed in an improper position, is a very common affection. The cramp is attended with severe pain, hardness and swelling, which do not always disappear with the spasm, but may remain for several hours subsequently. Corpulent, sedentary and nervous persons appear to be more subject to attacks of this malady, especially when under the influence of cold, fatigue, or some interference with the circulation, etc. I have seen numerous cases of this spasmodic difficulty during the past forty or fifty years, and have invariably succeeded in giving prompt relief by a very simple, yet certain method, viz.: the patient, or a member of his family, is requested to seize upon the foot of the affected limb and raise its anterior portion, as though endeavoring to bring its superior surface in contact with the anterior tibial portion of the limb (shin). The foot being thus firmly held for a minute or two, the cramp ceases.

Ophthalmia Neonatorum. In the treatment of a number of cases of this malady, I have of late years entirely dispensed with the application of solution of nitrate of silver. My chief reliance has been upon the following mixture: ℞. Pulv. Hydrastis Can., 1 ounce; Pulv. Geranium mac., ½ ounce. Mix. Of this mixture, the nurse is requested to place about fifteen grains in a warmed cup, and then to pour upon it, a tablespoonful of boiling soft water. Cover this, and when cold strain to obtain a clear fluid. In warm weather this will require to be made every day, as it soon spoils; in cold weather, every two or three days. The affected eyes are to be cleansed with this decoction every two or three hours, care being taken that some of it passes beneath the lids and upon the surface of each eye. A thin compress moistened with the decoction may be kept upon the lids, when the lashes are obstinately adherent or glued together, changing it every hour or two. In very severe or obstinate cases, and especially when there is reason for diagnosing a gonorrheal vaginal discharge as the (maternal) cause of the ophthalmia, in addition to the preceding treatment, by means of a camel's hair pencil, apply some of the solution of the chloride of gold and soda, hereafter referred to, once or twice a day. With this solution alone, applied three times a day, in gonorrheal ophthalmia from careless introduction of gonorrheal matter upon the eye, four cases, in adults, have been cured, and one case in which a drop of chancrous matter had come in contact with the eye.

The preceding treatment will also be found efficacious in scrofulous, or phlyctenular ophthalmia which, among children, many cases have been successfully treated.

Trachoma or Granular Conjunctivitis. Moisten an end of a pencil of sulphate of copper, hereafter described, and apply it thoroughly and carefully over the entire surface of the everted superior granulated lid; hold it thus everted for half a minute or so, then at once wash the lid, by means of a camel's hair pencil, with cool water. According to the irritation following this application it should be repeated every one, two or three days. In addition apply daily to the upper granulated lids, everted, using a camel's hair pencil, some of the solution of chloride of gold and soda, being careful to allow three or four hours to pass between this application and that of the copper pencil. This course has effected most remarkable cures of granular lids, in some instances of which an accompanying pannus had caused almost entire blindness. Of course, attention must be paid to the general health, hygiene, etc., of the patient.

Pencil of Sulphate of Copper. R. Pulv. sulphate of copper, one ounce; pulv. alum, half an ounce. Mix; place in a porcelain vessel, and gradually malt the mixture. The fused mass is now to be poured into a bronze or copper cylinder, having a diameter of not-quite one-fourth of an inch. These sticks, when cold, may be removed, and an extremity of each one be pointed by holding it in water arid scraping the softened part, repeating this until the desired reduction is had. Ordinary potash alum is to be used, and the metallic cylinders used as moulds for the pencils prevent the metallic copper from being precipitated.

Solution of Chloride of Gold and Soda. ℞. Chloride of gold and soda, twelve grains; hydrochlorate of ammonia, twenty-four grains; distilled water, two fluid ounces. Mix, and keep in a glass-stoppered bottle. When employing it pour a little into another smaller vial for present use, as the introduction of organic matter occasions a precipitate of the gold

This preparation is of value as a local application in the greater portion of corneal and conjunctival diseases, especially when these are associated with a strumous habit, as in purulent ophthalmia scrofulous ophthalmia, trachoma, pannus, corneal nebulous exudation, corneal ulceration, chronic iritis, etc.

Echinacea angustifolia. Narrow-leaved purple cone-flower. This plant abounds in Illinois, Nebraska, and from Missouri to Texas, being found in prairies and marshes. The root is the part used in the form of tincture. It was introduced to the medical profession in 1886 by H. C. F. Meyer, M. D., of Pawnee City, Nebraska. This gentleman states that he has used the article in his practice for more than sixteen years, and eulogises it very highly as an antispasmodic, and an antidote for blood-poisoning. Indeed, he asserts he has successfully used it in so many forms of disease, and under such varied conditions as to lead to a suspicion that he may have deceived himself in regard to its therapeutical value; and yet, so far as the remedy has been tested, his statements have certainly been corroborated.

Dr. Meyer deems it a specific in stings of insects, poison from the poison ivy, typhoid fever in which he relies upon the tincture alone, and in rattlesnake-bites, of which he has successfully treated over 613 cases among men and domestic animals. His confidence in the remedy induced him, as he states, to allow himself to be bitten by one of these snakes. When the arm became swollen from the hand to the elbow, he bathed the parts with some of the tincture, then swallowed a teaspoonful of it, lay down and went to sleep. Upon awakening the swelling had disappeared, and the doctor still lives. He kindly offered to send the writer a rattler eight feet long, that the antidotal influence of the tincture upon dogs, rabbits, etc., bitten by said serpent might be tested; but having no friendship for the reptile, and being unaccustomed to handling this poisonous ophidian, the generous offer was courteously declined.

Taken internally, Dr. M. considers the root-tincture a specific in malarial fever, cholera-infantum, cholera-morbus, boils, internal abscesses, and in colic in horses; also in typhoid fever when taken internally, and at the same time applied externally upon the abdomen; upon the throat in ulcerated sore throat; upon and around old ulcers; upon parts suffering from the effects of poison ivy, from erysipelas, carbuncles, poisonous bites or stings of bees, wasps, spiders, etc.; upon hemorrhoids, and by spray (diluted), in nasal and pharyngeal catarrh. He likewise recommends its employment in eczema, scald head, milk-crusts, acne, scrofulous ophthalmia, fevers of all kinds, congestive, remittent, etc., nervous headache, and in trichinosis, one case of which he reports as having recovered under its employment, the only instance of which he has had an opportunity for prescribing it.

Prof. I. G. M. Goss, M. D., (Marietta, Ga.,) who has experimented with the remedy, reports that he has successfully employed it in mad-dog bite, chronic ulcers, chronic catarrh, gonorrhea and syphilis. (See Chicago Medical Times, August, 1888, and Medical Brief, St. Louis, Mo., February, 1888). Dr. G. L. Nichols, (Pawnee City, Neb.,) reports to have successfully used it successfully in rattlesnake-bite, syphilis, and old fever-sores. He considers it a prompt and certain alterative. (See Medical Index, Kansas City, September, 1886.) Dr. A. Parker, (Wilber, Neb.,) has efficaciously administered it in a case of blood-poisoning pronounced hopeless by the leading physicians. Dr. J. S. Hayes, (Denver, Col.,) reports to have employed it with excellent results in hemorrhoids, in irritated and extremely sensitive conditions of the rectal mucous membrane, in malignant diphtheria, in "mountain fever," in typhoid fever, and in blood-poisoning. (See Eclectic Medical Journal, February, 1888, and California Medical Journal, March, 1888.)

The writer has tested the Echinacea in a few cases, and the patients have certainly derived prompt benefit under its influence. As the intention is merely to invite the attention of medical men to this remedy that further investigations may be made, particulars will not be entered into, but results alone will be briefly mentioned. Thus, in four cases of nasal catarrh, two of which were of several years standing, the disease having extended into the pharynx, and being of an obstinate character, recovery was effected in from four to nine months, the tincture being given internally, and applied locally in spray, one part to three of soft water. It has also proved efficacious in three cases of rheumatism, one being articular; in three cases of cholera morbus; in two cases of cholera-infantum; and in two cases of chronic ulcer of the leg, one of which was accompanied by an eczematous condition of the limb that had resisted years of treatment. It was used internally and locally. Also four cases of long standing and painful hemorrhoids were speedily overcome by its internal administration, at the same time applying it locally two or three times a day, one part tincture to three parts cerate; one case of vaginal leucorrhea, with ulceration of the os, in which it was given internally and applied locally, one part to four of water, on cotton introduced within the vagina, renewing it twice daily; five cases of poison-vine eruption, seven of stings of wasps, and four of bumble-bees (Bombus). In two of the latter instances a swelling and redness of the arm extended nearly to the shoulder. In all these poisonings the remedy, being only locally applied, acted with promptness. In three cases of abscess (one internal, the pus being voided with the urine), the internal employment of the tincture speedily checked the pus-formation. In six cases of dyspepsia its internal use has been decidedly beneficial, and though they can not be reported as having recovered, great relief has been afforded and permanent results are anticipated. One of these patients had for many years suffered great distress in the region of the stomach being constant, and which was invariably aggravated after a meal. Numerous remedies had been taken without the least benefit, and the person had given up all hope of relief from medicine. The first dose of Echinacea promptly relieved him and made him "feel better and more natural than for years past." He highly extols the medicine, and recommends it to every dyspeptic whom he encounters.

Prof. J. U. Lloyd has kindly made an analysis of this root for me, which I will now state. He writes: "Echinacea root is warm and peppery to the taste, leaving a tenacious aftertaste, and a peculiar numbness of the tongue. Its tincture is of a reddish-brown color, and imparts the above-named sensation to the tongue and fauces.

"The root is destitute of alkaloids and does not yield crystalline organic constituents by any method that we have applied to it. The characteristic principle, that which gives the peculiar action of the drug when chewed, and which predominates its sensible properties, is of a resinous nature.

"Description.—This resin may be obtained by extracting the dried root with alcohol, evaporating the tincture thus obtained to a small bulk, and precipitating by means of an excess of water. The crude resin, when washed with water and dried is of a dark brown color, odorless, and when chewed, tasteless at first, but after a time imparting the warm tingling sensation that is characteristic of the root. Chloroform dissociates it, dissolving a soft, greenish resin, and leaving a dark-brown one. The portion insoluble in chloroform possesses some of the sensible properties of the original resin, but it is questionable whether this is not owing to the presence of some of the resin soluble in chloroform that remains tenaciously attached, perhaps mechanically, with the other, resisting even the influence of good solvents to remove. This resin is inert.

"The chloroform soluble resin is in small proportion, but intensely active in sensible properties. It has a green color, no odor, is soft at ordinary temperatures, and when dissolved in alcohol gives a solution that is very sharp and pungent to the taste, and imparts the sensation heretofore named of numbness and warmth to the tongue and fauces in an intensified degree. This resin is the proximate principle that gives to Echinacea its peculiar taste, and no other characteristic substance was developed by my investigation."

The Echinacea purpurea—Purple cone flower, sometimes called "Black Samson," (see Am. Disp., 1870, p. 722), is a variety of the E. angustifolia, more common in the eastern section of the country, and is stated to possess similar therapeutical virtues. These plants should be thoroughly investigated. Especially would I recommend them in that class of renal diseases, now becoming so common and so fatal, which are generally known under the name of "Bright's Disease" a malady for which I have employed Rudbeckia laciniata with great benefit.

Transactions of the National Eclectic Medical Association, Vol. XVI, 1888-89, edited by Alexander Wilder.