Erratum

[This corrects the article on p. 637 in vol. 13.].

ment which would result from routine nursing care and from medical examination.
It is necessary to ensure an adequate intake of liquid. Water, fruit-juices, with glucose and lactose, are the most suitable. Milk is not easily digested by a toxaemic patient and is best avoided. Small quantities of brandy at regular intervals are sometimes advised, especially if the patient shows signs of exhaustion.
Acute pain in the chest, due to pleurisy, is common. It is best treated by the application of local heat. The usual poultice is composed of kaolin, which does not retain heat well and forms a cold, clammy lump on the chest in too short a time. On removal it leaves a sticky mess which needs considerable cleaning of t!he skin, and is a frequent source of irritation to the physician who wishes to examine 1:he chest. A linseed meal poultice retains the heat longer and is much cleaner.
Persistent pain may be treated by counterirritation. A mustard leaf, or even a blister, is usually effective.
Abdominal distension is a symptom of severe toxaemia, and it may also be a factor impeding respiration. A milk diet is sometimes -the cause. The distension may be relieved by a gently given turpentine enema. In very ill patients-a turpentine stupe is often helpful.
The cyanosed patient needs oxygen, but a tent is oftien badly tolerated by the patient who needs it most. The Tudor Edwards frame, although less efficient, is preferable in such cases.
In the absence of response to specific tJherapy with antibiotics the medical treatment is mainly directed to the relief of symptoms and control of complications.
At one time morphia was given freely in order to allay restlessness and secure sleep. The drug is usually effective, but it has disadvantages. Some patients are intolerant, and others are allergic. It must be given with care when there is abdominal distension or weakness of the circulation. A useful alternative is paraldehyde, given intramuscularly in doses of 6 to 8 ml.
Any sign of failure of the circulation, such as diminution in the volume of the pulse or a falling blood pressure, is an indication for digitalis, which is often very effective. It should be used early, whenever there is the least suggestion of weakness of the heart's action.
Gross cyanosis, with fulness of the veins in the neck, is still an indication for venesection, which is not practised as often as it might be.
Before the discovery of the antibiotics the drug which was most popular in the treatment of acute lung infections was quinine. It was given by injection, usually as transpulmin, and it was considered to be particularly useful in cases of bronohopneumonia following influenza. Failing an indication for a specific drug, quinine is still worth a trial.
Sometimes a lung infection appears to respond to the proper antibiotic, but the temperature rises after a day or two and the sputum again becomes purulent. In such cases an examination for monilia in the sputum should be carried out. Moniliasis is a not infrequent subsidiary infection, especially in elderly patients, and it usually responds quickly to nystatin.
The danger of our present success in t:he treatment of pneumonia is that it may cause us to become complacent. This attitude will not be an asset when we are faced with an acute pneumonia which fails to respond to antibiotics. There are plenty of supporting measures, both from t:he medical and from the nursing aspect, and they should he kept in mind, to be used in case of need.

Erratum
We regret that, in the June issue, page 432, Fig. 1 (d) in the article Ulcerative Colitis by S. C. Truelove, MD, MRCP, was wrongly cap• tioned. This should read: Epithelial cells in carcinoma of the colon.