demonstrated that it is only by restoring the equilibrium that sight is saved. I quite agree with DR. HOTZ regarding febrile symptoms, but it is my experience that they are secondary rather than primary.

DR. HENRY GRADLE said: The cases which DR. BETTMAN presented are of great interest from the fact that they have only lately been recognized. DR. GRUENING, of New York, was the first to point out that there existed affections apparently of the eye, but which in reality originated from the nose. I have watched for these cases ever since GRUENING'S paper first appeared, and would say that the cases in which the nasal trouble is entirely the cause of eye disease are not very frequent. But I have seen instances where affections of the eye were certainly complicated by nasal trouble, and the nasal trouble prolonged the eye disease. I recollect a number of cases of eye-disease either kept up or originated by nasal trouble. The first of these is a pseudo-erysipelas of the lids, which is not an infectious disease, but merely a secondary affection of the blood-vessels, only resembling erysipelas clinically. It is entirely due to irritation and engorgement of the bloodvessels in the front part of the inferior turbinated bone. A second type of nasal affection giving rise to eye-trouble is true periodical hayfever, and a non-periodical irritability of the nose, resembling hay-fever. I have published four cases, and have since seen another, of periodic conjunctivitis characterized by the formation of granules and follicles, which trouble always receded in winter, to reappear again in the spring or summer. In two of these cases a diagnosis of hay fever has since been made. I have seen a case which had been treated for trachoma by a number of specialists, where the history of the nose showed that the affection was of nasal origin. The same trouble may exist in a non periodic form, and present all the symptoms of hay-fever, the trouble not being limited to any season, but occurring in any part of the year, lasting a few days or weeks. But these cases are not common. In one of these cases I was able to effect a complete cure by cauterization of the nose. A third type of nasal affection giving rise to ocular symptoms is true catarrh of the upper and front part of the mucous membrane of the nose, where the membrane is distinctly reddened and where there are generally slight and by no means prominent symptoms of catarrh. In these cases I have very frequently found troublesome epiphora without any stricture of the duct; in some cases the test was made by using delicate probes. Such cases, I can testify from my own experience, are entirely curable by simple treatment of the nose. I have found a not sharply defined case of asthenopia, due not entirely to the nose, but complicated with refractive trouble, where nasal treatment was necessary to complete a

cure.

Once or twice I have seen polypi play the same rôle, and a number of times I have found the starting point of the irritation not in the front of the nose, but in the posterior part, in the form of the common adenoid vegetations.

This is a subject which has not been fully dealt with in literature, but I have several cases where the extirpation of the large post-nasal tonsil has given decided relief to the eye. Then I have found that in a few cases ulcers or chronic inflammation of the cornea were kept up by nasal trouble, which was probably started in the first place by a copious flow of tears from the eye. I have observed that local treatment by means of calomel, atropia, and the customary applications to the eye proved inefficient, while the addition of nasal treatment hastened the cure of some of these tedious cases. The nose was probably normal to start with, but the continual flow of tears produced either small erosions or some little catarrhal troubles of the mucous membrane at the front of the nose, subsequently increased to chronic catarrh, leading to congestive obstruction of the tearpassages, or exerting an unfavorable nervous influence upon the eye-trouble. Finally, as a rare instance, I will mention one case which is now cured. The patient was sent to me for polypi, which, however, proved to be the minor trouble in the nose, the real trouble being an immense vascular tumor occupying the entire floor of the right side of the nose, covering the inferior turbinated bone and reaching about to the middle turbinated bone. The patient had been reduced in strength, and the slightest exertion on his part produced hæmorrhage; therefore the most careful operative procedure was necessary. I finally succeeded in removing the entire tumor by the galvano cautery in twenty sittings. As the tumor began to shrink the hæmorrhage was less, but he lost thirty or forty ounces of blood in six weeks. During the latter part of the treatment his right eye began to bulge, and he complained of double sight. has remained healthy, but there was an unmistakable development of vascular tissue in the orbit and behind the eye, which receded by the time the tumor had been extirpated from the

nose.

It

DR. BOERNE BETTMAN said: I was very glad to hear DR. GRADLE corroborate my statements. I am well aware that these cases are comparatively rare; although I have recorded in my case book about twenty, seen during the last two years. I am acquainted with the article published by GRUENING. My attention was first called to the subject by the work of HACK, and since reading that I have made it a point never to allow an eye patient to leave my office until his nose has received a very thorough examination. I have seen a number of cases such as mentioned by DR. GRADLE, but I

thought it better to describe to-night only the typical ones. The connection between ocular and nasal troubles is a point all oculists should bear in mind, and when they find no local cause for epiphora they should examine the nose.

DR. A. P. GILMORE said: I would like to add one word in regard to glaucoma, and that is the importance of tension does not seem to have been sufficiently dwelt upon. Any careful general practitioner can ascertain whether the tension is increased or not, simply by comparison with the tension of his own eye. All pain referred to the eyeball, with or without the accompanying neurotic symptoms mentioned in the paper, does not mean glaucoma. Unless there is increased tension you cannot diagnosticate glaucoma. The author does not mention BADAL'S operation in the treatment of glaucoma. It is certainly entitled to a place among the operative measures. I will only speak of one point in DR. STARKEY's paper, viz.; epiphora. I do not believe with many, that epiphora is due primarily to a stricture which prevents the escape through the nose of the natural amount of fluid secreted, but is due rather to reflex irritation causing an hyper-se. cretion of tears. In health the eye is moistened with a moderate secretion. When the lachrymal gland is removed the eye contiues to be moist and the cornea retains its lustre. Tears are not essential to the lubrication of the eyeball; their function is to protect the eye against foreign bodies. A bit of dust under the lids will cause profuse lachrymation and the tears will flow over the face, not because of an obstruction to the natural amount of fluid secreted through the natural passage, but because of a hypersecretion due to reflex irritation. For treatment I never use a probe larger than BowMAN'S No. 6, usually No. 4. I seldom find it necessary to make BOWMAN'S operation in epiphora. I think its use is unnecessarily frequent. I use astringent and antiseptic solutions with a syringe small enough to be easily introduced into the puncture when slightly dilated. I am very careful to treat any nasal complications; it is impossible to treat diseases of the eye successfully without recognizing and treating reflex irritations of the nose.

DR. STARKEY said: My paper was necessarily cut down very much. As first written I had given some space and attention to cases similar to those mentioned by DR. BETTMAN. I had also spoken of the probability that in many cases of epiphora, where there had been inflammation of the tissues lining the lachrymal canals with partial closure, a continual irritation of the canal in some way, perhaps reflexly, so stimulates the lachrymal gland that the tears are poured forth more abundantly. There are well-known cases where the lachrymal canals have been completely closed by injury or operation, and yet lachrymation is

not annoying, although the gland has not been extirpated; tending to show, as mentioned by DR. GILMORE, that the normal secretion of tears is ordinarily very limited. It seems to me that in many instances lachrymation is due to irritation propagated reflexly, and, therefore, in treating such cases I thought of trying to restore the mucous membrane of the lachrymal canals to the normal condition, as well as to look for and treat points of irritation elsewhere.

DR. J. E. COLBURN said: In cases of injury where there is danger of sympathetic irritation, a foreign body being lodged in the anterior chamber, iris, ciliary body, or the choroid, where the chances are that in order to give all the advantages of treatment the patient must necessarily be idle for a considerable length of time, and where the sight in the injured eye has been irretrievably lost, I think it advisable to make the operation of evisceration or abscission as early as possible. The patient, if a laboring man, is then relieved from a long enforced idleness and anxiety, and the danger that lack of care frequently causes in this class of cases. Where the appearance is first to be considered, and the patient can be constantly under observation, the operation can be postponed, but with the strict injunction the patient is to be under constant surveillance. In a large majority of cases where there is great damage done and the foreign body is out of sight, it is safe and advisable to make the operation, trusting to that to save the other eye. In a case that came under my observation recently a piece of steel entered the anterior chamber near the centre of the cornea, passed through the iris and lodged in the sclera. No operation was performed, and the fellow eye became sympathetically affected, and on account of its sympathetic disturbance had to be removed. The steel produced some local irrita tion, and the eye was caught and rolled strongly toward the nasal canthus, and the piece of steel was found projecting into the orbit from the sclera and was removed. The track of the steel through the sclera was surrounded by a large mass of fatty degeneration, which was also removed. Vision remained about onehalf.

DR. W. FRANKLIN COLEMAN said: I agree with DR. COLBURN as to the desirability of timely enucleation in the case of a laboring man to save his time, but should ophthalmitis set in I should not, under any circumstances, enucleate the eye. I believe it is rare for German operators to risk removing an eye in a case of ophthalmitis, but in England they scarcely hesitate to remove an eye under any circumstances. I have never regretted recommending a patient to have an eye enucleated, but I have sometimes regretted that I did not urge the patient to have the eye out in order to avoid

the fearful risk of sympathetic inflammation. I am astonished at the position of so eminent an authority as NOYES, who says: "I hesitate to enucleate the eye on account of appearances, and do not do so unless symptoms of irritation or inflammation appear which I cannot relieve with medical treatment." In nineteen out of twenty cases the lost eye is not worth saving, but is a blemish, and an artificial eye would be more ornamental. And if a man wishes to get work he will deceive the very elect as to which is the real and which the artificial eye. I cannot see any advantage in not advising enucleation where the eye has been injured to such an extent as to menace the fellow-eye.

DR. GILMORE asked DR. HOLMES why he did not try a magnet?

DR. HOLMES replied that he had been in so much doubt what to do that he thought best to first try incision and forceps. He did not believe the best magnet could have liberated the end of the steel, buried in the tissues of Fontana's space. It is remarkable that so long a piece of metal should have been thrown through the cornea, making so minute an opening, and lodged in the anterior chamber, as described, without injury to the iris or lens.

For

DR. COLEMAN said: To my mind the magnet in the eye is a delusion and a snare. instance, if you introduce a magnet within the eye not knowing where the foreign body is before placing the point of your magnet, you have to search the whole cavity of the eyeball and reduce it to a jelly before you can extract the body. Granted no great harm is done if you do not extract it with the magnet, for you can afterwards enucleate the eye. But so far as I have tried it, and have seen others experiment with the magnet, it does not give satisfaction.

DR. HOLMES replied: That is very true in many cases, where the steel cannot be seen with the ophthalmoscope, but I think where a view of the foreign body can be obtained early, the magnet may be employed with brilliant results. There are now so many cases reported with excellent results after extraction with the magnet, that I cannot think it a delusion and a snare by any means.

DR. COLBURN said: I recently saw an interesting case in which the foreign body was lodged about half way between the ciliary body and the entrance to the optic nerve. The operator cut through the sclera about where he thought it was lodged, passed the magnet in and brought out the foreign body apparently without wounding the retina at the point of attachment. The patient made a good recovery.

Correspondence.

PECULIAR ERUPTION ACCOMPANYING PNEUMONIA.

Case No. 1.-LUCY S., aged 3 years and 4 months, was taken sick on Jan. 12th, 1884, with unmistakable symptoms of pneumonia, catarrhal form. The disease had its full duration, and just as convalescence was being established, there appeared an eruption resembling very much that of varicella, with the exception that the vesicles were much larger, varying from half the size of a common pea to one-half and three-fourths of an inch in diameter. There was not the space of an inch on the entire body and extremities that was not covered with this eruption. It ran almost the same course as would varicella, except the duration was about twice as long.

Case No. 2.-JENNIE V., aged 3 years 8 months, taken sick Jan. 2d, 1887. I diagnosed pneumonic fever, catarrhal form. This case ran the same course as the first, and the eruption made its appearance at the same time as it did in the first, both children making a good recovery.

At the time of the sickness of the children the fathers were occupied in "rendering" dead hogs that had died with the various diseases that hogs are affected with, and upon examining some hogs that have died in this locality within the past two months, I find they have had catarrhal pneumonia.

What I think peculiar in the cases, is the identity of the two cases and the; occupations of the fathers.

Was it possible that the children became infected with the poison from the dead hogs, and was the eruption what English writes term swine-pox?

ATROPINE AND QUININE.

I have lately been administering sulph. atropine in gr. doses to one of my patients in connection with quinine in 3-gr. doses, and found a remarkable tolerance of the former drug. Having left off the quinine for a few days, I was surprised to find that my patient could no longer tolerate the atropine as before, the symptoms produced being excessive dryness of the throat, dry cough, with difficult deglutition. On resuming the quinine, the toxic effects of the atropine passed off and she was able to continue the atropine as before. I should like to inquire through your journal if the antagonism between quinine and atropine, as shown by this case, has been observed by other practitioners, or is there some idiosyncrasy in the patient herself to produce it.

I will add that there was no other change in the treatment at the time.

YORK, MICH.

D. P. MCLACHLAN, M. D.

The Medical Age.

A SEMI-MONTHLY REVIEW OF MEDICINE.

JOHN J. MULHERON, M. D., Editor.

-PUBLISHED BY

GEO. S. DAVIS, Medical Publisher, Box 470.

DETROIT, MICH., MAR. 10, 1887.

Notes.

Our readers may have noticed the increase in the number of original contributions to our pages during the past few months. This increase has certainly been very gratifying to us, as evincing a growing appreciation of the AGE as a medium of communication between the members of the profession. The widely-separated places from which the contributions come, are, furthermore, very conclusive evidence of the national circulation of the journal. Without any doubt, the circulation of the AGE is not exceeded in size or scope by that of more than three other medical journals of this country. We are sure that we need offer no apology, when, as in the present issue, the number of contributions encroaches on the usual editorial space. A number of book notices which are unavoidably crowded out, will appear in our

next.

The question of how to determine whether the woman shall bring forth a male or a female seems to be exciting increased interest with the apparent growing disparity between the lords and the ladies of creation. In this country an extensive series of observations was made on cattle in Texas, the conclusions from which were published several years ago. Dr. Kisch, in the Centralblatt für Gynakologie, has formulated a law which conforms very closely with these conclusions: "When the husband is at least ten years older than the wife, and when at the same time the wife is within the age of highest reproductive power (twenty to twenty-five years), there will be a very distinct excess of boys born over girls. This excess will be marked, but less distinct, when the husband is at least ten years older than his wife and she is over twenty-six. When the husband is older than the wife, and she has not attained the age of highest reproductive power, the female births will be in excess. This excess of girls born over boys is most marked when husband and wife are of the same age. Yet when the wife is the elder there is a distinct excess of male births."

Dr. Kisch admits that both his own and Hofacker's statistics are not extensive enough to warrant very decided scientific conclusions, but interested parties will, doubtless, find in them a basis for experiments.

The Michigan State Board of Health was complimented at the 276th meeting of the Brooklyn Pathological Society, Feb. 24th, 1887, by the adoption of the following preamble and resolution: WHEREAS, the State Board of Health of Michigan, has been for many years a pioneer in the investigation of disease and the collection of vital statistics, and WHEREAS, the result of these investigations and of the collection of these statistics, has been to stim- . ulate men and boards of health throughout the country to undertake similar work for the public good, therefore be it Resolved that the Brooklyn Pathological Society heartily endorses and commends the course so admirably planned and so efficiently followed by the State Board of Health of Michigan, and respectfully but earnestly, appeal to the legislature of that state to be liberal in its support to its State Board of Health, and to widen its influence and usefulness by appropriating the necessary funds to establish and maintain a Laboratory of Hy. giene.

The Medical and Surgical Reporter tells of a rather ludicrous incident which happened to a physician at New Kingston the other day. The physician, DR. GIBSON, who has lately moved to that place, was called upon to see a patientan aged woman, but of strong muscular build and energy. He thought, after some little conversation, that she suffered with rheumatism, and was about to place a seat for her near the light in a warmer room, where she had followed him with her husband, when, without a word of warning, she struck DR. GIBSON in the neck, and with so violent a blow that for a moment he was afraid he would lose consciousness. The unfortunate woman's mind was unbalanced, and for some time past she has labored under the hallucination that every physician who has been brought to see her was a horse doctor, who mistook her for an animal of that genus, and wished to give her that kind of medicine.

EMIN PASHA, for whose relief Mr. HENRY M. STANLY recently left England for Equatorial Africa, is no less a man than the celebrated DR. HERMANN SCHNITZLER, better known as Emin Bey, and Surgeon-General of the Equatorial Provinces under CHINESE GORDON. He succeeded GORDON in the governorship, and has been engaged in bringing a barbarous region into a state of civilization. He has now been shut off from the outer world for three years by the barbarians to the north of him. He is a great linguist, and in addition to his medical

learning has an intimate acquaintance with geology, botany, meteorology, anthropology, geography, etc. The little leisure which he has had for the past five years has been devoted to the sick.

DR. JAMES DAVIES states in the Therapeutic Gazette that the Druidic College of the twelfth century considered tannin the most potent of all the products of nature in producing sterility, and that tea-drinking, as practiced by the public, undoubtedly acts in the same direction.Boston Med. and Surg. Jour.

Unquestionably the excessive use of tea and coffee has much to do in producing sterility among the antique spinsters who occupy their time and talent in correcting the excesses of others.-The Weekly Medical Review.

The Review editor must either be a very brave man or must occupy a strongly fortified position. In many sections such insinuations would be the percursors of an infinite amount of trouble.

The following are a few popular fallacies : 1. That a baby should be washed every day. 2. That sitting in the sun will give you chills. 3. That a homeopath gives different medicine from a regular physician.

4. That eruptions on skin from medicine show that the disease is coming out.

5. That a man grows in height in the spring and in bulk in the fall.

6. That scarlatina and scarlet fever are different diseases.

7. That sleeping in the moonlight will make you crazy.

8. That growing flowers are dangerous in the sick-room.

A young woman in Pennsylvania, had a man arrested on a charge of assault, she being at the time in her ninth month of pregnancy. The evidence was not conclusive owing to lack of witnesses, and the prisoner was likely to be discharged. An adjournment of the case was, however, had, and in the meantime the woman gave birth to a child whose arm was badly swollen, and whose neck bore the marks of four fingers and a thumb. The birth-marks corresponded exactly with the injuries which the mother swore the prisoner inflicted on her a month before. When the case was again called, the child was placed in evidence, and the prisoner was convicted.

The Indiana Medical Journal displays a wonderful familiarity with the wisdom of the serpent in the following: "The country physi cian aspiring to city life may join with some of his brethren who know the ropes, rent, charter, elect trustees, issue catalogue, organize, and lecture and be known as 'professor.' Rooms, $200; outfit, $100; diploma stone, $100;

permanent endowment fund for catalogue and graduating expenses, $100. Ten students, if they pay, will be enough to foot the bill. It is not by any means necessary to have so many students as professors, and a board of trustees from the out towns may be had for the asking."

PROF. PARVIN many years ago, while a resident of Indianapolis, started a medical journal of high order. Many physicians sent him their names as subscribers but they did not send the money to pay their subscriptions. He paid the bills out of his own pocket, in the belief that these physicians would meet their obligations. Thus he sunk four or five thousand dollars before he could accept the facts.Cincinnati Medical News.

This furnishes but another illustration of the popular saying that a man may be very smart and yet not know how to run a hotel.

JOUSSET, a leader among European homœopaths, gives the following expression to a belief that is in him: "Homoeopathy cannot take the place of palliative medication; nor of surgical medication; nor of antidotal medication in cases of poisoning; nor of parasiticide medication whenever clearly demanded; nor of medication by mineral waters; nor of hydro-therapeutic medication; nor of medication by electricity; nor even of empirical medication. Homœopathy is not everything, and liberal medication must include all collateral modes of treatment."

W. D. MILLER, an American, has been created a professor in the University of Berlin. He is the first of his countrymen on whom this distinction has been conferred. His eminence is chiefly as a microscopist, and his most important discovery was that of the particular bacillus which causes dental caries. When he discovers the agent which will destroy this microorganism, he will have, indeed proven himself a benefactor of his race.

We think we can discover evidences of a very general tendency on the part of our local profession to no longer let their light be hidden under a bushel. There are some who enjoy facilities for such advertising as is not forbidden by the Code, and those who are debarred from these have for some time been growing restitive. The result is the not infrequent appearance in the newspapers of names which erstwhile were never to be seen there.

WILLIAM H. CRANE, the comedian, tells this new story of his boy: "His mother asked him the other day whom he had been playing with, and he answered that he had been playing with old Jule Seligman's little boy. 'Hush, my dear,' cried his mother. 'that's not the way to speak