434 THE AMERICAN MONTHLY [Dec 



ttEDICAL MICROSCOPY. 



Pleuritic Effusions and their Treatment. — A bacterio- 

 log-ical examination should be made in all cases; both with 

 cover-g-lasses, with culture media, and with injections of 

 the eifusion in animals. Disting-uish between exudate and 

 transudate by using-the acetic acid chemical test, and by the 

 same process eliminate mucine. Many cases of pleurisy 

 are of an uric acid diathesis. These will yield readily by 

 the treatment of the salicylates. I believe not more than 

 15 per cent of pleuritic cases are rheumatic. The finding- 

 of pneumococci does not ag-g-ravate the conditioiis, and 

 often g-ives no markedly distinct symptoms. Pleurisy in 

 typhoid IS not a mixed infection, but a distinct condition. 

 Tubercle bacilli are often found in the pleuritic effusions. 

 I believe it is not only possible, but likely that the tuber- 

 cle bacilli do penetrate throug-h the alveolar septi, and en- 

 ter the pleura without producing- infection in the lung-s. 

 Tuberculosis may be differentiated by the ag-ar culture. 

 Hyper^esthesia of different parts is frequently present. 



I have washed out the cavity in 14 cases with an anti- 

 septic solution of one-half to two per cent of clove oil, with 

 most g-ratifying- results in 12 of the cases. The advantages 

 of this method are: Many patients will allow such an oper- 

 ation, who would object to an exsection of the rib ; no 

 bulky dressings are constantly interfering- with the com- 

 fort and convenience of both patient and physician ; much 

 shorter time is required. — Dung-lison's Colleg-e and Clini- 

 cal Record. 



Mixed Infection and Virulence of Diphtheria Bacilli. — 

 Dr. W. H. Park, said before the New York Patholog-ical 

 Society that he had been deeply interested in the question 

 of mixed infection, because of the important bearing- of 

 this subject on the anti-toxin treatment of diphtheria. He 

 presented temperature charts of three children affected 

 with laryngeal diphtheria. In the first case, between Feb- 

 ruary 11th and 19th, the temperature had rang-ed between 

 105 deg-rees and 105.5 degrees F. The glands had become 



