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Had been

CASE, W. B.- Male, age twenty-two. Admitted April 8. complaining some ten days with the usual pains and aches, and for three days was ill in bed; inability to sleep; delirious at night; no tenderness of abdomen; urine scanty and difficult to pass. Three days later became suddenly violent; would not stop in bed except when forced; retention of urine. On 12th, passed urine, but unconsciously in the bed. 16th, very violent and noisy, praying, singing, and screaming. 22d, diarrhoea smelling badly; has grown very weak, less violent. 25th, low muttering; very frequent, unconscious stools with blood; mouth in terrible condition, black putridity collecting as soon as washed off. 26th, hemorrhage increased, eyes open and glazed, breathing obstructed and choked; does not swallow unless forced; thought to be dying. 28th, much the same, but takes some nourishment. 30th, breathing easier, eyes closed, repeats one word "drink." The following day temperature rose again to 106°; but greatly to our surprise, from this time improvement was slow but steady, and he was discharged cured a month later.

Name, W. B.

Result, cured.

...

.......

CASE, J. J.- Male, age twenty-four, till and dark; is a wood-Name, J. J. Result, died. chopper, living in tent, drinking water from River Yarra into which much of the city sewage runs. When admitted to hospital had been feeling ill three days, though he continued at work. Complained of pain in head, back, and legs; " could not eat, and continued much the same for two days after coming to hospital.

On

NTIGRAD

third day was taken with severe epistaxis, lasting at intervals for some hours, and followed by coma, death taking place on fourth day. In this case there was absence of all abdominal tenderness, diarrhoea, and delirium.

CASE, K. C.- Female, age twenty-four. Admitted to hospital, April 13; had been ill five days. Usual symptoms of pain in head and body, loss of appetite, etc., with an unusually copious perspiration.

16th, complains of pain in right side; examination gives pleurisy rub;" the spots affected could be covered with small end of ordinary stethoscope. 20th, well-developed pneumonic condition of both lungs; deep red face;

great tenderness of abdomen,

21st.

All symptoms worse. Hemorrhage from mouth and nose. 22d. — Increased hemorrhage; stools of blood with little fecal matter; blood from ears, and so profuse from nose and mouth that nares plugged with the effect of lessening the flow; vomiting of bloody slime.

were

100

Name, K. C.

Result, cured.

Apr 13 14 15 16 17 1AFARB

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23d, loose rattling breathing; hemorrhage lessened from mouth, increased from bowels. 25th, less hemorrhage; breathing still very difficult, but can now raise a little stringy tenacious mucus. Improvement continued very slowly, and a week later she much improved with ultimate recovery.

PHOSPHORUS IN THE TREATMENT OF INCIPIENT

PHTHISIS.

BY E. A. WILSON, M.D., ROCKVILLE, CONN.

[Read before the Connecticut Homœopathic Medical Society.]

THE reports of the four cases brought to the notice of the Society are taken from my last year's practice, and in each case I have been able to have the sole management. In none of the cases was I the first physician. I wish to particularly emphasize the fact that phthisis in its incipient stage only is to be dealt with.

CASE I. Jennie B., age 26, spare build. For about a year has had slight cough in the morning, and on exertion; pain in left chest on inspiration, sensitive on pressure; expectoration frothy and occasionally stained with blood; fever in the evening; night-sweats about twice a week, generally about four o'clock in the morning; loss of flesh quite marked. March 15, 1886, examination showed depression in left supra-clavicular region; dulness on percussion over an area extending from the clavicle to the fifth rib; chest walls extremely sensitive to pressure. Auscultation: tubular breathing; moist râles; vocal fremitus increased; heart-sounds intensified. Respirations 22, pulse 108; temperature, morning 99.3°, evening 101°. For about six months. has been taking cod-liver oil and Fellows' Syr. Hypophosphites. No benefit has been derived. Phosphorus 3x., tablet every six

Observations taken as

hours. No more night-sweats; cough grew less in about two weeks, and gradually disappeared; improvement was rapid and general. March 31, the end of the fourth week, she began full inspirations at night and morning. June 1, coughs only in damp weather, and then very little. Complains of cold feet and limbs. Calc. sulph. 6x., tablet at night. June 28, reports that she thinks she is cured. Left town, and now writes that she is well.

Res

CASE II. Edward H. P., age 23, spare build. Father and older brother died of consumption within a year. He has had two slight hemorrhages within the last six months; has been taking cod-liver oil, Fellows' Syrup of Hypophosphites, syrup of iodide of iron, but with no benefit. April 10, inspection: left chest flat over second, third, fourth, and fifth ribs; inspiration hardly visible on that side; expiration slow and labored; percussion flat. Auscultation: moist râles; vocal fremitus increased; heart-sounds intensified; dyspnoea; night-sweats; cough constant; expectoration viscid, salty in taste, blood-streaked. piration 26; temperature, morning 99°, evening 102°. Pulse from 95 to 120. Phos. 3x., every four hours. The third night there was no sweat, nor has there been any since; less cough at night; expectoration whitish, and easier to raise; appetite improving; gained three and a half pounds in weight the first two weeks. May 10, "feels so much better that he said he would not need any more medicine." His condition had improved in all ways; slept all night without cough; temperature, evening, 99.4°. June, July, and August showed a steady improvement. In October was married. April 15, says he is a perfectly well man.

CASE III. Kate D., 19, tall and slight. In March, 1886, brother died of consumption. At that time was complaining of pain in left chest, and cough, loss of flesh, and occasional night-sweats. Took Fellows' Syrup of Hypophosphites until October, then began cod-liver oil, which nauseated her. Has grown weak very rapidly in the last six weeks. Oct. 24, came to my office in a carriage, was scarcely able to walk. Very marked dyspnoea and prostration; voice nearly gone, generally whispered; had a hemorrhage of bright red blood a week ago, about two mouthfuls as she said. Percussion: marked flat sound over upper third of left lung; left chest is almost immovable. Auscultation: loud sibilant râles; tubular breathing; heart-sounds intensified. Respiration 35; pulse 120; temperature, morning 100.2°, evening 102°; night-sweats frequent and very profuse. She could not stand alone over two minutes. She fainted before I finished the examination, and so it was incomplete. Menses have been irregular and scanty for four or

five months. Diarrhoeic tendency. Phos. 3x. every four hours. Oct. 31, reports as much improved; night-sweats ceased on the third night; no more diarrhoea; coughs very little at night; appetite and strength improved; walks across the room alone. From this time she gained rapidly for five weeks, when she caught cold and complained of sharp stitches in left side. Bry. 30 cured in two days. Dec. 15, phos. 3x. night and morning; now instructed her to take one full inspiration five or six times a day, always breathing with the mouth closed. Her progress was rapid, and Feb. 23 I discharged her with no cough or expectoration. Her weight had increased from 115 to 138 in four months. She took sac. lac. for the last month, one tablet at bedtime.

CASE IV. Alfred W., 19, slight build. Father and two brothers died of consumption in 1885 and 1886. He has had catarrh all his life; has been losing flesh for several months; cough; expectoration; dyspnoea; night-sweats; diarrhoea; two slight hemorrhages in the spring.

Sept. 12, percussion: dulness over second, third, and fourth ribs on left side, over a space of about 2 by 5 inches. Auscultation moist râles; tubular breathing; heart-sound intensified. Pulse 110; respiration 30; temperature, evening, 100°. Phos. 3x., three times a day. He did not report again until Dec. 5, when I found his condition very much worse. Dulness over the whole left chest, with marked flatness in the upper portion; loud sibilant râles; respiration very slight; expiration slow and labored; pulse 120; temperature 102°; respiration 44; sputum purulent, sinks in water, often blood-streaked. Phos. 3x., tablet every three hours. Dec. 10. Night-sweats ceased; diarrhoea much improved; cough not so violent; sputum copious and frothy; pulse 116; temperature 100.3°; respiration 38. He is now in bed. From this time until February he continued the phos. 3x. with improvement in every way. Feb. 6, complained of cold feeling; was anæmic. Ferrum phos. 6x., morning and night. During March remained about the same, except that his appetite was irregular. April 10, complained of sore throat on the left side; passive congestion; stitch-like pains; dysphagia. Lachesis 30 cured in three days. His cough tightened; slight and difficult expectoration; suffocative attacks at night. Phos. 30 relieved at once.

April 23, phos. 3x., because the patient said it made him feel better than any other medicine. May 1, is up and dressed one or two hours a day. The prognosis of this case is, to my mind, exceedingly grave; but it seems to me that without the phos. he could not have survived the winter.

As all the cases had been under the ordinary routine treatment for phthisis, and with no benefit, I gave phosphorus as a

last resort, having confidence that certain symptoms would be more relieved by it than by any drug I knew; viz., difficult and blood-streaked expectoration, dyspnoea, hoarseness, night-sweats, diarrhoea, loss of strength, and rapid emaciation.

PLASTIC OPERATIONS ON THE EYE AS PERFORMED BY PROFESSOR KUHNT AT JENA.

BY DR. AUGUST A. KLEIN.

CASE NO. I. A young man twenty-one years of age, glassblower, presented himself at the clinic with the following condition: Left eyelids swollen, red. Conjunctiva oedematous, injected. Cornea hazy, a gaping wound of about a quarter of an inch in length at lower quadrangle; iris protruding; severe pain in eye and through left side of head. Vision in left eye, only perception of light. Right eye normal.

History. While at work a hot piece of glass had flown into his eye; it was removed by the foreman of the factory. Prognosis very doubtful."

Treatment. Ice-bags day and night. On the following day the swelling had considerably diminished, so much so that an operation could be performed. The patient was put under the influence of chloroform. The professor performed iridectomy of the protruding iris, and then removed the thickened and infiltrated upper edge of the corneal wound. This caused a gap in the cornea about a twentieth of an inch wide. The conjunctiva was then separated from its attachment around the lower half of the cornea, and about a quarter of an inch from the sclerotic, a vertical cut having been made in it at the vertical meridian. It was then sewed together over the wounded and gaping cornea, covering the wound and lower half of the cornea completely. An incision was then made on each side, and as far back as possible, to prevent too severe stretching of the sutures. Iodoform and a light bandage were applied; the patient put to bed, and the ice-bags continued. Next day the eye presented a very swollen appearance, and the patient was suffering severe pains; leeches were applied to temple of the injured side, and ice-bags continued. Next day the swelling had gone down considerably, and the patient had less pain. Ice-bags were continued until all inflammation had gone. Six weeks after the operation, the patient was considered well. The corneal wound had united, with adhesion of the conjunctiva. The patient could read five-ninths, and although he had a large coloboma, yet, the conjunctiva covering that part of the cornea, it was less observable than it would have been otherwise. The patient's eye had been saved.