ordered: R Brom. potass., 3vi; fluid ext. ergot., 3iiss; aquam, ad., živ, to be given in teaspoonful doses every two hours. This I continued for thirty hours, when I could perceive that my patient's vision was returning. I then extended the time to four hours, and continued to give it until his vision was fully restored, Aug. 11th.

Now, first, was I right in thinking the amaurosis the consequence of the dilated pupils, caused by the congestion of the blood vessels which supply the optic nerve, or from the effects of quinine and an attempt of the congestion to return?

Second, if I was right, was it the effects of the bromide or the ergot, or was it the withdrawal of the quinine, that relieved my patient? From the result, I am inclined to the belief that I was right in the first place as to the cause, and in the second place, to the leaving off the quinine and to the use of both ergot and bromide was due the relief.

I do not present this case as new to the profession, but as it is the first case of complete amaurosis in my practice from malarial causes, I would like to hear the comments and opinions of those present on the case.

CHRONIC BRIGHT'S DISEASE.

Reported to the Tri-State Medical Association, November, 1885,

BY P. W. ROWLAND, M.D., COFFEEVILLE, MISS.

In March, '85, I was called to the county house for the poor to see one William S., æt. 23, male, white, with the following history: Up to the age of twenty had been very healthy; three years ago went to Arkansas, and there employed himself in general farm work; enjoyed good health for a while, but soon became the victim of the prevailing endemic disease of the country, ague; he continued to have chills, tertian form, for something over a year, when he went to Little Rock and entered the hospital; stayed there several months, improved considerably though not entirely freed from chills, having them at irregular intervals; he returned to work, and, in addition to having chills, began to suffer with pain in region of kidneys; his urine was sometimes scanty, and at other times very free; he again returned to the hospital, where he stayed sev

eral months, then came to Coffeeville, where he had formerly resided.

At the time of my visit he presented the following symptoms: Had been free from chills for three or four months; there was extreme depression of spirits, loss of appetite, irritable stomach, pain in frontal region of head and in region of kidneys, skin dry, considerable cedema of face, eyelids and ankles slightly dematous, profoundly anæmic, complete amaurosis, urine scanty, of a pale color, albumen present in large quantities, also contained bile; specific gravity, 1010. Prescribed R Potassii acetas, 3vi; tinet. digital., 3ij; spts. nit. dule., 3vi; aq. dist., q.s., 3viij. M. Sig.-Tablespoonful every three hours, and directed that a warm bath be given. Did not see him again till next morning; no improvement, very stupid, being aroused with difficulty, skin dry, and complete suspension of function of kidneys.

Having used pilocarpin in several cases of a similar nature, and being impressed with its certain and powerful diaphoretic effect, I decided to use it in this case. Accordingly, I administered hypodermically pilocarpin murias, gr. 4, (Wythe's tablets); remained one hour after administration of drug; left him in profuse perspiration. In the evening I returned, found skin in moist condition, and patient much brighter; directed the continuance of original prescription through the night. On the following morning found him much improved; could count my fingers across the room, a distance of ten feet, when the morning before he could not see my hand before his eyes. Prescribed: R Ext. ergota fl., tinct. digital., tinct. ferri , aa, fzi; liq. pot. arsen., 3iss; elix. pepsin, q.s., 3viij. M. Sig.-Dessertspoonful three times daily. Continued to improve in strength and general appearance; anæmia less; no return of cedema; but urine still heavily charged with albumen; specific gravity, 1010.

mur

him in worse condition than before; had been having convulDid not see him again till some days afterward, when I found sions for several hours, comatose, suspension of secretion of kidneys. Again resorted to the pilocarpin; left him in an hour in free perspiration. I returned in the evening, and there had been no more convulsions, and general condition better.

On the following morning found him much improved, entirely rational, kidneys performing their functions. Placed him again upon the above prescription. He continued to improve steadily in strength and appetite; no return of œdema, no amaurosis; ænemic appearance less, though urine still albuminous; specific gravity, 1012. In June the county, to get rid of a costly and troublesome patient, sent him to the hospital in New Orleans, since which time I have lost sight of him.

I report this case not because of any permanent cure, but from the fact that it seems to be the opinion of writers upon the subject-Roberts, Becquerel, Frerichs, and others—that organic kidney disease is never found following intermittent fevers; also to call attention to the powerful and certain diaphoretic, and consequently eliminative, properties of pilocarpin, which might possibly make it a valuable agent in the treatment of fevers of an inflammatory type, and in those fevers which are dependent upon the existence in the blood of some peculiar poison. I have not noticed the bad effects said to follow the use of pilocarpin, such as vomiting, headache, disturbance of vision, etc.

HYPODERMIC INJECTIONS OF ANTISEPTICS.-Last summer I had several well-marked cases of typho-malarial fever, in which I used listerine, both internally and as a hypodermic injection, with very good effect, more particularly from the injection in the more advanced stages; also as a prophylactic, or rather as an abortive, in cases having well-marked premonitory symptoms, the subject of which had been exposed to the same disease producing causes, being in the same families with those suffering under the fully developed disease, and in every case, without an exception, there was a rapid and entire recovery.

I administer listerine, hypodermically, full strength, in from 5 to 10 minim doses to adults, and about the same amount, diluted one-half, to children, repeating daily as the case may seem to require. I have often administered it in much larger doses (hypodermically), both in typho-malarial and zymotic affections, and never observed the least unpleasant symptoms from its use. I shall hereafter meet this class of diseases with much confidence, and shall rely to a great extent upon listerine.-G. S. HILL, M.D., Wilmington, O.-Lancet and Clinic.

Mississippi Valley Medical Monthly

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present to our readers this month an excellent wood

cut, reproduced from the Sunday Times of February 28, of Dr. Robt. W. Mitchell, one of the best known and most popular physicians of Memphis, and a gentleman of high professional attainments. Dr. Mitchell is a native Tennesseean, born in Madison county. He received his professional education

in the medical department of the University of Louisiana, and graduated in 1856. He began the practice of medicine in Vicksburg, Miss., as hospital physician in 1857. In the following year he came to Memphis, and has resided here ever since. He was elected secretary of the local Board of Health, and organized the city hospital in 1860, holding positions in both until he entered the army, in 1861. He served in the Fifteenth Tennessee, State troops, as Assistant Surgeon, and when the State troops were transferred to the Confederate service he was appointed Surgeon of the Thirteenth Tennessee, Col. John V. Wright commanding. He remained in the service until the close of the war, acting as Regimental, Brigade and Division Surgeon in the Army of the Tennessee. Dr. Mitchell returned to Memphis in 1865, since which time he has been actively engaged in the practice of his profession. Just after his return from the army he was elected to the chair of Materia Medica in the then existing Memphis Medical College, which he filled creditably for two years. During the yellow fever epidemic of 1873 he was an active worker. In 1878 he was tendered a position on the yellow fever commission to visit the Southern cities where the epidemic was raging, by Dr. John M. Woodworth, Supervising Surgeon-General of the United States Marine Hospital Service. This offer Dr. Mitchell promptly declined in the following memorable telegram : "Thanks for the honor, but I cannot leave my people in their distress." He remained at his post, and was appointed Medical Director by the Howard Association. His loyalty to his duty in those dreadful days is a matter of history. For a great many years he has been associated in practice with Dr. R. B. Maury, under the firm name of Mitchell & Maury, and always enjoyed a lucrative practice. From 1870 to 1876 he was a member of the Board of Education of this city, two years of which time he was President of the Board.

Dr. Mitchell is an active member of the American Medical Association, National Board of Health, American Public Health Association, State Medical Society, Tri-State Medical Association of Mississippi, Arkansas and Tennessee, and of the Shelby County Medical Society.