WHATLEY W. BATTEY.

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and he was given a neatly-fitting truss, the druggist making a diagnosis of hernia. This truss was worn constantly for two years. On November 19, 1907, while at work lifting lumber, in an attempt to stoop, the patient had sharp pain in right side of scrotum, which became more intense, and he was sent home, being unable to resume his duties. I saw him the following day. Upon examination of scrotum noted the following condition: Right scrotum very much enlarged and ecchymotic, owing to extravasated blood. There was swelling in the inguinal region just to the outside of external ring, which was painful upon pressure, resembling hernial protrusion. With the tumor in inguinal region, and enlargement of scrotum, and the history of patient having worn a truss, I at once concluded that the case was one of incarcerated hernia, and probably strangulated. The general condition of patient was good. Bowels had not been moved since the day before, but abdomen was soft and not painful. There was no nausea or vomiting. I advised an operation, which advice was accepted. Under ether narcosis, made an incision over tumor in inguinal region down to sac. Upon opening sac expecting to liberate intestine or omentum, I was surprised to find accumulated serosanguinous fluid and blood clots, the sac communicating with scrotum and not with peritoneal cavity. Upon further exploration found rupture of a varicose vein of cord, the hemorrhage from same having been arrested by pressure within sac. Cavity of tunica vaginalis was thoroughly cleansed out and same closed by suture above and Volkman operation done on scrotum. Serosanguinous fluid drained away for ten days, when incision finally healed, despite efforts to keep it open. Patient left hospital with slight swelling of tunica vaginalis testis with the direction to return and

have scrotum operated upon later, for hydrocele under cocaine anesthesia, using aspiration method.

This case proves beyond a doubt that we can add to the list of causes of hematocele, rupture of a varicocele and that rupture is more likely to occur in the presence of a hydrocele where the effect of traumatism, owing to pressure from hydrocele, would be greater; that the application of trusses by druggists to patients who do not suffer with hernia should meet with our condemnation.

EXCLUSIVE MILK DIET FOR TWELVE YEARS.

BY W. W. TERRELL, M.D., DOUGLAS.

To me the novelty of this case presents one of its most interesting features.

Here is a boy, twelve years of age, whose diet has been sweet milk from infancy.

I will give the clinical history of the case, and let you decide for yourselves upon the diagnosis.

John T. was born February 16, 1896, a healthy and normal child. He was nursed from infancy from a bottle.

At the age of one year he was attacked by epidemic la grippe, as were the other six members of the family. After suffering with la grippe two weeks, otitis media, set up in both ears, finally destroying his hearing; hence he has never been able to talk. Upon convalescence from la grippe he was attacked with cholera infantum, followed by diarrhea for seven months. During this time he had two separate and distinct attacks of jaundice. Upon recovery from the diarrhea he was attacked by successive crops of boils for some two or three months. Upon recovery from them, he was the most emaciated child I have ever seen. It was at this time the abnormal condition of the child was first noticed in regard to eating. The family began to try and give him some more solid food than sweet milk; to their dismay, he would not eat anything. For months they endeavored to feed him without success. He absolutely

refused to swallow any food except the sweet milk, with small quantities of sugar added.

At the age of four years he voluntarily began to eat small quantities of table salt, once or twice weekly. This diet of sweet milk and salt he continued to subsist upon until ten years of age, when he added clay to his diet and ate small quantities daily. Sweet milk, salt and clay has been his diet up to this time.

I will state here that the child's throat and esophagus are both normal, and there is no mechanical trouble existing in either.

His mind is bright for one to be void of hearing and speech.

He has associated all of his life with other children whom he could see eating candy, fruit, etc., but never intimates any desire to eat anything of the kind. Nor can he be hired or persuaded to eat anything except milk, salt or clay. He drinks from three pints to half a gallon of sweet milk daily generally taking it at five different times during the day-never any at night. He will occasionally quit his milk from twelve to twenty-four hours. He now presents the appearance of a child seven or eight years of age poorly nourished, but active. This presents the clinical history of the case.

The question with me is: Did la grippe destroy his taste, or can there be something abnormal with the secretions of the stomach? and how long can he probably live upon an exclusive milk diet?

THE PRESENTATION OF A NEW EYE

DRESSING.

BY J. LAWTON HIERS, M.D., SAVANNAH.

In practically every operation upon the eyeball or lids, we are obliged to use some form of covering or dressing. The same is also true in almost every form of injury to the eye and its appendages; therefore in the selection of a dressing for the eye, we should endeavor to choose one that will afford the greatest amount of safety and comfort to the patient, and that can at all times be held in position without fear of its slipping or producing an increased pressure upon the eyeball. Especially is this desired where the eye has been operated upon for a glaucomatous condition; or where the globe has been opened either by an operation or an injury.

For many years I have avoided the use of the roller bandage-so familiar to us all; and have attempted to confine my eye dressing to some form of gauze pad, held in position by narrow adhesive strips.

Many advantages may be claimed for this form of dressing. The pad may be applied and removed with the greatest amount of ease, both to patient and attendant, and if the patient be in bed and permitted to turn from side to side, we need have no fear of the dressing getting out of position or producing an increased pressure upon the eye. On the other hand, if the patient is permitted to be up and around, this form of dressing is far less conspicuous, and, at the same time, does not interfere with