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of the ventricles. Now, because of the recovery, I am not sure, however, I believe the two remedies saved the child's life.

Reader, what would an old school physician have done with such a case?

Case 5. Girl, aged 8 years; epilepsy for several years; constipated; treatment from various physicians without perceptible benefit. I treated her at irregular intervals for over two years without diminishing the epileptic attacks or in the least degree, diminishing the constipation. She had from fifteen to twenty epileptic seizures per month. After my failure for the above-mentioned length of time, the mother remarked that the attacks came at the change of moon and that they were confined to a period of a few days in the month. Alumina and causticum were given. The child showed improvement promptly. The constipation is cured. The bowels move regularly and the stool is normal, a condition that had not existed since infancy. The number of epilpetic paroxysms diminished to four or five in the month, and in degree from those of unconsciousness, followed by stupor, to a momentary dazed state and no sense of languor. The child was so full of life and mischief as to cause the mother to inquire if it were of serious import.

After several months of improvement, then several months of stationary condition she had one severe paroxysm. Silica was given; the following month she had none. Since that time I have not heard from her. She is now about twelve years old. I do not pronounce her cured of the epilepsy, but she is of the constipation. Mentally and in appearance she is greatly improved. I treated her for two years without benefit. That was not a failure of homeopathy, but my failure to apply the law of similia. It is a clear case of the efficacy and power of potentized remedies, not a coincident.

The causticum was given in the 6x. More than twenty years ago, I procured an ounce dilution of alumina, potency forgotten. Since that time, when bottle is nearly empty, I fill it with alcohol. It has been filled many times, and it was from that bottle the alumina was taken for this case.

EAR TROUBLE DUE TO SALVARSAN.-It is claimed by Bourgeois that serious results to the auditory apparatus have been observed to follow the use of salvarsan, even as late as three months after the injection, when intra-muscular. Headache, tinnitus, and vertigo are followed by more or less deafness.

BLOOD TRANSFUSION.*

E. L. HUNTER, M. D., CHICAGO.

Blood transfusion by the old methods has proved so unsatisfactory that for a considerable period of time the operation has been practically laid upon the shelf. The transfusion or infusion of normal salt solution, though lacking in many respects, and failing in proportionately as many cases to save life, has been the operation of choice. This we all know, and not being an authority, it is not my intention in this paper to give you the history of transfusion of blood, or tell you a long story about the different methods which have been disappointing in giving results hoped for.

It is my intention only to give to you what I have learned through recent investigation of what is being done of late in transfusion of blood. It is perfectly reasonable to think that a great deal of good in many conditions should result from blood transfusion with the proper apparatus and a simple technique. Fortunately this thought has been uppermost in the minds of a few, so that work has been going on in the way of perfecting the technique and apparatus to the extent that the near future may have for us something in this line that will be of great value. As yet the proven value is limited, but the possibilities are not so limited. Time for further experimental work and suitable cases will tell, as in everything else.

I must admit that it was the request to write a paper on this subject. that awakened my interest anew, and in looking about it was my good fortune to learn that Dr. Arthur H. Curtis, my next door neighbor almost, has been for the last year and a half working in perfecting a technique and simplifying an apparatus for transfusion which, to my belief, is the nearest perfect of any apparatus or technique to date. For that reason, and the fact that I take it for granted that most of you at least are familiar with the other methods, I will confine this paper to giving you a description of Dr. Curtis' apparatus and his technique.

The apparatus consists of a large glass bulb with two canula tips, and a rubber tube with a glass syringe attached. The glass bulb is sterilized by the dry method, and the inner surface coated with paraffin. The paraffin coat is best applied by pouring hot paraffin into the open end and then rotating the bulb to secure a uniform coat. The two canula tips are then heated, and each in turn dipped into melted paraffin and shaken, to make a thorough coating, so as to keep the excess from * Read at the I. H. M. A., 1912.

occluding the lumen. The syringe and rubber tube are prepared by boiling.

With the apparatus now ready for use, a one-half inch incision is made over the most prominent vein of the elbow region in both donor and recipient. The donor's vein is then clamped at the distal end of the incision, stripped, ligated proximally, cut below the ligature, and washed out with 1 per cent. solution of sodium citrate. The recipient's vein is ligated distally, stripped toward the heart, clamped at the upper end of the incision, cut above the ligature, and also washed out. The canula tips are moistened by introducing a few drops of liquid petrolatum through the bulb end, then inserted into the respective veins of donor and recipient, and are ligated in position, the heads of the patients being in opposite directions and elbows together. Aided by the use of a shoulder constrictor, blood rapidly enters the bulb when the donor's vein is released. As the blood rises in the tube, a covering cap of liquid petrolatum is added to relieve surface tension. The rubber tube is now fitted over the top of the glass bulb, and the tube and syringe are used to produce positive and negative pressure, as desired. (The bulb ususally fills without resorting to suction.) The donor's vein is then held by the fingers, the recipient's vein released and the blood introduced into the latter at any desired rate of flow. When the bulb is nearly empty, the recipient's vein is held and that of the donor released, thus allowing the bulb to again become filled with blood, after which the process continues as before. Bulbs of various sizes, ranging in capacity from 100 c. c. to 400 c. c., have been used. Experience indicates that the largest size is, as a rule, the most satisfactory.

In conclusion I wish to say so that due credit may be given to Crile and the canula which he uses, that the Curtis method grew out of experiments conducted, first using the Crile canula, and that in the use of any apparatus it is necessary that the operator be skilled and accustomed to delicate work, and that indications for blood transfusion are as yet limited to cases where there has been great loss of blood from whatever cause, but that in the near future we may be using it to advautage in combating many infectious conditions.

Dr. Curtis is now experimenting along this line, and he tells me that, while he has nothing definite to report as yet, he hopes to prove the value of blood transfusion in this class of cases, and the resuscitation of the new born that have the condition known as melena neonatorium or those that are depleted from other causes. His experiments so far are very gratifying in results.

In hydrophobia if the patient has reached a stage too late for the Pasteur treatment, transfusion of blood from one who has recently received the Pasteur treatment may bring results, but this work is still too immature for positive statement.

DISCUSSION.

The discussion was opened by Dr. Colwell, who recounted a number of cases where blood transfusion might have saved life, and also some in which it had been quite successful, although the blood transfusion was not that of a near relative. His experience was very instructive. Dr. FitzPatrick: Literature is quite alive with work that is being done along this line by various laboratories and research institutions, so that it is really worthy of trial. Dr. Hunter deserves a great deal of credit for having brought this topic up for discussion at this time. In a late report from New York, there were eight cases of hemaphilia; they lost the first four cases; the last four cases were all saved. They did a blood infusion—a serum infused from rabbits.

There is a report also of eighteen cases from another institution, in which they saved seventeen who were suffering from hemaphilia neonotorium. In three of the cases reported, they are clear, specific histories, so that the mother and child were hemophiliac and yet the children were saved. The blood infusion or serum infusion proved sufficiently successful in these cases.

There was a case of a man, twenty-nine years old, who was suffering from a hemorrhage of the nose to such an extent that the blood corpuscles went down to two million, and the white corpuscles carried below five thousand. The other had been bleeding for four days. A serum transfusion was made, using 30 cc. at the first injection, repeating it six hours, and repeating after that in three hours with 60.

Another case, in which a child of ten years had fallen down and bitten a hole through his tongue and was bleeding. The bleeding was severe, and the child was saved by the use of blood transfusion.

I was looking with interest for some tonsilar cases that I believe worthy of consideration from the men doing surgery of that type.

There is so much being done along this line that it behooves every one of us to become acquainted with it. Blood transfusion has lots of possibilities about it; there is a possibility of hemolysis, thrombosis and a possibility of infection that requires a very delicate apparatus,. and a skilled operator to do it satisfactorily.

Dr. Curtis has performed three blood transfusions for me this winter, and I know he used the utmost care. The serum infusion with the

hypodermic syringe can be done by anyone who qualifies himself with technical detail; when using the serums you do not have to ascertain the hemolytic relationship between the recipient and the donor.

Dr. Colwell said: While not in direct discussion of Dr. Hunter's paper on transfusion, I would just like to make a statement along the line that Dr. FitzPatrick was talking about, of apparently uncontrollable hemorrhages in the new-born, where it is not convenient, or under circumstances practically impossible, to make a transfusion. A good many cases are now recorded where hemorrhage has been stopped by the use of ordinary serum found in the diphtheria antitoxin, and you can sometimes stop the hemorrhage in that way. That is all sterilized and ready for use.

PINK EYE, OR ACUTE CONTAGIOUS CONJUNCTIVITIS.*

W. E. BOYNTON, M. D., CHICAGO.

In considering the ocular malady commonly known as "pink eye," we are confronted by the fact that there are two varieties of the pink eye; one that really is "pink eye," and several that are not.

It is this fact, that "pink eye" may be the diagnosis rather than the disease, that has prompted this paper.

True pink eye is a severe form of acute conjunctivitis, muco-purulent in type, highly contagious, and apt to occur as an epidemic.

Bacteriologically, it is due to infection with the Koch-Weeks bacillus, a micro-organism closely resembling the bacillus of influenza, but not identical with it. Pink eye is classed as Koch-Weeks conjunctivitis, by many authorities on this bacteriological causation.

Symptomatically, it has much in common with the other severe forms of conjunctivitis. In fact, severe cases of pink eye may be mistaken for gonorrheal or diphtheritic conjuncitivitis, though the diagnosis is easily cleared up by a microscopical examination of the discharge. The mistaking of pink eye for one of the severer forms of conjunctivits is, however, less fruitful of evil than when a more serious infection is mistaken for the pink eye.

While the differential diagnosis depends largely upon the bacteriological findings, there are certain symptoms, the presence or absence of which aid materially in distinguishing the pink eye from the more

*Read before the Illinois Homeopathic Medical Assn., Chicago, May 16, 1912.

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