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Macdonald (Journal of Tropical Medicine and Hygiene, June 15, 1920) note that the present ten- dency is to look upon all forms of erythema multi- forme, inckiding herpes iris, as being due to ana- phylaxis caused by the absorption of some chemical product from the intestine or other passages, or from a diseased organ. The success of treatment by intestinal antiseptic therapy in certain cases ofTers some support to this theory. The essential features of herpes iris are the central vesicle or bulla, the surrounding rirtg of vesicles, the affection of the lips and mouth, the formation of several rings of vesicles outside the first ; the slight constitutional disturbance, and the tendencies to recur if not properly treated. It is differentiated from its near- est ally, erythema iris, by the fact that in the former there is a vesicle surrounded by an erythematous blush. The first aim in the treatment should be to find the site from which some form of chemical absorption is taking place. In one of the author's cases the intestinal tract appeared to be the only possible source of trouble; the patient was placed in bed on restricted diet and given purgatives and salicin, with immediate and excellent results. New Method of Preventing Anaphylactic Manifestations. — Kopaczevvski ( Pressc medicale. June 16, 1920) has shown experimentally that anaphylactic manifestations can be obviated in ani- mals by injecting chloroform or ether in amounts insufficient to produce anesthesia. The widely ac- cepted theory of the important role played by the nervous system in anaphylactic shock is thought to be weakened by these observations. Since general and local anesthetics possess to a marked degree the property of reducing the surface tension of the blood, and since this property is also known to be the powerful factor preventing precipitation of col- loids — and therefore precipitation of the blood— the author is led to consider anaphylaxis simply as a precipitation of the colloids of the blood. The jirecipitate formed blocks the capillaries and thus causes sudden and grave asphyxia. Widal's labors have shown that many disorders are associated with anaphylactic manifestations, e. g.. asthma, hemo- globinuria, urticaria, the diathetic and dyscrasic affections, eclampsia, and serum disease. Diagnosis and Treatment of the Hemorrhagic Diseases. — Ralph C. Larrabee ( I-ioston Medical and Surgical Journal, August 5, 1920) says, concern- ing the treatment of these disea.ses, that local appli- cations are not satisfactory. The older ^astringents and styptics, such as ferric chloride and alum, do little but make a nasty mess. Epinephrine solu- tions will often control slight bleeding from the mucous membranes, but their action is quite fleet- ing. Cephaline, coagulen, coagulose and other tis- sue extracts are of somewhat greater value locally, both in platelet cases and in hemophilia, but appear to be ineffectual when used intramuscularly or in- travenously, while the possibility of producing em- boli would seem to make the intravenous use inad- visable. Calcium salts are of value only where the hemorrhagic tendency is the result of calcium de- ficiency. In such cases, when an operation is con- templated, calcium lactate should be given in large doses by mouth for several days, and operation should be deferred until coagulation time is nor- mal. Fresh animal serum contains prothrombin, which is absent in hemophilia and hemorrhagic dis- ease of the newborn, but this disappears in a few hours and old serum is worse than useless. ■ Fresh serum does not contain platelets, so can be of no value in hemorrhagic ]3urpura and other diseases where the bleeding is due to platelet deficiency. The value of diphtheria antitoxin rests wholly on em- pirical grounds. Theoretically and experimentally serum is of little value. The intravenous adminis- tration of whole blood comes nearer to being a universal panacea in this grotip of diseases than any other procedure. It is the method of prefer- ence except in chronic obstructive jaimdice, where calcium is better. Either the citrate or the paraf- fined tube method may be used. He prefers the latter because the citrate method causes more reac- tion and Buy Sildalis introduces fewer platelets. When facili- ties for intravenous transfusion are lacking, rapid intramuscular injection of small amounts of human lilood may be used, preferably in tissues near the bleeding area ; especially good results have been reported in purpura hemorrhagica. Proceedings of National and Local Societies MKDICAL SOCIETY OF THE STATE OF NEW YORK One Hundred and Fourteenth An7iital Meeting, Held in New York, March 23 to 25, 1920 The President, Dr. Claude C. Lytle, of Geneva, in the • Chair. {Continued from page 652) The Role of the Colon Bacillus in Infections of

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