tempted to do all that he was directed. | eye wards, reports (Brit. Med. Journ., Oct. He did not protrude his tongue when 26, 1872) the following cases treated in asked, but it did not seem as if that were Guy's Hospital. The solution used confrom paralysis of that organ, as he opened sisted of eight grains of the nitrate of his mouth and showed the tip of the strychnia in an ounce of water. The tongue, which was in the median line. treatment was commenced by injecting He continued in this way until the fifth ten minims into one of the temples three day, his breathing gradually becoming times a week, and the amount was inmore difficult, and he died. From the creased or diminished as seemed necestime he was first seen by Mr. McCarthy sary. A very large amount of the injecuntil his death he never uttered a word, tion (twenty-five minims) was used in nor could he write, although he made some cases without any bad symptoms. several attempts to do so. In the cases that improved under treatment, one eye only seemed to recover; but, although the patients were on the whole able to see much better, no change was observable by the ophthalmoscope. At the post-mortem examination the fracture was found to have traversed the course of the middle meningeal artery, which had not, however, sustained any injury. There was a laceration of the dura mater, some distance from the margin of the opening in the bone, which had doubtless been caused by one of the splinters removed at the operation having been driven through it at the time of the accident. There was no blood between the dura mater and bone, or in the arachnoid sac. There was a very little ecchymosis in the pia mater at the bifurcation of the Sylvian fissure, and beneath that a very small clot in the brain-substance. On tracing this there was found a large clot imbedded in the frontal lobe at its posterior part, coming to the surface by only a very small extent. It occupied the portion of the lobe corresponding to the interior and posterior part of the external frontal convolutions, and very closely bordered on the central lobe. When the clot was removed the brainsubstance presented the usual appearance when a clot has been found after an apoplectic seizure. The right hemisphere was ecchymosed very superficially. The vessels of the brain were much diseased. The basilar artery was varicose and opaque, and the inner coat was readily peeled off, showing the atheromatous degeneration beneath. The middle cerebral artery and its branches were in a similar condition. The other viscera were normal.-Lancet, Nov. 16, 1872. Cases of Anaemia of Optic Nerve treated with the Hypodermic Injection of Strychnia. -C. J. W. PINCHING, late dresser in the The test-types referred to in the following report of cases are those of Dr. Snellen of Utrecht. CASE I. Sarah M., aged 36, married, no family; catamenia regular. Three years ago, her right leg was paralyzed. She had regained use of it since, and had walked for the last twelve months. At the time of the seizure, her sight became so dim that she could not read; her left eye became worse, and for the last eighteen months she had scarcely been able to see the window with it. She could see with her right eye to go about. On admission, her right eye was sensitive to reflected light, and with it she could see coloured letters on a black ground (type XX), one or two of which she could distinguish. With her left eye she could not see reflected light, and called the A of type c c something black on a white ground. The ophthalmoscope showed in both eyes an optic disk, white throughout and the veins of the retina somewhat dilated, but much below par as regarded number. In this case, I injected ten minims three times a week for a fortnight, with slight improvement, the patient being able at the end of the time to read three letters of type vi with her right eye. I then increased the amount to fifteen minims, and continued for another fortnight with steady improvement, the patient being able to read all type iv, and some few letters of type III. I increased the amount to twenty minims; after the first injection she was giddy, and could not walk for a short | eased, and she lost the sight of it very time, but after this there was no bad quickly; she had not been able to see her symptom. I continued for a week, when way about for six months. There was no she had to go into the country for a month. history of bad sight in her family. She She was now able to read type III well had had pains in her head for two years. with her right eye; her left eye had made On admission, she could just distinguish no improvement. The ophthalmoscope the windows and fire with both eyes. The showed no change. ophthalmoscope showed, in the right eye slight anæmia of the optic disk, and numerous atrophic black pigment patches throughout the choroid. In the left eye the optic disk was slightly anæmic. The blood-supply to the retina was defective; the veins were slightly varicose. In this case, I injected ten minims for a fortnight and increased the injection to fifteen min She returned, after a month's absence, in the same condition as when she left. I now continued an injection of ten minims for a month, at the end of which time she could read most of type II with her right eye. She went away again for three weeks, and returned, her right eye being as well as when she left the hospital, her left having made no improve-ims for another fortnight, without the ment since the commencement of the treatment. The ophthalmoscopic appearances remained the same as on admission. CASE II. Susan G., aged 24, single, dressmaker, had always enjoyed good health; her catamenia were regular. Five weeks ago, she found she could not read, and, a little later, that she could not thread her needle; she gradually became worse. slightest change taking place. CASE IV.-Walter H., aged 19, had always enjoyed good health; had never smoked nor drunk. He could see to read quite well a month ago, when he thought he "caught cold in his eyes," since which his sight had been going gradually. On admission, perception of light and of reflected light was good with both eyes. He had no discrimination of colours. With the right eye he could see to read type xxx; with the left he could see the A of type cc. The ophthalmoscope showed in both eyes an optic disk, white throughout, and slight anæmia of the retina. In this case, for three weeks I injected ten minims, with slight improvement in the right eye. I then increased the amount to fifteen minims for a fortnight, with marked improvement, the patient being able to read type x with his right eye, and one or two letters of type LXX with his left, and to distinguish the colours blue and red with both. After a month's absence he returned, still in the same condition. I injected ten minims for a fortnight, when he left the hospital, On admission, she could just see light with her right eye, and could tell when a hand was passed before her face. With her left eye she had good perception of light and reflected light, and could read type XL and a few letters of type xxx. The ophthalmoscope showed that both optic disks were white throughout. In this case, I injected ten minims for a month, with steady improvement; at the end of this time she was able to read type VIII with her left eye. I continued for another month with the same amount, but she made very little progress, sometimes being able to read a few letters of type VII. At this time, she left the hospital, her right eye having made no improvement. The ophthalmoscopic ap-able with his right eye to read all type Iv pearances had not changed since admission. and most of type III, and to distinguish yellow and blue, calling red purple. His left eye made no further progress. The ophthalmoscopic appearances were not changed. CASE III.-Eliza H., aged 36, single, artificial flower maker, had worked a great deal by gaslight. The catamenia were regular. She could see well with both CASE V.-David M., aged 45, single, an eyes seventeen months ago. Nine months engineer, with no history of syphilis, had ago, she could not read with the right eye. smoked largely (an ounce of shag tobacco At this time, the left eye also became dis- | daily), and drunk considerably of spirits. Eighteen months ago he arrived in Rus-ences," and the "Boston Medical and sia with perfectly good sight; fifteen Surgical Journal" survive. It has seen months ago, while still in Russia, his feet many promising enterprises started, full and legs began to swell, and they pitted of hope, and with the brightest assuron pressure. A week after this his sight ances of success, only to perish after an failed quite suddenly, and the next day unavailing struggle with the obstacles was so imperfect as to compel him to which are sometimes not to be overcome leave off work, which he had been unable by the highest deserts. It has welcomed to resume, his sight still continuing in the its present contemporaries one by one into the field of common labor, and has watched their growth with the interest which should inspire fellow laborers in a cause so sacred as that of medical progress. It has sedulously cultivated the most friendly relations with all, and it has no memories of strife to embitter the retrospect. same state. On admission, he complained of numbness and pain in the feet and legs; they were not swollen. There were no cerebral symptoms. He had good perception of light and reflected light with both eyes; he could read type XVIII with his right eye, and type xx with his left. The ophthalmoscope showed, in both eyes, anæmia of the inner two-thirds of the optic disc, and anæmia of the retina; otherwise they were both healthy. I here injected ten minims for five weeks, with gradual improvement, the patient being able to read type v with his right eye at the end of this time. I then increased the amount to fifteen minims, and continued it for three weeks, but without improvement. The left eye remained the same as on admission. The ophthalmoscope showed no changes. I also took under my care two of Mr. Pye-Smith's cases (Nos. v and vi, reported in the British Medical Journal of May 18th, 1872) which had been unsuccessful under galvanism, but, I am sorry to say, without good result. MEDICAL NEWS. TO OUR SUBSCRIBERS. OBSERVING the words "No. 361" on the title-page of this number, we are reminded of the fact that the " MEDICAL NEWS AND LIBRARY" has completed its thirtieth year, and has entered upon its thirty-first. During this time it has been the witness of many vicissitudes in medical journalism. Few of the contemporaries who gave their kindly greeting to its first number are still in existence; indeed, if our memory serves us aright, only the "American Journal of the Medical Sci We feel that in our own modest and un pretending way we have not failed to render the service which we anticipated when we commenced the enterprise. As we look upon the solid row of thirty completed volumes we see them filled with the record of scientific progress during an era of development that has no parallel in previous medical history. In merely that portion of our pages which has been devoted to our " Library Department" we have been instrumental in spreading broadcast before the profession many of the works which have done the most to influence the professional mind and stamp their impress upon the age. Beginning, as we did, with the classical lectures of Dr. WATSON "ON THE PRINCIPLES AND PRACTICE OF PHYSIC," which we were the first to lay before the American profession, we have furnished to our readers Sir Benjamin Brodie's "Clinical Lectures on Surgery," Todd and Bowman's "Physiological Anatomy and Physiology of Man," West's 66 Lectures on the Diseases of Children," Simon's "General Pathology," Malgaigne's "Operative Surgery," Bennett's treatise on "Tuberculosis," West "On Diseases of the Os Uteri,” Brown “On the Surgical Diseases of Women," West's "Lectures on the Diseases of Women," Habershon On the Alimentary Canal," Sir James Simpson's "Clinical Lectures on the Diseases of Women," Smith "On Consumption; its early and remediable Stages," Salter "On Asthma, its Pathology, Consequences, and Treatment," 66 66 Handfield Jones's "Clinical Observations on Functional Nervous Disorders," Erichsen "On Railway and other Injuries of the Nervous System," Hudson's 'Lectures on the Study of Fevers," Eustace Smith "On the Wasting Diseases of Children," Radcliffe and others "On Diseases of the Spinal Column and of the Nerves," and Dunglison's translation of Guersant "On the Surgical Diseases of Infants and Children," making in all twenty octavo volumes, some of them of large size. We think that our subscribers have had no reason to complain, and the fact that we never addressed so wide a circle of readers as in the year 1872, and that some old friends who subscribed for the "NEWS" at its commencement are still upon our books, would seem to show that we have succeeded in our task. At the mature age of thirty completed years the "NEWS" feels that it is still in its early vigour. Never have its arrangements been more complete for supplying an abundance of professional reading to its subscribers, and never have the prospects been more promising for an enlarged sphere of usefulness. When thirty years more of its career have been numbered, we feel assured that our successors, in the year of grace, 1903, will be earnestly engaged in ministering to the intellectual needs of a still larger body of readers of a new generation. Injury to Lower End of Femur; Excision of five and a half inches of that Bone; Recovery. By AUG. CAMPBELL, M.D., of Dunleith, Ill. Henry A., German, aged 18, while working with a threshing machine, was caught in the tumbling rod. He had on a large pair of strong duck overalls, one of the legs of which was caught and drawn above the knee, and then the force exerted at right angles to the femur. This bone separated at the epiphysis, and five or six inches of it, entirely denuded of its periosteum, was driven through the external part of the leg into the dirt. I decided on a conservative course-to remove the end of the bone and wait. I accordingly removed five and a half inches of the femur, dressed the wound with water dressing, made extension and counterextension with a straight splint. There was a profuse discharge and some small spicula of bone worked out. I afterwards dressed it with a starch bandage. One year after the injury, he was walking without crutch or cane. The following year and since he has done the usual work upon a farm. The leg is about one inch and three-fourths shorter than the other. The foot moves upon the radius of a circle about twenty inches. The patient, although liable to corns and cold toes, says he prefers the old leg to one of Palmer's best. [Accompanying the above account was an excellent photograph, taken a year after the accident, exhibiting the appearance of the patient at that time.] On Some of the Uses of Carbolic Acid. By J. F. MACDONALD, M.D., of Hopewell, Nova Scotia. In the Medical News for December, 1872, I noticed an article on the Local Treatment, by Carbolic Acid, of Diphtheria, by Dr. H. Reynolds, of Maine. I wish to add my testimony to the use of carbolic acid in the treatment of that disease. About four years ago I began to use carbolic acid in the treatment of inflammatory sore throat and tonsillitis, in which I found it very useful. I use a gargle of a weak solution of carbolic acid, with chlorate of potassa. In severe cases I apply, by means of a camel-hair brush or wisp of cotton, a solution of the acid and water equal parts. In October, 1870, I first used carbolic acid in the treatment of diphtheria, and have, thus far, found it eminently successful. I apply, by means of a camelhair pencil or cotton wisp, to the part affected, carbolic acid 15 parts, water 5 parts, or equal parts of each. I also use a gargle of a solution of the acid and chlorate of potassa. In toothache it acts like a charm; in most cases relieving pain almost instantaneously. I apply the pure acid on lint to the carious tooth, repeating, if necessary, till pain is relieved. The acid kept in so lution by adding one-twentieth of its bulk of water is preferable. It will not injure the sound teeth. I have treated some skin diseases successfully by means of carbolic acid. In scabies I never knew it fail. I have found it safe, and not unpleasant. A professional friend told me a year ago that "Carbolic acid was his specific in treatment of itch." In herpes, eczema, tinea, psoriasis, and acne, I have found it very useful. In eczema infantilis it is especially useful. I have never seen it fail in producing a speedy cure. The solutions I generally use are, acid. carbol. 3j, or Zij, aq. ad Oj, or, what is better, the acid dissolved in glycerine. In tinea tonsurans I apply, by means of a camel-hair pencil, acid. carbol. 15 parts, water 5 parts; it will rarely need a second application. Internally I have used carbolic acid, but cannot say that I have seen any benefit from its use. In nausea and vomiting of pregnancy, in my hands, it has been a failure. Death by Chloroform, and alleged Death by Ether.-Dr. HENRY J. BIGELOW, of Boston, contributes to the Bost. Med. and Surg. Journ., Oct. 24, 1872, an able review of the cases of "death from ether," reported in the Medical Record of Oct. 1st, 1872 (see Medical News, Nov. 1872). Dr. Bigelow ascribes the death of this patient to having been gradually narcotized with ether until life was extinguished. "If the narcotism1 of ether," he says, "is ever fatal to an aged or exhausted subject, in the way described, it should be remembered that chloroform would be more fatal to the same patient under the same circumstances. opium, and is most likely to occur with the strongest of these agents. Moreover, precaution will prevent it. "But death from chloroform,' which has given to chloroform its doubtful reputation, is a different thing, which no human foresight can avert. It is death from a small and usual dose of this powerful agent; death to a healthy person, sometimes as sudden as by a stroke of lightning, without warning of any sort-by shock. We hold that ether has never produced such a result, but always gives fair and adequate notice of the approach of danger. to "If these views are correct, it follows that a certain small proportion of 'deaths from chloroform,' so called, should be subtracted from its bill of mortality, and credited to a narcotism' common ether and chloroform. But a similar analysis will wholly expunge the two or three fatal cases, for which ether has been by some persons held to answer. Chloroform will still be responsible for its monthly record of death by 'shock,' small in its percentage it may be, but inevitable, while ether will then have a clean bill of health." Dr. Bigelow says, if called upon to indicate in the absence of complete evidence, the probable cause of this death, he should perhaps rearrange the statement somewhat as follows: "A man of nearly 70 years, reduced by a fracture near the trochanter, of eighteen days' standing, and by pneumonia, was subjected to a somewhat protracted inhalation before coming under the influence of ether. At the end of ten or twelve minutes, his breathing became so feeble and irregular that etherization was suspended and artificial respiration was resorted to. In the course of four or five minutes more, there being some muscular action, the respiration being also stronger, and the pulse better, the ether was again administered, but the same bad symptoms soon supervened. On examination, the pupils were now found to be dilated. The heart was still beating (although there was probably no pulse at the wrist), but attempts at resuscitation were this time ineffectual. |