PHYSIOLOGY. 



T15 



long time. Cardiac weakness and dilatation oc- 

 curring in children from a primary insufficiency 

 of the heart muscle is regarded by Germain See 

 and other French physicians as due to the rapid 

 growth of body and of stature which takes place 

 toward the close of childhood, a growth in which 

 the heart muscle also participates. Other au- 

 thors have observed that the essential cardiac 

 condition is not one of true muscular increase of 

 growth or hypertrophy, but one of cardiac dila- 

 tation. Scrofulous children are especially dis- 

 posed to this, and the demands of school life are 

 mentioned as a possible exciting cause. In adults 

 alcohol is the most important predisposing cause 

 of heart insufficiency. 



From observations on the effect of baths, mas- 

 sage, and exercise on the blood pressure, W. Edge- 

 combe and W. Bain find that cold immersion 

 baths of plain water raise the arterial pressures, 

 maximum and mean, and lower the venous pres- 

 sure; after reaction the arterial pressure falls and 

 the venous pressure rises. The results may be 

 attributed to rise in peripheral resistance. Per- 

 cussion added to cold increases the rise in arterial 

 pressure. Hot immersion baths of plain water 

 lower the arterial pressure, and both absolutely 

 and relatively lower the venous pressure to an 

 extent roughly proportionate to the increase in 

 temperature. Turkish baths lower the arterial 

 -and venous pressure to a greater extent than the 

 preceding, though the fall in venous pressure is 

 proportionately not so great as that in arterial 

 pressure. Saline baths at warm temperatures 

 lower the arterial pressure to a greater extent 

 than plain water baths at the same temperatures. 

 The venous pressure, though absolutely lowered, 

 is relatively raised. When the amount of saline 

 matter in solution is considerable, and especially 

 if the factor of aeration is added, a further lower- 

 ing of arterial pressure takes place, while the 

 venous pressure becomes absolutely raised. Dry 

 massage lowers the arterial pressure and rela- 

 tively or absolutely raises the venous pressure, 

 provided it be not performed too vigorously. 

 When this is done, a rise in all pressure occurs. 

 Warm temperature plus massage, as in the Aix 

 douche, lowers the arterial and raises absolutely 

 the venous pressure to a greater extent than dry 

 massage. The effect of the Aix douche is cumu- 

 lative. In the Vichy douche, when the needle- 

 -spray form of application and the recumbent pos- 

 ture have influence, a rise in arterial pressure 

 takes place. The effect of exercise on blood pres- 

 sure depends on the severity of the work per- 

 formed. In all forms an initial rise in arterial 

 pressure occurs ; if the exercise is mild and insuffi- 

 cient to excite increased frequency of pulse and 

 respiration, a fall in arterial pressure occurs dur- 

 ing continuance of exercise; if it is severe, with 

 marked increase in frequency of pulse and respi- 

 ration, the initial rise becomes increased and may 

 be maintained throughout the exercise. After ex- 

 ercise, moderate or severe, a fall in arterial pres- 

 sure takes place. The venous pressure is raised 

 during all forms of exercise, and remains raised 

 during the subsequent arterial fall. The return 

 of the blood pressure to normal after exercise 

 1;ikes place more or less rapidly according to the 

 gentleness or severity of the exercise and the 

 temperature of the atmosphere. 



An important study of the variations of tem- 

 perature and pulse in attacks of idiopathic epi- 

 lepsy, epileptic vertigo, and hystero-epilepsy has 

 been published by Marchand. This author finds 

 that epileptic attacks cause an elevation of tem- 

 perature of 0.5 C. on an average, lasting gen- 

 erally about forty minutes after the fit. This 



rise of temperature is distinctly noticeable ten 

 minutes after the fit, and attains its maximum 

 which lasts only ten minutes in twenty minutes 

 after it. Attacks of epileptic vertigo cause a de- 

 cidedly less but still noticeable elevation of tem- 

 perature. Epileptiforrn attacks of general paral- 

 ysis cause a marked elevation of temperature 

 comparable to that occurring in true epilepsy. 

 In all cases, whether of epilepsy or epileptic ver- 

 tigo, there is in general no relation between the 

 maximum height reached by the temperature and 

 the age of the patient, and in the same patient 

 different attacks may produce slightly different 

 temperatures. The pulse rises about 31 beats in 

 frequency per minute above the normal after a fit, 

 but fifty minutes after the fit it has fallen to the 

 normal. The highest pulse rate is attained six- 

 teen minutes after the attack, and this rate per- 

 sists for five minutes. Both temperature and 

 pulse fall after maximum slowly and steadily to 

 normal, or only with slight oscillations during 

 subsidence. In epileptic vertigo the pulse rises 

 in proportion to the intensity of the attack. The 

 elevation of temperature in epileptic vertigo is 

 0.3 C.; it lasts forty minutes. The maximum 

 is attained fifteen minutes after the attack, and 

 continues thirteen minutes, after which a gradual 

 subsidence takes place. Hystero-epilepsy in- 

 creases the temperature 0.4 C., and the elevation 

 lasts thirty-five minutes, while a direct ratio ex- 

 ists between the length of the attack and the ele- 

 vation of temperature. The duration of the maxi- 

 mum temperature is eight minutes, and the fall to 

 normal is gradual. The pulse in hystero-epilepsy 

 rises 57 beats, and the acceleration lasts twenty- 

 four minutes. The maximum pulse rate is attained 

 at the onset of the attack (epileptoid period), and 

 this rate lasts for four minutes. The subsidence 

 thereafter is irregular, and marked by consider- 

 able oscillations of the pulse rate. No relation is 

 apparent between the duration of an attack and 

 the maximum rate attained by the pulse in hys- 

 tero-epilepsy. On the whole, the cardiac disturb- 

 ance, indicated by the modification and irregular 

 fall of the pulse, is much more marked than are 

 the temperature variations in hystero-epilepsy. 



Experiments by J. W. W. Stephens and W. 

 Myers, constituting an elaboration of some inves- 

 tigations previously described by Kantheck, show 

 that cobra poison delays or prevents the clotting 

 of normal rabbits' blood; that this inhibitory 

 action of cobra poison upon the clotting is neu- 

 tralized in vitro by Calmette's antivenomous 

 serum; that the action of the antivenomous 

 serum in vitro is specific; that the antivenom- 

 ous serum itself, when added to blood, delays 

 clotting; that for certain doses of cobra poison 

 (0.1 milligramme) the measure of the neutraliza- 

 tion in vitro, using clotting as the test reaction, 

 is also the measure of the neutralization in cor- 

 pore for guinea pigs; that the neutralization of 

 the toxin by the antitoxin in vitro is certainly 

 not vital or cellular, but must be chemical; and 

 that the blood of a rabbit immunized with in- 

 jections of cobra poison, so far as clotting is con- 

 cerned, has also acquired a certain amount of 

 immunity against cobra poison. 



MM. P. Cazeneuve and P. Breteau represented 

 in the French Academy of Sciences that pure 

 crystallized hsematine prepared from the blood of 

 the cow, horse, and sheep show distinct differ- 

 ences in composition, particularly in the amounts 

 of iron and nitrogen. 



Digestion. An important source of discrep- 

 ancies in fact and opinion in the results of study 

 of the physiology of the intestinal movements 

 lies in the circumstance that the muscular coat 



