fession with the hope that some, at least, will be encouraged to collect statis-tics and to present them, as here indicated, for publication. These statistics would be specially valuable if collected from a private, and I repeat especially, country practice, thus to become a leading factor to young physicians who follow in their footsteps, who have most need of these landmarks. For the inexperienced graduate in medicine enters upon this department of professional work with a greater degree of trepidation than any other. As surgeon he may call in an assistant, as physician he may deliberate or prescribe a placebo, but as an accoucheur he must be prompt. He has no time to refer to books, nor can he, except in rare cases, ask for a consultation. For these reasons, and others which might be given, he has need for all the information he can obtain from his preceptor, from his lectures and from carefully prepared works-and such valuable statistics as here suggested-on the subject before entering the lying-in room. ELECTRO-CAUTERY IN DISEASES OF THE CORNEA. BY FLAVEL B. TIFFANY, M. D., Professor of Ophthalmology, Otology and Histology, University of Kansas City. Of the many diseases of the eye and its appendices, there are none more obstinate to treatment than many of the affections of the cornea. Some of the forms of keratitis will continue many months or even years resisting all treatment-especially phlyctænular and interstitial keratitis; others, again, such as ulceration of the cornea, both deep and superficial, running a more rapid course, will go on to permanent injury or even destruction of the eye in spite of all we can do. The therapeutical agent in these affections of which I wish to speak is one that I have only employed for about six weeks, but from the brilliant results. obtained I have every reason to believe that we have in the thermo-cautery (either the Paquelin or electric) a most valuable agent in aborting and curing, affections of the cornea as well as some diseases of the lids. It seems to be the theory now, supported by the best authorities, that these diseases of the cornea are dependent upon certain microbes. Granting this, certainly there can be no surer or more effectual germicide than the actual cautery And that this is superior to all other agents is obvious from the fact that it can be localized. Illustrative of the good effects of this agent I will cite some cases treated within the past few weeks. Many of these cases were of years' duration, recurrent and chronic in the extreme, some of them having been treated by nearly all the oculists of the city, myself included, receiving either temporary or no benefit, and in no single instance have I failed, with the cautery, in getting excellent effects; and, in many cases, most brilliant results have followed its use, the cauterization seeming to dissipate the troublelike magic. And after the many hundreds of these cases which I have coaxed along for weeks, months and years, even not always in the end effecting a cure, I rejoice in the feeling that in the thermo-cautery we have a speedy and effectual curative agent. CASE I. Mary K. age 16 had interstitial and phlyctanular keratitis from infancy; she also was afflicted with trachoma. Five years ago this patient was under my care for several months, and went home as well as those cases usually get. She returned last September with recurrence of a most aggravated form of trachoma and interstitial keratitis, her vision being only perception of light with intense photophobia. During the winter months my assistant Dr. Merri. man treated the granulations by the ordinary methods, and they were almost obliterated but the interstitial and phlyctanular keratitis persisted. May 15, I applied the electro-cautery around the entire margin of the cornea and also to each individual phlyctanula of the right eye; this gave such fine results that I used the same treatment to the other eye, and a few days later the patient went home with a good pair of eyes-cornea clear, very fair vision and no photophobia. CASE II.-The father of this patient had similar trouble of 18 years standing which had resisted all treatment. I used the electro-cautery with excellent results, the cornea of each eye becoming clearer in a few days than they had been for several years. CASE III.- Frank C—, age 18, had interstitial keratitis of both eyes, intense photophobia, and only perception of light-not being able to distinguish objects. We all know how obstinate these cases of interstitial keratitis are, running frequently a course of 12 or 18 months resisting all treatment. In this case I applied the electro-cautery around the margins of the cornea of both eyes, slightly glazing the cornea at different parts. It is now about ten days since the cautery action and to day the patient can tolerate light, can even count fingers, while the opacity is fast clearing away. CASE IV.-James N- , age 33, came under treatment June 21, 1888; he had an ulcer of the cornea 15 years ago which was treated for several months ere it was cured. In 1885 it recurred and since that time the cornea has been more or less inflamed and cloudy. On June 21, I found vascular leucomatous keratitis covering a spot 3 the size of the cornea to the left of the center of the pupil, with two blood vessels running from the margin of the cornea to the opacity. I used the electro-cautery applying it to this spot and also at the margin of the cornea, cutting off or obliterating the two blood vessels mentioned. In two or three days the opacity became much thinner, the eye freer from irritation and the vision considerably improved. CASE V. Garret W—, age 31, vision. This patient had pannus with trachoma of several years duration. He had been treated at different times by various physicians; would be temporarily better but the trouble was ever recurOne week ago I used the electro-cautery on the cornea and lids of the left eye, with marked benefit. To-day I employed the same treatment with the other eye. There is already great improvement. rent. CASE VI.-Mary D, age 3 years, has been troubled with phlyctanular keratitis for the last 8 months. There are several phlyctænulæ, one large one in front of the centre of the pupil. The electrode was applied to each one of these phlyctenulæ on June 1. She was discharged on June 15, well, with an absolutely clear cornea. CASE VII.-Geo. W. mittent for several years. M, age twelve, had phlyctanular keratitis inter- the cornea was perfectly clear-no phlyctænulæ left. I have thus far treated twenty cases in this manner, and in no case have I had other than pleasing results. I have also applied the cautery to two cases of pustular blepharitis with marked improvement in two or three days. REPORTS FROM PRACTICE. ANTIPYRINE IN THE TREATMENT OF RHEUMATISM.* BY JOSEPH SHARP, M. D., KANSAS CITY, MO. Professor of Materia Medica and Therapeutics in the Kansas City Medical College. The three cases following are reported from a number of cases of rheumatism in which antipyrine was administered, for the reason that in all of these other well-known lines of treatment had been tried with failure to give relief Luther G, January 17, 1888, was taken with malaise, headache, coated tongue, soreness and aching of the joints, scanty urine, temperature slightly increased (101° F.). He felt certain he was going to have inflammatory rheumatism, as he had several times before. I did not feel so certain of it. Gave him bromide of potassium and tincture aconite root mixture to alternate with salicylate of cinchonidia in five-grain doses every four hours. Continued on this treatment, with seidlitz powders to move the bowels, two days with abatement of fever, but no marked improvement of the joints. He took twentygrain doses of salicylate of sodium every four hours, until he had ringing of the ears and free sweating, but still not much improvement of the extremities, although he was able to hobble about. Ten-grain (10-gr.) doses of antipyrine gave relief of pain with marked and immediate improvement of the joints. Th. McK- -, age 22, had suffered from one prolonged attack of inflammatory rheumatism, and had several minor attacks previous to this one. Saw him February 29, 1888, when he had been confined to his bed several weeks. High fever, coated tongue, elbow and shoulder joints involved. Put him on salicylate of sodium, and lemon juice and sodium bicarbonate at bedtime. Gradually improved, and at the end of ten days could be out of the house. March 23 was called to see him with relapse. Fingers, elbow, shoulder-joints and neck involved. He had been taking salicylates continuously, to which was added iodide potassium in carbonated water; he grew worse, fever higher, tongue heavily coated. Substituted salol for sal. sod. with no apparent advantage, the patient having to take Dover's powders or morphine every night to *Read before the Kansas City District Medical Society. get any rest. Two-grain doses of antifebrin in place of salol reduced temperature for one day, when it gradually arose and pain increased. Replacing antifebrin with ten-grain doses of antipyrine every three hours, it was followed by a good night's sleep with fall of temperature, cleaning tongue, return of appetite and convalescence. The patient had a relapse for a few days, when he again took antipyrine with relief. Theo. N, age 40, has had repeated attacks of rheumatism, usually occurring in the feet, leaving an cedematous condition. He is usually relieved by an application of mustard draughts over the instep and ankle, with salicylate of sodium internally followed by iodide potassium in carbonated water and roller bandage as soon as the acute symptoms are over. April 7, 1888, an attack came on involving the knee joints, although he had commenced salicylates on the appearance of the very first symptoms. Ten-grain doses of antipyrine gave speedy relief, as it did in a relapse since. Fraenkel, Clement, Davis N. S. Jr., and many others have reported cases or series of cases of rheumatism treated by antipyrine, with the most favorable results; in many cases after the partial failure of salicylates and salol. Antipyrine is basic in character, and may possibly in that way help to neutralize the acid condition of the blood; it is antiseptic, and in many cases we have indigestion and fermentation of the food antedating an attack of rheumatism. It affects profoundly the blood, frequently changing its color to chocolate; probably decreases tissue change as evinced by its effects on temperature. It has proven itself to be a very good analgesic, in neuralgia and other painful diseases. CONCLUSIONS.-In antipyrine we have a remedy that relieves the pain in rheumatism better than salicylic acid, salicylates or salol, as it is also better to reduce temperature and reflex nervous disturbance. REMOVAL OF A FIBRO-MYOMA FIVE DAYS AFTER LABOR.* BY E. VON QUAST, M. D., KANSAS CITY, MO. On May 20th I was called to the bedside of a lady, primipara, by one of our oldest and very competent midwives, who had attended her in confinement four days previously; delivery had been perfectly normal and uncomplicated. Placenta had come away without any undue traction, and a dose of ergot given afterward produced sufficient uterine contraction checking a rather free flow. There was no trouble until the fourth day, when she was startled by repeated gushes of blood at every movement in bed, and a digital examination revealed to the midwife the presence of a hard tumor within the cervix. She immediately sent for me; and I could only verify the correctness of her statement at an examination. The tumor, pear-shaped, was situated like a cork in the cervix, and was attached by a pedicle, of the size of a thumb, within the uterine cavity to the left side, about one-half inch above the cervix. The hæmorrhage became so alarming that it produced extreme pallor, syncope and a very faint, radial pulse, necessitating hypodermic injections of ergotine and brandy, tam Read before the Kansas City District Medical Society. The tumor was brought poning of the vagina, with compression of abdominal cavity and lowering of pa- These tumors are certainly rare, that is, they are seldom found to remain existing during pregnancy, labor and puerperium; so rare that we can find but few recorded. How long it had existed before this lady's pregnancy I do not know. She was twenty-six when she was married, first menstruated when fifteen, and never had any trouble, none during pregnancy, nor labor, until the puerperium. The majority of authors on gynecology think fibroids cause sterility; I endorse this view if they cause hæmorrhage and catarrh. Fibroid tumors composed of tissue identical with that of the uterus are generally expected to become modified by pregnancy; but this depends upon their kind, whether fibroma, fibro-myoma or myoma, and upon their seat; the more intimate their relation to the uterus the more profound will be their modification. They are supposed to disappear after labor; but if flattened during pregnancy often reappear after delivery in consequence of sub-involution. Interference during convalesence depends upon the condition of the tumor, the kind of complication and the general state of the woman. If they cause hæmorrhage that jeopardizes the patient's life, removal is the only remedy or the patient will succumb. FOR NASAL CATARRH.-Prof. Wm. H. Pancoast advises for nasal catarrh this formula: Mix. A little is to be poured in a cup of cold water and snuffed up the nose occasionally; or it may be added to water and used by means of a very gentle stream from a nasal douche. A |