Hemorrhages in the crura are rare while pontine hemorrhages are fairly common. Spontaneous hemorrhages in the frontal lobes are exceedingly rare and it behooves us to watch and note all symptoms connected with injuries and lesions involving the frontal lobes and especially the left. At one time it was thought and taught that the frontal lobe was the negative area of the brain, but we are now learning more and more that the left frontal lobe is a very important area. Hemorrhages in the substance of the cord are fairly common and are always serious and a favorite seat of spontaneous hemorrhages is in the cervical portion. J. C., age 62, in perfect health, while gathering fruit and without injury of any kind and without pain (for pain is quite an important element in differentiating extra from intracord hemorrhages) sank down and in a few minutes everything was paralyzed from the arms down. Perfect consciousness and no cerebral symptoms whatever. Lived for eight or ten days. P. W., age 54, alcoholic, good health, no demonstrable disease, while painting standing on the ground sank down and lost in a few minutes all motion from arms down. Perfect consciousness. No cerebral symptoms or pain at any time. In the course of some weeks sensation began to appear, and a little motion which gradually increased till almost perfect recovery, the arms remaining weak and unsteady.

B. L., age .68, perfect health, no visceral disease, while standing on the ground sawing a small limb, a very small piece fell, striking him on or about the middle of left frontal bone. There was no break or bruise of skin. No pain. Patient sank immediately to the ground, and in a few minutes everything paralyzed from neck down. No cerebral symptoms. Perfect consciousness. No fracture. Patient lived for sixteen days.

If you will pardon me I will relate a few illustrative cases of brain hemorrhages. C. J., age 52. Very fleshy and had had an albuminuria for some months. No other evidence of nephritic change. Cardio-vascular apparatus normal. No change in the back ground of eyes. While going up a short flight of steps had a sudden pain in the head; became a little dazed and was assisted home. I was called in consultation and made the

diagnosis of hemorrhage in internal capsule from conditions that existed. Patient lived 18 hours. No autopsy.

A. J., age 45. An alcoholic and tuberculous subject; was seized with pain and fulness in the head. Confusion of thought and a gradual increasing unconsciousness. I was called in con

sultation and from conditions present made diagnosis of internal capsular hemorrhage. Patient lived ten days and post mortem revealed a moderate size hemorrhage in capsule (internal) with an unusual degree of softening in adjacent areas.

T. C., woman, age 63. ease; eye ground normal.

Perfect health; no demonstrable disWas seized with nausea and vomiting and a dazed condition for a few minutes that soon passed away, and she was very comfortable. There was absent all motor sensory and speck symptoms. The pulse, however, was as hard and as full and rolling as is possible for one to be, and in the absence of other physical conditions pointing to a hemorrhage and with this pulse, I made the positive diagnosis of a hemorrhage somewhere in the brain mass and that it was not in the internal capsule. I left the patient in the condition described above and in about forty-five minutes she had a repetition of her first symptoms, with a more pronounced mental confusion that gradually increased till she became totally unconscious with a paralysis of both sides from the face down. Pupils dilated and irresponsive. I saw her again and made the diagnosis of a hemorrhage at the base of the brain outside of nerve tissue. The patient lived only a few hours and the post mortem revealed a rupture of one of the antero-lateral ganglionic branches, the blood from which traveled up the course of the fissure of Sylvius, also filling over the structures at the base of the brain from the middle of the Pons to the middle of the anterior fissure, and crossing over the base of the brain to the opposite side and traveling up and completely filling up the opposite Sylvian fissure. At no point was there a hemorrhage in the brain tissue.

R. W., age 49, perfect health, no visceral disease. While sitting and pleasantly chatting with his family he became suddenly confused; no pain; no nausea or vomiting. In the course of two days his mind became more confused, and while he would

make an effort to obey instructions, yet he would fail after making efforts to do what was asked or told. When I was called as consultant from the irregularity of symptoms, I was unable to locate the position of the hemorrhage when I made the diagnosis. During the first few days there was no pupilary change. He could move both hands and arms, but there was quite an irregular control of the lower limbs when they were moved from one position to another to test muscular tonicity. The pupils now became irregular. The left contracted. The right much dilated and fixed with the eye turned out. I then gave the opinion that a mild meningitis local and at the base had set up. The background of the eyes normal. The post mortem revealed a normal state of the cerebrum, but a large hemorrhage occupied the center and entire substance of the right cerebellar hemisphere.

The piamater in a portion of the base on the right side of median line was opaque with a small amount of floculent material. Cerebellar hemorrhages are not very common.

W. A., age 59, alcoholic, no visceral disease. While slowly walking along street with a friend' had a slight pain in the head and became just a little confused, which got better. No muscular disturbance and he walked one quarter of a mile after that to his home, but soon after he became rapidly profoundly unconscious, and when I saw him in consultation could tell nothing except that he had had a hemorrhage. The post mortem revealed a large hemorrhage not in the substance of the Pons, but upper surface and lower border and the hemorrhage extending into the fourth ventricle. The patient only lived a few hours. In studying the brain and blood supply in hundreds of post mortems, I have been wonderfully impressed with the early appearance of sclerosis in the larger vessels of the brain, and the smaller ones remaining normal, and these conditions often so when arteries in other parts of the body show no change. Much good has come and is still coming from that effort on the part of clinicians to locate accurately the seat of hemorrhage and not be content with the bold diagnosis of just a hemorrhage, and of course I cannot lay too much stress upon post mortem work in Neurology, because it is through a comparison of observation

and findings that some wonderful truths have been discovered. We have a condition or state in which patients often become dazed or possibly momentarily unconscious. Nausea and vomiting, with a disturbance of circulation, diagnosed as acute indigestion or a manifestation of lithaemia so-called, and in a few days patient well. After learning how frequent hemorrhages are and how variable their location and what a disturbance quite a small and apparently insignificant looking hemorrhage will produce, and seeing cases so diagnosed as indigestion or attacks of so-called lithaemia, and afterwards seeing some of those cases, days after presenting a progressive pathology, I cannot help but believe that small hemorrhages in nerve tissue are more frequent than we want to admit. I would not have you believe that we do not have cases of indigestion and storm explosion of the kind spoken about, but I am speaking of the comparative frequency and the great importance of considering the presence of minute hemorrhages in the brain mass.

TREATMENT OF ECZEMA AND KINDRED DISEASES.

BY H. M. MARSH, M. D., OF AUBURN, KY.

SUFFERERS from skin diseases constitute a class of cases which under ordinary methods of treatment are equally as trying to the physician as to the patient. This is especially true of chronic conditions which show but little if any progress under the old forms of treatment. If the disease appears on an exposed part of the body these patients are exceedingly sensitive about their condition, and appreciate to the highest degree speedy recovery more than any other class of patients. Recently I have had some wonderful success in the treatment of these cases and I attribute it in good part to the use of Resinol. I have been using this remedy in the majority of my cases of diseases of the skin of late years, and have had almost universal success with them. I find it to be a remedy of unusual value in eczema, both acute and chronic, and in all kindred skin diseases. It has greater healing properties than any preparation I have ever used. It relieves the almost un

bearable itching almost instantly, and when freely used without friction and kept constantly in contact with the diseased surface, even chronic cases will respond in a comparatively brief time. It possesses unusual' power in preventing the development of bacteria, and the decomposition of animal and vegetable matter, as well as destroying the germs found in the skin. In pruritus ani and vulvae it comes very near being a specific, in fact, I have never seen it fail to relieve any and every case attended with much itching, no matter what the disease may be called. For burns, scalds, or any inflammatory condition of the skin, I find it invaluable. In addition to this local treatment in skin diseases, I usually instruct the patient very carefully in regard to his diet, and general care of his body.

The elimination of effete matter by the bowels and kidneys must be given careful attention, since the excretion by the skin is always more or less interfered with, throwing extra duty on these organs. To stimulate the kidneys, I generally resort to small doses of potassium citrate in the drinking water, daily, and when necessary I give a dose of sodium phosphate to correct any inactivity of the bowels. I find nothing better than this drug for this condition.

In anemic, poorly nourished patients, I always give some good preparation of cod liver oil. Hagee's Cordial of Cod Liver Oil is one of the best and I invariably use it. The remedies given are always selected for each individual case. In most cases of chronic eczema with dry scaly skin I get good results from arsenic, and especially the sulphide or iodide. Tr. echinacea has served me well in some cases of late years. I have in mind the first patient I cured with Resinol. The patient was an old lady, seventy-nine or eighty years of age. She had been a sufferer for years with eczema, only on her hands and wrists. She told me she had suffered with it ever since she was a young girl. It was of the recurrent type, coming and going. Annually, for several weeks at a time, she suffered acutely, most intensely. At the time she came to me, she was suffering with one of these acute attacks. Her hands were very much inflamed,

dry and scaly, and cracked open almost to the bone in places, as