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he did he generally vomited it up. I endeavored to excite his appetite by the use of small portions of liquid nux vomica, but he would throw it up when given. Although the various functions of the skin, bowels and kidneys seemed to be very well performed, he rapidly went down hill, measurably, I apprehend, from want of nourishment. The action of the heart and lungs never improved any. He died on March 17th greatly prostrated. Shortly before death ensued he had a spasm.

This is the first case of Bright's disease in a child that ever came under my observation. As a rule, this disease in a child is a sequence to some skin affection, generally that of scarlet fever; but in the case under consideration I could learn of no history of scarlatina or any other skin disease. In fact I am entirely at a loss to account for its existence. Some authors ascribe the acute form of Bright's disease to exposure to chilly air, or getting wet while in a state of perspiration. I think this is a very reasonable conclusion, as no doubt in many instances these causes act in the production of the disease after attacks of scarlet fever. From all the symptoms present in this child I was compelled to term it a case of acute Bright's disease. I have never seen hematuria in a case of the chronic form. The character of breathing was also different from that we have in the chronic stage.

We may have quick action of the heart, due to resistance of passing blood through the diseased kidneys, but this little patient had not been sick long enough for hypertrophy of the heart to ensue. I think the rapid action of the heart was due mainly to debility. In the acute form of Bright's disease, it may be said, its pathology consists of inflammation of the parenchymatous structure of the kidney. If the patient should survive the acute stage, the disease extends, involving the interstitial tissue, terminating in fatty degeneration, and subsequently contraction, if early death or recovery does not take place.

It would be useless for me to speak of the different varieties of Bright's disease when you all are familiar with the various phases of character they present. I only report the foregoing case on account of its unusual occurrence in a child so young, independent of being the result of some skin affection.

MEADOW LAWN, KY.

Reports of Societies.

KENTUCKY STATE MEDICAL SOCIETY,

Forty-Third Annual Meeting, held in Maysville, May 11, 12, and 13, 1898.

Dr. Bate, of Louisville, in a paper entitled "The Rational Therapeutics of Some of the Animal Extracts," called attention to the normal physiologic action, and the action when administered as remedial agents of the thyroid, suprarenal, and ovarian glands.

Reports were cited in which the thyroid extract had been credited as being either curative or beneficial, viz., in obesity (Cabot), dwarfed children, impaired mental conditions, tetany (Wells), keloid and certain other tumors (ibid.) premature gray hair, skin diseases of non parasitic origin characterized by scaly thickening, pelvic hyperemia (Mallett), and that it was specific in cachexia strumipriva, cretinism, and myxedema.

According to his observation the thyroid extract produced daily evacuations of the bowels, diuresis at first, cheerfulness and amiability, smoothness of the skin, restoration of the color of the hair in one case, restoration of normal temperature in a case of diabetes insipidus and obesity where the usual temperature was 97° F., and a slight diminution of the weight of obese subjects.

It was believed to be contra-indicated in exophthalmic goitre (since this was characterized by the excessive secretion of thyro-iodin) and in all diseases of the heart other than those dependent upon fatty changes. The adult dose was from six to fifteen grains daily, given in divided. doses preferably an hour and a half after meals. This could be increased, but should be withheld for several days as soon as cardiac palpitation, weariness, nausea, cephalic or lumbar pains occurred. Alkaline diuretics, strychnia and morphine and atropine, he successfully used to relieve an almost comatose patient who had, contrary to orders, increased from fifteen to thirty-five grains daily. Vomiting, partial suppression of the urine, lowered body temperature, uremiclike spasms of the muscles of the face, intense caphalic and lumbar pains with accelerated pulse were the symptoms produced. Uniformity in dosage was obtained now, he said, since the preparations were assayed to a standard thyro-iodin strength.

Reports in which the suprarenal extract had been used with benefit were also cited, viz., Addison's disease (Olliver), also one case of his own, anemia and diabetes mellitus (Potter), exophthalmic goitre and cyclic albuminuria. Since its action was tonic or contracting to the general muscular system, especially the skeletal, vasomotor, and cardiac muscle (Schæfer and Olliver), it was probably indicated in all conditions attended with loss of muscular tone, neurasthenia, the same cardiac diseases in which digitalis was of use, anemia, melanemia, and conditions requiring vasomotor stimulants.

Lastly he quoted authors who had found the ovarian extract of service in ovarian dysmenorrhea, amenorrhea, the climacteric, neurasthenia, hysteria, mental disorders, lack of development, and after ovariotomy. He reported the case of an hysterical girl of twenty, who had been castrated at the age of eighteen, in whom the administration of the ovarian extract was followed by a slowing of the pulse from 100 to 80 beats per minute and a lessening in the frequency of the convulsions. The ovarian extract was believed to be in too transitional a state to do more than invite investigation. He emphasized the fact that these animal extracts when used upon isopathic principles were palliative rather than curative, and that their continuous use had been necessary in those cases reported as cured.

He believed this was necessary since they supplied a constant demand of the system, just as food. There was probably a complimentary action, he believed, between the thyroid and suprarenal principles. Whether malmorphosis was prevented by the secretion of these glands acting through the nervous system, or by chemical means, or by both, was as yet undetermined; but he hoped, until their exact limitations were understood, indiscriminate use would not cause them to pall upon the profession.

Pathology and Diagnosis of Diphtheria was the title of a paper presented by Dr. C. W. Aitken, of Flemingsburg.

Dr. S. G. Dabney, of Louisville, then read a paper entitled The Treatment of Diphtheria, paying special attention to serum therapy and intubation. He divided the subjects into (1) prophylaxis; (2) treatment of nasal and pharyngeal diphtheria; (3) treatment of laryngeal diphtheria including intubation. [See p. 461.]

Discussion. Dr. J. A. Stucky, of Lexington, emphasized the importance of early diagnosis. He questioned the value of local antiseptic treatment in healthy persons as a means of preventing infection.

He thought protonuclein of value both as an immunizing and curative agent. He has used the drug with excellent result in tonsillitis.

Dr. Letcher, of Henderson, said the importance of early diagnosis and the use of antitoxin could not be overestimated. He knows that deaths are constantly taking place in his part of the State from laryngeal stenosis due to failure to recognize the disease and resort to antitoxin and intubation.

Dr. Shoemaker, of Morganfield, said that in his part of the State diphtheria is an uncommon disease. Objections which he formerly had to antitoxin had been swept away by a recent experience in which the results had been remarkable.

Dr. G. G. Thornton, of Gravel Switch, read a paper entitled Membranous Croup and Intubation, with Report of Cases.

The essayist took the view that many cases of pseudomembranous laryngitis were not diphtheria. He has seen many cases, has never isolated them, and has not seen a case which could be traced to infection or from which others developed. Membranous croup seems to be influenced by heredity. Thus two brothers have lost three children, and a sister has had five cases and lost four children from the disease. Of these eight cases only two occurred within one year of each other. In the treatment, believing that antitoxin is specific for diphtheria only, and believing that membranous croup is not diphtheria, he leaves antitoxin out of consideration. He has not been able to find a remedy which has any curative effect upon the disease, and all that is left us is intubation, or tracheotomy, if demanded.

The conclusions with regard to intubation were as follows: (1) He has not seen a case of membranous croup get well without intubation; (2) Any physician skillful enough to catheterize the female should be able to intube; (3) It is best, especially with beginners, to leave the thread in; (4) The tube promptly removes the difficulty in breathing, but should the respiration remain at 30 to 35 per minute, the prognosis is unfavorable.

Dr. W. L. Rodman, of Louisville, read a paper on The Influence of Age, Sex, and Race in Surgical Diseases, with statistics bearing upon the relative susceptibility of the white and colored races to different surgical affections.

Varicocele: In 236 cases he has not found it beginning before puberty and rarely after thirty. While rather uncommon in married men, he has operated in four cases, the oldest case being fifty-six years.

Negroes are practically immune to varicocele and from varicose veins in the leg. In the analysis of 500 cases of varicose veins operated upon by Louisville surgeons, only one was encountered, and that was a mulatto. Prostatic hypertrophy is almost unknown in the negro. There are several anatomical and physiological reasons for the rarity of varicocele. Anatomically the testicle does not hang as low, being built more upon the plan of these organs in the dog, and are not so large as in the white race. The negro begins sexual life at puberty and does

not know what it is to be continent thereafter. Varicocele is rare in the Indian.

Gall-stones are practically never encountered in the first decade, and seldom in the second. It is unmistakably more common in womenaccording to statistics of Louisville surgeons, the prevalence is as 5 to 1. In 106 cases analyzed by him only one occurred in the negro. This is explained by their more active life and lessened liability to malaria and other diseases associated with disorder in the liver.

Tetanus: Infant mortality from tetanus is heavy in dark-skinned races. In negro infants it is explained by racial susceptibility and uncleanliness. In Jamaica and other West Indian islands the mortality from tetanus among negro infants is from one fourth to one half of all negro infants born. Trismus neonatorum is more common in Jewish infants than it should be, which is explained by the uncleanly habits of the mohab.

Harelip, clubfoot, and other congenital deformities are much less common in the negro. But a single case of harelip in the negro has been operated upon in Louisville in twenty years. Congenital deformities are rare in Indians, but this may be partly explained by the custom in Indian tribes of destroying puny or ill-formed children.

Erysipelas is not so rare in the negro as some suppose. Of the 79 deaths reported in Louisville in ten years, 17 were negroes.

Stone in the bladder: Johnson, of Richmond, has found that the negro is not so rarely affected as some believe, but it is five times more common in the Caucasian race.

Speaking of susceptibility to tuberculosis, he said that writers up to fifty years ago spoke of the infrequency of this dieease in the negro. At the present time the proportion is far greater than among the whites.

Discussion. Dr. S. G. Dabney: Trachoma is rare in the negro. Phlyctenular ophthalmia is much more common, and is the most common cause of blindness among them. Dr. Thaddeus A. Reamy, of Cincin

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