treated a patient who insisted on telling me how, when he got a piece of coal in his eye, he went to the mine physician to have the coal removed, and that after the kind hearted old doctor had gouged around the cornea for some little time remarked that he could not find any coal, and that he did not believe there was any there, and sent the patient home, and that after the patient got home one of the miners with the point of his pen knife picked out the piece of coal from the cornea. This case has severe ophthalmia and will produce me a nice little fee. General practitioners seem not to be prepared for the removal of foreign bodies from the eye. Many of these cases indeed require careful manipulation; all of them require good light and good corneal magnifiers and a steady hand. In my own practice I do not find that special lamps and special lenses for transverse illumination, and special microscopes and delicate foreign body evulsors, nor the giant magnet, nor the Hirschberg magnet, nor even the X-ray machine, any too much armamentarium for the successful discovery and location and extraction of foreign bodies from the eye.

It would seem a simple matter to reduce an ordinary catarrhal conjunctivitis, but I have just furnished an artificial eye to a patient who a short time ago had such an inflammation in his eye. The patient was a prominent educator, principal of a city school. One evening after leaving the schoolroom he felt a slight discomfort in one of his eyes. There was slight redness, but no especial pain. There was a little lacrymation, but no pus. He applied to his family physician. This physician kept a stock of drugs, and, after examining the patient's eye, went to his stock of drugs and made a lotion. The first application of this lotion caused a violent inflammation, resulting in a mucous discharge. After a few more applications the discharge became muco-purulent in character. The physician then changed the solution, but the inflammation became worse. Both physician and patient becoming alarmed, the services of an oculist were sought. From the violence of the inflammation and the gross appearance of the discharge, the oculist pronounced it to be gonorrheal ophthalmia, and after four weeks of hospital attention the inflammation was only partially subdued, and the vision became absolutely nil. A short while after being dismissed the patient sought my services. A large portion of the cornea had sloughed away. From the interior of the eye pus was discharging from the cornea; the orbital cellular tissues were

greatly swollen and in violent inflammation.

There was in

tense pain radiating into the temporal region. Sympathetic ophthalmia had begun to make its appearance in the other eye. So great was the mental perturbation of the patient. from his loss of sleep, from the severity of the pain, and from his great alarm, that when he came to me he was on the point of suing for malpractice everybody who had been connected with the case. Of course there was nothing to be done but to enucleate, and in two weeks he inserted an artificial eye and returned to his work. Wondering whether the lotion the general practitioner had given the patient was such as would cause an inflammation, I applied a couple of drops of the alleged solution into a dog's eye. One application was enough to produce a very violent ophthalmia. Now, while I was able to calm the patient's ire and dissuade him from suing everybody, still I think I have a right to protest against such results in ocular therapeutics. I think I am warranted in saying to the general practitioner that the eye is not an organ upon which bad work can be concealed; that while. the gynecologist can make an application to the uterus that will make the disease worse, and then lay the blame on "Divine Providence," and escape personal responsibility, any such bad work on the eye will always stare one in the face; and I feel like urging general practitioners to be sure they are right when they attempt to treat the eye or else let it severely alone.

Some of the medical journals of Paris are just now recommending formaldehyde in the treatment of burns, compresses soaked in a ten per cent. solution being applied to the affected part. It is said that in twenty minutes all the pain ceases, and that continued renewal of the application causes all traces of the burn to disappear, so that not the slightest redness of the skin is left. This goes with the ptomain-toxic element in burns, lately observed.

The Alabama Medical Age says: An Irish brakeman in the railroads vards was hurt by the train, and his friends offered to send for a physician. They asked: "Do you want an allo-path or homeopath?" He replied: "It don't matter -all paths lead to the grave."

THE PELVIS.

By J. H. Lamberson, M. D., Lebanon, Oregon.

The following case, which recently came under my care presents so many interesting points that I thought it would be of interest to the medical profession in this state, and consequentlyI make this brief report of the salient features concerning it.

I was called on November 21st, 1897, a distance of thirtytwo miles to see J. S., who, having been mistaken for a deer while hunting, had been shot with a 44-70 ball fired from a Winchester rifle at a distance of about thirty yards. Upon my arrival, twenty-three hours after the injury, I found the patient suffering great pain, and in a condition of profound collapse; and no pulse could be detected in the radial artery. An examination of the wound showed that the walls of the rectum had been penetrated about three inches above the anus, and that the coccyx had been fractured. In fact the ball passed entirely through the pelvis from behind forwards, fracturing its anterior wall, and in making its exit near the lower part of the scrotum, grazed the femoral artery. Strychnin, nitroglycerin and whiskey were administered in full doses; sufficient morphin given to relive the pain; the rectum irrigated, and the patient made as comfortable as possible.

Dr. J. P. Wallace met me in consultation twelve hours later and as the patient had reacted to the stimulants we enlarged the wound in the rectum, removed the loose spiculae of bone, and dressed the case by packing the wound with carbolized gauze.

The accompanying illustration will show the nature of the injury.

As the patient was a personal friend, I remained constantly with him in his isolated locality for twenty-three days. The temperature soon commenced to rise above normal, and there was considerable febrile disturbance, although the wound was irrigated every three hours with a two per cent. carbolic solution. On the thirtieth day the temperature reached 107°, which was reduced to 1020 in three hours by flushing the wound with a solution of mercuric chlorid1-2000. There was a continuous and profuse discharge of pus of a creamy color, and on the ninth day a large slough was removed that weighed eight ounces. The feces passed through the wound in the posterior wall of the rectum, but little trouble was experienced from this. Several long, tortuous sinuses formed, but by using catheters for drainage tubes I succeeded in keeping all the pus pouches drained. On the tenth day a very severe cystitis supervened, and the bladder was washed out with boric acid solution. He was also given.

salol and methoylene blue, which benefited the cystis, but the urine was loaded with pus and albumen, and the inflammation persisted to his death. An osteitis of the injured bone also occurred which caused the patient much suffering.

At the end of the twenty-third day I had him transported on a stretcher to the town, and although two days were required to accomplish it, the removal was effected without adding to the gravity of the case. I was fortunate in having intelligent and faithful nurses and assistants, to whom much credit is due. Although every thing possible was done for the patient, he continued to grow weaker from the exhausting purulent discharge, having a temperature of 102°104°, and became much emaciated. Numerous bed sores formed, although every effort and cushions of all kinds were employed to prevent their formation. He died seventy-eight days after the injury, after having made a grand fight for his life.

By Henry Waldo Coe, M. D., Portland, Oregon.

Alaska just now is the scene of an epidemic of this disease, and the rumors of devastation which it is supposed to be causing are attracting much attention, the newspapers having painted the horrors of the situation with all the fervor of a panic stricken reporter. As it does not often happen that an epidemic of this malady comes under the observation of physicians in private practice, and as sporadic cases are somewhat rare, it is safe to presume that the average doctor does not have the same fully in mind, and therefore that a few notes on the subject might not be out of order.

In the larger cities, especially among the poorer classes, the sporadic form of the disease is present almost all the time; and this form could generally be more definitely described by the term endemic. The endemic character in certain outbreaks is manifested by the form of the present attack in Alaska, where no cases have occurred in one of the new towns, while its neighbor, a few miles away, and with which it is in constant commercial communication, has suffered from the disease with sufficient severity to excite marked

comment.

Mills, in his new work upon nervous diseases, just from the publisher, describes the disease upon the general description of leptomeningitis, and sees no reason for a sub-classification of it as a specific disease, in view of the fact that the same micro-organisms are largely causative factors in this, as in other forms of suppurative meningitis.

Any exhausting influence, such as prolonged mental or muscular strain, predisposes to the disease, and at Dyea and Skagway at this season of the year those engaged in the delirium of business ventures, or the plucky miners climbing the passes for the interior, are no doubt materiallly weakened, and a portion of that immunity which the system enjoys against the attacks of pyogenic micro-organisms is lost.