warm hip-bath was a favorite and usually an efficient palliative remedy. He experienced marked but not complete relief from the combined influence of the bath and the opiate. The pain still recurred in paroxysms, but with diminished frequency and intensity. At length, more than an hour after the administration of the second dose, he was quieted so far as to consent to lie down; the intervals between the still occasionally recurring paroxysms were much longer, and the paroxysms bearable. The patient stating his confident expectation of being able to enjoy sleep, courteously relieved me from further attendance. Accordingly I left him, but directed the hotel-servant to remain in the room the remnant of the night, it being then near 3 o'clock A. M. Between 7 and 8 o'clock he came to inform me that Mr. F. had fallen asleep almost immediately after my departure; that he was sleeping quietly when he (the servant) left the room early in the morning, and that when he went back to get his orders for breakfast he could not awake him.

Proceeding in haste to the room, I found him in a state of profound coma without noisy stertor. While I was making my first observations there were exhibited slight convulsive movements, limited to one side of the face and the corresponding arm. The pupils were slightly dilated, skin warm, pulse 96-98, and of good volume, the respiration easy, 16-18, (subsequently it fell to 12.) My first impression was that the patient's condition was the result of an extraordinary susceptibility to the toxic effects of opium, an opinion which was subsequently, for a time, discarded by myself, but was maintained without doubt or hesitation by two experienced medical gentlemen, Dr. M. H. Houston, who at a late hour of the morning saw the case in consultation and watched with me for several consecutive hours until signs of returning consciousness were manifested, and Dr. O. A. Crenshaw, Mr. F.'s family physician, who did not see him until the following day, but who was cognizant of his intolerance of opi ates. If this was indeed the true explanation of Mr. F.'s condition, there were other remarkable peculiarties in the case besides the extraordinary susceptibility to the poisonous effects

of opium during the existence of severe pain, which usually creates a tolerance of much larger doses than the aggregate amount taken in this case. Thus I may cite the non-contraction, and even a marked dilatation of the pupil, persistent heat of the surface, quickness and fullness of the puise, and the trifling diminution of the frequency of the respiration. Such phenomena I have never witnessed in any case of opium poisoning where the coma was decided. May they be explained consistently with the hypothesis of opium poisoning by attributing them to the action of the belladonna antagonizing the opiate quoad these particular effects? This is conceivable. Apoplexy was held to be excluded by the absence of the low guttural stertor characteristic of that condition, and yet more decidedly, as the day wore on, by the protracted duration of the symptoms without further change for better or worse. Suppression of urine was also considered, and as there was nothing in the character of the rational symptoms to forbid this supposition I proceeded to test its truth by exploring the bladder. The test did not prove conclusive either way. This organ had been emptied in my presence as late as 2 o'clock in the morning, or perhaps a little later. When the catheter was introduced, at or about 9 o'clock, the quantity of urine was found to be a little less than two ounces. not examined chemically. It has been stated that the urine passed on the previous day was of low specific gravity, notwithstanding the presence of a notable amount of pus. As, however, the whole amount passed in a day had not been collected, and no quantitative estimate of the urea excreted in any given time was made, it cannot be asserted with positiveness that there was an absolute deficiency of this constituent. Yet this seems rather probable than otherwise. It was, I thought at the time, not unlikely that I had to deal with a case of partial suppression of the urinary excretion, in which the tendency to coma had been augmented by the concurrent effect of the opiate, which might otherwise have been harmless or even beneficial. It was, indeed, an obvious objection to this view that the coma

This was

supervened far more suddenly than is usual in cases of uræmic poisoning, but this rule is not absolute. Thus Da Costa, (Medical Diagnosis, 2d Edtion, 1866,) after stating the rule, adds in a foot-note "that there may, however, be exceptions to this rule, as in a curious case reported by Moore, in the London Medical Gazette, 1845, in which a person became comatose after taking laudanum, yet his death was found to have been caused by contracted kidneys." Happily the parallel was not carried out in Mr. F.'s case, and this circumstance may be considered as sufficient to exclude the apparent analogy. The subsequent and prompt recovery of my patient may be urged as an almost convincing proof that there could not have existed any uræmic poisoning. But there is high authority for doubting the conclusiveness of such reasoning. Dr. Austin Flint, Sr., in a paper "On the Prognosis of Bright's Disease," published in the New York Medical Journal for July, 1869, states that he could cite abundant illustrations from his own clinical experience of the fact that uræmic convulsions and coma often occur suddenly, and may be removed by therapeutical interference, and adds that even when they depend upon a well-marked renal disease, the removal of the prominent symptoms is sometimes followed by complete recovery of the renal affection.

Under the influence of such views I administered a saline hydragogue cathartic by the rectum, applied the ascetic cantharidal vesicant to the calves of both legs, and had the patient wrapped in warm blankets, a good fire being maintained in the room. The enema was retained for five or six hours, Dr. Houston having meanwhile arrived. The progress of the case was watched by us with great anxiety, but with more hopefulness by him than by myself. When the afternoon was far advanced there were manifested some indications of sensibility in very slight movements of the legs concurrently with the first appearance of redness and vesication on the surface to which the cantharidal solution had been applied. A little later the patient's face and body became covered with a profuse warm perspiration, and this was soon followed by an involuntary watery stool, and

not long thereafter, towards nightfall, Mr. F. opened his eyes and uttered an indistinct but audible sound when called by name. During the ensuing night he had numerous liquid stools, recovered complete consciousness, and slept at intervals quietly and refreshingly. The vesical symptoms did not recur in any degree of severity. The patient remained in bed more than a week, and took bromide of potassium in 10-grain doses three or four times a day.

ART. II.-A SLIGHT CONTRIBUTION TO THE KNOWLEDGE OF THE PHYSIOLOGICAL ACTION OF THE HYDRATE OF CHLORAL, CHLOROFORM, AND MORPHIA, AS EXHIBITED IN SOME EXPERIMENTS UPON DOGS AND CATS. [Read before the Boyle County Medical Society November 22, 1870.] By JOHN D. JACKSON, M. D., of Danville, Ky.

May 3, 1870, Experiment 1-9:10 A. M.-A male cat, white and black-spotted, weight five pounds; temperature by thermometer in anus, 103 F. Injected hypodermically behind left fore-shoulder hydrate of chloral (Liebreich's manufacture) Dj. dissolved in aq. fluv., m. XXX. 9:20, temperature 102. 9:45, injected additional gr. xv. hydrate chloral in aq., m. xxv.; great excitement immediately followed, struggling violently, tongue protruding, bowels evacuated, pupils dilated. Within a couple of minutes the excitement ceased. 10, temperature 100; 10:10, temperature 991; 10:20, temperature 971; 10:30, temperature 96; 10:40, temperature 95; 10:50; temperature 94. 11:15 I removed one of the testes, loss of blood only amounting to two or three drops. Though perfectly relaxed during the operation, yet he showed that sensibility remained by growling, though he did not struggle in the least or lash his tail (as the feline race do when in pain or anger).

12, pupils contracted almost to a line, temperature 93. 12:30, pupils widely dilated, membrana nictitans off of ball; tempera

ture 92. 1 P. M., pupils suddenly contracted, membrana nictitans on ball, temperature 91. 2:30, pupils still contracted, temperature 89; 3, temperature 881; 4, temperature 87; 5, temperature 861; 6, temperature 86; 7, temperature 85; 7:30 died, temperature 83.

From 1 until 4 o'clock the intestines of the animal kept up a continuous vermicular motion, so that their "growling," as it is called, attracted especial attention to them. I frequently put my hand on the abdomen, examining them, and their twisting vermicular action was most markedly perceptible. During the time of the continued vermicular motion within (just after 1 o'clock) I removed the remaining testis without the animal moving or exhibiting the least sign of sensibility. The variations in the dilatation of the iris during the evening was a phenomenon both striking and curious, when we consider the profound stupor and general anesthesia at the time existing.

Post mortem 6 A. M. on the morning following. Brain natural, lungs greatly congested, heart (right side) loaded, bladder filled with urine, bowels natural.

May 4, Experiment 2-2:15 P. M.-A large barrow (emasculated) cat, weight 61 Ibs, meagre and of unhealthy aspect; temperature 103. Injected hypodermically hydrate chloral, (Liebreich's) gr. xxv. aq. m. xl., making two injections, one just above the fore leg, the other just above the hind leg. On finishing the injection he was immediately turned loose and allowed to roam about the room. 3, has been much excited, walking around the room, but is now unable to walk. 3:30, lies upon his side, tries to get up, but cannot, breathing irregular and agitated, growls in low tone; temperature 98. 4:30, pupils dilated, tongue out, tries to crawl, temperature 951. 5:30, respiration 14; temperature 94. 6:30, respiration 20; temperature 91. 8, respiration 22; temperature 87. 9, respiration 22; temperature 88. 11, respiration 16; temperature 88.

May 5, 6 A. M., respiration 10; temperature 79. 7:30, respiration 8; temperature 79. Evidently on the verge of expiring. 7:40, injected hypodermically strychniæ sulph. in aq. m. x.