power of co-ordination, lies with extremities be shown that the heart, although decreased extended; sensibility in front and behind in activity, does not fall to an extent sufthe ligature is so much blunted that he per- ficient to so greatly depress reflex action. ceives no irritation of any extremity; when allowed to fall from a small height makes feeble movements.

Exp. 5.-Frog, at 6.18 P. M., received under the skin of the lower jaw twelve drops of the infusion of piscidia; the spinal arteries coming from the abdominal aorta were severed; 7.07 P. M., upon irritating the anterior extremities makes lively movements to escape. As to the bluntness of sensibility, it is not produced by the drug affecting the peripheral ends of the nerves. The experi ments just detailed quite conclusively prove that the cause of bluntness is central, and not peripheral, in origin.

SPINAL CORD.

To decide if the tetanus observed was due to spinal excitation or cranial, the cord was divided just below the medulla oblongata.

Exp. 6.-Frog, received about three drops of the fluid extract of piscidia subcutaneously at 10 A. M.; 11 A. M. cord divided just below the medulla oblongata. It was afterwards found that the convulsive state persisted.

REFLEX ACTION.

The fall must then be attributed to some action on the nervous system. The next experiment still further confirms these views: Exp. 8.-Frog, cerebrum ablated:

When the medulla is severed then reflex To study reflex activity in frogs poisoned actions are not greatly interfered with. by piscidia, I employed the method of Türck. There is a slight fall, followed by a slight A weak solution of sulphuric acid was made, rise, but by no means comparable to that into which the foot of the frog was dipped, observed in the previous observations. Now, and the time the foot remained in it before in making a section below the medulla, then withdrawal noted by a metronome beating the centres of Setschenow are removed. one hundred times per minute. The foot was always washed off with water immediately after the reflex movement occurred. Exp. 7.-Frog, cerebrum ablated.

TIME.

4.50 P. M.

Infus. piscidiæ, twelve drops.

4.55 P. M..

5.00 P. M..

5.05 P. M.

5.10 P. M..

5.20 P. M.

4

Now they have the power to depress reflex activity in the spinal cord. So it must be inferred from these experiments that the fall of reflex activity is due to a stimulation of METRONOME BEATS. the inhibitory centres seated in the corpora quadrigemina and optic thalami. The rise of activity is not due to the paralysis, because, when the rise commenced, a section of the cord at the medulla caused the spinal activity to rise, as in the normal state after a section of that nature.

5.30 P. M. No reflex action at 60.

5.35 P. M....

5.45 P. M.

6.07 P. M..

6

4

4

5

6

12

9

5

CIRCULATION.

To study the effect on the circulation I employed frogs and rabbits. The poison in The above experiment proves that it at the rabbits was injected through the jugular first gradually decreases reflex action, which towards the heart. The blood-pressure was afterwards again rises in activity to that ob- taken in the carotid by means of Ludwig's served in the normal state. That this fall canula and his kymographion. The pulse is not due to circulatory changes is proved and pressure are noted for periods of fifteen by a subsequent observation, in which it will seconds.

This experiment shows that in the frog of pressure, heretofore observed, is due to piscidia first increases and then decreases

stimulation of the monarchical vaso-motor center seated in the medulla and pons varolii. Erp. 11.-Rabbit, carotid and jugular pre- tion of the cord. The pulse also, as previIt is seen the pressure did not rise after secpared:

pains, such as nausea, constipation, and a generally disordered nervous system. In this drug piscidia, we have a less pleasurable intoxication, and the disagreeable after-effects of opium left out. The sleep of piscidia resembled in feeling that produced by large doses of bromide of potassium.

It is evident from the preceding experiments that in piscidia we have a drug capable of producing death by arrest of the respiratory apparatus. Frogs seldom recover from a moderate dose of the drug. The following conclusions may be drawn:

1. It is narcotic to frogs, rabbits and men. 2. It does not affect the irritability or the

motor nerves.

Melanotic Sarcoma of the Eyeball-A Case.
REPORTED BY JUDSON BRADLEY, M. D.,
Read before the Detroit Academy of Medicine.
N the 20th day of June, 1870, Mrs. C.

ON

H., aged seventy years nearly, but still active, from Newberry, Ontario, but stopping with friends near this city, consulted me on account of a painful condition of the right eye. Removal of the dressings exposed a tumor growing from eyeball, it having penetrated the cornea and covered it externally. The tumor presented a dark, ragged, suppurating surface, and caused the patient to suffer most intense pain, especially at night, when she would often be deprived of sleep from the intensity of the pain.

I obtained the following history from the patient and her friends: About 29 years before, directly after a confinement at term, a small "brown spot" appeared on the lower and outer segment of the cornea at its junction with the sclerotic. But little attention was paid to this "brown spot," and for sixteen years it scarcely increased in size. But at this time officious neighbors persuaded the patient to have powdered alum blown into the eye to remove the dark spot, as the neighbors insisted the alum would do. The alum was blown into the eye by means of a quill used as an insufflator, and no doubt was cation of the alum greatly irritated the blown with considerable force. The appliwhole cornea and conjunctiva. The "brown spot" still remained, and directly following the application of the alum the eyeball became at times very painful, and the "brown spot," which as yet had been scarcely larger than the head of a pin, began to grow larger.

If the action of piscidia is compared with that of chloral, it is found that the former has no dangerous action on the heart like the latter, nor such an energetic action like the About three years before Mrs. H. applied latter upon the respiratory apparatus. to me, she had been treated at an infirmary Compared with atropia, piscidia, unlike in London, Ontario. The treatment she the former, does not paralyze the motor there received consisted in the application of nerves; it does not paralyze the chord or some form of caustic or escharotic, but no tympani; it does not arrest the sudoral se- permanent relief was obtained, and only cretion; it does not paralyze the pneumogas- temporary mitigation of the pain. The tutrics, and does not elevate greatly the arterial tension, but like it dilates the pupil. Compared with morphia, like it it produces sleep, heightened excitability, spinal convulsions, general paralysis and stimulation of the main vaso-motor centre; unlike it it dilates the pupil. In the use of this drug I would like to add the caution that its surface is pleasure and its depth death.

mor continued to enlarge, yet so very slowly that the sight of that eye was not totally obscured until about two months before the time that I saw the patient.

At the time that Mrs. H. consulted me, the left eye was so much affected sympathetically that I did not hesitate a moment to advise the removal of the diseased eye. The patient was naturally very averse to an oper

ation, and was anxious to avoid it if possible. I therefore accompanied her to Dr. J. F. Noyes, of this city, who not only advised the removal of the eye, but advised that it be done at once to prevent loss of sight in the left eye, or at least serious impairment of its power of vision.

seen them, and consequently bases his divisions on what he has seen.

In regard to the malignancy of these tumors, Prof. Knapp records one case of melano-sarcoma which caused death a half year after the extirpation of the eyeball, by metastasis to the liver, kidneys and lungs; and another case of melano-glio-sarcoma which also caused death by similar metastasis to the liver, kidneys and lungs.

Dr. Noves consented to operate for me. Accordingly, on the 23d of June, 1870, having the full consent of the patient, and knowing that the urgency of the case de- Under prognosis of sarcoma, Prof. Knapp manded it, having administered ether to the further says that, "Sarcoma in general is a patient to complete anesthesia, Dr. Noyes disease terminating fatally sooner or later; performed the usual operation for extirpa- no case of spontaneous cure is known with tion of the eyeball. The patient rallied well certainty. This assertion is particularly apfrom the anaesthetic. The lancinating pain plicable to choroidal sarcomata, which, therefrom the eyeball was all gone, and only the fore, must be classed among malignant smarting of the operation remained. The growths. However, as regards their maligsympathetic irritation of the left eye speedily disappeared. The wound healed kindly and soon the patient was able to eat and sleep as well as she ever did.

Nearly ten years have elapsed since the diseased eye was removed for Mrs. H. She is now hale and hearty; nearly eighty years old, and attends to her own work about the house. There is no doubt that many years were added to this woman's life by the timely removal of a tumor that must, sooner or later, have caused the total loss of sight and, perhaps, the loss of life.

mors.

Microscopical examination of the tumor removed from Mrs. H.'s eye showed that it was very melanotic. Then, there were cells that looked very much like cancer cells, and the usual stroma that is found in such tuThe long time, nearly sixteen years, that the spot of exuded pigment remained stationary and painless, and the long time that it was growing and painful, nearly thirteen years, make the case very interesting. Then, the duration of the patient's life far beyond the allotted "three score years and ten," render this case worthy of a report. Mr. Paget classes such tumors with cancers, and says that life is rarely prolonged beyond four years, but a very few suffering from such diseases live beyond five years.

nancy, they do not stand foremost, but are secondary to carcinoma proper. Choroidal sarcomata are homoeoplastic tumors, and for this reason alone more benign than carcinoma." He also says that the forms of sarcoma which are poorest in blood vessels are less malignant than those tumors that are better supplied with vessels, and further says that the small-celled sarcomata are more malignant than the large-celled.

Alt, of Toronto, in a work just published, follows Prof. Knapp in his divisions and pathology, and agrees with Knapp that metastases may take place from sarcomata of the choroid, and be the immediate cause of death.

Enough has been written to prove that melano-sarcomata of the eyeball are not to be trifled with. They should be treated by enucleation of the eyeball if seen early, or if later and perforation has taken place, then by extirpation. If we believe in the doctrine of that best authority Knapp, cures can only be expected when the tumor is discovered early, and the eyeball at once removed.

Treatment and Management of Diphtheria.
BY N. F. BROWN, M. D., DETROIT, MICH.
Read before Detroit Academy of Medicine.

ITHOUT entering into the etiology As is well known, Prof. Knapp, of Heidand pathology of diphtheria, I will elberg, makes but two divisions of intra- speak of the treatment and management ocular tumors, viz.: glioma (encephaloid) of of the disease as pursued by myself, in an the retina and sarcoma pigmented and un- epidemic which prevailed in the city last pigmented of the choroid and ciliary body. autumn. Knapp also says that while he does not deny that other forms may be found, he has never

The disease appeared in the latter part of August, and continued as an epidemic till

about the middle of November
The symp-
toms presented nothing unusual, yet gener-
ally well defined.

Much has been written and spoken in reference to the treatment and management of the disease, and probably no two physicians would exactly agree in the treatment of diphtheria.

I have no new remedies to bring before you this evening for the disease in question, but will give my experience with remedies with which all are familiar. I regard glycerine, chlorate of potash and muriated tincture of iron as our most valuable agents in the treatment of diphtheria, and would attach importance to them in the order named. I need not speak of the properties of these drugs, or their physiological action, but would call attention to the fact that glycerine is no less depleting when applied to the mucous surface of the throat, than when applied to the mucous membrane of the vagina and uterus.

This course of treatment will reduce the temperature, relieve the common symptoms of pain in the head, back and extremities. In cases where there was little or no fetor, the iron was omitted.

For an adult, I gave one drachm of the chlorate with one half ounce of glycerine, with sufficient water to make four ounces, and then gave as in the case of a child.

With this treatment, conjoined with concentrated nourishment and quietude of the patient, kept in bed, I was pleased to see in many cases the membrane exfoliate, in from three to seven days, and not re-form on the surface again. It requires determination and courage to pursue this course, but I met many parents who were pleased that their little ones were spared the annoyance of frequent injections of the throat.

Too much importance cannot be attached to quietude of the patient.

I remember distinctly one child, sixteen months old, convalescing from a severe atThese remedies constituted very nearly all tack; the mother could not resist the temp. the medicines I used in the epidemic, in which tation to take the little one from the cradle over one hundred cases came under my ob- and carry it about the room, and the child servation and care. I admit, at once, that I died in her arms in a few minutes afterward. treated the disease greatly different from I entered the house a few minutes later, and what I formerly did, as I used no local appli- the mother, horror stricken, related these cation to the throat by insufflation, or otherwise, and discarded quinine completely in the early stage of the disease.

facts. Cases in which sudden death had taken place in diphtheria, from effort and exertion, are beyond contradiction; but to return to the family in which the sudden death occured: I found in this visit that another child, a bright little boy of three

There is no disease in which alimentation is more necessary; and the old rule of "rest in inflammation," is peculiarly applicable to diphtheria. You all know full well the deter-years, was stricken down during the night, mined resistance children often make to the introduction of a depressor in the mouth for the purpose of getting a view of the throat; their efforts in resistance at times are frantic, and in a disease in which there is such depression, syncope and paralysis of the heart might cause instant death.

When called to see a child three or four years of age, I gave the following prescrip

tion:

and on inspecting the throat found extensive diphtheritic deposit developing in the fauces, tonsils and pharynx, sanious discharges through the anterior nares, with a very fetid odor. In this case, the potash, glycerine and iron were combined, and given every half-hour, through the day and night, and when the patient was seen twenty-four hours later, the severity of the symptoms was decidedly lessened; medicine was then ordered given every hour, for twenty-four hours more. Beef tea and milk were given alternately with the medicine from the beginning. At the next visit, which was the third day, I examined the throat for the second time, which showed that the deposition of plastic matter was arrested from the first, and the existing membranes showed signs of exfoliation-the general condition of the patient favorable in every respect.