1
1368 patient’s devitalisation allows some unknown morbific agent I to attack the nervous system. There is, moreover, a discon- ’, certingly large proportion of cases of this disease in which I, no antecedent exciting cause whatever can be traced ; young patients who have lived all their lives in the country, under I excellent conditions, and without having suffered from even so common a disease as measles, are often brought up to town hospitals with unmistakeable disseminated sclerosis. It ,, seems, therefore, that we must either believe that a variety of causes can produce identical effects on the central nervous system or that we must look for some agent of a toxi- infective nature which has hitherto escaped identification. In this connexion it is of peculiar interest to record the fact that several recent examinations of cases of disseminated sclerosis have been more fertile of results. We need specify here only one-viz., that reported by M. Lejonne and M. Lhermitte in Z’ E’MoMe, March, 1909. A young woman, aged 20 years, died after having exhibited the characteristic symptoms of the disease for five years. Plaques of sclerosis in every stage of development were found, from recent inflammatory foci to old areas of neuroglial sclerosis. The interesting fact is that all these recent foci surrounded a blood-vessel which remained patent, and that the affected area and the vessel walls were infiltrated with small round cells undoubtedly of inflamma- ,, tory origin. It is legitimate to argue that this condition is ’,, highly suggestive of the action of some toxic or infective ’, materies which is not apparently of the nature of ordinary I pathogenic agents, inasmuch as it cannot be demonstrated If by present histological methods, but which nevertheless is transmitted by the vascular system. The subject is a tempting one for further investigation. THE DEATH OF PROFESSOR CANNIZZARO. THE death of Professor S. Cannizzaro, which took place in Rome on Tuesday last, May 10th, at the ripe age of 84, recalls a time in the history of chemistry when considerable confusion prevailed as to atomic values, the confusion having been worse confounded by the fact that certain elements had more than one combining power. The great Italian chemist soon reduced matters to order in his classic thesis, "Sunto di un Corso de Filosofia Chimica, in which he threw light upon the methods employed for determining atomic weights. Above all he pointed out the great value of determining the vapour density of compounds, and he further showed how trustworthy as a confirmatory aid was the simple process of ascertaining the specific heat of elements. He was insistent upon distinguishing between atoms and molecules. Cannizzaro did much research work, he was joint discoverer with Cloez of cyanamide, but was alone in the discovery of benzyl alcohol. AN INTERNATIONAL CONGRESS ON THE CARE OF THE INSANE. AN international congress concerning the care of the i insane will be held in Berlin from Oct. 3rd to 7th. The congress will deal not only with questions referring to the modern treatment and the care of the insane, but also with measures and institutions for preserving mental health. An exhibition will be held in connexion with the congress and i will include a history of the progress made in the treatment of the insane. The following papers will be read : On the i Connexion between Civilisation and Insanity; Do Mental ] Diseases Increase in Number? on Sleeping Sickness ; on the Care of Infants and Children as a Prophylactic against < Epilepsy, Idiotism, and Mental Diseases ; and Psycho- I pathological Symptoms in 3tode-n Art and Literature. For 1 further paiticulars concerning papers and reports medical I men are asked to apply to the secretary, Dr. Boedeker, Schlachtensee, near Berlin ; concerning other matters to Dr. Falkenberg, Lichtenberg, Berlin, 79 Hernbergstrasse. ROYAL COLLEGE OF PHYSICIANS OF LONDON. THE following lectures at the Royal College of Physicians of London are announced to take place. The Croonian lectures will be delivered by Dr. F. W. Andrewes on Tuesdays and Thursdays, June 14th, 16th, 21st and 23rd, at 5 P.M. The Harveian Oration will be delivered by Dr. H. B. Donkin on Oct. 18th (St. Luke’s Day), at 4 P.M., to be followed by the Harveian dinner at 7.30 P. M. The Bradshaw lecture will be delivered on Nov. 1st, at 5 P.M., by Dr. G. N. Pitt. The Fitz Patrick lectures will be delivered by Sir T. Clifford Allbutt on Nov. 3rd and 8th, at 5 P. M. The Horace Dobell lecture will be delivered by Dr. W. Bulloch on Nov. 10th, at 5 P.M. ____ THE THERAPEUTIC APPLICATIONS OF CALCIUM CHLORIDE IN view of the prominent place that has been given to the calcium salts by therapeutists during the past few years it is of interest to refer to a resume of the therapeutic applications of calcium chloride by Dr. Moncany in a recent number of La Olinique. It has been employed more particularly in traumatic hoemorrhage, in purpura, haemophilia, hsemor- rhagic small-pox, and other hasmorrhagio diseases, and in hasmoptysis, in which its usefulness is a question of divided opinions. It has been given to increase the tonicity of the heart and vessels, in certain forms of headache, neuralgia, pruritus, eczema, and in urticaria. It has also been recom- mended in obstinate diarrhoea, epilepsy, laryngismus stridulus, convulsions, neurasthenia, hysteria, and mental alienation ; its results in these cases are considered to be due either to its calmative or to its recalcifying action. Excellent results have been reported in the treatment of chilblains, acute cedema, serous effusions, oedema following vaccination, and viper bites. The eruptions that are liable to follow injections of anti- diphtheritic serum may in most instances be averted by the administration of a daily dose of calcium chloride on the day of the injection and the two following days. The dose of the calcium salt varies according to the quantity of serum injected, and must be increased when several injections are given. Dr. Moncany also refers to the use of calcium chloride in albuminuria, nephritis, pneumonia, tuberculosis, pregnancy, coryza, and rickets. The salt has been given by the mouth, subcutaneously, and per rectum. Wright found that the hypodermic method tended to cause sloughing. The intravenous method has been condemned on account of the supervention of throm- bosis in experiments performed on dogs. Enemata con- taining calcium chloride are readily absorbed and are well borne by the patient. It is the usual practice to prescribe the calcium salts in small repeated doses, given by the mouth in dilute solutions. It is generally agreed that the treatment should be interrupted after a few days, as the continuous administration of the calcium salts tends to produce results which are just the opposite of those required. It is recom- mended to omit the treatment every fourth day, allowing a longer interval every eight or ten days. Calcium chloride must not be given to persons predisposed to calcic retention or atheroma, on account of which it is generally contraindicated in elderly persons, alcoholics, and persons suffering from lead poisoning. The best results will be obtained by cautiously administering the drug by the mouth, in small, divided doses, for brief periods with intervals of cessation. Calcium chloride may be combined with opiates in the treatment of haa-norrhage. Its intensely disagreeable taste has long militated against its employment. Perhaps

ROYAL COLLEGE OF PHYSICIANS OF LONDON

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1368

patient’s devitalisation allows some unknown morbific agent Ito attack the nervous system. There is, moreover, a discon- ’,certingly large proportion of cases of this disease in which I,no antecedent exciting cause whatever can be traced ; young ’

patients who have lived all their lives in the country, under Iexcellent conditions, and without having suffered from even socommon a disease as measles, are often brought up to townhospitals with unmistakeable disseminated sclerosis. It ,,seems, therefore, that we must either believe that a varietyof causes can produce identical effects on the central nervoussystem or that we must look for some agent of a toxi-infective nature which has hitherto escaped identification.In this connexion it is of peculiar interest to record the factthat several recent examinations of cases of disseminatedsclerosis have been more fertile of results. We need

specify here only one-viz., that reported by M. Lejonneand M. Lhermitte in Z’ E’MoMe, March, 1909. A youngwoman, aged 20 years, died after having exhibitedthe characteristic symptoms of the disease for five years.Plaques of sclerosis in every stage of development werefound, from recent inflammatory foci to old areas ofneuroglial sclerosis. The interesting fact is that all these

recent foci surrounded a blood-vessel which remained patent,and that the affected area and the vessel walls were

infiltrated with small round cells undoubtedly of inflamma- ,,

tory origin. It is legitimate to argue that this condition is ’,,highly suggestive of the action of some toxic or infective ’,materies which is not apparently of the nature of ordinary Ipathogenic agents, inasmuch as it cannot be demonstrated Ifby present histological methods, but which nevertheless istransmitted by the vascular system. The subject is a temptingone for further investigation.

THE DEATH OF PROFESSOR CANNIZZARO.

THE death of Professor S. Cannizzaro, which took place inRome on Tuesday last, May 10th, at the ripe age of 84,recalls a time in the history of chemistry when considerableconfusion prevailed as to atomic values, the confusion

having been worse confounded by the fact that certainelements had more than one combining power. The greatItalian chemist soon reduced matters to order in his classic

thesis, "Sunto di un Corso de Filosofia Chimica, in whichhe threw light upon the methods employed for determiningatomic weights. Above all he pointed out the great valueof determining the vapour density of compounds, and hefurther showed how trustworthy as a confirmatory aid wasthe simple process of ascertaining the specific heat of

elements. He was insistent upon distinguishing between

atoms and molecules. Cannizzaro did much research work,he was joint discoverer with Cloez of cyanamide, but wasalone in the discovery of benzyl alcohol.

AN INTERNATIONAL CONGRESS ON THE CAREOF THE INSANE.

AN international congress concerning the care of the i

insane will be held in Berlin from Oct. 3rd to 7th. The

congress will deal not only with questions referring to themodern treatment and the care of the insane, but also withmeasures and institutions for preserving mental health. Anexhibition will be held in connexion with the congress and iwill include a history of the progress made in the treatmentof the insane. The following papers will be read : On the i

Connexion between Civilisation and Insanity; Do Mental ]Diseases Increase in Number? on Sleeping Sickness ; onthe Care of Infants and Children as a Prophylactic against <

Epilepsy, Idiotism, and Mental Diseases ; and Psycho- I

pathological Symptoms in 3tode-n Art and Literature. For 1

further paiticulars concerning papers and reports medical I

men are asked to apply to the secretary, Dr. Boedeker,Schlachtensee, near Berlin ; concerning other matters to Dr.Falkenberg, Lichtenberg, Berlin, 79 Hernbergstrasse.

ROYAL COLLEGE OF PHYSICIANS OF LONDON.

THE following lectures at the Royal College of Physiciansof London are announced to take place. The Croonianlectures will be delivered by Dr. F. W. Andrewes on Tuesdaysand Thursdays, June 14th, 16th, 21st and 23rd, at 5 P.M.The Harveian Oration will be delivered by Dr. H. B. Donkinon Oct. 18th (St. Luke’s Day), at 4 P.M., to be followed bythe Harveian dinner at 7.30 P. M. The Bradshaw lecture will

be delivered on Nov. 1st, at 5 P.M., by Dr. G. N. Pitt. TheFitz Patrick lectures will be delivered by Sir T. CliffordAllbutt on Nov. 3rd and 8th, at 5 P. M. The Horace Dobell

lecture will be delivered by Dr. W. Bulloch on Nov. 10th,at 5 P.M.

____

THE THERAPEUTIC APPLICATIONS OF CALCIUMCHLORIDE

IN view of the prominent place that has been given to thecalcium salts by therapeutists during the past few years it isof interest to refer to a resume of the therapeutic applicationsof calcium chloride by Dr. Moncany in a recent number ofLa Olinique. It has been employed more particularly intraumatic hoemorrhage, in purpura, haemophilia, hsemor-

rhagic small-pox, and other hasmorrhagio diseases, and in

hasmoptysis, in which its usefulness is a question of dividedopinions. It has been given to increase the tonicity of theheart and vessels, in certain forms of headache, neuralgia,pruritus, eczema, and in urticaria. It has also been recom-

mended in obstinate diarrhoea, epilepsy, laryngismus stridulus,convulsions, neurasthenia, hysteria, and mental alienation ; itsresults in these cases are considered to be due either to its

calmative or to its recalcifying action. Excellent results havebeen reported in the treatment of chilblains, acute cedema,serous effusions, oedema following vaccination, and viper bites.The eruptions that are liable to follow injections of anti-diphtheritic serum may in most instances be averted by theadministration of a daily dose of calcium chloride on the

day of the injection and the two following days. The dose

of the calcium salt varies according to the quantity of seruminjected, and must be increased when several injections aregiven. Dr. Moncany also refers to the use of calciumchloride in albuminuria, nephritis, pneumonia, tuberculosis,pregnancy, coryza, and rickets. The salt has been

given by the mouth, subcutaneously, and per rectum.

Wright found that the hypodermic method tended to

cause sloughing. The intravenous method has beencondemned on account of the supervention of throm-

bosis in experiments performed on dogs. Enemata con-

taining calcium chloride are readily absorbed and are wellborne by the patient. It is the usual practice to prescribethe calcium salts in small repeated doses, given by the mouthin dilute solutions. It is generally agreed that the treatmentshould be interrupted after a few days, as the continuousadministration of the calcium salts tends to produce resultswhich are just the opposite of those required. It is recom-

mended to omit the treatment every fourth day, allowing alonger interval every eight or ten days. Calcium chloridemust not be given to persons predisposed to calcic retention oratheroma, on account of which it is generally contraindicatedin elderly persons, alcoholics, and persons suffering from leadpoisoning. The best results will be obtained by cautiouslyadministering the drug by the mouth, in small, divided

doses, for brief periods with intervals of cessation.Calcium chloride may be combined with opiates in thetreatment of haa-norrhage. Its intensely disagreeabletaste has long militated against its employment. Perhaps