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congestive forms of the disease, not to the non-conges- cesses or cysts of an equal amount. In this way every tive.
force is exactly balanced and a most perfect compensaThese results were applied to the theory that a tion is afforded for the change in volumes. change in the form of the crystalline lens was one of the By a relaxation of the muscles the liquid would recauses of glaucoma. It has been shown that the lens treat from the lens into the reservoirs, again filling the progressively increases in size throughout life. He com- space made vacant by the flattening of the lens. pares the treatment of acute glaucoma by iridectomy to The lens also is nourished at each effort of accomthe relief of strangulated hernia by operation.
modation for a near object from a far one. By allowing
too long an interval to elapse between such movements SYMPATHETIC OPHTHALMITIS-STUDY
there may be a cause for disease for which the remedy HUNDRED CASES.- Mr. Nettleship (British Medical would be at once apparert. Journal, March 20,) gives a report on two hundred cases of sympathetic ophthalmitis. From a study of these he INTERSTITIAL KERATITIS, DentAL MALFORMAreached the following conclusions:
TION, AS RELATED TO HEREDITARY SYPHILIS.-Dr. A. The excision of the exciting eye soon after the W. Baker (Ophthal, Review, Nov.) presents a study of onset of the sympathetic inflammation had not been fifty cases of interstitial keratitis. In two of these the proved to have any marked effect on the progress of the keratitis was not typical. In these two the teeth were sympathetic disease, it certainly did not increase its normal. In the remaining forty-eight cases Hutchinson's severity.
“syphilitic” teeth were present thirty-one times. The Mercury seemed to have little effect on the disease. teeth were noted as doubtful or suspicious in three cases,
Iridectomy, performed on the sympathizing eye early normal in seven, and no note taken in seven cases. in the disease, was thought to be less unfavorable than is In the forty-one cases of diffuse interstitial keratitis usually held.
where the teeth were examined, thirty-one individuals It was found that sympathetic inflammation rarely were found with the typical syphilitic deformity of their occurred unless the exciting eye had been perforated. teeth, three had suspicious teeth, and only seven pos
Only a dozen cases occurred more than a year after sessed absolutely normal teeth. the primary injury, etc. In eighteen the interval was a Hutchinson's teeth were therefore present in more month or less.
than seventy-five per cent. of the cases examined. The proportion of cases of blindness was greater in In twenty of the forty-eight cases of keratitis there the cases showing the longer interval than those showing was other definite evidence of syphilis aside from the the shorter.
keratitis and condition of the teeth. In the remaining In thirty cases the sympathetic inflammation had set twenty-eight cases there was no definite history of syphiin after the removal of the injured eye. In five cases lis. But in no case was it certain that there was no the interval was from four to eight weeks. In all cases syphilis. Thus, in more than forty-one per cent. of the the exciting eye had been wounded and left in the socket cases of diffuse interstitial keratitis, evidence of heredilong enough to excite the disease. It was concluded
tary syphilis was satisfactory, and in the remaining that the wounded eye was the cause of the sympathetic cases no other cause could be assigned. attack rather than the operation for its removal. On Thus it appears that hereditary syphilis is an efficient these cases more than half recovered entirely.
cause in producing Hutchinson's notched teeth and in
terstitial keratitis, and it is the only cause whose presence A New THEORY OF THE MECHANISM OF ACCOM
has been proven and whose efficiency is undeniable. MODATION.-Dr. Furney (Amer. Jour. Ophthalmology)
The inference is plain that all cases of diffuse interstitial advances the following theory of the changes which take
keratitis should have anti-syphilitic treatment to secure place in the crystalline lens during accommodation. The
the most successful results. size of the lens capsule is assumed to be constant. Its contents or the volume of the lens are assumed to be JacksON ON THE PRESCRIBING OF CYLINDRICAL variable. This variability is supposed to be due to the GLASSES.—Dr. E. Jackson (American Journal of Ophthal. injection into or withdrawal from the intercellular spaces mology) gives the following principles for prescribing of a small quantity of transparent liquid. The ciliary cylindrical glasses: processes may serve as reservoirs of this liquid or possess One cylindrical glass of the proper strength, placed the power of quickly secreting it.
with its axis in the right direction, and with the proper It is assumed that the arteries contract and press spherical lens will correct any case of astigmatism, in so the fluid out of these reservoirs into the lens, thus in- far as it is capable of correction by cylindrical lenses. creasing its volume and the convexity of the anterior Having determined the degree of ametropia in the segment and projecting it forward into the space left principal meridians of refraction, the proper correction vacant by the reduction in volume of the ciliary pro- is thus arrived at:
Make the sperical plus or minus as the meridian obstructed, chronic nasal catarrh was also present. The of least ametropia requires a plus or minus correction. number of cases in private practice, however, is much
Make the spherical just strong enough to correct smaller, Dr. Allen having met with only three in all his the meridian of least ametropia.
practice. 3. Make the cylindrical plus or minus, as the meridian of greatest ametropia requires a plus or minus JEQUIRITY POWDER IN TRACHOMA. — Dr. Alt,
(American Journal of Ophthalmology) from a considerable 4. Make the refractive power of the cylindrical experience in the use of jequirity concludes thus: equal to the difference between the refractive powers of
1. That the inspergation of jequirity powder seems the principal meridians.
to be a much safer method than others in treating 5. Place the cylindrical so that its axis corresponds trachoma. with the axis of greatest ametropia, its meridian of great
2. That its effect can be well dosed and confined est curvature corresponding to the meridian of greatest almost to a small portion of a lid. ametropia.
3. That in order to manage this effect in the way
just mentioned, the powder must be applied directly to The Results OF THE OPERATION FOR Converg- the parts to be affected by it. ENT SQUINT.—Dr. D. B. St. John Roosa, in an able 4. That a peculiar infiltration of the granula will, a paper (Med. News) read before the last meeting of the few days after the inspergation, give an idea of what New York State Medical Society, last February, sums number of granula are going to disappear, and how many up as follows:
may be expected to remain for further application of the 1. The operation for convergent strabismus is suc- powder. cessful in removing the deformity in from seventy to
5. That since I have used the remedy cautiously in eighty per cent. of cases operated upon.
the manner just described, I have seen nothing but good 2. When complete control of the patient may be
and excellent results from it, and especially in cases in obtained, and as many tenotomies as are necessary are
which I should not have dared, from former experiences, performed, the percentage may be easily raised to more to use the infusion of the jequirity bean. than ninety-five.
THE EFFECTS OF 3. No essential improvement of the vision of the
THE GOUTY DIATHESIS UPON squinting eye arises as a result of the operation.
THE EYE.—Lychon (Recule d'ophthal., Amer. Jour Med. 4. After parallelism of the optic axis has been
Sciences) gives the following results of his study of eye secured, glasses may be worn that, in some cases, give affections of persons of gouty diathesis: an increased vision in the formerly squinting 'eye.
1. Gout produces in the skin and conjunctiva of the 5. The loss of sight in a squinting eye is probably eyelid a dry eczema, lithiasis, and a peculiar form of cona congenital amblyopia, the nature of which is not exactly, junctivitis. if at all, known, and which is as yet incurable.
2. It causes in the cornea a calcareous degeneration 6. No substitute has, as yet, been found for the
of the epithelium. division of the recti muscles for the cure of squint.
3. It causes simple and complex inflammation of the
sclerotic. ON THE CONNECTION BETWEEN OBSTRUCTION OF 4. It causes iritis and irido-choroiditis of a special THE LACHRYMAL DUCT AND NASAL CATARRH.-Dr.
character. Harrison Allen, of Philadelphia (Med. News), calls at
5. It has a marked tendency to produce hæmortention to the relation that sometimes exists between rhagic glaucoma. nasal catarrh and inflammation of the lachrymal duct.
6. It causes characteristic exudations in the retina. His attention was called to this condition in one of his 7. It gives rise to sclerosis of the lens. patients, whom he was treating for chronic nasal catarrh. 8. It causes thrombosis of the intracranial and inThe lachrymal passage on the same side became inflamed traocular vessels and consequent partial or total hemi.. and the lachrymal sac distended at the same time that anopsia, or a more or less complete blindness. treatment was progressing toward recovery. This led to an investigation, as the result of which the doctor has INTRACAPSULAR INJECTION OF WATER IN CATARcome to the conclusion that this condition is found in ExtRACTION.-Dr. W. A. McKeown (Ophthalmic only two classes of cases, namely, in chronic nasal Review, Nov. 85,) describes his method of washing out catarrh, in which there are submucous infiltrations and the cortex in cataract extraction. The washing takes atrophies, and in cases in which the bony walls of the the place of pressing, rubbing, and scooping out. His nasal chambers are attacked either by osteitis or necrosis. method calls for a corneal section above at the sclero
Twenty patients were examined at Wills Hospital, corneal junction. Iridectomy is done as usual. After and in every instance where the lachrymal duct was the capsule has been lacerated and the lens expelled, the
nozzle of a perfectly clean scoop syringe is introduced Naphthalin (C1, H3) is a derivative of benzole, and
extent of cutting short the disease. For this purpose he
goes only partial decomposition in the bowel, depriving
the fæces of odor. It gives a dark color to the urine,
. Blätter, No. 28 of the contents of the bowel, it has established its place
[Other observers have found the internal adminis-
erts a very slight local irritation of the skin, but, as one
JODOL-ITS DRAWBACKS.–From an editorial in the
This drug was designed to replace iodoform, so dis-
a solution of 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 tory fibres of the vagus, and possibly of other similar caused pain which lasted for from one to twelve hours, nerves, the peripheral endings of which are paralyzed, and in two of the cases the drug had to be abandoned are unaffected by the poison; while the peripheral endon this account. In a fourth case the disease (chronic) ings of the sensory nerves are paralysed by kairine. actually made a retrograde progress—the iodol not 9. Kairine depresses both the normal and the febrile hindering it in the least. Thus we are to lose a drug temperature. that at first seemed destined to supply a want long felt The temperature of septic fever yields to the drug by the profession (and a profit to the druggists-one more readily than that of inflammatory fever. firm in the city asked $1.00 per drachm for it, from phy- The fall of the systemic temperature is dependent sicians), and so it must remain unless some means of on a decrease of combustion in the body. dissolving it, as iodol, shall be discovered.
Large individual doses may be dangerous, since they
inhibit the secretion of urine and thus interfere with the HYDROCYANIC ACID AS A RESULT OF THE FER- process of effacing the lesion produced by the drug. On MENTATION OF FLAX SEED.—Jorissen, in the Bulletin the contrary, small individual doses increase the secreof the Royal Academy of Belgium, has shown that a mix- tion of the urine, and thus enable us to repeat them at ture of flax-seed meal and warm water exposed to a tem- certain intervals, without any risk of accumulation of the perature of 80° F., will, upon distillation, yield a certain drug in considerable quantities (St. Petersburgh Inaugural quantity of hydrocyanic acid. This observation has Dissertation). - London Med. Record, Nov., 1885.
M. 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 appli
PRACTICE OF MEDICINE. cation of these observations is evident.—Les Nouveaux STAMMERING AND STUTTERING.—Dr. J. D'Orsey Remèdes., Med. News.
writes to the British Medical Journal, June 27, 1885, that, as much misapprehension exists concerning the
above subjects, the following may be of interest: ACTION OF MEDICINE.
1. Speech, or articulated voice, depends for its perTHE ACTION OF KAIRINE.—Popoff, experimenting fect production on vigor of mind, on sound natural oron frogs and dogs with the above antipyretic, concludes ganization, and on due training of the vocal or articulatthat:
ing apparatus. Kairine is a blood-poison which acts mainly on 2. Stammering is inability to articulate, marked by the blood corpuscles, destroying their hæmoglobin, and slowness, stoppage, hesitation, and indistinctness, but not partly on the plasma, increasing its coagulability (due to with repetition; whereas, stuttering consists in a painful the passage of the products of decomposition of hæmo- repetition of the same consonants, often attended by globin from the blood corpuscles to the plasma).
Aushing and facial contortions. It is also a cerebro-spinal poison, exciting the 3. Stammering and stuttering inay sometimes be cerebral centres and paralyzing the transmissory centres caused by organic defects, such as cleft palate, hare(reflex) of the cord.
lip, enlarged uvula, inflamed tonsils, etc.; but these im3. The drug at first produces cardiac slowing, with pediments are far more frequently due to functional a subsequent increase in frequency; the former due to causes, that is, habit, imitation, heredity, etc. Nervousexhaustion of the excito-motor cardiac ganglia, and, ness is often the consequence, or concomitant of stam. probably, also, upon irritation of the inhibitory ganglia. mering, rather than its cause. Organic defects must, of The acceleration is caused by excitation of the central course, be treated medically or surgically, but the subseends of the fibres of the pneumogastric nerve.
quent cure belongs to the elocutionist, while functional 4. The arrest of the cardiac contraction as observed derangements (wrong action of the voice apparatus), are in kairine poisoning,can be explained only by paralysis of peculiarly his province. the motor cardiac ganglia.
4. The sooner the curative process begins, the 5. Respiration is retarded due to paralysis of the greater is the prospect of success. What is easily eradirespiratory centres. It is arrested before complete car- cated at an early age becomes hard to remove at a later diac paralysis is established.
period; though at any time of life, alleviation, if not 6. Arterial tension, generally, sinks below the stand- cure, can be assured as the result of perseverance. “He ard; varying greatly, however, with the cardiac action. will grow out of it," is a fatal saying. A fair time ought The fall of blood-pressure is dependent on the failure of to be given, according to the nature of the case; for “a propulsive energy of the cardiac muscle.
few lessons " cannot reasonably be expected to undo the 7. The loss of motion which is observed in animals mischief of many years; and the teacher is often accused poisoned by kairine is of cardiac origin.
of failure, when the blame is solely attributable to the Motor nerves, except the splanchnic, the inhibi- patient or the parent. (Med. Record.)
TREATMENT OF CATARRHAL PHTHISIS, HÆMOP- render it highly probable that it will give much relief in TYSIS, AND CHRONIC BRONCHITIS BY TERPINE.-M.
many cases of hay-fever. Germain Sée considers terpine to possess the power of
A PECULIAR CASE.-The St. Louis Medical Review modifying the mucous membrane of the respiratory tract, ‘and to be also a powerful agent in checking its secre
publishes a letter from a Jacksonville, Mo., practitioner tions. He says:
which gives the history of a young man, 26 years of age, It diminishes and causes the disappearance of
who has menstruated since his nineteenth year. The the purulent expectoration in the catarrhal forms of attacks are generally regular, coming on every month, phthisis, since the purulent secretion proceeds from bron preceded by severe pain in the back and lower part of chi irritated by tubercle, or from the walls of pulmonary the abdomen, but occasionally he misses a period or goes cavities; when the patient is in the beginning of the
one or two weeks over time. purulent stage, or, indeed, in the stage when cavities are
The pain lasts from 24 to 48 hours, and is then folbeginning to form, terpine is indicated in all cases where lowed by a muco-purulent discharge, streaked with blood the formation of pus is sufficient to fatigue the patient,
from the penis, lasting four or five days. destroy his strength, and cause wasting.
The penis and testes are well developed. The 2. It is employed with success in hæmoptysis of patient is married, has one child, and enjoys sexual interbeginning tuberculosis; that is to say, when the disease
course naturally. He has a rather feminine disposition, has not yet advanced to the development of large cavi
wears a corset, can do any kind of sewing or housework, ties with aneurism of the pulmonary artery.
and feels as much at home in a “mother-hubbard" as 3. In the treatment of pulmonary catarrh, chronic
with his pants on. He has a small waist and a broad bronchitis independent of asthma, and only causing dys- pelvis
, has no mammary development, and has a respectpnea by obstructing the bronchi, terpine constitutes the able growth of beard. best means of decreasing the secretion.
STRYCHNINE IN ACUTE ALCOHOLISM.—Dr. Lardier 4. Its action, prompt, certain, and free from physi
has long employed strychnine in the treatment of deliriological inconvenience, should make it preferable to
um tremens, and regards it as the best remedy which we preparations of tar and turpentine. It presents, more
possess for this condition; as, in fact, a veritable specific. over, on account of its perfect harmlessness and easy
He insists upon the necessity of giving the drug in large digestibility, advantages over creasote.
doses. In one case he had given granules containing 5. The best mode of administering the drug is
each i grain, every two hours for several days, without either by pill or in alcoholic solution. The best dose is fifteen grains.
any appreciable result. He then increased the number
of granules and also administered the drug hypodermic. 6. In the treatment of nervous asthma, emphyseally, giving in all 123 grains in the space of twenty-three matous or catarrhal, which must be distinguished from
hours. The result was a most happy one. primitive catarrh, iodine, and pyridine, possess undoubted
tient soon fell into a refreshing sleep, never exhibiting superiority. (L'Abeille Médicale; Med. News.)
the slightest symptoms of strychnine poisoning. (Jour. Hay-FEVER:
de Méd. et de Chirurgie Pratiques, June, 1885; Medical ITS CAUSE AND CURE.-Dr. E. Fletcher Ingals (Chicago Med. Jour, and Examiner), in
Record.) an able article, reviews this troublesome affection, and
ON THE TREATMENT OF ACUTE CORYZA.-Dr. comes to the following conclusions regarding its cure:
Solomon Solis-Cohen, in the Medical Times, recommends 1. Nearly all cases may be cured by systematic, strongly the internal use of belladonna, or atropine, in thorough, superficial cauterization of the hypersensitive doses of Ito to to grain of the latter. This is to be reportions of the nasal mucous membrane, providing the
peated every four hours, until the physiological effecttreatment is carried out during the interval between at
dryness of the throat and dilatation of the pupil—is protacks.
duced. Usually two or three doses will suffice. Where The most effective and least painful means of the cold" has reached an advanced stage, and atropine accomplishing this, is by the galvano-cautery.
is insufficient, ammmonium salicylate in ten to fifteen 3. Care must be exercised to treat every sensi
grain doses, every two hours, until tinnitus aurium is tive spot, and not to cauterize too large a surface at
produced, has been the most effective remedy in the once.
doctor's hands. 4. The operation may be made painless by a proper
Salicylate of cinchonidine is of great benefit in the use of hydrochlorate of cocaine.
later stages with constitutional symptoms. 5. In nervous subjects general treatment must not be neglected.
THE PERSONAL EQUATION IN PRESCRIBING.-Dr. 6. The effect of cocaine in hypertrophic catarrh, Roberts, in his address on “Therapeutics,” read before and in the case of idiosyncratic coryza just reported, the British Medical Association, states an undoubted