*The Alleviation of the Discomforts following

Anesthesia

BY AGNES PILLOW, CLASS 1906, The Lakeside Hospital School for Nurses.

In preparing for the care of a patient after an anesthetic the first thing to be considered is the room.

It should be well lighted and ventilated and at a temperature of 68° to 70° F.

The bed should be placed in a position so as it will be accessible from both sides and foot, and so the light does not shine in the patient's eyes. The bed should be warm, and hot water bottles left about the patient after the patient's return from the operating

room.

The alleviation of discomforts of a patient after an abdominal operation performed under ether anesthesia may be:

1 Vomiting-in which case the patient should not have anything by mouth.

2 Nausea—often relieved by inhalation of vinegar from a cloth.

3 Dryness of the tongue and lips, and thirst-moist compress to lips. Allow patient to rinse mouth frequently.

4 Backache-(a) rub back, (b) small pillow to relieve pressure, (c) turn patient slightly on side and support by pillows.

5 Numbness of limbs-(a) massage, (b) elevate knees on pillows. (1) Pains in head, (a) ice-cap, (b) massage.

6 Pains

(2) Pain in abdomen due to:

(a) Gas, which may be relieved by hot water bottle.

(b) Distended bladder-hot water bottle over bladder; hot perineal stupes; catheterization.

(c) Wound in abdominal wall-lighten binder.

(d) Operation upon viscera-heat.

(e) Pain in chest due to pleurisy or pneumonia-pneumonia jacket; ice-cap; room temperature 65°-68° F.

7 Irritation (1) Skin—from discharges as bile, pus, urine, etc.,— cleanliness; ointments: lanolin, zinc oxid, boric.

(2) Irritation of nose and throat-keep air warm and moist; liniment as camphorated oil.

(3) Irritation of eye-dark room; ice compresses.

8 Sore mouth and tongue due to mouth gag or tongue forceps— mouth wash of listerine 1-8.

9. Sore lips (herpes)-vaseline or cold cream.

10 Nervousness-(1) In alcoholics, massage.

(2) Morphin fiends, massage.

(3) Neurasthenia, (a) massage, (b) sympathy, (c) scolding.

11 Faintness-(1) From loss of blood, (a) elevate foot of bed,

OFFICE, 260 EUCLID AVENUE

Entered March 7, 1902, as Second-Class Matter, Post-office at Cleveland, Ohio, under Act of Congress of March 3, 1879.

EDITORIAL

Walter Reed and Yellow Fever

Dr Walter Reed's epoch-making discovery of the relationship of the mosquito to the spread of yellow fever, was given to the world, now, nearly six years ago. As so often happens, Dr Reed was not spared long enough to appreciate the immensity of his gift to mankind. It is a strange but admitted truth that often, in our interest in the establishment of a scientific fact itself, we forget the man to whom we are indebted for its discovery. Could Dr Reed's life have been spared long enough to have seen the methods planned and outlined by himself, carried out upon the exhaustive scale which was followed last fall in New Orleans, how much more would he have appreciated the greatness of his service to the world at large.

We are indebted to Dr Howard A. Kelly, of Baltimore, for again calling our attention to the life and work of Walter Reed. In this singularly charming and interesting volume "Walter Reed and Yellow Fever," (McClure, Phillips & Co.), Dr Kelly has given us a glimpse of Dr Reed's early life and an account of his scientific career, which, when taken up cannot be laid aside until it has been read from cover to cover.

May we here remind our readers that of the memorial fund

raised under the auspices of the Walter Reed Memorial Association, $8,000 is still wanting to complete the $25,000 fixed by the Association as the sum desired. It is the purpose of the Walter Reed Memorial Association that the interest from this fund should be paid during their life time to the wife and daughter of Dr Reed, while at their decease the principal is to be used either in the erection of a monument to Dr Reed's memory, or in the promotion of research in his especial field of work. We earnestly hope that the balance of this amount may be quickly forthcoming.

Ehrlich's Recent Work Upon Cancer Immunization

The results of Ehrlich's recent work upon the immunization of mice against malignant growths, commands at the present time, the interest of all scientific workers.

Ehrlich's original paper appeared in the Zeitschr f. Artzi. Fortbilding 3, 1906, No. 7, and marks an epoch in the problem of the treatment of malignant growths.

Ehrlich has established beyond dispute a method of immunizing the animals of the laboratory against malignant growths. If, now, this method can be applied to human beings and it is certainly within reason to assume that this end will be ultimately possible, then indeed may we take heart for the future in the matter of treating malignant diseases.

Adami, writing in the Montreal Medical Journal for June, 1906, of this recent work of Ehrlich's, says, "Thus we are able to chronicle the advance of which all must hope heralds eventual victory", and in conclusion says, "The all important point is that active immunity against cancer is shown, not simply to be possible, but to be gained with precision by a specific method of procedure and that against cancer of maximum virulence. The application of these results in human medicine can only be a matter of time: we see the dawn."

The State of Chicago's Health

In the June number of the Journal, we published at length, an abstract from the Biennial Health Report of the City of Chicago, a report which presented graphically the condition of Chicago's health for years past and demonstrated the enviable fact that Chicago was the most healthy city, in proportion to the population, in the United States. In view of the recent public

agitation as to conditions at the Union Stock Yards of that City, and of the fact that the Commissioner of Health has been misrepresented in certain of the public points, he has, in the Bulletin of the Department of Health, for the week ending June 2, made a brief statement which is not without interest at this time.

Whatever may be the real truth of the situation at the Union Stock Yards, we are confident that the Commissioner of Health of the City of Chicago, has done all that was within his power to eliminate the danger from diseased meats and condemnation of unhealthy cattle for the protection of the denizens of Chicago. Any other imputation, implied or direct, is in our judgment, a gross injustice. The records of Chicago's health are in themselves sufficient proof of the efficiency of the Department of Health.

It is interesting to note that on March 21, 1906, the United States Government sent to Chicago, a number of Pathologists from the Bureau of Animal Industry, who, together with the City Pathologists, revised the rules and regulations which are now the standard for both Government and City Inspectors.

It is further interesting to note that during the month just ended, a total of 697,577 pounds of food stuffs were condemned and destroyed by the Department Food Inspectors, of which amount 481,795 pounds was condemned and destroyed at the Union Stock Yards. These figures are capable, perhaps, of two interpretations and certainly speak for themselves.

The Other Side

The April number of the St. Louis Medical and Surgical Journal contains an editorial signed by the editor, A. H. OhmanDumesnil, dealing with the evidence upon which one of our well known lay weeklies has recently attacked the widespread and indiscriminate use of headache remedies. The Proprietary Association of America has investigated a large number of specific instances, cited as incriminating such headache powders and the editorial gives their version of the cases in parallel columns with the facts as presented to the public by the newspapers.

That there is undoubtedly a very wide and indiscriminate use of potent drugs by the laity cannot be denied. It is to be regretted that the great American public should be so addicted to drug taking and self-prescribing. This is the evil which the lay journal is rightly attempting to correct, but it is unfortunate that they did

not make their case more convincing by first attempting to corroborate the evidence presented in the newspapers.

The value of the coal-tar products is proven beyond question but they are undoubtedly dangerous if indiscriminately used by the laity and ample evidence of this can be found authenticated in reports in reputable medical journals.

Three Prize Essays

We take great pleasure in calling attention to the three essays, appearing elsewhere in this number of the Journal, written by members of the senior class of the Lakeside Hospital Training School for Nurses, in competition for the prize awarded by the Trustees of the Hospital. These essays are published as originally written and should prove helpful and suggestive, especially to those who are forced to work without every modern resource at their elbow. The prize essay written by Miss Ashton covers in an unusually intelligent and careful way the all-important field included by the title of these essays. The essays appear in the order of merit as decided upon by the jury of award.

Department of Therapeutics

Arteriosclerosis:

CONDUCTED BY J. B. McGEE, M. D.

Sir James Barr, in Merck's Archives for May, states concerning the use of drugs in arteriosclerosis, that there are two classes of drugs which he seldom prescribes, digestive agents and hypnotics. If a man cannot eat or sleep, there is something wrong with him, he requires to be treated, not palliated. In this disease the man eats too much, and when his digestion fails, he can readily subsist on some hot water until his appetite returns. In these cases insomnia depends on high blood-pressure, arising from whatever cause, and it is much better to remove the cause than treat symptoms. The thyroid preparations are extremely useful in arteriosclerosis. George Oliver showed that thyroid dilated the arteries and Barr found that it increased tissue metabolism. Of course, it must not be pushed to the extent of producing thyroidism, as then the excited heart becomes exhausted and dilated in its futile efforts to maintain tension in unfilled arteries. Iodin is often more valuable than the thyroid, as its metabolic effects are attained by its stimulating action on the thyroid gland. He has seen two cases of exophthalmic goiter produced by the rather excessive use of iodin, both recovering on the stoppage of the drug. As a rule he prefers for medicinal use the tincture of iodin, and the syrup of iodin and tannic acid, to the more stable iodids. Adrenalin raises arterial tension, and is as a rule injurious in arteriosclerosis, but when combined with thyroid or iodin it occasionally does good by maintaining arterial tone and