to cause ventricular dilatation. The absence of marked unilateral motor or sensory symptoms seemed to point to this situation. The actual situation of the growth, as revealed by the autopsy, was in the inferior parietal lobule, too far forward to involve the angular gyrus, and yet posterior to the motor area. Probably the greatest difficulty in localization in a case of this kind is due to lack of an accurate clinical history of the early symptoms in the case, as it is well known that some forms of impaired functions, especially as regards the sensory areas, may be compensated for so to largely disappear in time. Respecting the case of the lady who is present to-night, there seemed to be an entire absence of unilateral symptoms. Her vision has certainly improved since I saw her, three months ago, when she was absolutely blind. Her general health seems also much better. DR. D. T. VAIL: The Academy owes a debt of gratitude to Dr. Sattler for the interesting cases exhibited and his truly scientific paper, the reading of which has been of great interest and profit to me. These three cases of double optic neuritis are interesting because each demonstrates a different cause for this condition. In the case of a young man who underwent a surgical operation and had a tumor removed from the occipital region which was pressing against the brain, we have a tangible cause. lation, and cause elastic swelling in this locality. Such a swelling would also increase if the patient leaned forward or strained in the act of lifting heavy weights. A fracture across the base may also cause tinnitus aurium. All these symptoms this patient has, but there is no history of injury whatever. Marked. improvement under K.I. treatment, with positive absence of specific history, would also be noted in case of fracture, but from the history this patient has no fracture. It is very important in optic neuritis to exclude albuminuria and lead poisoning, as has been done in each of these cases. I recall a case of monocular neuritis with normal vision, accompanied by slight exophthalmos and intense headache. The right optic nerve was in a state of plastic swelling, while the left was absolutely normal. Two weeks later Dr. Leonard Freeman made the autopsy, which revealed a large abscess involving the right frontal lobe. This abscess was of nasal origin. A case of Dr. Holmes' which I remember, had violent double optic neuritis and no history of lues or trauma. Dr. Leonard Freeman, who examined the patient, concurred in the diagnosis of tumor. This patient suffered from nasal catarrh. The turbinates were swollen and pus flowed down from the upper meatuses. Dr. Holmes opened the ethmoidal and sphenoidal cells, evacuating pus, which greatly relieved the patient's headaches, but no sight was restored, for the nerves had passed into a state of atrophy. The patient died several months later. An autopsy was denied us. I think it of interest to observe that the symptoms found in the case of double plastic papillitis in the athlete are the same as may be present in a case of fracture through the body of the sphenoid bone. A fracture here would pass under or near the optic commissure, and it is easy to imagine how the exudation and hemorrhage in this locality would excite double papillitis. Another condition which he has, which may be found in case of a fracture of the base, is the presence of a soft elastic mass in each temporal region, especially marked on the right side. A DR. J. C. OLIVER: The young man fracture near or across the sphenoidal referred to by Dr. Eichberg was in my fissure would impede the venous circu-office a few days ago, and from him I DR. JOSEPH EICHBERG: That there is some connection between tumors of the brain and optic neuritis is borne out by Dr. Oliver's report of a case of abscess diagnosed by an optic neuritis upon the same side. The case did well for a year, but had an epileptic seizure, since which time he has had several such attacks, probably due to adhesions. learned that he had had but one attack | ject, and for this reason made reference only to one sided neuritis optica. of epilepsy since the operation. This attack was in July, and, according to his statements, there has been no repetition. As already mentioned, there was unilateral optic neuritis in this case. My experience with intra-cranial growths has been limited to cases in which cyst-formations were present. A case seen with Dr. Leonard Freeman two or three years ago was due to a gun-shot injury of the head. In this case complete blindness was present. The case was operated upon and a large cyst evacuated. The blindness remained the same as before, as did also the other symptoms. About six weeks ago I operated upon a case in which there was a history of injury to the brain six years previously from the explosion of a gun. A portion of the ramrod was removed from the brain; four years subsequently he developed epilepsy, Jacksonian in its nature, the convulsions beginning in the right hand. I evacuated a very large cyst in this case near the base of the motor area on the left side. No optic neuritis was present in this case. An interesting point relates to the nature of the change which takes place in the so-called optic neuritis. I am inclined to doubt the propriety of calling this an inflammatory affection, if we use the term inflammation in its ordinary sense. It scarcely seems possible to me for a tumor or cyst in the brain to give rise to an actual inflammatory condition in the fundus of the eye. It seems probable that some better explanation of the process will be forthcoming in the future. Dr. Oliver said he could not understand inflammations of the optic nerve, and did believe that it is present, at least not explained. We can in these cases assume with reasonable certainty that the process which attacks the intraocular end of the nerve is at first, and in some cases remains, a simple edema, with serous infiltration and dilation of the venous channels. As an advanced expression of a progressive intra-cranial lesion, however, the same process is only a beginning of a true neuritis. Numerous proofs based on microscopic examinations support this, and also that in the beginning the inflammatory change extends only for a short distance beyond the intra ocular end, and only later on, when a true neuritis is set up, farther backwards. What constitutes the real causative factor or factors in the production of neuritis optica, focal lesion and its absence in others, is at present unsolved. It is certainly not the increase of intracranial pressure alone, but whether, as it is held by recent investigators, it is due in addition to the presence of irritating exudates which are generated by the tumor, remains to be established on more reliable proof. ON THE ANTI-RHEUMATIC ACTION OF SALICYLATE OF STRONTIUM.-Pure salicylate of strontium made by Paraí - Javal process occurs in white crystalline needles, which are slightly soluble in water and alcohol. It is this salt only which should be administered internally. It increases the blood pressure, which is not diminished unless the dose is increased far beyond the amount required when salicylaie of soda is employed. Clinical observations show that in doses of DR. SATTLER: I believe I referred in my paper to the diagnostic importance of unilateral optic neuritis as a local symptom in involvement of the frontal lobe. In one of Dr. Keen's last and 5 grains its antiseptic properties are most enermost brilliant achievements with cere-getic, and that as an intestinal antiseptic, it is bral surgery, unilateral optic neuritis superior to salol, naphthalin and similar antiwas one of the localizing symptoms. I septics. have at present two cases of unilateral optic neuritis on left side due to cerebral syphilis. Both have labored speech and aphasic symptoms. I have carefully excluded all cases of syphilis in the cases reported and in treating the sub rheumatic subjects, give the same results as Doses of from 10 to 15 grains in gouty and other salicylate preparations, but its superiority lies in the fact that it does not interfere with the stomach; it is therefore especially indicated matism and gout.-Translated from the Bullewhere digestive troubles occur in chronic rheutin de Thérapeutique. THE command of bank balances which give Cincinnati Lancet-Clinic: them a social force that brings them A WEEKLY JOURNAL OF into an undue prominence. Mentally unfit and incapable of occupying any position of honor or trust beyond that of being the adored husbands of other J. C. CULBERTSON, M.D., Editor and Publisher. weaklings of the upper crust. The writer believes in the upper crust, whether it be of a pot-pie or of the social elements. The upper crust is luscious, delicious and appetizing, but it should be of equal thickness, well browned, and self-supporting. Unfortunately, the constituent elements are sometimes rolled very thin, and in certain places are pointed, prominent and stuck up. A natural equilibrium is not present. The young men who were at the New York Seely dinner are of the lamented Oscar Wilde order. They have a gorgeous sun-flower taste, that is apparently entrancing to some silly maidens of the social upper crust, who represent a thinness of intellect sometimes found in the top strata. Less than a month ago there took place in New York an alleged dinner, given by a creature wearing an image of man, in honor of his brother, who was soon to present himself at a wedding altar. The company was constituted of male expert perverts. The amusement of this Gotham set or dinner party consisted in a drinking and wast-ness broke out in Cincinnati last Saturing of wine, succeeded by lascivious day, when an effort was made to outdo songs and dances given by depraved the original nastiness. professional performers. The host and his guests were of the class who neither toil nor do they spin to earn a living. Petted, dawdled and fondled products of financially fortunate ancestors, their brains and minds were badly developed. There was lacking the equilibrium of intellect that belongs to every well-balanced mind, and, unfortunately, the weak segment in the mental circles of those young men is to be found in a scarcity of moral molecules with which they should be gifted. They are mental weaklings, but in The orgies and disgraceful scenes of the New York Seely dinner proved contagious, and a foul eruption of the blackened plague of immoral lascivious Such infectious disorders are to be treated heroically if eradication is to be accomplished. Those who have debasing ambitions for notoriety, or satiation of bestiality, should be incarcerated beyond the sight and hearing of all friends. Contact with them is with that of an incurable leper. They should be kept beyond the city limits during life. This may seem to be severe treatment, severity of treatment is called for, and the municipal authorities are weak when they do not enforce the laws as they exist against such social lepers. Allowe but to live and move about among the un- | better ways of life through the publicacontaminated, there is a continuous tion of crime annals. danger of spreading the infectious plague. Such members of the social upper crust are degenerates, in whom there is a lack of development of the moral faculties. They are dangerous members of society, and are dangerous citizens; if possible, worse than anarchists, thieves and robbers. Openly any household is in danger from their visits, and openly every household entered by them is in danger from the contaminating infection always carried with them. They are moral imbeciles, and the lunatic asylum should be their place of abode. NEWSPAPER MEDICINE. With the marvelous advancements of science in every direction, there has been a corresponding advance made in methods of gathering and publishing the ordinary and extraordinary news of the day, the facilities for which are such as to reach and include people in every walk in social life. Murders and murderers-in fact, crime and criminalsare made to perform star newspaper engagements in the public press. In justification the newsmen claim that such publications are prophylactic agents, in that they exert a restraining influence over the wicked who are timid and have not lost all personal respect. Furthermore, such publications lead to the seeking for individual or personal notoriety, and among those engaged in every occupation there may be found those who have such abnormal cravings as to lead them to place themselves in the way of seeing their names in print. In a recent conversation with one of the old Cincinnati Gazette staff, he said his criticism of our papers is that "too much prominence is continuously given to unimportant people." Just read that criticism over again and endeavor to comprehend its meaning. Too much prominence is given to unimportant people! No, In pondering over this subject, a first thought was as to its application to members of the medical profession. First, are there any unimportant mem. bers of the medical profession? there are none, at least hardly any, for all who are reputable physicians stand for people of education, culture and refinement. All stand for a peculiar education, one that teaches of the brotherhood of man, the Golden Rule and its practical application to all affairs of life with which they are connected. They are also taught humility and the personal offensiveness to others that follows in the wake of uncalled-for newspaper advertising through puffs, pictures and reports of marvelous and wonderful cases miraculously cured, the reading of which is always revolting to the sensibilities of cultured physicians. It is thought this is an error of judgment, which is no doubt backed by good motives in many instances. In others it is purely mercenary, and intended as revenue producers through There is a place, and one that is the sensational yell of the newsboy. always wide open, for the publication The fact of the matter is, the reading of of clinical cases of rare character, and such matter contaminates, and does not that is through the pages of medical purify. Familiarity with sins and sin- journals, which circulate among physiners leads to lenient-looking eyes. cians. Most-yes, nearly all-rightThere is no uplifting to higher and minded physicians recognize such pro fessional conditions, and their names in | Scarlet Fever... connection with the performance of medical miracles do not appear in the daily papers. The fact that some are there with undue frequency, and in ways that are unjustifiable, leads to a belief that the abnormal crave for notoriety found in those may be taken as good evidence of moral and intellectual degeneracy. Typhoid Fever.. Varicella. Total...... The mortality report for the week Other Zymotic Diseases. Phthisis Pulmonalis.. Other Constitutional Diseases. These conditions are, unfortunately, not confined to New York and Cincinnati, but are observed as outcroppings in other localities. So offensive have they become in some instances as to call for special medical society action in order to squelch the evil. It is always a matter of great regret that such extreme measures seem to be necessary, as occasion is usually taken to raise a cry of persecution, rivalry of the juniors and Deaths from Developmental Diseases.. seniors, envy, jealousy, etc. It is recognized that the temptation to step over the bounding rails of propriety into the wide-open pastures of impropriety is sometimes very great and hard to withstand, but the odor of the grazing in the big field is beyond scientific disinfection, and it clings and sticks to the every-day garments of the grazer for years and years and years. When the oleaginous tempter comes along, mentally the prayer should be very firmly uttered, "Lead me not into temptation and deliver me from all evil." Then stand erect for that which is good and true in the brotherhood of the medical profession. Other Local Diseases.. Deaths from Violence..... Deaths from all causes. Deaths under 1 year.. Deaths during preceding week. 3 4 I 3 2-13 4 23 3-30 362 93. 3 2 4 5 2 16 THE Medical Society of the State of New York will hold its ninety-first annual meeting on January 26, 27 and 28, 1897, in Jermain Hall, Albany, commencing at 9:15 A.M. on the 26th, and ending at 1 P.M. on the 28th. Ammonia and Alcoholism. Dr. Baratier recommends, in El Siglo Medico, the addition of ammonia to wine or liquor in order to produce a distaste for alcoholic beverages. After a few doses the disgust to the mixture becomes so intense that even the sight or smell of wine is unpleasant.-St. Louis Med. and Surg. Journal. FOR mastitis and orchitis, says the Med. Age, the fluid extract of phytolacca, five drops in water every two hours, will prove very satisfactory. |