Earrespondence.

NOCTURNAL INCONTINENCE OF URINE IN CHILDREN. EDITORS MONTHLY-In the journalistic literature upon this subject every writer presents some new idea regarding its pathology and treatment. In my early professional career a novel idea of its pathology and treatment was suggested to me by the recital of the confession of a gentleman who in his early life belonged to this large class of little sufferers. I will use his own language:

"When I was a boy I habitually wet the bed until I had arrived at my twelfth year. My father and mother used to threaten me with various methods of punishment to break me of the habit, and my playmates were constantly guying me about it. I was heartily ashamed of it, and every day from noon till bedtime would try by repeated acts to evacuate my bladder of its entire contents, often micturating ten or fifteen times during the afternoon, and then at night wet the bed. My parents on this account would never let me spend the night away from home. I would think about it all day, and at night would dream about urinating out behind the chimney, and would wake up to find the bed wet, and that, too, before the older members of the family had gone to bed. I would pass my urine two or three times every night, every time dreaming that I was out behind the chimney making suds boil, and would awaken to discover my mistake. I was very miserable, thinking this would be my fate during my whole life, and it was an awful feeling to try to reconcile myself to such a future. One morning about this time I was sent to accompany two young ladies on a visit about thirty miles distant. We went in one of those old time C spring carriages, and in those days it took nearly all day to make the trip. I was tolerably comfortable for the first six or eight miles. I then, however, began to want to urinate, and before we arrived at our journey's end I thought my bladder and the bottom of my abdomen would burst. We got out of the carriage, but we were in town, and as I had never been in town before, and saw houses and people everywhere, I was in

as bad a dilemma as ever. I kept as still in the house as I possibly could. I was in great misery, and saw no chance of relief until night, and as the sun was then two hours high, I thought I would die before dark. This was the longest time I had ever held my urine, and you may imagine my distress. At this stage one of the boys at the house asked me if I did not want to go and go in swimming with him. When Gabriel blows his trumpet I don't suppose any of the ancient masters will feel more elated than I was at this prospect of relief. We were soon out of sight of the town folks, and I began to evacuate my bladder. It was so full that it took me a long time to do this, however, and the process occasioned in me a feeling of most exquisite relief. I have never wet the bed more than once or twice since that time.”

It is more than likely that this boy's bladder was not large enough to hold the amount of urine naturally accumulating in it during the night, and all that was necessary was to give it the required amount of dilatation to give it a proper capacity, which was done by retention. The cause of enuresis in a great majority of the cases that have fallen under my observation has been a contracted bladder, and I have never had any trouble in relieving it by advising the retention of the urine during the day, until the bladder is properly dilated. Of course there are cases which this treatment will not relieve, but it has relieved nearly all the cases that I have met with in a practice of nearly forty years. L. L BATTLE, M.D.

RIVERSIDE, ARK.

ECLAMPSIA IN A CHILD AGED FOUR YEARS SUCCESSFULLY TREATED BY SUBCUTANEOUS INJECTIONS OF MORPHIA.

EDITORS MONTHLY-I was called in great haste a week ago to see little George S., who was having spasms, as the messenger said. I arrived at 1 o'clock in the evening, and found my friend, Dr. Wesson, with the patient. The little fellow had had four severe spasms since morning, having the fifth immediately upon my arrival. Upon the subsidence of the spasm I found him unconscious, spasmodic jerking of the extremities and twitchings of the face. Temperature over

105, pulse rapid and bounding, face flushed, eyes injected. Dr. W. had been with him most of the morning, and had used most of the remedies appropriate in such cases: brom. potass., chloral hydrate, antipyrin, cold sponging, chloroform by inhalation, etc., etc. We continued the treatment for some three hours, substituting the cold pack for the sponging without any benefit, in fact the little patient was rapidly growing worse, and seemed ready to die at each succeeding paroxysm. From 1 to 5 o'clock he must have had fifteen or twenty spasms, each one seemingly the finishing stroke. His pulse was now almost imperceptible, the face pale, lips blue, pupils dilated. In this fearful extremity, I, naturally enough, thought of your morphine treatment, as detailed in the August number of the MONTHLY. Dr. Wesson, like myself, had been educated to believe that this class of remedies in such cases was peculiarly contraindicated, but when men get to the point we had arrived at. they are willing to give up most anything; but to be on the safe side, and as I had to send back home for my hypoder. syringe, I sent for the journal, and upon the return of the messenger we had a regular consultation, Dr. W., the MONTHLY, the father and myself. The result was the of a gr. of morph. hypoder. administered. Not another spasm. Went through the night reasonably well. Becoming restless the next day the dose was repeated. The little fellow recovered right along, and is now as bright as So it is to the MONTHLY we are indebted for the prescription, and it is to the MONTHLY as well as the editors we return thanks. W. H. McCARGO, M D.

ever.

FOREST HILL, TENN., September 10, 1886.

MONSTROSITY.

EDITORS MONTHLY-In my practice, on the 8th of last month, I attended a lady in confinement with results decidedly unusual-the child being peculiarly deformed.

The left arm was entirely absent, and the patella and tibia. of left leg wanting. The right side, unlike the left, supported a good leg, but the forearm had but one bone, the radial, and no thumb.

The entire weight of the child was but three and a half pounds, yet at the time of writing, nine days after its birth, it is alive and doing well.

I may mention that the cord was unusually short-ten inches-and at the time I made my first examination it was found prolapsed, but the labor was so rapid as to render its return both useless and impracticable.

DRUMMOND, TENN.

Yours truly,

W. F. COOPER, M.D.

Translations from the German and French

BY A. G. SINCLAIR, M.D.,

Professor of Diseases of the Eye, Ear and Throat, Memphis Hospital Medical College. Formerly Resident-Surgeon of the New York Eye, Ear and Throat Infirmary.

TINNITUS AURIUM IN DISORDERS OF THE STOMACH.

BY DR. E. MANIERE.

[Revue Mensuelle de Laryngologie, d' Otologie et de Rhinologie.]

[CONCLUDED.]

Among the cases recorded are some which prevent me from accepting this opinion. Moreover, the theory of Woakes, based upon anatomical data, appears to me sufficient to explain the cases offered in support of that view. Beginning with 1880 I have continued to take notes upon all dyspeptic cases met with in my practice, and an unfortunate chance has enabled me to observe a perfectly typical case. It concerns myself, and the following is my report:

Case I. February, 1884. Age forty-four; habitual good health; no appreciable diathesis; probably arthritic, although there have been no symptoms of it, (an aunt, aged seventyeight, has had an eczematous eruption on the hands, and diabetes.)

In 1874 suffered greatly from dyspepsia; was frequently indisposed; dilatation of the stomach easily demonstrated. Passing by well-known details, I will state that after having tried various methods of treatment and obtained only minimum results, a severe regimen was adopted, which resulted in the recovery, and maintenance, of relatively good health. Appetite was always excellent.

That tinnitus is always a forerunner of diminished hearing power.

In February, 1884, one day, I seemed to hear in my left ear a slight continuous rustling, which might be represented thus, bjiiiiiiii. Close attention convinced me that I was not mistaken. I believed it a temporary effect, from closure of the tube, inflexion of the membrana tympani, etc. Thinking it not a matter of much importance, I employed various simple remedies, without, however, obtaining much benefit. During four or five days the trouble continued, and, growing anxious, I employed more energetic means of treatment, but without being able to modify in the least my bjiiiiiiii.

I should state here that at the end of 1883 I had several attacks of dyspepsia, which were much more severe than those from which I had previously suffered. At that time I tested my hearing and found it normal. These phenomena were so peculiar that it is difficult to describe them, but as, after all, the noise was not very great, I submitted patiently, hoping that time would bring relief.

Toward the end of 1884 it seemed to me that the noise was less during the night, in the day time it was almost entirely annulled by exterior sounds. This continued until September, 1885, when I had a severe attack, with vertigo supervening three to five hours after meals. At that time the noise increased suddenly, and for about a month has been almost continuous. Always the bjiiiiiiii, which I hear without any modification save during the night. Whenever I close the ear in any manner the noise seems somewhat louder. Following an attack of indigestion it always increases, and diminishes again when the attack is over. Exercise lessens it somewhat, but continuous work and mental disturbance increase it. Hearing remains good, but the noise is constant. What is to be the result? Am I menaced with deafness? What is the causal lesion?

I am convinced that there exists in the internal ear a modification which is under the influence of the innervation of the stomach. Such is my observation; I have made it with care, and I am fully convinced of the influence which diseases of the stomach exercise upon the auditory apparatus and of the correctness of the opinion of M. Leven.