one eye of another two drops of a two per cent solution of nitrate of strychnine. Both animals died from tetanoid convulsions in ten minutes. Ten and fifteen minims of a two per cent solution of cocaine injected into the orbits of rabbits had no general effect. The alkaloid stenocarpine was separated by Dr. Seward from the leaves of a tree growing in Louisiana, called the "Tear Blanket Tree." From its likeness to the Acacia stenocarpa he dubbed it stenocarpine. which continued for five or six hours, the child crying constantly during this time. At about 7 or 8 o'clock P. M. a serous discharge was then noticed from the eyes, which in two or three hours became tinged with blood. This continued as a slow oozing during the night, becoming more sanguinolent until about ten o'clock of the next day, when the doctor arrived. He found it to be now almost wholly sanguinolent. He at once used cold applications which, having no effect, were A CASE OF WELL-NIGH FATAL HEMORRHAGE changed to hot. Neither of these succeeding, FROM THE CONJUNCTIVA. Prophylactic instillations of nitrate of silver into the eyes of the newly-born have of late come more and more into use. The case of Dr. Pomeroy's in conjunction with other observations of disagreeable results following such instillations should be enough to warn practitioners that it is better to substitute milder antiseptics for the nitrate of silver. Sublimate 1 in 5,000 will answer the purpose. The case observed by Dr. Pomeroy is the following: B. A——, a male child, from the middle walks of life, was born of healthy parents on April 30, 1887. The physician did not arrive until after the child was born. Mother had excessive uterine hemorrhage which reduced her to an almost pulseless condition, and the most prompt measures were required to restore her. She, however, made a rapid recovery. On account of the mother's requiring so much attention the child's eyes were not specially attended to until the next day, at about 12 M., when two drops of a two per cent solution of arg. nit. in water were placed upon the slightly separated eyelids. The doctor thinks that not more than one drop came in contact with the palpebral conjunctivæ; this was at once neutralized with a solution of salt and water. The drops were applied from a spoon, and no laceration of the conjunc tivæ resulted from opening the lids. At once the most violent pain resulted, resort was had to digital compression. This arrested the hemorrhage during the contact of the fingers, but as soon as the fingers were removed bleeding recommenced. I arrived at 1 P. M. Compresses of absorbent cotton, with vaseline to prevent imbibition, were at once applied by means of a firmly applied bandage; this arrested the hemorrhage for an hour, but it again returned, first in one, and after a little in the other, when two more bandages were applied over the first. This controlled the hemorrhage until 6 P. M., when it again commenced. At 8 P. M., I again saw the patient, and found the bandage soaked with nearly or quite pure blood, clots readily forming beneath the eyelids. Iced applications were now made with temhour or porary success; this failing after an an hour and a half, the upper lids were everted and touched with alum in substance. This did no good; the slow but persistent oozing of blood was startling to observe. A compress was then applied very firmly, with sheet-rubber applied to the eyelids, knowing that blood could not soak into the cotton compresses. The bandage was applied very tightly indeed, the attending obstetri cian reminding me that a child's head in the inferior straits was often compressed for hours with great intensity without harm. The bleeding now ceased. This compress remained thirty-six hours; on removing it it was found that the left had not bled a particle, but the right had lost about half a drachm. The bandage was reapplied to the right for one day, when there was found to be no more hemorrhage. Blood clots were found beneath each eyelid, but it was thought injudicious to remove them, and a bichloride collyrium was used. On the next day the clots were found to have disappeared, and a saturated solution of boric acid in water was ordered to be used twice a day. The lids were now carefully inspected, and each upper lid showed that there had been a superficial slough. The retro-tarsal folds were considerably swollen, but the corneæ were perfect. Child opened the eyes readily; no photophobia; continued wash. At the third day it seemed as though the child might die. The pulse was very feeble; patient extremely quiet; respiration weak; showed inability to nurse, for hours at a time, and when it did so only caught the nipple feebly. It was estimated that four ounces of blood had been lost. Stimulants were used, and in two days the child rallied satisfactorily, so that in a week there was no further trouble. The parents seem fairly healthy and strong; the mother, it is true, had serious post-partum hemorrhage, but there was no tendency toward being hemophylic, nor is there a history of anything of the kind in the family. The child only bled from the conjunctivæ. I found it difficult for a time to believe that the collyrium could be the cause of the trouble; not more than a single drop touched the palpebral conjunctiva, not a particle touched the globes on account of somewhat imperfect separation of the eyelids, and the prompt neutralization of the collyria by a solution of sod. chlorid. still further rendered the application apparently safe. Three weeks after the instillation both upper eyelids exhibited a minute cicatrix. I have made ineffectual efforts to obtain an exact examination of the solution, to determine whether it was properly dispensed. By the chloride of sodium solution I thought a more dense precipitate was thrown down than in the case of a solution known to be two per cent. It evidently was cent. It evidently was not much stronger than intended. THE BACTERIOLOGICAL QUESTION OF TRACHOMA. Rucharsky having repeated Michel's experiments in order to find out whether and what kind of micrococcus caused trachoma, and whether there was a specific micrococcus in the trachoma granule as such, comes to the following interesting conclusions: 1. Trachoma is an affection of the conjunctiva, sui generis, since we find always in the contents of the granules a kind of micro-organisms which possess especial morphologi cal and biological peculiarities. The pathogenic properties of this micro-organism are not yet proven, since Sattler's and Michel's successful inoculations in man are very doubtful. (Each succeeded in one case only.) 2. This micro-organism is found, according to one, but rarely and in small numbers in the secretion; according to the other, always and in large numbers in the secretion. It will require numerous examinations to definitely determine whether we have to deal with a diplococcus. 3. Michel's trachoma-coccus which is a diplococcus, looks very much like the gonococ cus, and has nothing characteristic. 4. The micrococcus found by myself in trachoma grows on firm nutritive material in the shape of white spots which readily coalesce and form a viscid membrane. 5. Meat-peptone-gelatine (5 per cent to 8 per cent) is always liquefied, and on its surface a white, very viscid membrane is formed. 6. If the temperature is increased the culture grows much quicker. 7. The culture of this micro-organism may in some respects be mistaken for that of the micrococcus pyogenes albus and others which are found in the air. 8. By inoculating the culture into the eyes of pigeons, rabbits, cats, dogs and man, I have not been able to produce a true trachoma. 9. By inoculating the contents of the trachoma-granules into the conjunctiva of cats, granules were produced which are in every way analogous to trachoma-granules. (From these granules I made cultures which in no way differed from those made from the trachoma-granules of man.) 10. Trachoma and the so called follicular catarrh (folliculosis conjunctiva) which by some authors are considered to be totally different diseases, can from a bacteriological standpoint be called identical, since we find the same micro-organism in both of them. CITY HOSPITAL REPORTS. H. C. DALTON, M.D.. Superintendent. TRAUMATIC RUPTURE OF hernia, because, first, the trouble seemed to be the result of the fall on the previous night; second, the collapse was not intense enough, the pain was only of moderate severity-in fact, toward evening of the first day, and throughout the second, it was present only when excited by manipulation, although very little morphia was administered during this time. Rupture of the gut was excluded because it was thought that could have occurred only in the lower part of the duodenum, or upper part of the jejunum, and here were feces coming from the ileum-below the point. of possible break. It was thought that were that lesion present a greater degree and more rapid ballooning would have taken place, and that the pain would have been more localized and the prostration greater. There was no INTESTINE. straining or other indication of intussusception; so it was concluded that the patient was suffering from a contused gut, which had caused a paralysis of the intestinal muscle and stoppage of vermicular movement at the site affected, resulting in the apparent obstruction, the peritonitis being due to the injury. On the first day he was given moderate doses of morphia, and ice water cloths were applied to the abdomen. With exception of the morphine this treatment was continued during the second day; stimulants were also given hypodermatically every three hours. He seemed then to be better and was very comfortable. On the fourth day he appeared weaker, but had less pain, even on pressure, than he had had before. The tenseness of the abdomen was distinctly diminished. He continued to vomit fecal matter. About noon he passed about a quart of feces from the bowel, exactly similar to that which he had vomited. At night delirium, with desire to get out of bed, set in. Patient continually called for water, grew weaker and died at 2:45 A. M., August 5. J. G., male, æt. 32, German, single, carpenter, admitted at 12:30 A. м, August 1, 1887, while unconscious, supposed to be suffering from the effects of the heat. No information about him was obtained; there was no evi dence of traumatism, and the catheter drew off clear urine. By ten o'clock the following morning the patient became conscious and said that during the previous night, while sitting in a window, he suddenly lost consciousness and fell to the ground, a distance of 16 feet; until then he had felt perfectly well. His abdomen was much distended with tympanites, was painful and tender generally, but most markedly so in the epigastrium and lower abdominal regions. There was no point of special severe suffering. Vomiting had begun in the night and occurred at intervals during the day. The vomit about noon of the second day became fecal, evidently from the ileum. The pulse was weak and rapid, but the patient did not seem to be much depressed; temperature, 38° C. (100.2° F.) An enema produced no action of the bowels, and he had had no movement since his entrance. In determining on a diagnosis the following points were considered: It could not be obstruction from a band, or internal 2 Autopsy was held eleven hours after death. Evidences of a contusion were found over the lower half of gladiolus; the abdominal wall appeared to be normal. A considerable quantity of pus was found in the abdominal cavity, and the intestines were covered and bound together by a large amount of inflammatory exudate of recent formation; congestion was everywhere visible. Located at about the upper border of the middle portion of the umbilical region, and covered by the adherent omentum, a slit-like opening 1 cent. (about inch) long was found in the anterior wall of the ileum. It was situated at a point eight feet above the cecum, and 11 feet below the duodenum; it lay parallel with the canal of the gut. The wall of the latter gave no evidence of previous ulceration, and there were no ulcers in any part of the tract. No fecal matter could be discovered in the cavity. The stomach and intestines contained thin, yellow feces. A small hemorrhagic area was found in the tissues covering the right psoas muscle. Its source was not ascertained. The other organs of the body were normal. From the above is disclosed the secret of the vomiting of feculent matter whose source was below the site of the rupture. The tear occurring probably when the bowel was comparatively empty, was hastily sealed over by the inflammation gluing the omentum to the gut at the site. This prevented much extravasation of the bowel contents, and gave rise to the delusive symptom of continued fecal vomiting without proportionate increase in the ballooning, pain, collapse, etc. ORIGINAL ARTICLE. Father, aged 28 years, merchant, temperate in his habits, no family history of any constitutional trouble. Mother, aged 25 years, very stout build, had four children, no miscarriages, as a girl had no menstrual trouble. They had been married 7 years on June 13, 1887, are first cousins. Family history on mother's side of one child said to have had a face like a bat. Mother's parents both liv ing. Father's father is dead. TWO MONSTROSITIES. BY W. WEST, M. D., BELLEVILLE, ILL. CASE I. Ida T, anencephalic. -, anencephalic. Born Saturday, 2:30 A. M., May 21,1887, after labor of about twelve hours,head presenting,nothing peculiar about the labor, nor nothing noticeable about the pregnancy. Mrs. T. said she had a fall on the ice during the winter, occasioning no alarming symptoms at the time. The infant had no cerebral mass, cerebellum normal, animal functions all normal, no roof oforbit, build symmetrical, weighed about 10 pounds, length 18 inches, lived 48 hours did not nurse, took a small quantity of fluid with a spoon, cried little, died quietly, no con vulsions, no autopsy, photograph taken dur ing life. CASE II. Hydrocephalic-Hermaphrodite with webbed toes and fingers. Seventh child of John and Lucy H.of whom six still live, and are in good health. Mrs. H has had two miscarriages, both at about the second month. This pregnancy presented only one unusual feature and that was her enormous size. The labor was normal,foot presentation,immense quantity of water,flooding bed and floor, child born at two o'clock P.M. June 8, 1887, and lived but one hour and a half. Middle and ring fingers of right hand were fully webbed in the entire length;left hand middle and ring finger webbed in only half their length, the second and third toes of both feet fully webbed. The entire weight of the child was about five pounds, of which head weighed one half. Photograph taken five hours after death, made no cry, nor did it make any attempt to nurse. The male organ predominated as there was a rudimentary scrotum, no testicles, and a small protuberance like a split pea fissured underneath at site of penis, and pressure over the bladder brought a few drops of urine from this fissure. WEEKLY MEDICAL REVIEW, EDITED BY THE MEDICAL PRESS AND LIBRARY ASSOCIATION. Contributions for publication should be sent to Dr. B. J. Primm, 3136 Olive Street. All remittances and communications pertaining to Advertisements or Subscriptions should be addressed to J. H. CHAMBERS, 914 LOCUST STREET, ST. LOUIS, MO. SATURDAY, SEPTEMBER 10, 1887. THE STYLISH COCAINE HABIT. Of all the vile practices which have in times past become fashionable, many had compensating advantages, or their general introduction among the genteel was dependent upon some condition which offered extenuating circumstances. That many people are by nature unfitted to rebel against and overcome a habit which apparently sustains them in affliction, is not to be wondered at, and the censure can be hardly so severe when we consider their weakness of nature. All people are not alike, and what might be an easy task for one, presents insuperable obstacles to others. It is a question of nature, and not of will-power or inclination. It is not of these unfortunates that we propose to speak, but of that class of beings, many of whom are born and bred among circles which would almost positively assure them worldly success, were it not for some of the fallacies of our social system, which teach them to look upon work as something for their inferiors, as they are pleased to call them, and to consider themselves as creatures intended to uphold the respectability and style of their families. These scions of a noble house will proceed on one of their "toois," as they please to term them, which generally consist of a few hours of the night passed in some down town den, the time being enlivened by the introduction of two or three "dutch cocktails" under their vests, and then along toward ten or eleven in the morning will be found at some convenient spot, taking cocaine, the latest and most stylish drug for this purpose, |