congestive forms of the disease, not to the non-congestive.

These results were applied to the theory that a change in the form of the crystalline lens was one of the causes of glaucoma. It has been shown that the lens progressively increases in size throughout life. He compares the treatment of acute glaucoma by iridectomy to the relief of strangulated hernia by operation.

SYMPATHETIC OPHTHALMITIS-STUDY OF TWO HUNDRED CASES.-Mr. Nettleship (British Medical Journal, March 20,) gives a report on two hundred cases of sympathetic ophthalmitis. From a study of these he reached the following conclusions:

The excision of the exciting eye soon after the onset of the sympathetic inflammation had not been proved to have any marked effect on the progress of the sympathetic disease, it certainly did not increase its severity.

Mercury seemed to have little effect on the disease. Iridectomy, performed on the sympathizing eye early in the disease, was thought to be less unfavorable than is usually held.

It was found that sympathetic inflammation rarely occurred unless the exciting eye had been perforated.

Only a dozen cases occurred more than a year after the primary injury, etc. In eighteen the interval was a month or less.

The proportion of cases of blindness was greater in the cases showing the longer interval than those showing the shorter.

In thirty cases the sympathetic inflammation had set in after the removal of the injured eye. In five cases the interval was from four to eight weeks. In all cases the exciting eye had been wounded and left in the socket long enough to excite the disease. It was concluded that the wounded eye was the cause of the sympathetic attack rather than the operation for its removal. On these cases more than half recovered entirely.

A NEW THEORY OF THE MECHANISM OF ACCOM

MODATION. Dr. Furney (Amer. Jour. Ophthalmology) advances the following theory of the changes which take place in the crystalline lens during accommodation. The size of the lens capsule is assumed to be constant. Its contents or the volume of the lens are assumed to be variable. This variability is supposed to be due to the injection into or withdrawal from the intercellular spaces of a small quantity of transparent liquid. The ciliary processes may serve as reservoirs of this liquid or possess the power of quickly secreting it.

It is assumed that the arteries contract and press the fluid out of these reservoirs into the lens, thus increasing its volume and the convexity of the anterior. segment and projecting it forward into the space left vacant by the reduction in volume of the ciliary pro

cesses or cysts of an equal amount. In this way every force is exactly balanced and a most perfect compensation is afforded for the change in volumes.

By a relaxation of the muscles the liquid would retreat from the lens into the reservoirs, again filling the space made vacant by the flattening of the lens.

The lens also is nourished at each effort of accommodation for a near object from a far one. By allowing too long an interval to elapse between such movements there may be a cause for disease for which the remedy would be at once apparer.t.

INTERSTITIAL KERATITIS, DENTAL MALFORMATION, AS RELATED TO HEREDITARY SYPHILIS.-Dr. A. W. Baker (Ophhthal. Review, Nov.) presents a study of fifty cases of interstitial keratitis. In two of these the keratitis was not typical. In these two the teeth were normal. In the remaining forty-eight cases Hutchinson's "syphilitic" teeth were present thirty-one times. The teeth were noted as doubtful or suspicious in three cases, normal in seven, and no note taken in seven cases.

In the forty-one cases of diffuse interstitial keratitis where the teeth were examined, thirty-one individuals were found with the typical syphilitic deformity of their teeth, three had suspicious teeth, and only seven possessed absolutely normal teeth.

Hutchinson's teeth were therefore present in more than seventy-five per cent. of the cases examined.

In twenty of the forty-eight cases of keratitis there was other definite evidence of syphilis aside from the keratitis and condition of the teeth. In the remaining twenty-eight cases there was no definite history of syphilis. But in no case was it certain that there was no syphilis. Thus, in more than forty-one per cent. of the cases of diffuse interstitial keratitis, evidence of hereditary syphilis was satisfactory, and in the remaining. cases no other cause could be assigned.

Thus it appears that hereditary syphilis is an efficient cause in producing Hutchinson's notched teeth and interstitial keratitis, and it is the only cause whose presence has been proven and whose efficiency is undeniable. The inference is plain that all cases of diffuse interstitial keratitis should have anti-syphilitic treatment to secure the most successful results.

JACKSON ON THE PRESCRIBING OF CYLINDRICAL GLASSES.—Dr. E.Jackson (American Journal of Ophthalmology) gives the following principles for prescribing cylindrical glasses:

One cylindrical glass of the proper strength, placed with its axis in the right direction, and with the proper spherical lens will correct any case of astigmatism, in so far as it is capable of correction by cylindrical lenses.

Having determined the degree of ametropia in the principal meridians of refraction, the proper correction is thus arrived at:

I.

Make the sperical plus or minus as the meridian of least ametropia requires a plus or minus correction. 2. Make the spherical just strong enough to correct the meridian of least ametropia.

3. Make the cylindrical plus or minus, as the meridian of greatest ametropia requires a plus or minus correction.

4. Make the refractive power of the cylindrical equal to the difference between the refractive powers of the principal meridians.

5. Place the cylindrical so that its axis corresponds with the axis of greatest ametropia, its meridian of greatest curvature corresponding to the meridian of greatest ametropia.

THE RESULTS OF THE OPERATION FOR CONVERGENT SQUINT.-Dr. D. B. St. John Roosa, in an able paper (Med. News) read before the last meeting of the New York State Medical Society, last February, sums up as follows:

I. The operation for convergent strabismus is successful in removing the deformity in from seventy to eighty per cent. of cases operated upon.

2. When complete control of the patient may be obtained, and as many tenotomies as are necessary are performed, the percentage may be easily raised to more than ninety-five.

3. No essential improvement of the vision of the squinting eye arises as a result of the operation.

ON THE CONNECTION BETWEEN OBSTRUCTION OF THE LACHRYMAL DUCT AND NASAL CATARRH.-Dr. Harrison Allen, of Philadelphia (Med. News), calls attention to the relation that sometimes exists between nasal catarrh and inflammation of the lachrymal duct. His attention was called to this condition in one of his patients, whom he was treating for chronic nasal catarrh. The lachrymal passage on the same side became inflamed and the lachrymal sac distended at the same time that treatment was progressing toward recovery. This led to an investigation, as the result of which the doctor has come to the conclusion that this condition is found in only two classes of cases, namely, in chronic nasal catarrh, in which there are submucous infiltrations and atrophies, and in cases in which the bony walls of the nasal chambers are attacked either by osteitis or necrosis.

Twenty patients were examined at Wills Hospital, and in every instance where the lachrymal duct was

obstructed, chronic nasal catarrh was also present. The number of cases in private practice, however, is much smaller, Dr. Allen having met with only three in all his practice.

JEQUIRITY POWDER IN TRACHOMA. Dr. Alt, (American Journal of Ophthalmology) from a considerable experience in the use of jequirity concludes thus:

1. That the inspergation of jequirity powder seems to be a much safer method than others in treating trachoma.

2. That its effect can be well dosed and confined almost to a small portion of a lid.

3. That in order to manage this effect in the way just mentioned, the powder must be applied directly to the parts to be affected by it.

4. That a peculiar infiltration of the granula will, a few days after the inspergation, give an idea of what number of granula are going to disappear, and how many may be expected to remain for further application of the powder.

5. That since I have used the remedy cautiously in the manner just described, I have seen nothing but good and excellent results from it, and especially in cases in which I should not have dared, from former experiences, to use the infusion of the jequirity bean.

THE EFFECTS OF THE GOUTY DIATHESIS UPON THE EYE.-Lychon (Recule d'ophthal., Amer. Jour Med. Sciences) gives the following results of his study of eye affections of persons of gouty diathesis:

1. Gout produces in the skin and conjunctiva of the eyelid a dry eczema, lithiasis, and a peculiar form of conjunctivitis.

2.

It causes in the cornea a calcareous degeneration of the epithelium.

3. It causes simple and complex inflammation of the sclerotic.

4. It causes iritis and irido-choroiditis of a special character.

It has a marked tendency to produce hæmorrhagic glaucoma.

nozzle of a perfectly clean scoop syringe is introduced well within the capsule and some distilled water at a temperature of 100° F. injected within the capsule. He reports most excellent results from actual experience with this procedure. He claims that the injection of water is innocuous; that it operates equally well in unripe as in ripe cataracts; that it shortened the duration of cataract operations; and that it is a most effective method for clearing the wound.

MATERIA MEDICA AND THERAPEUTICS. BINZ ON SOME NEW REMEDIES.-Dr. Binz, of Bonn, contributes to the Wiener Med. Blätter, No. 28 (London Med. Record), notes on a few drugs of recent introduction:

Arbutin. The principal constituent of the leaves of the uva ursi is a crystalline, slightly bitter, non-irritating glucoside, non-poisonous in doses of eight grammes (3 ii). In the bladder it appears partly broken up into sulphate of hydrochinon. Both bodies retard putrefaction, whence the value of arbutin (and in less degree the leaf) in catarrh of the bladder, a remarkable instance of which Binz saw in a case of nine years' duration, in a man aged 68, to whom he gave 1 gramme (15 grains) three times a day, in the form of a powder. It costs 30 pf. (about 8 cts.) the gramme.

Eucalyptol is an ethereal oil, colorless and aromatic, the chief constituent of the eucalyptus globulus. Its chemistry has been worked out by Hugo Schulz and Schleinitz; and others have observed in man what Binz had demonstrated in animals, that, while perfectly nonirritating to the most delicate tissues, it paralyses, as it were, the lymph-cells, and deprives them of the power of migrating through the walls of the vessels. Even when they have partly protruded, they may be seen under its influence to assume their spherical form, and losing their contractility, to fall back into the general blood-current. This remarkable property explains the control exerted by eucalyptol over suppuration.

Mercury-urea is a combination of corrosive sublimate and urea (HgCl2+ CH, N,O), which, in cheapness, stability, and absence of any irritating action on the skin, far surpasses all previous preparations designed to render corrosive sublimate available for subcutaneous injections. It is freely soluble in water, and does not precipitate albumen. One gramme dissolved in 100 cubic centimeters of distilled water remains unchanged for over a week. The dose for injection is 5 milligrammes to a centigramme, or 0.03 gramme as a maximum. In 1650 injections only .o were followed by abscesses, and six of these occurred in one individual specially prone thereto. A somewhat similar preparation, much used in the treatment of syphilis, is contained in the German Pharmacopoeia, the hydrargyrum cyanatum, a solution of mercuric cyanide, Hg Cyg.

10

Naphthalin (C1, Hg) is a derivative of benzole, and allied to phenol. When pure, it appears as a thin, white, shining, rhombic crystal, with a strong pungent odor and burning taste. Insoluble in water, it dissolves with ease in alcohol, ether, and fatty and ethereal oils. It is a powerful parasiticide, useful in scabies, and also in antiseptic surgery. Rossbach states that it exerts a considerable antimycotic action in enteric fever, even to the extent of cutting short the disease. For this purpose he gives 3 to 5 grammes daily, in divided doses. It undergoes only partial decomposition in the bowel, depriving the fæces of odor. It gives a dark color to the urine, and in large doses irritates the kidneys. In putrid states of the contents of the bowel, it has established its place as a remedy of approved value.

[Other observers have found the internal administration of naphthaline to produce renal irritation and other untoward effects; externally applied, it is of undoubted value in scabies, etc.—ED.]

Osmate of Potassium and Hyperosmic Acid.-The compound which is variously designated as osmic acid, per osmic acid, hyperosmic acid, is in reality an anhydride, having the composition Os O1, with a neutral reaction, easily parting with its oxygen to organic matter. Four to six drops of a one-per-cent. solution are of use, injected subcutaneously in peripheral neuralgia. It exerts a very slight local irritation of the skin, but, as one might expect from its pungent odor, it irritates and inflames the mucous membranes. The acid is a yellowish-white crystalline mass, easily volatile, extremely deliquescent and sparingly soluble in water. It is a very active poison. Heated, it breaks up into hyperosmic acid and osmic hydroxide. The potassium salt is darker in color, for.ning a red solution in water, with an alkaline reaction. It appears useful in epilepsy, given in the form of pills containing 1 milligramme (with kaolin), raised to 15 milligrammes daily.

[The hygroscopic nature of osmic acid, and its costliness will limit greatly its usefulness.-ED.]

JODOL-ITS DRAWBACKS.-From an editorial in the Medical News we abstract the following observations in regard to the new drug "iodol":

This drug was designed to replace iodoform, so disagreeable on account of its odor. It contains over 90 per cent. pure iodine but, it has been shown, it is so insoluble that it is nearly useless. The experiments were made by Dr. Sternberg. He used a saturated aqueous solution and also the powder. The solution added to decomposed urine, fresh urine, or gelatine had not the least power to prevent putrefaction. The powder added to the urine and well shaken was no better. Dr. Sternberg thought that on granulating surfaces it might possibly be decomposed and the iodine set free. In the experience of the writer, who has tried it faithfully in five cases of acute and chronic purulent otitis media,

such has not been the case. In three of these cases it caused pain which lasted for from one to twelve hours, and in two of the cases the drug had to be abandoned on this account. In a fourth case the disease (chronic) actually made a retrograde progress the iodol not hindering it in the least. Thus we are to lose a drug that at first seemed destined to supply a want long felt by the profession (and a profit to the druggists—one firm in the city asked $1.00 per drachm for it, from physicians), and so it must remain unless some means of dissolving it, as iodol, shall be discovered.

C.

HYDROCYANIC ACID AS A RESULT OF THE FERMENTATION OF FLAX SEED.-Jorissen, in the Bulletin of the Royal Academy of Belgium, has shown that a mixture of flax-seed meal and warm water exposed to a temperature of 80° F., will, upon distillation, yield a certain quantity of hydrocyanic acid. This observation has been confirmed by Senior, who has further shown that the reaction is not due, as has been supposed, to the presence of any adulterant in the flax seed. The application of these observations is evident.-Les Nouveaux Remèdes., Med. News.

ACTION OF MEDICINE.

THE ACTION OF KAIRINE.-Popoff, experimenting on frogs and dogs with the above antipyretic, concludes that:

I. Kairine is a blood-poison which acts mainly on the blood corpuscles, destroying their hæmoglobin, and partly on the plasma, increasing its coagulability (due to the passage of the products of decomposition of hæmoglobin from the blood corpuscles to the plasma).

2. It is also a cerebro-spinal poison, exciting the cerebral centres and paralyzing the transmissory centres (reflex) of the cord.

3. The drug at first produces cardiac slowing, with a subsequent increase in frequency; the former due to exhaustion of the excito-motor cardiac ganglia, and, probably, also, upon irritation of the inhibitory ganglia. The acceleration is caused by excitation of the central ends of the fibres of the pneumogastric nerve.

4. The arrest of the cardiac contraction as observed in kairine poisoning,can be explained only by paralysis of the motor cardiac ganglia.

5. Respiration is retarded-due to paralysis of the respiratory centres. It is arrested before complete cardiac paralysis is established.

6. Arterial tension, generally, sinks below the standard; varying greatly, however, with the cardiac action. The fall of blood-pressure is dependent on the failure of propulsive energy of the cardiac muscle.

7. The loss of motion which is observed in animals poisoned by kairine is of cardiac origin.

tory fibres of the vagus, and possibly of other similar nerves, the peripheral endings of which are paralyzed, are unaffected by the poison; while the peripheral endings of the sensory nerves are paralysed by kairine.

9. Kairine depresses both the normal and the febrile temperature.

The temperature of septic fever yields to the drug more readily than that of inflammatory fever.

The fall of the systemic temperature is dependent on a decrease of combustion in the body.

Large individual doses may be dangerous, since they inhibit the secretion of urine and thus interfere with the process of effacing the lesion produced by the drug. On the contrary, small individual doses increase the secretion of the urine, and thus enable us to repeat them at certain intervals, without any risk of accumulation of the drug in considerable quantities (St. Petersburgh Inaugural Dissertation)-London Med. Record, Nov., 1885.

PRACTICE of mediICINE.

M.

STAMMERING AND STUTTERING.-Dr. J. D'Orsey writes to the British Medical Journal, June 27, 1885, that, as much misapprehension exists concerning the above subjects, the following may be of interest:

1. Speech, or articulated voice, depends for its perfect production on vigor of mind, on sound natural organization, and on due training of the vocal or articulating apparatus.

2.

Stammering is inability to articulate, marked by slowness, stoppage, hesitation, and indistinctness, but not with repetition; whereas, stuttering consists in a painful repetition of the same consonants, often attended by flushing and facial contortions.

3. Stammering and stuttering may sometimes be caused by organic defects, such as cleft palate, harelip, enlarged uvula, inflamed tonsils, etc.; but these impediments are far more frequently due to functional causes, that is, habit, imitation, heredity, etc.

ness is often the consequence, or concomitant of stammering, rather than its cause. Organic defects must, of course, be treated medically or surgically, but the subsequent cure belongs to the elocutionist, while functional derangements (wrong action of the voice apparatus), are peculiarly his province.

process begins, the What is easily eradi

4. The sooner the curative greater is the prospect of success. cated at an early age becomes hard to remove at a later period; though at any time of life, alleviation, if not cure, can be assured as the result of perseverance. "He will grow out of it," is a fatal saying. A fair time ought to be given, according to the nature of the case; for "a few lessons" cannot reasonably be expected to undo the mischief of many years; and the teacher is often accused of failure, when the blame is solely attributable to the (Med. Record.)

C.

TREATMENT OF CATARRHAL PHTHISIS, HÆMOPTYSIS, AND CHRONIC BRONCHITIS BY TERPINE.-M. Germain Sée considers terpine to possess the power of modifying the mucous membrane of the respiratory tract, and to be also a powerful agent in checking its secretions. He says:

I. It diminishes and causes the disappearance of the purulent expectoration in the catarrhal forms of phthisis, since the purulent secretion proceeds from bronchi irritated by tubercle, or from the walls of pulmonary cavities; when the patient is in the beginning of the purulent stage, or, indeed, in the stage when cavities are beginning to form, terpine is indicated in all cases where the formation of pus is sufficient to fatigue the patient, destroy his strength, and cause wasting.

2. It is employed with success in haemoptysis of beginning tuberculosis; that is to say, when the disease has not yet advanced to the development of large cavities with aneurism of the pulmonary artery.

3. In the treatment of pulmonary catarrh, chronic bronchitis independent of asthma, and only causing dyspnoea by obstructing the bronchi, terpine constitutes the best means of decreasing the secretion.

4. Its action, prompt, certain, and free from physiological inconvenience, should make it preferable to preparations of tar and turpentine. It presents, more

over, on account of its perfect harmlessness and easy digestibility, advantages over creasote.

5. The best mode of administering the drug is either by pill or in alcoholic solution. The best dose is fifteen grains.

6. In the treatment of nervous asthma, emphysematous or catarrhal, which must be distinguished from primitive catarrh, iodine, and pyridine, possess undoubted superiority. (L'Abeille Médicale; Med. News.)

E.

HAY-FEVER: ITS CAUSE AND CURE.-Dr. Fletcher Ingals (Chicago Med. Jour. and Examiner), in an able article, reviews this troublesome affection, and comes to the following conclusions regarding its cure:

1. Nearly all cases may be cured by systematic, thorough, superficial cauterization of the hypersensitive portions of the nasal mucous membrane, providing the treatment is carried out during the interval between attacks.

2. The most effective and least painful means of accomplishing this, is by the galvano-cautery.

3. Care must be exercised to treat every sensitive spot, and not to cauterize too large a surface at

once.

4. The operation may be made painless by a proper use of hydrochlorate of cocaine.

5. In nervous subjects general treatment must not be neglected.

6. The effect of cocaine in hypertrophic catarrh, and in the case of idiosyncratic coryza just reported,

STRYCHNINE IN ACUTE ALCOHOLISM.-—Dr. Lardier has long employed strychnine in the treatment of delirium tremens, and regards it as the best remedy which we possess for this condition; as, in fact, a veritable specific. He insists upon the necessity of giving the drug in large doses. In one case he had given granules containing each grain, every two hours for several days, without any appreciable result. He then increased the number of granules and also administered the drug hypodermic. ally, giving in all 13 grains in the space of twenty-three

The pa

hours. The result was a most happy one. tient soon fell into a refreshing sleep, never exhibiting the slightest symptoms of strychnine poisoning. (Jour. de Méd. et de Chirurgie Pratiques, June, 1885; Medical Record.)

ON THE TREATMENT OF ACUTE CORYZA.-Dr. Solomon Solis-Cohen, in the Medical Times, recommends strongly the internal use of belladonna, or atropine, in doses of to grain of the latter. This is to be repeated every four hours, until the physiological effectdryness of the throat and dilatation of the pupil-is produced. Usually two or three doses will suffice. Where the "cold" has reached an advanced stage, and atropine is insufficient, ammmonium salicylate in ten to fifteen grain doses, every two hours, until tinnitus aurium is produced, has been the most effective remedy in the doctor's hands.

Salicylate of cinchonidine is of great benefit in the later stages with constitutional symptoms.

THE PERSONAL EQUATION IN PRESCRIBING.-Dr. Roberts, in his address on Roberts, in his address on "Therapeutics," read before the British Medical Association, states an undoubted