alimentary tract would, in cases of this kind, have a very very powerful separating capacity. The paper is an extremely suggestive one and the practice will receive wide attention. Dr. L. C. Ager, of Brooklyn, said: I would like to ask the Doctor regarding the action of atropine, not as an emetic, but simply to stimulate respiration. The other question I would like to ask is whether the poison has been worked out, as to when the absorption ceased and when the secretions began, or whether the two processes go on at the same time. I Dr. Ely replied: These questions are a little difficult to answer. I will speak with regard to Dr. Carmalt's question at least. My impression is that the reason why · atropine allays the vomiting when ether is given is probably because it depresses respiration and in consequence the reflex vomiting resultant from ether narcosis. cited vomiting as an almost constant symptom in opium poisoning in dogs, but not in men. I had something in my paper in regard to the value of strychnine in those cases as increasing the secretions as well as stimulating the nervous system as a whole. I might add there were some other things I hoped to say. One is this, I would like to impress upon you all the great desirability of conserving the strength of the patient. I believe that almost every one of the cases of morphine poisoning occurring in persons of good constitution can be cured, unless prevented by diseased kidneys, if the strength of the patient can only be conserved. I would inveigh against the old system of walking the patients up and down quite as strongly as I would against the ill-judged use of atropine in morphine poisoning. . BIBLIOGRAPHY. 1. Frenkel, Sophie - Klinische Untersuchungen über die Wirkung von Coffein, Morphin, Atropin, Secale cornutum und Digitalis angestellt mittelst des v. Basch'schen Sphygmonianometer. Deut. Archiv. für klinische Medicin, XLVI, 1890, 542. 2. Kauzmann. Beiträge für den gerichtlich-chemischen Nachweis des Morphins und Narkotins in thierischen Flüssigkeiten und Geweben. Inaug. -Dissert. Dorpat, 1868. 3. Vogt, E.-Ueber das Auftreten von Morphin im Harne und den Faeces enthaltender Morphiumconsumenten. Archiv der Pharmacie, II. Jahrgang, IV. Band, 1875, 23. 4. Jacques. Essai sur la localisation des alkaloides dans la foie. Thèse-Bruxelles, 1880. 5. Landsberg, E. Untersuchungen über das Schicksal des Morphins im lebenden Organismus. Archiv f. d. gesammte Physiologie, XXIII, 1880, 413. 6. Eliassow. Beiträge zur Lehre von dem Schicksal des Morphins im lebenden Organismus. Inaug. -Dissert, Königsberg, 1882. Burkart. Weitere Mittheilungen über chronische Morphinvergiftung. Bonn, 1882. 7. 8. Marme. Untersuchungen zur acuten und chronischen Morphiumvergiftung. Deutsche med. Wochenschrift, 1883, No. 14, 197. 9. Leineweber, K. Ueber die Elimination subcutan applicirter Arzneimittel durch die Magenschleimhaut. Inaug. -Dissert, Göttingen, 1883. 10. Alt, K. Untersuchungen über die Ausscheidung des subcutan injicirten Morphium durch den Magen. Berliner klin. Wochenschr, XXVI, 1889, No. 25, 560. 11. Tauber, E. Ueber das Schicksal des Morphins im thierischen Organismus. Archiv f. exper. Path. u. Pharmacol., XXVII, 1890, 336. 12. Faust, E. S. Ueber die Ursachen der Gewöhnung an Morphin. Archiv f. exper. Path. u. Pharm., XLIV, 1900, 217. 13. Riegel. Ueber den Einfluss des Morphiums auf die Magensaftsecretion. Zeitschrift f. klin. Medicin. XL, 1900, 347. 14. Rosenthal, J. Ueber die Ausscheidung subkutan injicirten Morphiums durch den Speichel. Centralblatt für klin. Medicin. 1893, No. 1, 8. 15. Donath. Das Schicksal des Morphins im Organismus. Archiv f. d. gesammte Physiologie, XXXVIII, 1886, 528. Compare also Faust, loc. cit., 225-226. 16. Cheatham, W. T. Interesting Cases of Opium Poisoning, North Carolina Medical Journal, XVIII, 1886, 21. (Case VI). 17. Bashford, E. P. Untersuchungen über das Bestehen eines gegenseitigen Antagonismus zwischen Atropin und Morphin. Archives internationales de Pharmacodynamie et de Therapie, VIII, 1901, 311. 18. 19. Moor, W. Permanganate of Potassium as an Antidote for Mor- Moor, W. The New Antidote for Opium Poisoning. British 20. Luff, A. P. Permanganate of Potassium as an Antidote for Opium and Morphine Poisoning. British Medical Journal, A DISCUSSION OF THE ETIOLOGY AND MODERN TREATMENT OF ECLAMPSIA. OTTO G. RAMSAY, M.D., NEW HAVEN. In selecting the subject of Eclampsia for my paper to-day, I do not hope to bring before you anything very new or startling, but I felt that some subject with which we are all more or less familiar, and one that is likely to bring about discussion, would be most agreeable to you. My idea is to discuss briefly the supposed etiology of eclampsia, and with this as a starting point, take up the various methods of treatment. I was interested, while looking up the subject to note the conception of the disease as held by some of the earlier physicians, and with your permission, I will preface my paper with a few extracts from their writings. Save for the fact that Hippocrates mentions the liability of pregnant women to convulsions, we find no notice taken of the condition until about the latter part of the sixteenth century, when Rosengarten writing of pregnancy spoke of "pregnant women accumulating in their bodies large amounts of a noxious material, which when it flows to the stomach makes it weak and powerless, so that the appetite is lost. Then the fumes and vapors from the material rise to the head, and cause vertigo, specks before the eyes, and other bad symptoms which finally injure the brain." Peu in 1694 wrote of general convulsions occurring in pregnancy and differentiated between epileptic and hysterical spasms, describing also a species of convulsion due to anemia. Stissern writing in 1712 divided the attacks into those of epilepsy, catalepsy, and analepsy, and said in refer ence to convulsive attacks during pregnancy, which he did not differentiate from true epilepsy, that there are some persons of purely melancholic complexion who have paroxysms during the waning of the moon, or they are lymphatic, and have them during the time of the new moon, or finally there are those of passionate disposition who are not safe at any time. Somewhat later Gaub evidently conceived a difference between eclampsia and epilepsy, as he wrote of the first as transient, while the second were enduring. Gehlen in 1777 first really differentiated the disease using the name of parturient eclampsia to describe it. Even this did not serve either to finally fix the name nor the conception of the condition, as we find Kilian in 1814 writing of cases of labor accompanied by epileptic convulsions, and even as late as 1844 Naegele writes of the peculiar convulsions of pregnant women: naming them puerperal convulsions, though the term eclampsia had been in general use for quite a number of years. This brief review merely serves to show how slowly a definite conception of the disease was arrived at, and it was of interest to me, to see how comparatively a short time it has been recognized. As the disease became better and better recognized as a definite clinical condition, its causation naturally excited much interest and discussion, and Zwiefel describes it aptly as the "disease of theories." Among the strongly supported theories, as to the etio logy of the disease we find the claim of Frerichs and his followers, that eclampsia was uremic in origin and like the uremia of Bright's disease, and for many years after his work appeared the uremic origin was accepted as the true one. Even to the present time uremia is always noticed in discussing eclampsia, though it is now mentioned chiefly, that it may be refuted, and when we consider the clinical course of eclampsia, its sudden onset in many cases, the rapid recovery after delivery, and es |