Early Blistering in Pneumonia-A, N. Perkins, M. D., Sabine Pass, Texas.

I visited

taken with a severe chill on the twentieth. her on the twenty-second. Temperature, 104; hurried breathing; very severe pain in right side; expectorating blood freely; right lung very much engorged.

Treatment: Tr. aconite, gtt. iv; Tr. veratri viridi, gtt. iv; Fl. Ext. jarborandi, 3ss, every two hours until fever is reduced; a large blister over engorged lung. After second dose of sedative mixture, she took, at bedtime, calomel, grs. x, with a full dose of Dovers powder, with a view of giving her ease and rest.

23-Respiration easy and natural; no pain and but little fever. Quinine and Dovers powders to-day, as in former case, with directions to give the sedative if the fever showed any disposition to rise. Her recovery was rapid.

Without trespassing upon the patience of the Society by a repetition of cases, I would remark that the two cases reported are fair specimens of cases treated by early blistering. In nearly every instance, where the patient was seen during the first few days, before the lung had become completely consolidated by the effused product of inflammation, similar results followed the treatment. I am aware of the fact that our best authors, and the profession generally, would condemn the treatment of the above cases. The common idea is that a blister applied in pneumonia, before the active character of the disease has been subdued by proper remedies, would only be adding fuel to the fire; in other words, increase the excitement and add to the inflammation.

APPENDIX-Section on Practice of Medicine, etc.

Perhaps this would be the effect, if applied without, at the same time, using remedies to reduce the momentum of the circulation. After the vis a tergo of the heart has been diminished by the sedative remedies, a blister stimulates the capillaries of the engorged lung to relieve themselves by contracting, before they have become paralyzed and permanently disabled by over distention. Quinine with opium, in liberal doses, greatly facilitates the equalization of the circulation and removal of congestion.

We are not without precedent in the treatment of acute inflammation, in its early stages, by blisters. They are highly recommended in acute rheumatism. Perhaps there are few experienced practitioners present who have not witnessed their good effects in this painful disease. It is an old and common practice to treat acute bubo by blisters. It is also claimed that felons may be aborted by blistering.

In conclusion, allow me to say that I do not mean to convey the idea that any and all cases of pneumonia can be throttled or aborted by the early application of blisters. I am far from believing this to be true. On the contrary, I hold that pneumonia is often the local manifestation of a general blood disease, and, as such, has a definite course to run. I would as soon expect to modify and bring to a speedy termination a case of measles, by blisters, as a case of croupal pneumonia, It is only in catarrhal pneumonia that I would recommend their early application, with a view of modifying and control ling its severity.

SECTION ON SURGERY AND ANATOMY.

REPORT OF THE CHAIRMAN.

W. P. BURTS, M. D., CHAIRMAN, FORT WORTH, Texas.

The subject that has been assigned to me to report upon includes anatomy, but, as there has been but little -I might say nothing-of general interest brought forward, during the past year, in this branch of our science, I feel that I would be wasting your valuable time, did I touch upon that part of the subject. I am reminded of the old doctor, who, having practiced for a lifetime in the country, went on a visit to the city wherein he had pursued his medical studies. Among those whom he encountered was one of his old college mates, now a great professor of anatomy. To him he puts the question, asking for a recent work on Anatomy, fully up to date. The reply was given: "Why, my dear sir, there have been no bones or muscles added to the human body since you and I were students." So I say to you,

there have been no bones or muscles, ligaments, tendons or bloodvessels added to the human body during the year just past, and I find, therefore, nothing of value to report in this branch. In surgery, on the other hand, I am embarrassed by the richness of the material that is offered to me, and I propose, as I take it to be the cor

APPENDIX-Section on Surgery and Anatomy.

rect way of making a report of progress, to collect together for you all those practical points in surgery that will prove of use to the physician in his every-day work. With this word of explanation, I go to my task.

One of the most practical little points that I find is a suggestion in reference to the introduction of a catheter. Those who have much of this kind of work to do, and, particularly, those who have had this instrument passed on themselves, are aware of the great suffering it causes at all times, which is greatly enhanced if the urethra happens to be in a state of hyperæsthesia. From Arkansas, from Dr. John A. Stamps (Medical and Surgical Reporter, July 4th, 1885), comes the suggestion, that we should introduce the nozzle of an ordinary male urethral syringe (previously filled with water as warm as the patient can bear) into a soft catheter, and inject the water slowly, as the catheter is gently passed along the canal. If the bladder is not entered by the time the first syringe full is exhausted, refill the syringe and proceed as before. You will find that the water will regurgitate between the catheter and urethral wall till the catheter has reached the prostatic portion, thus lessening the danger of injecting too much water into the bladder. This method the author claims to be very successful; and I will say, here, that I have collected only that which I find in reliable quarters.

I find that Dr. R. G. Bogue has reported, for the Chicago Medical Society (June 15, 1885), a very interesting case of nephrectomy. Following upon a strain

Report of W. P. Burts, M. D., Chairman, Fort Worth, Texas.

of the back, there was formed a renal abscess, which opened externally. Satisfying himself that the kidney was the seat of the disease, which he did by an explorploring incision, he passed a ligature around the ureter and blood vessels, and removed the organ. The patient made an uninterruptedly good recovery. This case is of value, as it outlines for us, in such cases, a method of treatment; for it may be fairly inferred that, had this festering mass been allowed to remain, the result would have been very disastrous. In this connection, I note

that Dr. Polaillon, of Paris, records, as the result of his operation on a case wherein he had performed nephrectomy, that the remaining kidney took on a supplemental action, and amply sufficed for the excretion of the urea contained in the organism. I would say, as the result of my researches, that nephrectomy may be now regarded as an established operation in surgery.

Of course, you will expect to hear something about cocaine in surgery, and I am pleased to say that I will be able to gratify you with considerable on the subject.

In the first place, I find that it has been successfully used in laying open the sinuses about a bubo, a four per cent. solution being injected into the fistulous canal, and held there for about five minutes. So, also, in ophthalmic surgery, has it been found most useful, Dr. Koller, of Vienna, saying: "I have cauterized the cornea with the nitrate of silver stick until it becomes milky white, during which proceeding the animals did not move." So has he used it in lymphatic (phlyctenular) conjunctivitis