The Brain

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Abstract

Lean tenometer. The irides were violently inflamed; the anterior chambers were full of floating cells and a fibrinous exudate. A deep keratitis began at one side of the right cornea and had gradually extended into part of the pupillary area. The vision in both eyes was limited to the perception of hand movements at a distance of a few feet. The general physical examination, the urine and blood Wassermann were negative. The blood count was not remarkable. The youth of the patient, the presence of the recent violent inflammatory reaction in the immediate neighborhood of the eyes, and close contact with an extensive case of impetigo in the same family, made me very hesitant to undertake any operative procedure. One dose of suprarenin bitartrate was administered to both eyes. This resulted in the elevation of the intraocular tension in both eyes and a fairly wide dilatation of both pupils, and in greatly increasing the discomfort and apprehension of the patient. The day after the administration of the suprarenin bitartrate, Doctor Josephson's reprint arrived. I found that the substance was available under the name of Eschatin (Parke, Davis & Company); and after a consultation with Dr. Chauncey Leake, professor of pharmacology at the University of California, and Dr. Garnet Cheney, who had used the substance extensively in the treatment of Addison's disease, I decided to use it intravenously. One cubic centimeter was administered intravenously on August 28, 1935. Immediately before administration the tension was 60 in the right eye and 55 in the left by the McLean tenometer. Before the needle was withdrawn from the vein, the patient sat up and remarked that she saw better. I ascribed this to the Italian temperament; but in thirty-five minutes I again took the tension with the tenometer and could hardly believe my eyes when both eyes registered 45, McLean. The substance has been administered intravenously in doses of 1 cubic centimeter daily since, each time with a marked drop in the tension and a corresponding improvement in vision. As soon as it was considered safe, her hypertrophied, infected tonsils were removed, and she has since shown slow but steady improvement. The cortin has tided her over the acute stage and saved her eyes from surgical operation, which at best is not very satisfactory in this type of case. This experience leads me to believe that cortin has a very definite place in the treatment of glaucoma. It is, of course, probable that the more frequent administration would be advantageous. It would be interesting to investigate the possibility that the occasional beneficial effect of epinephrin in glaucoma may be due to an admixture of cortin, and to determine if instillation in the conjunctival sac is effective. 490 Post Street. GEORGE N. HoSFORD, San Francisco. NARCOSIS AND OXIDATIVE MECHANISMS OF THE BRAIN