membrane was well set with a beautiful specimen of negro wool. It was unilocular, but attached to its pedicle were five other small cysts, from the size of a pea to that of a partridge egg. The case illustrates, first, the effect of ovarian irritation on the nervous system, and through the nervous system on the mind; second, the sudden, decided and permanent relief afforded by the removal of a diseased ovary; third, the fact that listerism, one of the grandest principles that has ever been incorporated into surgical science, can be simplified and carried into the hovels of the poor, and there made to do its work of preservation as well as in the palatial halls of a costly hospital. ERYSIPELAS. Read before the Tri-State Medical Association, November, 1885, BY J. D. TALBERT, M.D., COLDWATER, MISS. It has been my fortune to meet with three cases of erysipelas worthy of record, and while I have neglected to report two of these cases so long, I am reminded of them so forcibly by the occurrence of the third within the last few weeks that I feel impelled to record them after lapses of ten and fifteen years. The first was a case of chronic erysipelas in a married lady, mother of three children, the youngest being fourteen months old at the commencement of the attack. She was a school teacher of untiring zeal, and in addition to her labors as such did a great deal of house work, and walked three miles a day to the school. At the close of the session in the latter part of June, being much worn by the performance of her duties and the effect of summer heat, she was a fit subject for the attack, which fixed itself on the front of the left leg, four inches below the knee. The unpleasant burning sensation, confined to a limit of three by four inches, rapidly increased in all the unmistakable symptoms of erysipelas, until she was soon quite helpless and suffering intensely. This spot passed through all the stages of the disease, extending to about double its original size only. VOL.VI-8 Within a few days the metastatic character manifested itself by the appearance of a similar spot on the front of the right arm, which soon covered the elbow joint and rendered the arm helpless, followed by others on the right leg below the knee, on the left above the knee, on the left arm near the shoulder joint, on the lower jaw, on the back of the shoulder, on one breast, and on the face. When the nose was reached the patient was greatly distressed with persistent sneezing, which continued about twelve hours. These places mentioned were invaded in succession, and many of them a second and a third time. During three months the disease was vigorous, causing much suffering and giving but little respite. The next three months were marked by a modification of the graver symptoms, which were, however, still severe enough to make the patient exceedingly uncomfortable. Case second, female ten months old, daughter of a clerk. The disease made its appearance on October 2nd, 1874, in a very small spot about half way between the base of the neck and the point of the left shoulder. It spread over the chest and back, and down the left arm, which last became very much swollen and could not be moved without severe suffering. The line of demarkation encircled the base of the neck, and meeting on the right side extended downward both in front and behind, and down the right arm, all undergoing the ordinary changes characteristic of the disease. A fresh impetus sent the inflammatory process creeping down both legs, and they suffered all the pains of an acute attack of erysipelas. I thought it wonderful that a babe so young could endure so much affliction and the effects of such extensive inflammation of cutaneous surface, and felt greatly apprehensive as to the final result. Indeed there was small reasonable hope that she could withstand so formidable an attack of such a dangerous disease. Just as we begun to flatter ourselves that there might be a favorable termination of the case, and before the feet were relieved, a second appearance was discovered in the very place where the first begun, and it spread and followed the same course as the first. While it was a little less severe in all its symptoms, it was still decidedly well marked and distressing. Before this circuit was complete a third flush was observed in the place that marked the beginning of the first and second circuits, and though much modified, still a distinct and welldefined line manifested clearly the location and progress of this course, which was made complete in the same manner as the others, and yet the babe survived, and is to-day a pretty girl eleven years old. She was under treatment thirty-four days. The third case was a girl of five years, daughter of Mr. C., a farmer. She was first taken with erysipelas about the 15th of August. The part invaded was the right leg below the knee. The parents concluded to undertake the treatment of this case themselves, under the advice of neighbors, and they made frequent and bountiful applications of tine. iodine to the part affected, and to unaffected parts above and below, hoping thus to kill out and limit its extent. When I first saw her she had been sick five days, and the leg was very large and tense, and blistered from the ankle to two inches above the knee. The disease was traveling upward slowly, but surely, and it continued on its course in spite of the plan of treatment adopted and persisted in by me. I gave her large doses of tinc. iron, frequently repeated during several days, until the system was thoroughly saturated with it and the stomach began to eject it, after which the dose was reduced and the medicine continued for two or three days. During a greater part of the treatment local applications of flour dough were constantly made, with the view of excluding the air and keeping the part moist. In addition to the iron two-grain capsules of quinine were given every four hours. The spread of the erysipelas was not interrupted, the lower part of the body becoming covered and the left leg encroached upon. Bearing in mind the successful treatment of this formidable malady by the use of calomel, as reported by Dr. Ford at the last meeting of our Association, I determined to adopt his plan while the patient took a rest from the iron, the results from which had been so very unsatisfactory. I administered calomel during two days, and had it well guarded by Dover's powder to prevent its too early action and the loss of its most desirable effects. In a reasonable time several dark bilious passages from the bowels were had, and after waiting in vain. for the good results so earnestly hoped for, as I dared not give more calomel, I returned to the iron in full doses, with the vengeance advocated by my friend Dr. Sim, with no better success than before. There was no check to the advance of the erysipelas, and the upper part of the body and the arms in succession passed through all its stages. Before this was finished a new accession took place, involv ing the leg first attacked and pursuing the same general course as that taken before, with but slight modification of the symptoms. While this was still in progress a third and somewhat milder form had for its starting point the same as the others, and with some variations and irregularities made the circuit of the body, except the head and neck, which were never affected during her illness; neither was the head or neck involved in the preceding case. Several times during the last round there was little evidence of the grave condition through which the little girl was passing, and the temperature declined to normal; then a bright red, much swollen and exceedingly tender place, four to six inches in diameter, would manifest the ravages going on. From August 20th to September 14th this case was under treatment. Three times I tried calomel thoroughly, as I think, and three times iron, and during the latter days I used Fowler's solution, with poke root and iodide potassium. The recovery was ultimately complete. AMAUROSIS-A CASE IN PRACTICE. Read before the Tri-State Medical Association, November, 1885, BY R. C. PREwitt, M.D., of OSCEOLA, ARK. GENTLEMEN-I beg leave to submit for your consideration and discussion a few points in a case of amaurosis which occurred recently in my practice: I was called on August 7th to see a little son of one of our merchants, Jimmie C., aged five years, whom I found to be just passing out of a severe convulsion, which his mother stated to have been on him some twenty-five or thirty min utes. His pulse was so rapid I could scarcely count it, probably 160 per minute, and he very nervous. I immediately applied ice-cold water to his head, and flannel cloths wrung out of warm water to the extremities. Gave one-half drachm each of spr. nit. ether and Hoff's Anodyne, in a little water, every hour, until he had taken three doses, when, his nervous system being somewhat quieted, I changed my prescription to spr. nit. ether, 5j, and two drops of veratrum viride (Norwood's preparation) every two hours, until I had reduced his pulse to 100 per minute, which required about eight hours; at this time his skin became moist, and I discontinued the cold and warm applications, also the nitre and veratrum, and ordered three capsules of calomel and Dover's powders, each containing three grains of the former and one grain of the latter, to be given every four hours, and four grains of sulphate of quinia every two hours, until six doses had been given, after which time every four hours to keep up the effect of the quinine sufficiently. The following day his bowels acted well from the effect of the purgative, and I thought my patient was doing well, but on my third visit was astonished to find him perfectly blind and with but little fever. The pupils were dilated to the fullest extent, the family greatly distressed. I saw something must be done, and having no special data by which to be governed, I began studying the cause of the amaurosis. I concluded it must proceed from the congestion of the central artery of the optic nerve, this causing the extreme dilatation of the pupil. Now, what produced this congestion was the next question. Was it the effect of the convulsion? or could there be periodicity, an attempt of the congestion to return, and it intensified by the administration of quinine? I reasoned that, as there was no dilatation of the pupil on the first and second days, the quinine must have something to do with bringing about this result, and knowing that congestion did exist, I decided to discontinue the quinine and direct my remedies to reducing the congestion; hence I ordered an active purgative: R Calomel, grs. vj, aloes, grs. iij, hoping it might act as a revulsive to the brain; and knowing that brom. potass. and ergot would contract the arterioles of the brain, I |