of the tubes from exhaustive attempts to cough up the secretion during the pre-existing bronchitis. Therefore we must first stimulate the mucous glands to increase the watery elements of the secretion. For this the steam spray is an excellent adjuvant, but the most reliable drug for this purpose is ipecac. Combined with the latter to relieve the irritability and restlessness some form of opium is advantageous, and that we may get free elimination and a good action of the kidneys I generally add citrate of potash.

For the foregoing reasons I have been in the habit of prescribing the following formula:

Aquæ distil. qs. ad. oz. 4

Elixir simplicis oz. 1.

4 grams.

2 grams.

8 grams.

..30 grams.
120 grams.

M. Sig.--A teaspoonful to an infant six months old every two hours.

Stimulating expectorants, so-called, are sometimes useful in the latter stages of this disease, but are useless in the earlier stages.

Much benefit will be obtained by the boiling in the sick room of a kettle of water; the steam arising therefrom tends to ease the cough by facilitating expectoration. Turpentine may be added if desired.

The bronchial tubes, stomach and intestinal canal will be relieved of the mucus and muco-pus by an occasional emetic or a little calomel, given cautiously but not in sufficient quantity to tax the strength of the child. I have seen good results in clearing the intestinal tract by allowing the child to drink freely of water into which has been put a little of Marchand's "hydrozone" in the proportion of a teaspoonful to the half pint of water. If used too strong the hydrozone will occasion decomposition of the pus into painful quantities of carbonic acid gas, causing colic, but if this destruction of pus is carried on less vigorously by a larger dilution, the pain or discomfort is obviated. The action of the hydrozone is one simply of cleansing the mucous membrane.

Stimulation. The heart tonics necessary in this form of pneumonia do not differ from those indicated in the croupous variety, except that the objection to digitalis are removed in broncho-pneumonia; in fact together with whiskey or brandy we are quite in need of it. It is always a good plan to combine any depressing antipyretic with a drop or two of digitalis in bronchial inflamma tions in children. It is spur and oats to a flagging heart where not contra indicated by any extensive consolidation of lung tissue.

Malarial element may be occasionally found in these bronchial affections of children, and if suspected should receive propor attention.

In broncho-pneumonia, the result of intestinal disturbance and the bacterium coli communis, Sevestre employs calomel in one-grain doses to children. under six months. To relieve the lungs dry cupping or mustard plasters are used; for dyspnea two or three injections of ether or caffeine each day and alcohol rubbings for the algid tendencies are advised.

The complications of pneumonia, pleurisy and cerebral symptoms are to be met by revulsive treatment, and the bromides and chloral with ice to the head. The diet in this disease should be fluid, chiefly of milk.

RESTORATION OF LOWER EYELID-REPORTS OF TWO CASES

BY W. C. TYREE, M. D., KANSAS CITY, MO.

Professor of Ophthalmology and Otology, Kansas City Medical College &c., &c.

Some time since I had the pleasure of exhibiting before a joint meeting of the Kansas City District and Jackson County Medical Societies of this city, a man on whom a complete restoration of the lower lid had been successfully practiced. The whole damage, both loss of the lower lid, and sloughing of the entire right side of the nose to the septum and median line and considerable of the integument and periosteum covering the superior maxilla on that side, was the result of some sort of paste applied by a traveling quack to remove what he had persuaded the unfortunate patient to believe, was a malignant growth.

FIG. I-EYELID AND SIDE OF NOSE DESTROYED.

The deficiency of the nose was remedied by my friend, Dr. J. D. Griffith, by means of a flap of skin taken from the forehead and skillfully stitched into place on the right side of the nose. Though the excellent result shown in the picture needs no apology from any source, it is but justice to the operator to say that when the photograph was taken, the operation was yet unfinished. After drawing the flap towards the tip of the nose a better appearance was obtained. The lower lid with part of the tarsus was destroyed and nothing left, except a very narrow cilliary border containing the lashes, which was

drawn by cicatrization down upon the cheek, as shown in the cut. The strip containing the cilliae was dissected up and attatched to the upper lid leaving the space to be filled by the flap. A flap was taken from the cheek external to the canthus and twisted over and made to fill up the vacant space. The cut represents the case as seen eight months after the operation, after all contraction can reasonably be expected to have taken place and shows the permanent result; a complete restoration of the lid.

There are two methods of skin grafting in vogue, viz.; that with a pedicle and that in which the skin is taken from a distant part and entirely transplanted. In these cases I prefer the former method because of the certainty of success in healing as nourishment can be taken from the pedicle. Although this makes more or less scar upon the face it may be said that when there are so many more unsightly scars upon the face this slight addition will add very little to the effect.

The second cut represents a well to do farmer who consulted me about an epithelioma on the lower lid, which not only involved the conjunctiva covering the lower lid of the left eye, but had also involved the cilliary margin, and to some extent the integument of the lid. Uncertain as to the depth of the growth, the patient was made to understand, that should we deem it necessary

in order to thoroughly evacuate the epithelioma, the eye should be enucleated, and more of the contents of the orbit should if necessary be removed.

FIG. III-EPITHELIOMA OF EYELID REMOVED AND LID RESTORED BY OPERATION

Fortunately after cutting the lower lid and conjunctiva to the eyeball, we could find no more induration nor other evidences of the growth. It was only necessary now to restore the lid which we had been compelled to destroy. The operation chosen was that of the pedicle method, and if there be any thing in the idea that a salutary effect is produced by the transplantation of healthy skin into a space tainted with malignancy, this case is a favorable representation, because, for eighteen months not a sign of return of the epithelioma has made its appearance.

SOCIETY PROCEEDINGS.

THE JACKSON COUNTY MEDICAL SOCIETY.

The Jackson County Medical Society met in regular session, at the Society Hall, 916 Walnut Street, September 13, 1894. The paper of the evening was read by Dr. Clarence E. Edwords, subject, "Suggestive Therapeutics." (See page 329). Discussion, Dr. Jones: "There are really two kinds of suggestion; an auto-suggestion and the hypnotic suggestion of the operator. In my office work I frequently use hypnotism for various reasons, but more particularly in hysterical cases, and it often succeeds admirably in relieving certain of these annoying cases. I think it is safe to say that eighty per cent, of all persons can be hypnotized; the remaining twenty per cent. probably cannot. Persons used to obey and used to being directed are more easily hypnotized; soldiers make

the best subjects. The hypnotist cuts no figure. It is not my strength of mind over that of the patient, but simply a matter of getting his attention and my suggestion paramount, or getting his auto- in line with my external suggestion. I think that every college should have a chair of psychological physiology. It is proper that all physicians should thoroughly understand hypnotism and use that portion of it which they find good. Because the quacks have made use of it is no reason why we should leave it alone."

DR. HANAWALT: "The cause of the disrepute into which hypnotism has fallen lies in the fact that mystery has been thrown about it. I believe that man can hypnotize the lower animals. Frequently we see the magnetic trainer who can handle animals with ease that an ordinary individual has no control over. I think that Dr. Jones' estimate of eighty per cent. is too high; probably forty or fifty per cent. will include all the persons really subject to hypnotism. The medico-legal points, which must always be considered, are not of as much importance as has frequently been supposed. The questions of murder, outrage, theft, etc., claimed to be done by subjects under hypnotic influence are shown in the majority of cases to be exaggerated, and it is usually the case, while supposed to be hypnotized, the subject is really self governed. In organic diseases, in the essential fevers and like conditions it is not of much value as a curative agent. In minor operations, however, and functional nervous troubles and hysteria, quite brilliant results are frequently obtained. As to the class of people most easily hypnotised, the Latin race seems to be peculiarly susceptible. It is claimed, however, that in all races, some persons are especially subject to influence. It is often claimed that hypnotism has been accomplished over the telephone. The consent of the hypnotized is not at all essential and if we all knew just how to do it we could probably hypnotize one hundred per cent, and the unwillingness of the subject would not stand in the way. Like any other agent of power, barm can be done with it unless its use is understood."

DR. SEXTON; "The profession should stand in an expectant attitude toward hypnotism; however, we must not accept that which is not thoroughly proven. If all that the medical profession has been told in regard hypnotism is true, we should have made more use of it than we have, but much of it lacks confirmation. I have had occasion to use it in my insane asylum work and have record of quite a number of cases, which have been cured by hypnotic . suggestion.

REV. DR. ROBERTS: "I think the force of hypnotism and other cosmic forces are but a proper recognition of forces that have always been at work and without which the world would not exist in its present complete form. All mental phenomena are the result of suggestion. The hypnotized person seems to be the reflector or irresponsible implement of the operator where completely under control. I think the experiment detailed by the lecturer, where the subject dropped the knife where he had previously assaulted his victim with a pasteboard knife, shows the patient to be hardly under complete control."

DR. TODD said that for one hundred years the public mind has been familiar with the fact that very remarkable phenomena may be induced by a successful operator and may often be self induced. He then gave a remarkably complete history of mesmerism and of the development and study of hypnotism, with which he has had quite an extended experience.

DR. EDWORDS, in closing, said that to the regular profession is due the elevation of this matter from the disrepute into which it had fallen on account of its employment by quacks, charlatans and irresponsible persons. He thought that ninety-five per cent, of all people were susceptible in some degree, to hypnotic influence; that mesmerism and hypnotism were not the same; that mesmerism was not an occult force.