white paper on the end of a long lead pencil, and then holding it in various positions, note the result. This can be compared with the field of a normal eye. In glaucoma, as a rule, the contraction begins on the nasal side, finally extending over the whole field.

We omit appearances discovered by the ophthalmoscope as too complicated for the purpose of this present paper. To those who can use that beautiful instrument, this article may be useless, while to those who can not, the symptoms revealed by it would be of no avail whatsoever.

All of the diagnostic points above mentioned will not be found in the same person, but whenever one of them exists, the physician may well pause and study the case long and carefully before he advises any course, much less a thoughtless one, which may result in total blindness to his patient, and in just censure to himself.

BELINO ADDISON BROWN, M. D.

201 Grand Avenue,

Milwaukee, Wisconsin.

Muscular Cramps.-Cataract.

EDITOR MEDICAL WORLD:-In reply to Dr. R. L. Burns, in the February WORLD, asking advice in the treatment of a man "who has been suffering with cramping of the muscles of the chest for the last ten years," I would say that I had a patient last summer, a young woman, twenty-three years of age, who had suffered from cramping of the limbs for four years. She had tried many physicians with no relief. I gave her general treatment with Faradic electricity and thorough massage to the limbs for two weeks. She reported that she had no more cramps, although they had been almost a nightly occurrence before.

I have at present a woman, aged sixty, under treatment, who has had cramping frequently, but principally at night, in the right arm and leg. This condition always comes on with her in connection with indigestion. I am giving her similar treatment, and improving her digestion by carefully regulating the food, and toning up the stomach. She reports "much better." She has been a sufferer for many years.

In return I would like to ask the advice of the brethren if any one can give me a system of treatment that will retard or prevent the growth of cataract on the eye after it has once commenced. I am aware that the books say: "The treatment of cataract is entirely operative, no kind of medication being of any use. The patient is a woman, aged forty-seven, in fairly good health. The difficulty has been noticed on one eye for over a year and now

the other eye is becoming affected, but she can still see fairly well with the worst eye. She lost the sense of smell after a severe attack of the grippe, but that is now returning with the use of a mild galvanic current, the negative pole being used for about five minutes each day up the nose.

Cleveland, O. D. WALLACE MASON, M. D.

Treatment of Ulcers by the Use of Tin Plates.

EDITOR MEDICAL WORLD:-In the Philadelphia Medical News for December 13th, 1890, Dr. E. R. Moras very strongly urged the use of tin plates in the treatment of indolent and varicose ulcers of the leg. The re

sults obtained by him from this novel and rather ingenious method were, to say the least, gratifying.

Since the doctor's article appeared, I have had ample opportunity to test the efficacy of the tin plate treatment, and can fully and unreservedly endorse all that was said for it. As it would be a waste of time and space to enumerate the number of indolent and varicose ulcers successfully treated by me by the tin plate method, I will report one case only; it being the worst and most hopeless of all that have yet come under my observation.

Mrs. M., aged fifty-five, a stout though not very strong woman, came under my care some months ago. She had two large callous ulcers, co existing with varicose veins, on the left leg, measuring 34 by 234 inches, and 2 by 12 inches respectively. The larger ulcer was two inches above the outer malleolus, and the other three inches above the inner malleolus. Both presented a dirty scooped out appearance, discharging freely at times, and always more or less painful.

Completely surrounding both ulcers was an elevated zone of dense, hardened tissue, while the parts immediately around the sores were edematous and excessively tender. Indeed, the entire limb frequently pained the patient so much that it had become necessary to administer opiates to alleviate the pain, and secure rest at night. This patient had been treated by many physicians, and had tried almost all kinds of treatment for a period of thirty years without relief. Indeed, the ulcers had never been entirely healed up, and this woman told me when I was called in that she hardly thought anything could be done for her limb, but at the earnest solicitation of her husband and family she submitted to treatment.

The first step in the treatment of this previously incurable case was the application, for several days, of flax seed meal poultices, for the purpose of softening the dense indurated tissue surrounding the ulcers, after which they

were depressed to the level of the sores by means of adhesive strips varied with each dressing. Two pieces of sheet tin were then cut with a common shears, sufficiently large to cover each sore and one-eighth inch of the adjacent skin. The plates, with two pieces of rubber tissue protective the same size, were then placed in a 1 to 1000 corrosive sublimate solution for five minutes, and, in the interim, the sores well washed with the same solution.

Having made all the parts perfectly antiseptic, the tin plates were next applied smoothly with the rubber tissue protective underneath the plates, and next to the sores respectively, the plates being secured by means of adhesive strips. Corrosive sublimate gauze was placed over the plate dressing, and the whole kept in position by a roller bandage, applied from the toes to the knee. In six days the entire dressing was removed, and the ulcers, on inspection, showed signs of beginning activity. The edema being gone, and the pain in the limb, so much complained of before, had entirely abated. At the end of eight more days the dressing was again renewed, and both ulcers had then lost their excavated appearance, and presented a healthy, even, granulating surface. The same dressings were subsequently renewed every week or ten days and, by the sixth week both ulcers were completely healed. This patient now wears a stout silk elastic stocking, and can do all her own house work with ease and comfort, the limb not causing her any pain in the least.

The prompt and gratifying results obtained. in this case, which had successfully resisted nearly all other forms of treatment for many years, is but a tithe of what can be accomplished by the proper and judicious use of the tin plate in all chronic indolent and varicose ulcers, wherever may be their site.

L. FRANK SIEGLER, M. D. New Kingston, Penna.

Hematemesis Caused by Parasite.

again fainted, and vomited a still larger amount of dark clotted blood. I was then summoned and found her in an extremely collapsed condition. I injected, hypodermically, a tenth grain of ergotin, ordered ice to the epigastrium, and ice to swallow. The following night she had another hematemesis, more profuse than any previous, filling a large wash bowl twothirds full; (this, of course was partly due to melted ice and gastric juice, but contained a large number of clots.) More ergot was injected, and also morphia one-eighth grain, to quiet nausea, continued at intervals of four hours. Rectal feeding was employed. Pal. pation revealed a localized tenderness, slightly to the right of epigastrium, and downwards; considerable pain was complained of in this location, also. When the stomach seemed full, and just before a hemorrhage, there would be pronounced epigastric pulsation. At this point she was given a quarter grain nitrate of silver pill, twice a day. She continued improving for three days, but Friday night vomited more blood, not so great in quantity, but brighter and fresher looking. After the last hematemesis she complained of a choking sensation, for which I allowed her a little cold water. She immediately vomited a large and lively round worm, measuring ten inches in length. She was at once put on an emulsion of turpentine, half a diam at a dose, followed in twenty-four hours by a full dose of castor oil, but no more worms were obtained. Her recovery was rapid and uneventful.

Undoubtedly this was a case of simple gastric ulcer caused, or aggravated, by the parasite, which, when the cause was removed, recovered. I have been unable to find any ref erence to intestinal worms as a cause for gastric ulcer, and the case is of interest in that respect, as well as to find worms in a patient of her age.

F. S. PARSONS, M. D. 1438 Dorchester Ave., Boston, Mass.

nine for Alcoholism.

Mrs. B., age twenty five years, widow six months, but not pregnant; at time of sickness had been a cook in small family four months. She had been complaining of dyspeptic symp. toms, with considerable epigastric pain, for which she had been treated by a lady physi. cian of this city, for three weeks prior.

While visiting a lady friend one Sunday afternoon, she suddenly fainted, and on rally ing vomited a large quantity of clotted blood. She was at once gotten to bed, where she remained until morning, when on rising she

EDITOR MEDICAL WORLD:- For the information of the many readers of your valuable journal, I send you the following as showing the wonderful curative effect of hydracetine in psoriasis. This disease is one of the most stubborn and persistent of the inflamma tory diseases of the skin, and will often resist the best directed treatment; and many times, as the physician is congratulating himself on being master of the situation, in his treatment of this disease, his patient has a relapse. Hav ing four cases under treatment last summer, and noticing in THE WORLD that Guttman, of

Paris, had cured psoriasis in seven days by the use of an ointment (five to ten per cent) of hydracetine, I concluded to give it a trial.

These four cases had been through the hands of able physicians, and had received no substantial benefit. Two of the cases were covered with scales from head to foot; the other two were covered in spots on the body and legs. My treatment was as follows: Liq. potass

ars, in three drop doses after each meal, increasing a drop a day for ten days and gradually returning, drop by drop, to the three drop dose. Only in one case did I vary this internal treatment, and in that I gave: Liq. potass ars 31⁄2 drams; Elix. calisaya q. s. ad., 4 ounces. Sig. One teaspoonful in water three times daily after meals

Externally I gave treatment as follows: Every night and morning the patient washed the scales off, first by softening them up with olive oil, and then washing off with tar soap, to be followed by a thorough rubbing in before a fire, of a five to ten per cent ointment of hydracetine. Every case yielded promptly and all are apparently permanently cured. One case was cured in ten days, one in fifteen days, and the other two were cured in less than twentyfive days.

The curative action of hydracetine in psoriasis is truly phenomenal, and if any of our readers have a case of psoriasis on hand I would by all means advise this treatment.

I would like to give the results I have obtained by the use of strychnine nitrate in chronic alcoholism.

I have treated nine cases, a majority of them old topers, and two of them regular brandy drinkers for years. Internally I gave:

R Tinct. nux vom..
Dil. mur. acid.
Pepsin scale (P. D. & Co.)
Glycerine...

3

5 drams

66

.2 46

2 ounces

Infus, gentian co. q. s. ad. .....8

ཝ་

M. Sig.-Two teaspoonfuls in from one half to a glass of water three times daily just before each meal; the dose of the nux or pepsin can be increased if necessary. Bromide of soda. and bromide of ammonia, with cannabis indica or hyoscyamus, tinct. or fluid extract, separate or in combination may be given to procure sleep.

I gave daily, and in some cases twice daily, a hypodermic injection of one-fortieth grain. of strychnine nitrate, varying the dose a little to adapt it to each case. In a few days I was astonished to find that they had no desire for drink of any kind; and in from ten to twenty injections daily, or twenty to forty if given twice daily, they had acquired so thorough a distaste for alcohol that I discontinued the use of the daily injections, and gave them every other, and every third and fourth day, and inside of two months discontinued treatment

altogether, with the exception of the two brandy drinkers, and with them I kept up the internal treatment for about four months. The result of this treatment was not only very gratifying to me, but very surprising, and I believe that strychnine nitrate is a specific 'or dipsomania. CHAS. W. SCOTT, M. D.

52 Union Park, Boston.

[Knowing that the above-named drug was not found in the general drug stores, and that our readers would want to have definite information regarding it, we addressed a letter of inquiry to the Theodore Metcalf Co., Boston, for full commercial information, and received the following reply:]

BOSTON, Mass, Feb. 11, 1892. DEAR SIR-Hydracetin or pyrodin is a chemical made by Merck & Co., although not in their printed list. It is a salt, unlike pyridin, which is liquid, and in no way resembling hydrastin.

We have not seen the article you speak of in any journal, but can safely say that it refers to "hydracetin" or "pyrodin," of which we sometimes prepare ointments as they may be pre-cribed. Under the name of "pyrodin" you will find it in Eisner & Amend's list, New York. Very truly yours,

THEODORE METCALF & Co.

Early Escape of the Amniotic Fluid. EDITOR MEDICAL WORLD:--A recent case of early escape of liquor amnii has, I trust, points of interest sufficient to occupy space in your valuable journal. Mr. R. called upon me December 1, 1891, stating that his wife was pregnant, and fluid had been escaping from the vagina for some days. One week later, the 8th, he requested me to visit his wife then learned from her that she was about seven months pregnant, and the water had continued (to escape) since the first, soiling several napkins each day. She had diminished in size since the leakage began. I left her a prescription with advice to keep as quiet as possible, as we would have to wait the event of time.

I

nine weeks before labor. Matthews Duncan mentions one in which the pregnancy continued forty-five days after the first discharge of water. He also mentions that a friend of his, mistaking pregnancy for an ovarian dropsy, performed paracentesis, draining off a large quantity of amniotic liquor, when he desisted, because of feeling the fetus strike against the canula, and yet the pregnancy did not end for a month. I have before met cases where the water had escaped two weeks before confinement, but in every case the child was dead. No doubt others of your readers have met similar cases, and if so, suppose they give us their experience through the authorized organ of our world's society, THE MEDICAL WORLD. Alba, Pa.

C. SMITH, M. D.

Therapeutics of Nitro-Glycerine.-Recurring Erysipelas. Treatment of Varicose Veins of Pregnancy. - Febricide Pills-Methylene Blue for Malaria.

EDITOR MEDICAL WORLD:-In reply to Dr. Campbell's query in regard to the use and modes of administration of nitro glycerine, I would say that I have found that one or two minims of a half per cent solution given during a paroxysm of angina pectoris will often give excellent results where the nitrite of amyl has proved a dismal failure. I continue the administration of nitro-glycerine between attacks, gradually increasing it, as I believe they are by this treatment warded off and robbed of part of their extreme severity. I prefer amyl nitrite during the attack however, in cases where it proves of benefit, on account of the utmost promptness of action that is required, but be. tween attacks nitro-glycerine is preferable on account of its being more permanent and sustained in action. The other heart affections in which it can be used with signal results, (those which are most benefitted coming first,) are pseudo-angina pectoris, weak, fatty, and dilated heart.

It has also been tried and proved highly valuable in migraine, neuralgia of the fifth pair of cranial nerves, reflex vomiting, epilepsy, sea sickness, gastralgia, hiccough, laryngismus stridulus, tetanus, hydrophobia, hepatic colic, spasmodic, uremic and cardiac asthma, simple and pernicious anemia, acute and chronic Bright's disease, puerperal and uremic convulsions. The cold stage of an intermittent fever may be aborted by its timely administration.

The best modes of administration I have found are in the shape of an alcoholic solution, hypodermatically, and in pill or tablet form. The "spiritus glonoini" and "pilulæ glonoini" of the National Formulary, and the hypoder

His

Rest in bed in a dark room is essential. mode of treatment with jaborandi or by the hypodermic use of pilocarpine is attended with good results in young and robust adults, but in the anemic or debilitated subject I would not use them for fear of serious cardiac depression. I have made use of a pill four times daily containing quinine sulph grains three and extract belladonna grains one twelfth with good effect. As some patients require stimulation from the beginning and will not bear the employment of jaborandi, pilocarpine, aconite or any other heart depressant, and as the tincture of the chloride of iron is almost a specific in both the sthenic and asthenic forms, I now invariably prescribe it when called to see cases of that nature.

In reply to Dr. J. W. Yancey's request for the best treatment for varicose veins of pregnancy he will find the first indication is best fulfilled by regulation of the bowels and the wearing of an elastic stocking or bandage. If these measures were not sufficient after a trial, I would try the sub-cutaneous injection of one or two grains of ergotine. He need not fear exciting uterine contractions by this method of treatment as all authorities report that such is not the case, and I have seen the treatment carried out in several cases, and have never observed any untoward results from it. The formula for febricide pills asked for in last issue is

chill. After the chills cease I would continue the drug for eight or ten days longer in the same dose every four hours. As most com. mercial grades of this product contain chloride. of zinc, an impurity in this case which disqualifies it for indicated use I would be careful and obtain the C. P. Medicinal, which is guaranteed by most of our reputable manufacturing chemists as being free from all deleterious substances. The methylene-blue manufactured by Lehn & Fink, New York, I can recommend as being absolutely chemically pure. CHAS. L. KERR, M. D.

Falls City, Nebraska.

A Peculiar Observation In Regard to Rabies. EDITOR MEDICAL WORT.D.--I have always wanted to know if it is known by Pasteur that rabies is first produced by the animal passion of the wolf or dog.

My attention was first called to the fact by a mad dog biting a sow with young pigs, also a male hog. The latter was castrated immediately and did not go mad. The sow was not spayed on account of nursing the young pigs and did go mad. An old colored man, a miller, and a man of observation assured me that "altered or castrated animals would not go mad if bitten." It seems that of the dogs following a female when in heat, only a few have their passions gratified and it is the one that has had his passions aroused for several days. by following the female that always goes mad. I witnessed a case to the point on one occasion that could not be doubted. Would be glad if this fact could be irvestigated, and as Pasteur is an expert on rabies, he is the man to be in possession of the fact; if he is not already aware of it.

Jarratts, Va., W. T. MCNAIR, M. D. In a subsequent personal letter the Doctor writes as follows:

Since those facts have come to my knowledge, I have known several castrated dogs bitten by rabid dogs and have never known one of them to go mad; when others that were not castrated, bitten at the same time and by the same animal did go mad. This looks conclusive. However, I would like for it to be thoroughly investigated.-W.T. MCN.

THE Columbus Medical Jov nal says of "The Physician as a Business Man:"-Any good physician who will use ordinary business methods in conducting his affairs, especially in the matter of collecting, will be able to live well and to enjoy a good competency when compelled to retire from active work. On the contrary, the most successful physician imaginable, without these methods, will leave his widow to take in boarders."