of this process, and after the operation was completed complained of severe nausea and sickness in the stomach, syncope was imminent and he had to be placed in the prone position. These two cases showed a gangrenous area almost identical, the gangrenous process extending along the skin of the penis at some points a quarter of an inch, at others up to three-quarters of an inch at least, and although the operations were performed about a month ago, the patients have not as yet recovered. The conclusions of the speaker were that stovaine is not as efficacious as cocaine in its anesthetizing effect and is as toxic as cocaine, produced gangrene when used in this strength, and is consequently a most dangerous drug. He had used it in a case of ischio-rectal abscess, and the man complained most bitterly of pain, claiming that he felt every step of the operation.

Dr. Earl Connor read the paper of the evening, which was entitled:

INFLAMMATION OF THE OPTIC NERVE DUE TO ALCOHOL AND

TOBACCO POISONING

He said that inflammation of the optic nerve due to alcohol or tobacco poisoning, or both, may be acute or chronic. The acute cases are the result of the ingestion of an overdose of the poison. The symptoms are a rapid reduction of the visual acuity, even to light perception only, within a few days. Vision is subject to variation, and partial recovery may precede permanent blindness. The ophthalmoscope shows a congested nerve head, with blurred edges, dilated veins, and perhaps some small hemorrhages. Prognosis is usually bad, but a useful degree of vision may follow early and persistently energetic treatment.

The chronic form yields readily to abstinence from the exciting cause. There is variation in vision, and the prognosis depends on the early recognition of the disease, so that the inflammation may be checked in its incipiency. The pathologic changes in the chronic cases he thought degenerative, but said that differences of opinion existed regarding this point. Prognosis is good in the first attack, but proportionately less so in recurrent attacks.

Treatment consists in total abstinence from the toxic agents known to produce the disease. Active diaphoresis assists in the

elimination of the poison. Strychnia pushed to the limit of toleration is probably the best remedy, and the iodides are of value in stimulating the absorption of exudates. Plenty of sleep and fresh air, good food, and proper exercise are also necessary.

Dr. McAuliffe said that he thought the optic nerves were affected more by pipe smoking than by any other form of tobacco. He had seen one patient in whom this condition had been produced by cigarette smoking.

Dr. Perry Hough said that he wished to emphasize the fact that a slight amount of alcohol would keep up the inflammation of these nerves. The patient may have been abstaining absolutely from alcohol, and have been treated with strychnia and hydriodic acid, with marked improvement, and he will return to the doctor with a decided relapse, and questioning will reveal the fact that he has had one or two drinks. The patient must abstain absolutely from the exciting cause, if there is to be any permanent improvement.

TWO CASES REPORTED AT REGULAR MEETING OF THE NASHVILLE ACADEMY OF MEDICINE.

Tuesday, Oct. 11th, 1904.

BY LUCIUS E. BURCH, M. D., OF NASHVILLE, Tenn.

CASE. I. TYPHOID INFECTION OF GALL BLADDER-OPERATION— RECOVERY.

Mr. M-, aged 39. Morning and evening temperature were normal for a week following typhoid fever. At one o'clock in the morning of August 24 he was seized with a severe pain in the epigastrium associated with a profuse vomiting of bilious material. As the pain increased in severity his physician, Dr. Witherspoon, was notified, who ordered grain hypodermic of morphia. This, however, gave him but little relief, and Dr. W. asked me to see him at eight that morning. I found him with temperature normal, pulse 64, abdomen soft, with, however, slight tenderness in epigastrium and over gall bladder. Pain was somewhat re

lieved by hot applications, but vomiting continued intermittently. At two-thirty that afternoon, he had a chill lasting ten minutes, and temperature rose to 104°-pulse 112. A sponge bath and enema were ordered; bowels moved well, temperature dropped to 102°, pulse 116; vomiting stopped, pain but slight and limited to region of gall bladder. Patient had a fair night, but at ten next morning had another chill lasting ten minutes, temperature rose to 103°, pulse 130; slight rigidity of upper right rectus, lower part of abdomen soft; no mass could be detected, but on palpation pain over gall bladder was apparent. Vomiting started again after the chill. I diagnosed typhoid infection of gall bladder, and advised immediate operation. Family asked for further consultation, and when consultants arrived patient was having another chill, so we had to postpone consultation for twenty minutes. After this chill temperature 103°, pulse 140 and barely perceptible, and patient quite blue. Diagnosis agreed to by consultants, patient operated on immediately. Gall bladder distended with a blackish pus, and at tip a necrotic spot just ready to rupture. The usual cholecystotomy was performed, the patient put to bed in as good condition as he was before operation. Next morning temperature 99°, pulse 100, and from there on an uneventful recovery.

CASE. II. ECTOPIC GESTATION-TUBULAR ABORTION.

Mrs. T-, aged 25. Family history negative, has been married six years. Had three abortions before giving birth to a child. Has one child three years old, labor easy and normal; menstruation returned eight months after labor, and from that time on has occurred every three weeks; flow lasts five days, rather profuse and without pain. Seven weeks ago flow occurred at regular time and lasted ten days associated with cramping pain in left side.

In a week's time flow returned again and pain at this time was so severe that she was compelled to remain in bed for two days. In a few days, however, she felt perfectly well and went out for a buggy ride, and on getting out of the buggy on her return she was again seized with this cramping pain, and it was so severe

that she fainted; she was taken into the house, put to bed and quietly rallied and next day was up again. From this time on there was an intermittent flow from the uterus, slight in character. At the end of four days on getting out of bed one morning she was again seized with this severe pain and I was sent for. I found her with pulse of 96, temperature 97°, anxious expression, no rigidity of abdominal muscles; on digital examination I found uterus normal, cervix rigid, and no mass in either fornices or cul de sac. There was no discoloration of areola and no history of morning vomiting. I told the family I suspected extra uterine pregnancy, but could not find sufficient local symptoms to advise operation. As I was leaving the city for two weeks I told her to remain in bed, and if she had the least trouble to summon a physician immediately. On my return two weeks later, she informed me that she had had no more severe attacks, although there was still a cramping in left side increased on exertion and that the flow during this time had been intermittent. At this examination I found a mass the size of a large marble in the cul de sac, and another on left side as large as three fingers. Operation was advised and agreed to by consultant, Dr. Witherspoon, and also the family. She was removed to St. Thomas' Hospital and just as I opened the peritoneum there was a gush of bright red blood, showing that rupture had occurred from the examination just before operation. A large blood clot was found in cul de sac and a partial tubal abortion on left side. Patient stood the operation well and is now on high road to recovery.

This case well illustrates several common points concerning ectopic gestation -- namely, that amenorrhea is often absent, that in many cases there is no change in areola and no vomiting, and that the most common termination is tubal abortion and not rupture.

ECONOMICAL. A society of women in Berlin has recently presented a petition to the Prussian Minister of Education, praying for the prohibition of corsets in young ladies' schools on the ground that this garment is prejudicial to the health of the growing girl. For the prevention of "waist."

Beconds, Begollections and Beminiscences.

SPECIAL NOTICE.

The Association of Medical Officers of the Army and Navy of the Confederacy will hold its next annual meeting in Louisville, Ky., Tuesday, Wednesday, and Thursday, June 6, 7. and 8, 1905. JNO. S. CAIN, M. D.,

DEERING J. ROBERTS, M. D.,

President.

Secretary.

Obituary.

DR. G. S. WEST.- Died at his home in Palestine, Texas, December 27, 1904, Dr. G. S. West, aged 81. Dr. West was one of the most distinguished surgeons in the Confederate army, and was the first one to whom a commission was issued by the war department. Dr. West graduated from the Medical Department of the University of New York in 1854. When yellow fever broke out with great violence in Norfolk, Virginia, in 1856, he went from his home in New York to the stricken people and gave his services freely to all classes. After the epidemic was over the citizens were so pleased with him and so grateful that they gave him a residence and guaranteed him $3000 a year to remain amongst them. He accepted it. When the war broke out they said to him, "We know you wish to go North and go in the Union army; do so. After the war, return to us, and live with us." Dr. West said, "I cast my lot with the South when I came here. I will enter the Southern army." He did so, and filled many positions of honor and usefulness. During those terrible last days around Petersburg and Richmond he was