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alleged to occur from cannibalism appear to have fol- lowed in this case, as, despite their prolonged sufierings, the men seem now to have recovered a large measure of health. Much sympathy is expressed for them in their present position. Hospital Saturday has realized more than was at first thought, and the total will be more than last year. The workshop contribution is still very small. The council of the Health bactrim bactrim Exhibition have handed mrsa bactrim _;:£^4,ooo to the Lord Mayor for distribution among the London bactrim and hospitals. Mr. Netten Radcliffe has just died after a long illness. He was well known as a sanitary worker, and was for some time assistant medical officer to the local govern- ment board. Menthol Pencils. — These pencils or cones, whose therapeutic value is very limited at best, have become so popular that great adulterations or substitutions are now practised. The ordinary oil of peppermint is probably substituted for the menthol, in large part at least. October ii, 1884.] THE MEDICAL RECORD. 417 THK OPHTHA.LMOLOGICAL CONGRESS IN HEIDELBERG. (From our Special Correspondenl.) MURIATE OF COCAINE AS A LOCAL AN.flSTHETIC TO THE CORNEA NO RADIATING MUSCULAR FIDRES IN THE IRIS — ACTUAL CAUTERY IN SUPERFICIAL CORNEAL UL- CERATIONS OPTICO-CILIARY NEURECTOMY — IS CATA- RACr THE RESULT OF CHRONIC BRIGHT'S DISEASE ? — PROFESSOR ARLT AND HIS RECENT WORK IN GLAU- COMA. K.KHLZNACH, Germany, September 19, 1SS4. Sir : The usual Ophthalinological Congress in Heidelberg has just closed its session, and a few cursory notes at this early date may interest some readers. At this meet- ing elaborate papers are not read, but condensed state- ments are presented of the subjects introduced. The notable feature of this Society is that only new things or new phases of old topics are presented. This is not from any expressed rule, but is from the tacit under- standing which controls men who are so diligently inves- tigating the unknown in science as are these eager workers. These men have no patience with mere reiter- ations. Perhaps the most notable thing which was pre- sented was the exhibition to the Congress upon one of the patients of the Heidelberg Eye Clinic, of the extra- ordinarv anaesthetic power which a two per cent, solution of muriate of cocaine has upon the cornea and conjunc- tiva when it is dropped into the eye. Two drops of the solution were dropped into the eye of the patient at the first experiment, and after an interval of ten minutes it was evident that the sensitiveness of the surface was be- low the normal, then two drops more were instilled and after waiting ten sulfa bactrim minutes longer there was entire absence of sensibility, a probe was pressed upon the cornea until its surface was indented, it antibiotic bactrim was rubbed lightly over the surface of the cornea, it was rubbed over the surface of the conjunctiva bulbi, and of the conjunctiva palpebrarum ; a speculum was introduced to separate the lids and they bactrim 400 mg were stretched apart to the uttermost ; the conjunctiva bulbi was seized by fixation forceps and the globe moved in various directions. In all this handling the patient de- clared ihat he felt no unpleasant sensation, except that the speculum stretched the lids so widely asunder as to give a little discomfort at the outer canthus. Before the experiment his eye was shown to possess the normal sensitiveness, and the other eye, which was not experi- mented on, was in this respect perfectly normal. The solution caused no irritation of any kind, nor did it at all influence the pupil. The anaesthetic influence seemed to be complete on the surface of the eye, and it lasted for about fifteen minutes and the parts then resumed their usual condition. This first experiment was done in the presence of Professor Arlt, of Professor Becker, of the clinical staff, of Dr. Ferrer of San Francisco, of some other physicians, and of the writer. The next day tlie same experiment was performed on the same patient in the presence of the Congress and with the same bactrim generic results. This application of the muriate of cocaine is a discovery by a very young piiysician, or he is perhaps not yet a physician, but is pursuing his studies in Vienna, where he also lives. His name is Dr. KoUer, and he gave to Dr. Brettauer, of Trieste, a vial of the solution, to be used m the presence of the Congress by Dr. Brettauer. Dr. KoUer had but very recently become aware of this nota- ble effect of cocaine, and had made but very few trials with it. These he had been led to make from his knowl edge of the entirely similar eft'ect which it has for some year or more been shown to have over the sensibility of the vocal cords, and because of which laryngologists pen- cil it upon their surface to facilitate examinations. The future which this discovery opens up in ophthalmic surgery and in ophthalmic medication is obvious. The momentous value of the discovery seems likely to i)rove to be in eye practice of more significance than has been the discovery of aniusthesia by chloroform and ether in general surgery and medicine, because it will have thera- peutic uses as well as surgical uses. It remains, how- ever, to investigate all the characteristics of this sub- stance, and we may cost of bactrim yet find that there is a shadow side as well as a brilliant side in the discovery. Professor Kiihne, who in the Heidelberg Physiological Laboratory worked out the details of Boll's discovery of the visual purple of the retina, received the news of this new dis- covery with the liveliest interest. We may, perhaps, get from him a further investigation into its properties. The substance makes a clear solution, and is bactrim 800 mg found in Merck's catalogue. Another notable statement came from Dr. Eversburch, of Munich, as the result of very exact and elaborate studies, to the bactrim prices effect that there are no radiating muscular fibres in the iris ; in purchase bactrim other words, that the dilator iridis has no existence in man. It is found, he says, in some animals, and especially in those which have oblong pupils, whether vertical or horizontal, and in the form of fasciculi at the extremities of the slit. He absolutely denies the existence of such fibres in the human eye, and asserts that the fibres hitherto described under this name are nerve-fibres. These revolutionar)' assertions were re- ceived with respect and attention, because the investi- gator was known to be a careful and competent anato- mist. If his declarations should be confirmed, and they will not be lightly accepted, we must find out a new theory for the active dilatation of the pupil. .\ good deal of physiology will have to be cast into a new form. It is true that the anatomical discussion has not been closed on this point, but in favor of the existence of the dilator stand the names of Merkel, Henle, and Iwanoff among re- cent investigators. Eversburch has in his possession the preparations of Iwanoff, who died a few years ago, and he knows the nature of the contest into which he en- ters. The uses of the actual cautery in superficial forms of corneal ulceration and in some other superficial pro- cesses, especially in those of micrococcic origin, were dis- cussed both here and in Copenhagen. There seems to be a general consensus as to the usefulness of this treat- ment in selected cases of superficial corneal disease, viz., in bactrim price ulcus rodens, in superficial suppurative processes, in atonic ulcers, and by Nieden in xerophthalmus. Nieden will shortly announce his views in full in an article in the Archives for Ophthalmology. He presented a most delicate and elegant form of galvano-cautery which he had devised, and to which he had applied a very delicate and promptly acting key invented by Professor Battler. Another form of cautery is in use in the Heidelberg Eye Clinic, which has been devised by Professor Becker, and is a very small and utilizablc Paquelin cautery. Both these instruments can be handled with nicety and deli- cacy, and without frightening the patient, and also in most cases without giving him any pain. This treatment, as well as the scraping of such ulcers by a sharp spoon, as does Meyer, of Paris, is founded on the micrococcic theory of the pathology of tiiese processes, and marks another forward step in ophthalmic therapeutics. Optico-ciliary neurectomy as a preventive of sympa- thetic ophthalmia has not i)assed out of practice, as to a considerable degree has become the case among us. So able an observer and logical a reasoner as Professor Schweigger, of Berlin, recommends its performance and holds it in higher esteem than enucleation. He divides the internal rectus muscle to gain easy approach to the nerve, and he lifts it from its bed by a sharp double iiook and excises lo mm. of it. He is said to be ex- tremely skilful in this proceeding, and the very small dis- turbance which he causes in the structures of the orbit may perhaps explain generic for bactrim the success which he has had and the confidence whicli he expresses in its pro])hylactic virtue. Among over a hundred cases which furnished the material for his conclusions, in two cases he saw occur in theoi)posite eye an acute neuro-retinitis, with opalescent infiltration, etc. There was no reduction of vision either central or peripheral. In two weeks the appearance 4i8 THE MEDICAL RECORD. [October ii, 1884. had entirely passed away without treatment. He regards this intlimmation as coming to pass, because neurectomy antibiotics bactrim liad been attended by unusual eflusion of blood into the sheath of the divided nerve — that this had obstructed the bactrim tablets lymph channels, and a process had thus been set up which travelled around by the chiasuia to tlie opposite eye, and there expressed itself in a lymphatic neuro- retinitis such as is well known to occur. The explanation is very plausible. bactrim 800mg Another most peculiar observation among his cases was, that in one of them the anterior part of the eye was normal, and when the nerve was excised the pupil at once expanded to an extreme degree, more widely th.in it is possible for bactrim and uti atropine to produce. He put eserine into the eye and found that by it the pu|)il at once became contracted, as is usual with this drug. To this Professor Laqueur justly re- marked that absolute proof was thus afforded that, as has been before claimed, the action of eserine is not upon the nerves of the iris, but is directly upon the muscular fibres. A beautiful experiment in physiology was bactrim cost thus made with conclusive result. A most laborious statistical paper was presented by Professor Becker to elucidate the question whether it is true, as has lately been averred by Deutschmann, that cataract is the result in many cases of chronic Bright's disease. To arrive at a trustworthy conclusion, Professor Becker summed up the results of a most exhaustive and exacting series of studies, first of patients with cataract, whether they had albuminuria ; then of persons within the limits of age when both cataract and albuminuria chronica may occur, who were not aware of any trouble of sight or of the kidneys, as to whether they might have incijiient cataract with or without kidney trouble, and these persons he found in insane asyluuis, in poor-houses, in retreats, and bactrim for mrsa among the patients in his clinic and else- where ; thirdly, he went through the records of 250,000 autopsies which had been made in Vienna of cases of Bright's disease, to see how often cataract had been noted to exist. The final sum of this vast amount of labor was treated according to the principles of the mathematics of the doctrine of probabilities, and the outcome of it all was found in the conclusion that Deutschmann was not justified in his assertions, and that cataract cannot with reasonable and just probability be declared to be an ef- fect of, although it may occur with, degeneration of the kidneys.

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