ORIGINAL COMMUNICATIONS. Granular Opthalmia. By D. McGillivray, M.D Medico Chirurgical Society of Montreal. Ventilation. By Henry Howard, M.D. Vaccination and Re-Vaccination. By F. W. Campbell, M.D. PERISCOPIC DEPARTMENT. SURGERY. On the removal of the Nævoid Growths.. Congenital Occlusion of the Rima Glottidis. Is Imperforate Hymen ever Hereditary?. Medicated Bougies in Gonorrhoea.. The early symptoms of Spinal Disease. Intestinal Obstruction: Amussat's Operation. MEDICINE. Treatment of Chorea by Ether Spray to the Spine. A new Test for Hysteria. Mammary Abscess and its Remedy. By Joseph R. Beck, M.D. MIDWIFERY. Leaving open the Abdominal Cavity after operation.... PAGE 537 538 538 545 563 564 564 564 565 565 566 568 572 573 573 574 575 MATERIA MEDICA AND CHEMISTRY. The action of Mercury on the Liver. 576 On Tincture of Hyoscyamus. By M. Donovan, Esq. 576 Ice per Rectum in Chloroform Narcosis.. 578 578 Iodide of Iron as a remedy in Incontinence of Urine. including Localized and General Electrization, by George M. Beard, A.M., M.D., and A. D. Rockwell, A.M., M.D., with one hundred and two illustrations. Price $4.50. For sale by DAWSON BROS. ATTFIELD'S CHEMISTRY. HEMISTRY: General, Medical, and Pharmaceutical, including the Chemistry of the CHU.S. Pharmacopoeia, a Manual on the General Principles of the Science, and their application to Medicine and Pharmacy, by John Attfield, Ph. D., F.C.S. New and Revised Edition. Price $2.75. CANADA MEDICAL JOURNAL. ORIGINAL COMMUNICATIONS. Granular Ophthalmia-Treatment of. By D. MCGILLIVRAY, M. D., Physician to the Ottawa General Protestant Hospital. Granular conjunctivitis is a very troublesome and frequent disease, and often very obstinate to treatment. It is found more prevalent in some districts than in others. But why it so prevails in certain places is not well defined. I cannot say that it is peculiarly prevalent in this section of the country, as most of the cases that have come under my notice were immigrants from foreign countries or from other parts of Canada, excepting that portion of our floating population formed by the lumbermen, who frequently seek medical advice for conjunctival diseases. The disease consists in a roughened state of the mucus lining membrane of the lids, and more especially of the upper lids. The granular elevations are simply the conjunctival papilae in a hypertrophied condition from inflammation, and vary in degree and extent in different cases. In some they are very minute and scarcely appear to the naked eye, while in others they are as large as pinheads and cover the greater part of the conjunctiva or appear only in patches. They are most frequently found on the internal surface of the tarsi, while other parts of the membrane appear healthy or sometimes swollen and injected. On closely examining the everted lid, small greyish white bodies like sago grains appear on the palpebral conjunctiva. They appear in greater number at the retrotarsal fold; these are termed simple granulations, or according to Stelwagg, "granular trachoma," and are met with in the acute and chronic forms of the disease. This state of the eye is accompanied by a mucopurulent discharge which is very troublesome to the patient, vision is also frequently impaired from opacity and thickening of the cornea, the result of friction by the granulations; and if the disease is allowed to go on, especially in the acute form, loss of vision may follow II from ulceration of the cornea. To prevent this friction many plans have been adopted, such as attaching the upper lid to the eyebrow by means of stiches or adhesive plaster, and applying solutions of lunar caustic, sulphate of zinc, sulphate of copper, acetate of lead, &c., to the granulations, a method attended with pain and annoyance to the patient and sometimes with but little benefit. While treating cases by the above methods, it occurred to me that friction in this disease might be prevented or at least greatly lessened on the same mechanical principle that it is overcome between other opposing surfaces, namely by oiling. Acting on this suggestion, I made a solution of cod-liver oil and alum sulph, half a grain of the latter to the ounce of the former, and applied the mixture by a camel hair pencil to the granulations, night and morning or oftener. After several weeks' trial the result exceeded my expectations, the opacity of the cornea and the granulations disappeared and the eye recovered its natural clearness. I have used this local treatment in several cases that have come under my care during the last two years, with equally good results. The modus operandi consists in the oil lubricating the granular surface and allowing it to slide smoothly over the cornea, while the alum astricts the granulations and makes them smaller, thus also helping to lessen the friction and consequently reducing the amount of mucopurulent discharge. I have no doubt that the cod-liver oil exercises a medicinal influence over the diseased conjunctiva owing to its chemical composition. In all the cases thus treated, tonics combined with alkalies and a generous diet, were prescribed. Total abstinence from alcoholic drinks should be strictly enjoined, as they invariably aggravate the disease; the eye should be kept well sheltered from wind and cold, and bathed several times a day with warm water, or the conjunctiva well washed of discharges by syringing with warm water three or four times a day, especially before applying the oil solution; I have found it beneficial to bandage a wet pad on the eye, as it absorbs discharges and prevents to some extent the movements of the lid. This mode of treatment was persevered in for several months in some cases, while other cases yielded to the remedy in a few weeks. MEDICO-CHIRURGICAL SOCIETY OF MONTREAL. MEETING HELD, APRIL 28TH, 1870. The President G. W. CAMPBELL, A.M., M.D., in the chair. The minutes of the last meeting were read and confirmed. The President then introduced Dr. HENRY HOWARD, Superintendent of the Provincial Lunatic Asylum, at St. Johns, P.Q., who read the following paper on his system of "Ventilation." MR. PRESIDENT AND GENTLEMEN,-The subject which I beg leave to bring before you this evening (my system of the ventilation of buildings) requires no proof of its actual necessity, or of how important it is in a sanitary point of view, you all know its importance just as well as I do. My system of ventilation I wish to be considered and discussed, by this Society, and that they would give their fair and candid opinion upon it without any prejudice. If you find it what I believe it to be, you will give me credit for it; if on the contrary you differ from me you will honestly give your reason why. Allow me for a moment to digress. I know there are many in this city, whom I fear are very ignorant of any system of ventilation, and when speaking on the subject begin to sneer at all systems. Men of such pretended knowledge, may (perhaps inadvertently) do a great deal of harm, without being able to offer any opinion, or suggestion, that would be of any benefit in a question of such vital importance. The majority of the medical and scientific men of the present day, have embarked in the subject of ventilation in order to secure some certain means of preserving the health of their fellow creatures. It is not the time through selfish motives, or egotism, to oppose instead of endeavouring to forward it. If such men are not capable by their own talents to add something to science, at least they should do so by encouraging all and every individual who is working hard for the sake of humanity. I believe, sir, it is a recognised fact that Dr. Parkes of the Royal Victoria Hospital, Netley, England, is one of the best authorities, in the present day, upon Hygiene, and I know that the high and responsible position that he holds, is due to his work on that subject. He certainly has grappled with the matter well, and has proved the errors of many old and new theories. So far as wind sewerage and foul gases are concerned, I have carefully studied his work and have adopted his theory: that foul air should be drawn off above, and not below the person, and that pure air should be admitted in a similar manner. That the great object in ventilation was to expel foul air as soon as possible after it was exhaled or generated, and admit pure air to take its place. That there should, in fact, be two distinct currents always going on in the place to be ventilated, and all this should be done without producing sensible draught. Dr. Parkes in his work gives all the different means that had been invented to accomplish this end and concludes that they were all imperfect from one cause or another. To depend upon the wind was absurd, for we have no control over it, and when most wanted, very frequently there |