of slight prostatic hypertrophy, the suspicion being now confirmed by rectal examination. The long-continued dysuria and necessity for the catheter were, I think, in large measure due to the increase of this former trouble. From June 30th to July 9th the bladder was daily washed, at first with boracic solution, later with bichloride of mercury, I to 16,000. On July 9th the pain in the renal regions, both sides, increased and became severe. Up to this time it had been slight. Under the vigorous application of hot baths and large hot poultices this subsided. On the evening of the 9th Holland gin was given, a teaspoonful every two hours. Within twelve hours improvement in the urinary symptoms was marked, due doubtless to the juniper in the gin. The use of the catheter was stopped on the 10th. On this date the temperature and pulse became normal. In the meantime the bowels had, with periods of remission, gradually improved. By July 10th the abdominal tenderness had largely passed away, and with it the gaseous distention, which had been present almost from the start. The movements had lost the black color, their appearance indicating simply a catarrhal condition of the bowels. It is of interest to note, as showing the violent disturbance of the intestines, that for two weeks after the beginning of the attack all solid food, which was several times tried, passed through with hardly any appearance of digestion. The urine was examined during the height of the attack for albumin and sugar. Neither was found; casts were not looked for. It is to be noted that this examination was not made till after the treatment had induced a marked increase in the amount of urine passed. I regret that the blood was not examined. After the cyanosis passed away the appearance of the patient was that of marked anæmia, which was still pronounced at the time of my last visit, on July 14th. He was ordered to continue iron, which he had been taking for a week, and a short time after was sent to West Baden Springs, this State, to recuperate. During his illness the patient was seen by Dr. H. M. Lash, and by Dr. Thompson, of Irvington. In looking back over the case the things which stand out most prominently in the clinical history are, the violent irritation of the bowels, the equally violent urinary disturbance, the great prostration, and the evidences of profound alteration of the blood. DEATH BY DROWNING. BY N. L. NORTH, M.D., BROOKLYN, N. Y. In a recent case of supposed drowning doubts were ocean (salt) water were found in the stomach, doubt Again, a purely accidental drowning would be more Drowning, then, asphyxia by submersion, "is not owing to a certain quantity of liquid being introduced into the alimentary or air-passages, but simply to the interception of air, and of the respiratory phenomena;" hence the post-mortem appearances other than those which show externally-the cold, pallid, corrugated skin, with the half-open eyes, swollen tongue, partly protruded, and with the lips and nostrils covered with frothy mucus-would be those of suffocation and consequent upon the sudden and complete suspension of respiration, the right side of the heart and the lungs gorged with blood, the bronchial tubes and trachea more or less filled with frothy mucus, and not necessarily anything else. There may be water in the lungs and the bronchiæ and the stomach, or there may not, the condition may be the same, and only the same as if the person had been confined in nitrogen gas, or as if the individual had been simply smothered, suffocated, and died from lack of oxygen, or as if he had been in a vacuum, except that there would be the added symptoms caused by the removed air-pressure. A CASE OF OPIUM - POISONING TREATED BY R. G. EBERT, M.D., ASSISTANT SURGEON UNITED STATES ARMY. MRS. F, mulatto, aged twenty-three, took an un- Respiration and pulse, the former slightly, the latter At 1.5 P.M. an additional one-fiftieth grain of atropia was given; at this time the post surgeon, Major Wilcox, arrived, and at his suggestion permanganate of potash, which was being prepared for irrigation of stomach, was injected deeply into the tissues of both thighs in a concentrated solution, quantity not measured, but assumed to be between one and a half and two grains of the salt. In less than three minutes (only time sufficient to lay aside the hypodermic syringe and render the stomach-tube flexible) she responded to the stimulus produced by the passage of the oesophageal tube through the pharynx, the first reflex obtained. A pint and a half of a strong solution of permanganate was thrown into the stomach, further introduction being arrested by regurgitation of the fluid, and on withdrawal of the 2 1 tube copious emesis followed; the returning liquid was not wholly discolored. Further active medication ceased. Coffee and nursing meeting all requirements. At 1.45 P.M. consciousness was manifested; fifty minutes later questions were answered intelligently, and the facts elicited that morphine had been taken at the time above mentioned. The first injection of atropia had no perceptible influence on the pupils; the second was so shortly followed by the permanganate that no time had been allowed to show its effects, if there were any, upon the eye. An hour afterward the size of the pupil was still below normal. The good results, so rapidly and markedly obtained, are attributed by Dr. Wilcox and myself entirely to the permanganate. FORT HUACHUca, Arizona TERRITORY. THE EMPLOYMENT OF PILOCARPINE IN THE TREATMENT OF URTICARIA. BY AUGUSTUS A. ESHNER, M.D., ADJUNCT PROFESSOR OF CLINICAL MEDICINE IN THE PHILADELPHIA POLYCLINIC. I AM prompted to make this report by the recommendation of Abrahams,' of pilocarpine hydrochlorate in the treatment of acute and chronic urticaria, with a recital of three illustrative cases, and by the confirmatory report of McBrayer.2 Á married woman, forty-three years of age, came to my service at the Polyclinic several weeks ago, with a history of having suffered for two months, intermittently, with an urticarial eruption upon the elbows, forearms, and legs, recurring for periods of two or three weeks at a time, at intervals of about a week. There was no history of the ingestion of shell-fish or other article of diet to which etiologic significance could be attached. The woman was constipated and complained of attacks of smothering attributable to distention of the stomach. No heart-lesion could be detected, and the urine presented no abnormality. Other symptoms of vasomotor ataxia were wanting. On inquiry it was learned that a dog was kept in the family, but investigation disclosed a freedom from fleas, and no other member of the household suffered as did the patient. Pills of pilocarpine hydrochlorate, gr. 2, three times daily, were prescribed, and the woman returned in a week much improved. Thereafter no more "hives appeared, and four days later the woman reported that she had not felt so well for two years. My employment of pilocarpine in this case was purely empirical. The drug has such a pronounced effect upon the circulatory and secretory activity of the skin, and I had observed such strikingly favorable results from its systematic employment in the treatment of erysipelas, that I was led to its use for the relief of urticaria. I fancy, too, that the drug is worthy more extended application in the domain of dermato-therapy than it has heretofore received. I should prefer its subcutaneous injection when the patient is under immediate observation, but I feel safer in directing its administration by the mouth in the case of out-patients. FRACTURE OF THE FOURTH CERVICAL VERTEBRA AND RECOVERY. BY CHARLES J. RINGNELL, M.D., MINNEAPOLIS, MINN. ON August 3, 1893, Julius A——, a farmer, aged nineteen, came under my care at the Deaconess Institute, presenting all the symptoms of a "broken neck." After having made a careful examination, I arrived at the conclusion that the laminæ of the fourth cervical 1 MEDICAL RECORD, September 15, 1894, p. 342. 2 Ibid., November 3, 1894, p. 564. vertebra were fractured. Crepitation could be elicited. Two days previous he was about to take a bath in a small river, eighty miles from this city. He jumped in the river head first, thinking the water was deep; but to his misfortune struck the bottom and became unconscious immediately, in which state he remained for about five minutes. His companions noticed the condition he was in and carried him to the shore. After regaining consciousness he was unable to move any part of the body, excepting the head. Pain was felt only in the neck. The next day he was sent to the hospital, and when first seen he presented the symptoms above stated, with these additions: Temperature, 103° F.; pulse, 72; labored breathing; retention of urine and fæces; anesthesia of lower extremities, extending over the abdomen, and complete paralysis of lower extremities, bladder, and lower bowel. The arms could be raised slightly, but fingers could not be moved. Complained of thirst, was unable to take any nourishment, and could not sleep. Bowels and bladder were attended to, and head fixed. The following three weeks he was expected to die every day, as no improvement could be noticed. Temperature ranged from 102° to 105° F. Pulse never went over 72, but was generally about 65. Vesication and head-sores developed. After the third week the temperature commenced to sink, and a slight improvement could be noticed daily. In the meantime quite a severe cystitis had developed, although every precaution had been taken in regard to cleanliness. This, however, abated, and was followed by incontinence, and it became necessary to keep a urinal in the bed to receive the urine, which came drop by drop until the twelfth week, when it could be retained for an hour's time. In the eighth week anesthesia commenced to disappear on the right side, and in a short time on the left also. The paralysis gradually disappeared in the same order. Improvement continued, and about December 1, 1893, he was able to sit up in the bed, having his head. supported. About January 1st, this year, he commenced to walk with the aid of a chair. He remained at the hospital for ten months, and his improvement was uninterrupted. The enlargement in the neck was quite marked when discharged. Head being fixed with appropriate dressings, the other symptoms were treated as they appeared. Iodide of potassium in increased doses was given from the sixth week, and later on electricity and massage. A few days ago I had a letter from my patient, in which he stated that he has recovered almost entirely, and that he has been attending school ever since last LOOSE BODY IN THE KNEE-JOINT. ST. CLAIR COUNTY PHYSICIAN, BELLEVILLE, ILL. MR. A. M―, a farmer, was admitted to the St. Clair County Farm in June, 1894. He was admitted as a patient with inflammatory rheumatism. He gave a history of two years' suffering, all his trouble being located in the left knee-joint. Examination of the knee showed it to be very much swollen and exceedingly painful to touch, and almost immovable. Local applications and rest in bed with the leg elevated reduced the symptoms very materially. About a week after, at another examination, I found what later proved to be the cause of the trouble. There was a loose body floating in the joint. This body was movable to almost all parts of the knee, both anterior and posterior, and could be carried about six inches above the patella. At times it would be lost, and then could not be found after the most diligent search. I have hunted as long as an hour for it and been unable to locate it. Twice I was ready to remove it and it slipped from my fingers and was lost. Finally I located it about three inches above the patella to the inner side of the thigh. I then passed a needle under it and fixed it so I could cut down on it. The incision was about two inches long. With a pair of thin forceps I removed the body, stitched up the sac with catgut, closed the external wound with the interrupted stitch, and put on a dry dressing. The patient made a good recovery. This body which I removed was globular in form and about half an inch in size, covered all over with little knobs which made it look very much like a blackberry, only that it was perfectly white. Microscopical examination showed it to be of bone tissue. How did this piece of bone get into the joint? The only explanation I know of, and I think probably it is the correct one, is this. About two and a half years ago he had his knee caught between the wheels of a wagon, which laid him up for some time, and after that thought he had rheumatism in his knee. To my way of thinking, it is more than likely that a piece of bone was knocked loose and floated in the joint, causing his trouble. Five months after I saw him, and he was doing all the work on a farm, and had as good use of his left knee as his right. A UNIQUE CASE OF COMBINED ANTRUM AND MASTOID DISEASE. BY CHARLES H. BAKER, M.D., BAY CITY, MICH. THE following case is, I believe, unique from the occurrence simultaneously of abscess of the antrum of Highmore and of the mastoid antrum, and because the latter was the direct result of the former. Mrs. Mary N, fifty-eight years of age, had in April, 1893, what she calls hay-fever and sunstroke (?), which was accompanied by swelling between the eyebrows and in front of the left ear; considerable pain in the cheek and a profuse nasal discharge, which lasted two or three weeks. She was treated by the use of the nasal douche, prescribed by a physician, and remained well until September 27, 1894. At this time she nursed a very severe case of puerperal fever, losing much sleep and becoming much exhausted. While overheated, and in this condition, she laid down for a nap between two open windows, and was awakened by severe pain in the left cheek. This was soon followed by a thick, foul, and badsmelling discharge from the left nostril, and to relieve it she again resorted to warm douches, which she continued a week, when one day she took cold water and snuffed it into the nostril from the palm of the hand. She was immediately seized with pain in the middle ear on the left side, which increased until the exudation forced an opening through the tympanic membrane; no relief followed the perforation, and the tissues behind the ear rapidly swelled. On visiting her with the attending physician, it was decided to drill into the mastoid and also the antrum, which was done, finding a little pus in the mastoid antrum and a great deal of foul pus in the antrum of Highmore. The opening into the latter was made through the socket of the first molar, which was extracted for the purpose. A soft rubber drainage-tube was used, for want of a regular antrum-tube, and the teeth adjoining the opening being absent, it was stitched to the gum in order that it should not be lost in the antrum or swallowed during sleep. The patient was a confirmed morphine eater and in the habit of consuming large quantities of the drug. During her recovery she had a mild attack of facial erysipelas, which, with the use of carbolic acid and compound tincture of iodine, equal parts, applied to and around the infected area, was easily controlled. The mastoid opening was completely healed in two or three days, the discharge ceasing promptly. The antrum was irrigated with dilute hydrogen dioxide, followed after a few weeks by potassium permanganate solution, and at the present writing, three months after the operation, she is still cleansing the cavity by irrigation from below, causing the fluid to issue from the nose. The secretion of pus is very small in amount, and will no doubt in a short time more entirely cease. In a series of sixteen mastoid cases, this is the second in which water in quantity, douched or snuffed into the nose, has carried infection into the middle ear, and the necessity of care in cleansing the nose cannot be too strongly insisted upon. Cold water, by its action on the erectile tissues of the nose and pharynx, is more liable to cause swelling and retention long enough for mischief to be done, but any fluid which enters the Eustachian tube after first passing over a suppurating nasal membrane is dangerous. In this connection I have often noticed an anatomical peculiarity which predisposes to the entrance of secretions into the Eustachian orifice, and so far as I have examined it has been present in all my cases. The top of the Eustachian tube, in a normal throat, protrudes from the side of the pharyngeal vault somewhat as a dormer window does from a roof, thus shedding the mucus to either side and causing it to flow down the pharynx. But in these and some other cases, I have seen the opening nearly or quite flush with the side wall of the pharynx; or even having the lower edge of the opening the most prominent, thus predisposing to the entrance of fluids into the Eustachian tube. PERMANGANATE OF POTASSIUM IN MORPHINE POISONING. BY WILLIAM E. PUTNAM, M.D., WHITING, IND. HAD I known the value of permanganate of potassium sooner, I might have saved the lives of two men who have died from morphine poisoning in less than two But thanks to the discovery of Dr. Moor, my years. third case was saved. Mrs., aged forty-five, took at least two ounces of laudanum. When I was called the pupils looked the size of a pin's point, the hands and feet were cold, and the nails blue. Respiration was irregular. I sent first for my bottle of one-grain tablets of permanganate of potassium. Second, for my colleague. Dr. J. R. Harvey. Our diagnosis was death in thirty minutes unless permanganate of potassium would save the woman's life. Dr. Harvey, like Dr. C. Monroe McGuire, had no faith in permanganate of potassium, simply because he had never fitted the drug to the right case. We dissolved fifteen one-grain tablets in four ounces of water and two ounces of white wine vinegar, but we could not get the patient to swallow. I picked up a piece of rubber hose and cut off four inches, and with this over a piece of pine stick I made a gag and inserted it between the jaws. I then held the nose tightly and Dr. Harvey fed the woman the permanganate of potassium solution with a tablespoon. We gave forty-five grains or more, and slowly our patient began to recover. She was very low for about four days, her mouth and throat, and I suppose stomach, were thoroughly blackened and dry and sore from the permanganate of potassium. tube copious emesis followed; the returning liquid vertebra were fractured. Crepitation could be elicited. was not wholly discolored. Further active medication ceased. Coffee and nursing meeting all requirements. At 1.45 P.M. consciousness was manifested; fifty minutes later questions were answered intelligently, and the facts elicited that morphine had been taken at the time above mentioned. The first injection of atropia had no perceptible influence on the pupils; the second was so shortly followed by the permanganate that no time had been allowed to show its effects, if there were any, upon the eye. An hour afterward the size of the pupil was still below normal. The good results, so rapidly and markedly obtained, are attributed by Dr. Wilcox and myself entirely to the permanganate. FORT HUACHUCA, Arizona Territory. THE EMPLOYMENT OF PILOCARPINE IN THE TREATMENT OF URTICARIA. BY AUGUSTUS A. ESHNER, M.D., ADJUNCT PROFESSOR OF CLINICAL MEDICINE IN THE PHILADELPHIA POLYCLINIC. I AM prompted to make this report by the recommendation of Abrahams,1 of pilocarpine hydrochlorate in the treatment of acute and chronic urticaria, with a recital of three illustrative cases, and by the confirmatory report of McBrayer.2 A married woman, forty-three years of age, came to my service at the Polyclinic several weeks ago, with a history of having suffered for two months, intermittently, with an urticarial eruption upon the elbows, forearms, and legs, recurring for periods of two or three weeks at a time, at intervals of about a week. There was no history of the ingestion of shell-fish or other article of diet to which etiologic significance could be attached. The woman was constipated and complained of attacks of smothering attributable to distention of the stomach. No heart-lesion could be detected, and the urine presented no abnormality. Other symptoms of vasomotor ataxia were wanting. On inquiry it was learned that a dog was kept in the family, but investigation disclosed a freedom from fleas, and no other member of the household suffered as did the patient. Pills of pilocarpine hydrochlorate, gr. 2, three times daily, were prescribed, and the woman returned in a week much improved. Thereafter no more "hives peared, and four days later the woman reported that she had not felt so well for two years. ap My employment of pilocarpine in this case was purely empirical. The drug has such a pronounced effect. upon the circulatory and secretory activity of the skin, and I had observed such strikingly favorable results from its systematic employment in the treatment of erysipelas, that I was led to its use for the relief of urticaria. I fancy, too, that the drug is worthy more extended application in the domain of dermato-therapy than it has heretofore received. I should prefer its subcutaneous injection when the patient is under immediate observation, but I feel safer in directing its administration. by the mouth in the case of out-patients. Two days previous he was about to take a bath in a small river, eighty miles from this city. He jumped in the river head first, thinking the water was deep; but to his misfortune struck the bottom and became unconscious immediately, in which state he remained. for about five minutes. His companions noticed the condition he was in and carried him to the shore. After regaining consciousness he was unable to move any part of the body, excepting the head, Pain was felt only in the neck. The next day he was sent to the hospital, and when first seen he presented the symptoms above stated, with these additions: Temperature, 103° F.; pulse, 72; labored breathing; retention of urine and fæces; anæsthesia of lower extremities, extending over the abdomen, and complete paralysis of lower extremities, bladder, and lower bowel. The arms could be raised slightly, but fingers could not be moved. Complained of thirst, was unable to take any nourishment, and could not sleep. Bowels and bladder were attended to, and head fixed. The following three weeks he was expected to die every day, as no improvement could be noticed. Temperature ranged from 102° to 105° F. Pulse never went over 72, but was generally about 65. Vesication and head-sores developed. After the third week the temperature commenced to sink, and a slight improvement could be noticed daily. In the meantime quite a severe cystitis had developed, although every precaution had been taken in regard to cleanliness. This, however, abated, and was followed by incontinence, and it became necessary to keep a urinal in the bed to receive the urine, which came drop by drop until the twelfth week, when it could be retained for an hour's time. In the eighth week anesthesia commenced to disappear on the right side, and in a short time on the left also. The paralysis gradually disappeared in the same order. Improvement continued, and about December 1, 1893, he was able to sit up in the bed, having his head. supported. About January 1st, this year, he com menced to walk with the aid of a chair. He remained at the hospital for ten months, and his improvement was uninterrupted. The enlargement in the neck was quite marked when discharged. Head being fixed with appropriate dressings, the other symptoms were treated as they appeared. Iodide of potassium in increased doses was given from the sixth week, and later on electricity and massage. A few days ago I had a letter from my patient, in which he stated that he has recovered almost entirely, and that he has been attending school ever since last LOOSE BODY IN THE KNEE-JOINT. ST. CLAIR COUNTY PHYSICIAN, BELLEVILLE, ILL. MR. A. M, a farmer, was admitted to the St. Clair County Farm in June, 1894. He was admitted as a patient with inflammatory rheumatism. He gave a history of two years' suffering, all his trouble being located in the left knee-joint. Examination of the knee showed it to be very much swollen and exceedingly painful to touch, and almost immovable. Local applications and rest in bed with the leg elevated reduced the symptoms very materially. About a week after, at another examination, I found what later proved to be the cause of the trouble. There was a loose body floating in the joint. This body was movable to almost all parts of the knee, both anterior and posterior, and could be carried about six inches above the patella. At times it would be lost, and then could not be found after the most diligent search. I have hunted as long as an hour for it and been unable to locate it. Twice I was ready to remove it and it slipped from my fingers and was lost. Finally I located it about three inches above the patella to the inner side of the thigh. I then passed a needle under it and fixed it so I could cut down on it. The incision was about two inches long. With a pair of thin forceps I removed the body, stitched up the sac with catgut, closed the external wound with the interrupted stitch, and put on a dry dressing. The patient made a good recovery. This body which I removed was globular in form and about half an inch in size, covered all over with little knobs which made it look very much like a blackberry, only that it was perfectly white. Microscopical examination showed it to be of bone tissue. How did this piece of bone get into the joint? The only explanation I know of, and I think probably it is the correct one, is this. About two and a half years ago he had his knee caught between the wheels of a wagon, which laid him up for some time, and after that thought he had rheumatism in his knee. To my way of thinking, it is more than likely that a piece of bone was knocked loose and floated in the joint, causing his trouble. Five months after I saw him, and he was doing all the work on a farm, and had as good use of his left knee as his right. A UNIQUE CASE OF COMBINED ANTRUM AND MASTOID DISEASE. BY CHARLES H. BAKER, M.D., BAY CITY, MICH. THE following case is, I believe, unique from the occurrence simultaneously of abscess of the antrum of Highmore and of the mastoid antrum, and because the latter was the direct result of the former. Mrs. Mary N, fifty-eight years of age, had in April, 1893, what she calls hay-fever and sunstroke (?), which was accompanied by swelling between the eyebrows and in front of the left ear; considerable pain in the cheek and a profuse nasal discharge, which lasted two or three weeks. She was treated by the use of the nasal douche, prescribed by a physician, and remained well until September 27, 1894. At this time she nursed a very severe case of puerperal fever, losing much sleep and becoming much exhausted. While overheated, and in this condition, she laid down for a nap between two open windows, and was awakened by severe pain in the left cheek. This was soon followed by a thick, foul, and badsmelling discharge from the left nostril, and to relieve it she again resorted to warm douches, which she continued a week, when one day she took cold water and snuffed it into the nostril from the palm of the hand. She was immediately seized with pain in the middle ear on the left side, which increased until the exudation forced an opening through the tympanic membrane; no relief followed the perforation, and the tissues behind the ear rapidly swelled. On visiting her with the attending physician, it was decided to drill into the mastoid and also the antrum, which was done, finding a little pus in the mastoid antrum and a great deal of foul pus in the antrum of Highmore. The opening into the latter was made through the socket of the first molar, which was extracted for the purpose. A soft rubber drainage-tube was used, for want of a regular antrum-tube, and the teeth adjoining the opening being absent, it was stitched to the gum in order that it should not be lost in the antrum or swallowed during sleep. The patient was a confirmed morphine eater and in the habit of consuming large quantities of the drug. During her recovery she had a mild attack of facial erysipelas, which, with the use of carbolic acid and compound tincture of iodine, equal parts, applied to and around the infected area, was easily controlled. The mastoid opening was completely healed in two or three days, the discharge ceasing promptly. The antrum was irrigated with dilute hydrogen dioxide, followed after a few weeks by potassium permanganate solution, and at the present writing, three months after the operation, she is still cleansing the cavity by irrigation from below, causing the fluid to issue from the nose. The secretion of pus is very small in amount, and will no doubt in a short time more entirely cease. In a series of sixteen mastoid cases, this is the second in which water in quantity, douched or snuffed into the nose, has carried infection into the middle ear, and the necessity of care in cleansing the nose cannot be too strongly insisted upon. Cold water, by its action on the erectile tissues of the nose and pharynx, is more liable to cause swelling and retention long enough for mischief to be done, but any fluid which enters the Eustachian tube after first passing over a suppurating nasal membrane is dangerous. In this connection I have often noticed an anatomical peculiarity which predisposes to the entrance of secretions into the Eustachian orifice, and so far as I have examined it has been present in all my cases. The top of the Eustachian tube, in a normal throat, protrudes from the side of the pharyngeal vault somewhat as a dormer window does from a roof, thus shedding the mucus to either side and causing it to flow down the pharynx. But in these and some other cases, I have seen the opening nearly or quite flush with the side wall of the pharynx; or even having the lower edge of the opening the most prominent, thus predisposing to the entrance of fluids into the Eustachian tube. PERMANGANATE OF POTASSIUM IN MORPHINE POISONING. BY WILLIAM E. PUTNAM, M.D., WHITING, IND. HAD I known the value of permanganate of potassium sooner, I might have saved the lives of two men who have died from morphine poisoning in less than two years. But thanks to the discovery of Dr. Moor, my third case was saved. Mrs. aged forty-five, took at least two ounces of laudanum. When I was called the pupils looked the size of a pin's point, the hands and feet were cold, and the nails blue. Respiration was irregular. I sent first for my bottle of one-grain tablets of permanganate of potassium. Second, for my colleague. Dr. J. R. Harvey. Our diagnosis was death in thirty minutes unless permanganate of potassium would save the woman's life. Dr. Harvey, like Dr. C. Monroe McGuire, had no faith in permanganate of potassium, simply because he had never fitted the drug to the right case. We dissolved fifteen one-grain tablets in four ounces of water and two ounces of white wine vinegar, but we could not get the patient to swallow. I picked up a piece of rubber hose and cut off four inches, and with this over a piece of pine stick I made a gag and inserted it between the jaws. I then held the nose tightly and Dr. Harvey fed the woman the permanganate of potassium solution with a tablespoon. We gave forty-five grains or more, and slowly our patient began to recover. She was very low for about four days, her mouth and throat, and I suppose stomach, were thoroughly blackened and dry and sore from the permanganate of potassium. |