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8. The media through which human beings are ordi- narily infected by animals are milk and meat. 9. Houses in which consumptives have lived, and in which immediate sterilization of all broken-down tissue has not been practised, are infected houses, and are liable to convey the disease to subsequent occupants. 10. Spitting upon floors and into handkerchiefs, and permitting the broken-down tissue to dry and become pulverized, is a prolific cause of spreading tuberculosis. 11. Temporary occupation of hotel rooms, sleeping- car berths, and steamer cabins by consumptives in the infectious stage, can infect them so as to convey the dis- ease to subsequent occupants, unless proper precautions are taken against contamination of the bedding, furni- ture, and walls with broken-down tubercular tissue. We recommend the following practical measures for the prevention of the disease : 1. The notification and registration by health author- ities of all cases of tuberculosis which have arrived at the infectious stage. 2. The thorough disinfection of all houses in which tuberculosis has occurred, and the recording of such ac- Order Lotrisone tion in an open record. 3. The establishment of special hospitals for the pre- vention of tuberculosis. 4. Lotrisone Online The organization of societies for the prevention of tuberculosis. 5. Government inspection of dairies and slaughter- houses, and the extermination of tuberculosis among dairy cattle. 6. Appropriate legislation against spitting into places where the sputum is liable to infect others, and against the sale or donation of objects which have been in use by consumptives unless they have been thoroughly dis- infected. 7. Compulsory disinfection of hotel rooms, sleeping- car berths, and steamer cabins which have been occupied by consumptives, before other persons are allowed to oc- cupy them. The reports and recommendations of the Committee were adopted. Tropical Diarrhoea. — This paper was contributed by Sir Joseph Favrer, of London, England, and read by Dr. Gihon. This is a form of disease which is gener- ally, if not always, the result of tropical and climatic in- fluences, and the debility and cachexia induced thereby. It is now not infrequently observed in Europe, owing to the ever-increasing means of communication with foreign countries. It is apparently generally confined to adults, is insidious in its onset, slow in progress, and often, when not arrested sufficiently soon, fatal, owing to ir- reparable degenerative changes. It has been described by many observers, both English and foreign, in India, China and Cochin Buy Lotrisone Online China, and Batavia, Most of the cases seen in Purchase Lotrisone Online this Lotrisone Generic country come Buy Cheap Lotrisone from China, India, or Ceylon. In India it is met with frequently, where a form of it is known as " hill diarrhrea," from its proce- ness to affect dwellers in hill stations, especially those who have previously lived in the plains ; atmospheric changes, vicissitudes of temperature, greater altitude, rarefied atmosphere, and possibly water, being concerned in its causation. Some authors consider it a distinct disease from the white flux which may be seen in any part of the country, but Generic Lotrisone they are so much alike as to justify the belief in their identity, at all events for prac- tical purposes. Occasionally there is a resemblance to certain forms of chronic dysentery ; the two conditions may be associated, or one may merge into the other. Tropical diarrhoea occasionally makes its appearance years after the subject of it has returned from the tropics. It not infrequently begins without any previous apparent derangement of health, though it is sometimes preceded by dysentery, diarrhoaa, some indication of malarial in- fection, or functional derangement of the liver or other abdominal viscera, and is not noticed until excessive soreness of the tongue and loss of strength and wasting reveal the gravity of the condition. Semeiologv. — This form of diarrhoea may begin with simple looseness of the bowels, or may supervene on or- dinary diarrhoea or chronic dysentery. The action pro- duces a sense of relief. The dejecta at first may be nat- ural and bilious, but gradually become light colored, frothy, pultaceous, and copious. As the disease advances they are occasionally tinged with blood, and the sufferer becomes more attenuated, exhausted, and incapable of any prolonged exertion. The appetite may be good, but rawness and tenderness of the mouth and tongue, fre- quently accompanied by aphthous spots and ulcerations, interfere with its gratification. Treatment. — From the insidious character of the dis- ease, tropical diarrhoea not infrequently gains ground be- fore radical measures for its relief are resorted to. Sue- 568 MEDICAL RECORD, [October 28, 1893 cessful issue depends much on the patient's resolution and perseverance in carrying out instructions. Ahernations of temperature, errors of diet, fatigue or excitement, exer- tion, mental or physical, should be avoided. Physio- logical rest should be insisted on. There is a tendency Purchase Lotrisone in the earlier stages to get well. The object is to favor this tendency, and not thwart it by neglect of precautions. Diet is the most important con- sideration, and must be strictly regulated and adhered to ; and scarcely less important is the question of clothing, habits, and mode of life. Milk alone should be the only diet, and it must be given in small quantities often repeated, say from four to six ounces every hour, day and night. Larger quantities at longer intervals will not do. When in the twenty-four hours an adult is able to take three to four quarts of cow's milk in this way, ample nourishment is afforded to sup- Lotrisone Ointment port his strength and to enable him to recover. This method of treatment was begun by the author be- fore leaving India in 1872. After prolonged experience and trial of all other forms of remedies, he has found it more effective than anything. It seldom fails except in the very advanced and chronic cases, or in very aged per- sons. Buy Lotrisone The conclusion arrived at is that, though drugs are generally of little avail, if milk, taken as prescribed, does not succeed, there is but small chance that any other form of treatment will do so. Cholera Infantum and its Treatment, by Dr. Manuel Septien, of Queretaro, Mexico. The treatment proposed is exceedingly efficacious. It consists in the total sup- pression of all food and medicine during twenty-four or forty eight hours, and the prescription of pure cold water in Lotrisone Price great abundance. The author Lotrisone Uses said there is scarcely any disease that causes a greater mortality in childhood than that known by the name of estival diarrhcea or in- fantile cholera. In one single week, the last one of July of the present year, there were one thousand one hundred and twenty-six deaths in thirty-three of the largest cities of Clotrimazole And Betamethasone England, caused by this disease alone. Statistics show everywhere a notable increase in the number of deaths during the months of June, July, and August, that is to say, during the warmest season of the year. The malady is not limited to children only, but attacks also a great number of adults and old people, being less mortiferous in the latter than in the former, in whom it causes a mor- tality of fifty, sixty, and even eighty per cent. Only Asiatic cholera, to which it has the greatest similarity, can be compared to it for its ravages. It is undoubtedly of microbic origin, as recent investigations have shown. Energetic drainage is the supreme effort which nature executes to rid the organism of the deleterious elements that poison it. To try to suppress it by therapeutical means is not an easy or rational thing tp do. It would only hinder the natural curative process. The only thing that can be done is to oppose the extreme dehydration of the tissues by restoring to them without delay at least a part of the water lost. This is the therapeutical indica- tion, and no drug can take its place, nothing but pure cold water. All the curative methods tried leave much to oe de- sired. Order Lotrisone Online Their results are very precarious ; all consist in the administration of various medicinal substances, as- tringents, absorbents, antiseptics or antiperistaltics, Lotrisone Cost and in the prescription of some alimental regimen. Such treatments, according to the author, are not in conformity with the great principle that governs therapeutics, namely, the rest of the organ that suffers. The author had practised successfully the treatment recommended by Luton, of Reims. He summarized the points of his paper as follows : i, To suppress all nourish- ment and medicine for one or two days ; 2, to give at dis- cretion pure cold water; 3, to return by degrees to a rational regimen. ,Origin and Dissemination of Typhoid Fever, by Pro FESSOR W. T. Sedgwick, of Boston. Professor Sedg- wick's remarks on this subject were impromptu. He first dwelt upon the reorganization of the State Board of Health in Massachusetts in 1886, shortly after which an experiment station was established at Lawrence for the purpose Lotrisone Otc of studying typhoid fever chemically and bacte- riologically, looking to the purification of the water. In 1890 an epidemic of typhoid fever broke out upon the Merrimac River, in the city of Lowell, and shortly after- ward Lotrisone Lotion appeared at Lawrence, nine miles below. These epidemics afforded unusual opportunities for the investi- gation of the epidemiology of typhoid fever. Afternoon Session. Sewage Disposal. — Mr. Allen Hazen, of Lawrence, Mass., read a paper entitled "The Sewage Disposal Prob- lem in American Cities." He said one of the striking features of the .sanitary development of American cities is the very rapidly increasing number of places which, for one reason or another, are treating in some way their sew- age. It is not so very many years since there was hardly a sewage purification plant in the United States, while at the present time there are some thirty municipalities, in a dozen different States, which give their sewage a more or less thorough treatment. Of these a number are in the far West, where the sewage has a commercial value for irrigation which has probably been considered quite as important as the sanitary advantages secured by the treatment ; but the greater number are in the East, where a dense population and increasing desire for cleanliness in the waters of streams and lakes, and particularly in water-supplies, has brought to an issue problems which as yet have scarcely received the attention of the inhabitants of the less thoroughly settled States. There are two sewage problems which are entirely dif- ferent in their nature, although the same remedies may often be applied to both. There is first the pollution 01 rivers and lakes to such an extent that they produce a nuisance to the people who live upon their banks, and secondly the pollution of water-supplies by sewage. The first case is often that of a city upon the banks of a small river which becomes so reduced in volume in dry weather that the sewage may fairly be said to be the Betamethasone Cream predominat- ing element in its composition. Up to a certain point, rivers are capable of taking sewage without causing a serious nuisance to the people Lotrisone Creme who live upon their banks, so long as they do not drink from them ; but when this quantity has passed, deposits are formed, decomposition sets in, and the stream is rendered foul in appearance and objectionable in its odor. The exact quantity of sewage which can be mi.xed with water without causing a nui- sance, varies with local conditions, and can only be ap- proximately estimated, but as long as the limit is not

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