434 THE AMERICAN MONTHLY [Dec 



IIEDICAL MICROSCOPY. 



Pleuritic Effusions and their Treatment. — A bacterio- 

 logical examination should be made in all cases; both with 

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

 the effusion in animals. Disting'uish between exudate and 

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

 sameprocess 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 percent of pleuritic cases are rheumatic. The tinding- 

 of pneumococci does not aggravate the conditions, and 

 often gives 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 through the alveolar se])ti, and en- 

 ter the pleura without producing infection in the lungs. 

 Tuberculosis may be differentiated by the agar culture. 

 H3'peraDsthesia 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 gratifying 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. — Dunglison's College and Clini- 

 cal Record. 



Mixed Infection and Virulence of Diphtheria Bacilli. — 

 Dr. W. H. Park, said before the New York Pathological 

 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 ranged between 

 105 degrees and 105.5 degrees F. The glands had become 



