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administration is just now quite a fad.

But certainly

in this case its use has appeared to be attended by most excellent results. How the treatment has acted I do not pretend to say, nor do I claim a single case proves such. I do desire, however, to call your attention to the case particularly, and shall take the opportunity of reporting it for what it is worth, in the hope that the remedy may be duly tried in similar conditions by other practitioners. It is but just to say that I have been using the drug for a few weeks in several other cases of a milder type of inflammation of the genito-urinary tract, without having obtained as yet an appreciable effect. That the remedy has been in this particular case of valuable service as a tonic and alterative, and that it has had a special action on the effected structures is, to me, quite apparent: I do not, however, claim to entirely eliminate the possible element of coincidence in this solitary case. Further than what I have stated I do not pretend to explain the action of the drug.

I will not at this time expatiate upon calculus, tubercular and other forms of surgical pyelitis, with their attendant features of pyo-nephrosis, changes in the renal tissue, characteristic of the various forms of so-called surgical kidney perinephritic abscess, etc., but will reserve these topics for future consideration.

*The Weight of the Fœtus at Term.

BY LOUIS BECKER, M. D., Knoxville, Ill.

On the morning of Jan. 15, 1891, I was called in consultation to see Mrs. G. She had been in labor the entire night and for various reasons was becoming rapidly exhausted. The physician in charge informed me that he had given her during the night in the neighborhood of an ounce of fl. ext. ergot. Under its influence the woman, a multipara, was having intense pains. On examination I found a breech presentation; the bag of waters ruptured; a considerably swollen and lacerated scrotum, and a tensely rigid os uteri tightly clasping the body of the child a little above the fold formed by the legs with the body. The pains, though very severe, had made no impression on the position of the fœtus for some time. We at once chloroformed the patient thoroughly and the os uteri relaxed to some extent. I succeeded, with some difficulty, in hooking the first finger of each. hand in the fold between the legs and body of the child, and by exerting my strength slowly and at intervals to the utmost, succeeded in about ten minutes in delivering a large male child. Quickly introducing the whole hand into the uterine cavity I found in a separate amniotic sac a second fœtus, which after rupturing the sac, I turned and delivered with some difficulty. Both the mother and the children recovered rapidly. My surprise may be imagined when on weighing them I found their combined weight was 211⁄2 lbs.; one weighing 112, the other 10 lbs. They are both alive and healthy to-day. The mother is of large frame and has a roomy pelvis. Her first child, a girl, she told me weighed 13 lbs. On investigating

the case still further I found that the woman's mother, on the authority of a thoroughly reliable physician had a record even more remarkable.

She was delivered of triplets whose aggregate weight was 25 lbs. Two and one-half years after

*Read before the Military Tract Medical Association at Peoria, Ill., Oct. 20 and 21, 1891.

this she had twins whose aggregate weight was 20 lbs. Still later she had a single child whose weight was 1634 lbs. All these were born alive. She is of large frame and a very powerful build, and, as she expressively remarked, "never had any runts."

Thinking these cases somewhat remarkable, I have investigated as far as possible with the facilities at my command, the records both of average weight and of excessive weight.

Roederer, of Germany, gives the average as 7 lbs.; Clark, formerly of the lying-in-hospital, Dublin, gives the average 7 lbs. but says it varies from 4 to 11; Comus, of France, gave the average 64 lbs. and the records of the Maternite confirmed this.

In Brussels the average was 61⁄2 lbs. Beck a former American obstetrician gave the average in various institutions as 7 lbs.

Scanzoni, in his "Lehrbuch der Geburts-hülfe," gives the average in 9,000 births as 7 lbs. Ingersley,

of Copenhagen, in the Obstetrical Journal gives the average in 3,450 cases as 7 lbs., the largest being 103% lbs.

Hecker, of Munich, gives the average in 1,000 births as 6 lbs., two being between 10 and 11 lbs. Fesser, of Breslau, gives the average as 61⁄2 lbs. Bailly, of France, gives the average under 7 lbs. Lusk, in 200 births at Bellevue Hospital mostly of foreign parentage gives the average weight as 73, the largest being 11 lbs. La Chapelle, in 7,000 births found 13 weighing 10 lbs., none over that. Lusk, says: "Credible histories of children weighing 12 to 16 lbs. are extant; such children are generally stillborn.

Charpentier, gives as the largest child he has ever seen 101⁄2 lbs.; La Chapelle, 12; Bondelocque, 13.05 Merriman, 15.5; Waller, 15 lbs. 15 oz.; Graft, 16 lbs., and Cazeaux, 18 lbs. The largest child on record was that of Anna Swann, 23 lbs., but as she was a giantess such a weight could hardly be compared with the weight of children of moderate sized women. Thus we see that the average is quite unanimously near 7 lbs., the American staticians going a little above and the Europeans a little below that mark. As to the weight of twins or triplets, I can find very little. The authorities agree however in making the average weight in multiple pregnancy considerably below that of single births.

I think most of us, at a guess, would place the average weight above 7 lbs. and I think almost all of us are sure we have seen a child at birth weighing more than 101⁄2 lbs. which Charpentier said was the largest he had ever seen. But most of the babies we see weighed have a good share of the immense wardrobe necessary for a baby now-a-days on their backs and this makes their seeming weight very misleading. In the cases I have given, allowance has been made for all clothing so that the weight given is practically the actual weight.

The size of the child is influenced by 1st, the sex, boys averaging larger than girls. 2d, Number of pregnancies, the weight usually increasing in each successive pregnancy. 3d, The age of the mother, the child weighing heaviest when the mother is between the 25th and 35th year. 4th, The constitution and health of the parents. By some the weight of the father is thought to exert some influence.

Taken together these cases seem rather remarkable. The case of the twins, which came under my own observation, I am unable to find statistics with which

to compare. But the fact that the weight of each child was excessive leads me to believe that it was a rare case. The other cases include the greatest weight in children I can find on record as carried in one uterus at one time, that is, 254 lbs., also a remarkable weight in twins, 20 lbs.; and the second largest single child, 1634 lbs., of which I can find any record, born of a woman of somewhere near the ordinary size. Truly there were no runts in that family.

The Prevention of Contagion in Tuberculosis.* By E. M. SUTTON, M. D., CANTON, ILL. Tuberculin and cures innumerable for consumption have been tried and found wanting. Let us now direct our attention to the prevention. We have limited the mortality of other contagious diseases. Can we not bring our germicides into use to destroy the deadly bacilli and so prevent contagion and autoinoculation? I submit that we can, and furthermore it is our duty to do so. The trouble is, we are too intent on the cure and lose sight of the road to prevention.

The following rough family history is suggestive enough to encourage attempts to prevent contagion. Mr. A- died at the age of forty of consumption, leaving a wife and eight children. The oldest son married, moved away and is healthy, the third son. died three years after the death of his father at the age of twenty, of consumption; the second son died a year later at the age of twenty-three of the same disease; the mother is at present in the last stages of this disease, forty-five years of age; she says that her parents were free from the disease and her brothers and sisters are healthy. Her health was good until some time after the death of her husband, when she developed symptoms of consumption and is now expectorating large quantities-more than a pint a day of tubercular matter. The remaining children of the family are healthy, but the mother told me that a doctor said they would all die with consumption. While getting this history I learned something of the habits of the family, and the use of a coal bucket for receptacle of the sputum in the day time, and a dry wash bowl at night for the same purpose, was one of the worst. This habit I have reason to believe began with her husband's illness. No better way for infecting other members of the family could have been found if wanted, and I felt like corroborating the other doctor's statement when I observed one of the children get coal in that bucket, and in replenishing the fire use the poker to scrape out the last bits of coal, tubercular matter and dust, succeeding well in liberating small clouds of the two latter well mixed for inhalation. Some might say that the people are acquainted with the contagious nature of the disease, but they are not. When I told the mother of the danger of such careless habits she was greatly surprised and at once suggested disinfecting the rooms and wished to be provided with germicides, which shows that the laity will eagerly grasp any method to prevent contagion when once they learn the truth. It would be interesting to compare the mortality from this disease in the cultured classes with that of the uncultured, both having like evironments, as to wealth the former scrupulously clean, the *Read before The Military Tract Medical Association, Peoria, Illinois, October 20 and 21, 1891.

latter positively sloppy. I dare say the mortality is less in the former class. Germicides are mighty and can accomplish more than isolation, therefore, let us make bichloride a household term, and through the agencies of our Boards of Health, instruct the people how to use it along with good hygiene, then the mortality from this disease will be low in proportion to the amount of dread we can inspire for it as shown by the comparatively low mortality from diphtheria, smallpox and other most dreaded diseases. Many papers are being read on this subject with statistics, pro and con, as to the the theory of contagion, but while we wrangle among ourselves consumption sweeps us away, therefore we must unite to prevent its progress.

*What I Learned to Unlearn in Gynecology.

BY CHAS. C. KOHNING, M. D., BRUSSELS, Ill. Every earnest worker in any field of problematical science finds himself compelled to unlearn what he had erroneously learned. The errors which he discovers and with modern tuition weeds out are usually traditional teachings-the legacies left us by our forefathers. For it must be self-evident that many of our diseases, and might add even our opinions, are largely heredity.

What I have learned to unlearn in the treatment of diseases of women will be the burden of this paper.

What physician of any practice has not been called in to see some wretched sufferer whose health has been crippled for months or even for years, by hæmorrhage or other discharges from the sexual organs which were attributed to the "change of life" by her friends. Successive physicians were called whom she consulted, and even they were unable to diagnose her case. Whether through ignorance or courage, they failed to make a digital examination.

A more alert or up to the times physician was called and he found a polypus or fungoid degeneration of the endometrium or uterine fibroid, or a cancer of the cervix.

The alert physician did not believe in climacteric omnipotency.

I shall never forget, with all my experience, a case, I might add not the only one, of a beautiful woman, beloved by a large circle of friends, and surrounded by every luxury wealth could furnish; who was allowed by her physician to almost bleed to death-and the question might arise why? Because of a polypus, being at first intrauterine, was not recognized and her age justified in his opinion, the diagnosis of "change of life." This diagnosis having been made, no vaginal examination was thought of. When the writer was called in, he found a polypus dangling in the vagina. She was bedridden and as translucent as alabaster. I twisted off the growth. The hæmorrhage did not return, neither did her health. She died several months later quite suddenly and unexpectedly.

I have learned to unlearn the teaching that woman must not be subjected to surgical operation during monthly flux. Our forefathers thought and taught the presence of a menstruating woman would pollute sacred and solemn religious rites. Query: Would sour milk spoil the fermentation in wine vats? Influenced by hoary headed tradition, modern physicians generally postpone all operative treatment until the flow has ceased. Why this delay? If time is pre

* Read before The Military Tract Medical Associatian at Peoria, Ill., Oct. 20 and 21, 1891.

cious, and undoubtedly it is, it then becomes an important factor in such cases. I have found by experience menstruation to be the best time to curette away fungous vegetation of the endometrium; for being swollen by the afflux of blood, they are larger than at other times, and can be more readily removed.

I have learned to unlearn that anteflexion and anteversion in themselves, that is to say as displacement merely, and without narrowing of the uterine canal, are necessarily pathological conditions of the womb. Text-books speak of them as such and exhibit many ingenious forms of pessaries to rectify these so-called displacements.

Very rarely indeed do I resort to those, and then only to a stem pessary in anteflexions. For I find from treatment, that in every virgin or barren woman the womb, in varying degrees, is bent forward or tilted forward and apparently resting upon the bladder. The mistake made, as I will show in this paper, is in attributing to this natural position of the womb. the various forms of pelvic trouble; especially that of irritability of the bladder, to which woman and man are so liable. The sympathy between the brain and bladder is so remarkably close-so close indeed that some physiologists contend that every "mental act in woman or man is accompanied by a contraction of the bladder." The irritability of the bladder thus becomes one of the first symptoms of nervousness, to which every one is liable.

Many a lawyer before pleading an important case, and many a clergyman before delivering a discourse, and many a general and the bravest of soldiers on the first shock of battle had to involuntary empty their bladders. So it is with the lower animals, when frightened, involuntary micturate. A nervous bladder is then the first phenomenon of a nervous brain. For nervousness is a deficient control of the higher nerve centers over the lower ones-in other words a lack of brain control.

Now, a hysterical girl or woman whose nervous system has given away under the strain of domestic cares, consults a physician for such ordinary symptoms of nerve exhaustion, wakefulness, utter weariness, a bearing down feeling, back ache, and perhaps above all, an irritable bladder.

Upon making a digital examination he usually finds the fundus of the womb resting on the bladder, where it should as nature intended, rest.

At once he concludes by a hop, skip or jump the whole trouble is due to pressure of the womb on the bladder, viz: to the existing natural anteversion or to the anteflexion as the case may be.

Enticed away

by the vesical lapwing from the bottom factor- the shattered nerves - he now makes local applications and racks his brain to adapt or devise some pessary capable of overcoming the supposed difficulty, heedless of the dilemma that the upward shoving pressure of the pessary on the bladder must be greater than the counter ordownward pressure of the womb, to which he attributes the vesical irritability.

In the lying-in chamber the fear of septicemia will ever haunt us; but I have long since abandoned the idea cherished by that class of wasteless and witless nurses now happily obsolescent, that the parturient woman is to be swathed like a mummy and kept as immovable.

What earthly harm can befall a woman after a natural labor if she turns over in bed from side to

side; even sits up in bed if she feels like it or to use the commode if she desires too, I cannot see. Natural labor is a physiological process not a pathological one, but tradition has thrown around the lyingin bed a glamour of idiotic and mischievous sentimentality.

As proof of this see American Indian and several other nations.

66

In regard to my subject of Gynecology permit me to express my disbelief that mammary abscess comes from caked breast" or from breast over distended from a secretion of milk too great for the infant's need. Mammary abscess in the suckling woman, in my opinion comes from cracked nipples alone.

In proof of this let me ask my fraternal brothers if any one of them ever had a case of mastitis after a miscarriage, or one of gathered breast following a stillbirth, always providing the breast was left alone so far as pumping and sucking is concerned.

Under these circumstances the unsucked and unpumped breast may swell up and grow painfully hard, but will not inflame or suppurate. Let me not be understood as saying an over distended breast should not be relieved by sucking or pumping; but the means employed should sparingly and at long intervals be so used as not to crack the nipples. The immunity from mammary abscess after miscarriage and stillbirths is attributed by the physician to his local application of belladonna or other milk drying drugs. That, I think is an error. It comes from the absence of the exciting cause of cracked nipplessucking child.

Long ago I came to the conclusion that the womb, like unto the nose, has its own secretions; and that because the cervical canal is stopped up with mucus, it should not be treated more harshly than a stopped up nose. I came to this conclusion from seing many cervical canals wholly closed up; even destroyed by the remedies that had been applied to get rid of the mucus. Then, again I discovered just as the nose secretes abundantly, under the stimulus of the emotions; so the womb secretes more actively under the stimulus conveyed to impressionable nerves. So much indeed, that leucorrhoea is a common adjunct to nerve prostration, and is cured by the cure of its

cause.

This nasal analogy led me to think that even uterine catarrhs are not of such paramount importance as to merit heroic treatment, and that metritis and endometritis so far as symptoms are concerned, are often idle words. The mucus of a uterine catarrh is in quality very much the same as the mucus of nasal catarrh, and its secretion is in itself no more weakening. It is not a disease of itself, but is merely a symptom of disease. It is not therefore, that highly vitalized fluid, the loss of which, according to traditional belief of a majority of physicians and women, saps the very citadel of life; brings on decrepit and premature old age. and sends its victim to an untimely grave. This widespread error is a relic of medieval ignorance which believed in the existence of hoo-seeds!—the male and female semen and their admixture to insure conception. Hence leucorrhoea has erroneously come to mean pretty much the same as spermatorhea, a belief invented and fostered by cunning quacks who know how large sex and sexuality make one being and thus impose upon our credulity.

As a corollary to this, let me add, that I have freed myself from the belief that cellulitis is at the bottom

of most female ailments, and the hot water douche is its cure all.

My experience teaches me that, save in some cases of active congestion or of acute inflammation of the pelvic organ, the hot water douche is of questionable utility, and its indiscriminate employment has done far more harm than good; especially when continued for any length of time.

I cannot withold the opinion that from its injudicious use both ovaritis, salpingitis and periuterine inflammation has actually been set up by the too much use of the caloric, and the subsequent chilling of the pelvic organs.

The crucial test of surgical research, which cannot be gainsaid, has shown that cellulitis is almost a myth, and what has long been deemed exudation tumors and inflammatory deposit in the alveolar tissue, are tubal and ovarian lesions.

I have learned to unlearn the idea- and this was the hardest task of all-that uterine symptoms are not always present in cases of uterine disease; or when present, they necessarily come from uterine disease. The nerves are mighty mimes, the greatest mimics, and cheat us by their realistic personations. of organic disease; especially of uterine disease. Hence it is that even seemingly urgent uterine symp. toms may be merely counterfeits of uterine disease.

I have therefore, long since, given up the belief, which with many amounts to a creed, that the womb is at the bottom of nearly every female ailment.

As the outcome of much that I have learned to unlearn, I have arrived at this very short gynecological creed.

I believe the physician who recognizes the complexity of woman's nervous organization, and appreciates its tyranny, will touch her well being at more points and with a keener perception of her needs than the one who holds the opinion that woman is woman because she has a womb.

PROCEEDINGS OF SOCIETIES.

ALLEGHENY COUNTY MEDICAL SOCIETY.

Scientific Meeting, December 15, 1891. T. D. DAVIS, M. D., President, in the Chair. Subject for discussion, SYPHILIS.

DR. THOMAS: It was but a few days ago that I received a notice requesting me to open a discussion at this meeting. It is usual to open the discussion with a well-digested paper. The time has been so short that it would be impossible for me to prepare anything worthy of the dignity of a "paper." What I shall present will be more in the form of a syllabus, expecting you to elaborate.

1st.

How long is syphilis contagious?

The profession, as a rule, does not have definite and uniform opinions upon this point. Judging from remarks that I have heard made at various times, some believe that there is no limit to the contagious character of syphilis, forgetting that the disease is a selflimited one.

Possibly I can formulate my views better by reporting three cases, from a number of similar ones, from my case book, as follows:

Case 1. Mrs. A. married, when the man who became her husband was in the secondary (end of first

year) stage of syphilis. In ten months afterward she gave birth to a very large (weighing 12 pounds) and healthy looking child. The child was still-born, not from syphilis, but from asphyxia, owing to tardy delivery of the head, the presentation being pelvic. The case was in charge of a midwife, and when I arrived upon the scene I found a dead child hanging from the vulva.

In nine months after she gave birth to a macerated foetus of five months uterogestation.

In another eleven months she again gave birth to a macerated fœtus of seven months uterogestation.

In one and a half years more she gave birth to a full term and healthy looking child. In a short time this child developed a papular syphilide. It remained under my care for two years, and is to-day a large and healthy looking lad.

In another twenty-one months she gave birth to a fine child that never presented the least suspicion of syphilis.

In two years more she gave birth to a healthy child, which is now nearly three years old, and has never shown any evidence of syphilis.

Mrs. A. has been under my continuous observation since her first accouchement. I have been unable to get a history of primary lesion or secondary symptoms in her case; she passed through them without her knowledge, but I have treated her for serious tertiary lesions, such as deep ulcers on the posterior fauces, headache and syphilitic liver.

In this case, supposing the mother acquired syphilis in the early months of marriage, the contagious character of the disease disappeared in about four years. She received no treatment for her early syphilis.

Case 2. Mr. B., in the summer of 1885, acquired a chancre on the lip through kissing a prostitute, and conveyed the disease to his wife, who was also treated by me. They already have several children.

On March 3, '86, a living child is born, but dies in five months from marasmus, having been puny from birth.

On May 30, '87, at full term, a macerated child is born.

On August 31, '88, a healthy child is born and remains free from the disease.

On Feb. 17, '90, a healthy child is born and so remains to the present time.

In this case the mother ceases to convey or transmit the disease in less than three years.

Parenthetically I mention that Mr. B. also conveyed the disease to his little son, two years of age, by kissing him on the forehead where there happened to be an abrasion, for it was here the chancre developed. Recovery.

Case III. Mrs. C. contracted a chancre about the time of her marriage, and was treated by me for the secondary lesions. She became pregnant for the first time in twenty-seven months after her marriage. The child was born at full term and apparently healthy, but in about three weeks snuffles began, an eruption appeared about the anus and afterward over the body. After a long treatment it recovered.

In one year and three months after the birth of her first child she again became pregnant, went to full term and was delivered of a healthy looking child. This child is now about three months old and has shown no signs of syphilis. Neither has it received any antisyphilitic treatment.

In this case the contagious character of syphilis disappeared before four years and three months-some time after the third year.

You may say that this child is only three months old and that it may develop syphilis later. If a child is born and does not present evidence of syphilis before the end of the third or fourth month it is rare that it ever will. Out of 158 cases summarized by Diday only five cases presented symptoms of syphilis after the fourth month.

In brief, then, I believe that syphilis is not contagious, as a rule, after the third year. Exceptionally in the female it may continue until the fourth year.

2d. What secretions contain the syphilitic virus? None of the physiological secretions of the body. Experiments by inoculation have been practiced again and again with the physiological secretions of syphilitic patients upon healthy persons without the production of the disease. Diday and others have inoculated persons with the saliva from syphilitic patients who were free from mouth lesions without results. Spermatozoa from a patient in the height of the secondary stage of syphilis have been inoculated, by Mireur, in the nonsyphilitic without producing the disease. The same thing has been done with the other physiological secretions of the body and with a like result. The only elements, then, in the body that contain the germs of syphilis are the blood, and the serum which is found upon the lesions of syphilis upon the skin and mucous membranes. A man may be suffering from the secondary stage of syphilis, and providing he be free from lesions of the skin and mucous membranes, many procreate a perfectly healthy child, because he cannot inoculate the mother and a nonsyphilitic mother never brings forth a syphilitic child-she cannot.

Dr. Batten: I have given a great deal of thought to this subject. The presence of the syphilitic germ depends a great deal on circumstances; upon the temperament and the constitution of the patient. In the discussion of this question we have to depend a good deal on the truthfulness of our patients. It is impossible to watch a patient carefully; we must depend a great deal upon his veracity. Now I believe syphilis may be conveyed a long time after the patient has contracted the disease. For instance, a man had contracted syphilis in about 1869. He married in 1882 a very plump and healthy woman, who weighed about 120 pounds. Shortly after she conceived, and gave birth to a child. Some time during her pregnancy she took syphilis, and I treated her. The child was born healthy, but the mother was reduced to ninety-five pounds. She had a second child, and the second child is healthy. Both of these children are healthy, although the man's appearance denotes that he has syphilis, and denoted that before he was married.

Another case was a man whom I treated for the disease twice. He went through the usual course. He married and his wife has had three children, and they are all healthy. The wife is a healthy, fine looking woman and is well.

Another case that came under my observation was a young man who had the disease. He married and impregnated the wife, and the child was dead in the uterus. Before her next pregnancy I put her under treatment, and since that time her children have all been born healthy, and all are healthy and living at the present time. I believe, and my experience bears me out in my belief, that a person once syphilitic is

always syphilitic, and that the disease may be conveyed through any of the secretions of the body.

DR. GREEN: I have no criticism to offer on the paper. I believe my observations would lead me to agree with the paper. I might state an example or two that have come under my observation. One case occurs to me in reference to the length of time that the poison may remain in the system and be conveyed to others. I remember treating a young man quite a number of years ago, I think some seventeen, probably eighteen, for syphilis; he went through all the usual symptoms, primary and secondary. I told him not to marry for at least three years. I was not aware there would be no danger at that time, but I supposed the most dangerous period would be passed; but he married short of three years-two years and eight months. I attended his wife in confinement, but failed at any time to observe any syphilitic symptoms in the first child. I attended her in seven confinements, and I never saw healthier children than these. They are all living to-day. When I see them I fail to see any symptoms in any of them; and to show you how violent an attack of syphilis this young man had he resigned his situation and left the city and went into Maryland while the eruption was on his face. He was completely discouraged during the first year of his illness; it seemed to break his entire constitution, and I cannot tell how it happened these children are so healthy. The father of the children was killed about a year ago. About three months ago I

saw the mother of the children, and according to my observation she has never shown any symptoms of syphilis. I could mention numerous instances similar to that.

I

DR. SHILLITO: In 1883 a gentleman came to my office, who at that time expected to be married very soon, and related this history: He told me that during the war he was a clerk in Washington City. He had contracted syphilis and had been treated by what he considered the best physicians he could find. He came to Pittsburg, and up to that time he had one attack of iritis; he had also had a skin eruption. When I saw him he seemed to be a man of average health. The nasal septum was perforated. I told him after so long a time and after having received so much treatment, that there was no particular danger of transmitting it to his offspring. He married. attended his wife in confinement and delivered her of a living child. I think about one-third of the epidermis of the face had gone and one eye was entirely gone. The other eye was wanting until you could only see a little coloring of the cornea and one spot that seemed to be as large as a pinhead, but since that time it admits a little light. That child enjoys good health, most excellent health, up to the present time, although of course permanently blind. I took special care to watch the mother both before and after for any marks of syphilis. I have knowledge of her ever since until up to a very short time ago, but I have not seen her within a year or two. She has had no evidence of syphilis. I understood about a month ago that she had become insane, or troublesome, and had to be taken away to some asylum. They had but one child. He contracted syphilis during the war, and the child was born in September,

1884.

DR. THOMAS: with the child. DR. SHILLITO: The epidermis of the face was nearly

What was the form of the trouble

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