The above reproduction is from the architect's drawings of the seven-story apartment-house to be built on the site of Dr. Osler's old home, Charles and Franklin streets, by Mr. W. L. Stork. The site was purchased from Dr. Osler last December, a few months after the Oxford appointment had been made known to the world. REVIEW IN PEDIATRICS. Under the Supervision of José L. Hirsh, M.D., Baltimore. G. ON THE INTESTINAL ANTISEPTICS AND DISINFECTANTS IN THE Mya seeks to show that the antiseptic treatment of gastroenteric diseases of children is not based on scientific principles, and that it may do more harm than good in some cases. He thinks that the treatment of these conditions demands not merely the writing of prescriptions, but proper attention to all the conditions which enter as causes of infantile diarrheas. He would like to see fewer prescriptions written for children affected with these maladies and more attention paid to diet and hygiene. Bouchard's theory of autointoxication, which was the basis of the modern intestinal antiseptic treatment, is not founded on scientific principles and has never been demonstrated clinically. The trouble lies in the fact that this theory applies the principles of toxicology to a totally different branch of knowledge-pathology. The author is convinced that the small amounts of indol, skatol, etc., which are found in the urine and in the feces, if mixed with a healthy man's food, would produce in him about the same effect as the fly in Aesop's fable. Clinical experience teaches that the process of intestinal putrefaction is far more complex than Bouchard would have it, and that we know as yet little on the subject of autointoxication. The use of intestinal antiseptics and antiputrefactive remedies is irrational, because it has never been proved that the symptoms which we wish to relieve are due to an excess of putrefaction or fermentation; it is irrational because no dose which can be borne can be hoped to influence the overproduction of the fermentative products so-called; finally, the use of these remedies is irrational because when they are given in sufficient doses they may actually do harm. The author reports several cases of this kind, including a case of poisoning due to the injection of resorcin solutions into the intestine of a child. The author therefore rejects all antiseptics in the treatment of gastroenteritis in children with the exception of the use of I per cent. solution of tannic acid. A CONTRIBUTION TO DIPHTHERIA IN EARLY LIFE. A. Siebert. Archives of Pediatrics, February, 1905. Siebert discusses three cases of diphtheria, all of which are of interest from certain points of view. The first case is one of hidden nasal diphtheria with severe systemic infection. The patient, a child 22 months old, was attacked with acute rhinitis, with a temperature of 105°; no membrane was visible in the nose or nasopharynx; there were a few small swollen lymph nodes along the posterior half of the neck, especially between the deeper muscles; some albuminuria was present. Upon these points the diagnosis of diphtheria was ventured and antitoxin used, when all the symptoms promptly cleared up. Not until the fourth culture was made, eight days after the use of the antitoxin, were Loffler bacilli found in the nasal secretions. The history of this case proves that a negative report as to the presence of diphtheria is of no value in a doubtful case of diphtheria, and that a serum test is indicated wherever diphtheria is suspected. The second case is one of diphtheria of the tongue, lips, and the conjunctivae, with little systemic infection. Astonishing in this case is the expansion of the local colonies of diphtheria organisms, with so little poisoning. A doubt as to whether the organisms found were true or pseudo-diphtheria bacilli seems evident, as the Behring serum proved effective. Another peculiar fact is that no post-diphtheritic paralysis presented itself after this manifold and extensive surface infection. Case 3 was a baby, eight weeks old; temperature moderate; was unable to swallow; there was no nasal discharge. The surface of pharynx and of the tonsils appeared pale and normal. On palpation multiple hard infiltration of the posterior cervical lymph nodes was found between the deeper muscles of the neck. On close inspection of the throat it became apparent that although attempts at vomiting were caused by the introduction of the tongue. depressor, the muscles of the velum palati and of the uvula took no part in these contractions. This proved a paralysis of the soft palate, which explained the inability of the child to swallow. The diagnosis of diphtheritic paralysis was made and antitoxin used, and the condition cleared away in a few days. The author calls especial attention to two points. The first is the diagnostic value. of multiple retrocervical lymph-nodular swellings in young children. If no other source is visible, like eczema capillitii, this phenomenon usually points to nasopharyngeal infection. The second point to be emphasized is the doubtful value of an early bacteriological finding. Exudate in the throat is highly suspicious of true diphtheria in every case, and Siebert prefers to rely on a serum test made in the body of the patient by an antitoxin injection than a search for bacilli in the laboratory. THE TREATMENT OF SCARLET FEVER WITH THE MOSER ANTISTREPTOCOCCUS SERUM. L. K. Shaw. Medical News, October, 1904; Archives of Pediatrics, January, 1905. The author gives a short account of the experience in Vienna with Moser's serum. During the last four years all the severe cases of scarlet fever admitted to the Anna Kinderspital in Vienna have received the Moser serum, with results which are claimed to be not less remarkable than those seen after the use of diphtheria antitoxin. Moser profited by the experiences of Meyer and Pe trusky and Koch, which had shown that streptococci passed through animals lose their earlier agglutination power with a certain serum, and that in the passage through rabbits the virulence of Marmorek's streptococci was increased towards rabbits, but decreased toward man. He did not attempt therefore to increase the virulence of his streptococci, but injected them as soon as obtained into horses. He injected some 30 different strains of streptococci, and the serum that he obtains is therefore a true polyvalent one. It takes seven to nine months to produce a satisfactory serum, and some horses never produce a satisfactory serum. No preservative is used for the serum. When sufficiently potent the serum, in a dilution of 1 to 250,000, should agglutinate the streptococci. The dose usually given is 200 c. c., and the only unpleasant result following its use is the serum exanthem. This, as in diphtheria, is often accompanied with fever, and it makes the children very uncomfortable. The custom at the Anna Kinderspital is to give the serum to the very severe and lethal cases. Marked improvement and recovery are claimed in many otherwise hopeless cases. For more favorable cases the results from the serum are soon manifest. The fever falls to normal without collapse, the pulse improves, and the nervous symptoms rapidly disappear. During the past four years 228 patients were treated with the serum, many moribund, and the majority severely ill. The mortality for the four years before the employment of this remedy was 14.5 per cent., and the four years since its employment 8 per cent. Moser also uses the serum as a prophylactic measure in children exposed to scarlet fever. A SUMMER'S EXPERIENCE WITH INFANTILE DYSENTERY. J. H. M. Knox. Journal of the American Medical Association, December 17, 1904. Knox presents a very interesting and instructive study of 43 cases of infantile dysentery which came under his observation at the Thomas Wilson Sanitarium. In all of these cases the etiology of the disease was positively determined and all were infected with the so-called "acid type" of the bacillus dysenteriae. The cases are considered from a clinical and patholigic point of view. As to the post-mortem alterations the author says that it is evident that the dysentery bacillus does not always produce in the infant a uniform pathologic picture, but is capable of setting up alterations differing widely, both in severity and extent, from cases where the intestinal wall is practically unchanged to those in which large areas of the mucosa, particularly of the large intestine, is lost. The result of this study may be summarized as follows: During the summers of 1902 and 1903 epidemics of diarrheal disorders among infants and young children appeared in Baltimore. A large proportion of these cases properly investigated were found to be produced by the proliferation in the intestinal tract of the B. dysenteriae (Shiga), the variety of the organism |