246 DISCUSSION. 



suffering from malaria because it has no taste and hence is easier to 

 administer. 



I encountered a number of cases of malaria in the year 1889, after 

 the great rainfall which we had in Hongkong. You probably have all 

 heard of this downpour during which 30 inches (900 millimeters) fell 

 in twenty-eight hours. As a natural result much malaria developed at 

 that time, and at least 12 malignant cases came to the Government Civil 

 Hospital. 



Dr. J. M. Phalen, captain, Medical Corps, United States Army, mem- 

 ber of United States Army Board for the Study of Tropical Diseases as 

 they Occur in the Philippine Islands. — While recognizing the necessity 

 of large doses of quinine in exceptional cases, I wish to call attention 

 to a danger which is present in administering such large amounts. It 

 not infrequently happens that impaired vision supervenes, dating from 

 the time of the administration of quinine in doses which are not to be 

 regarded as excessive. I am not referring now to the quinine amaurosis 

 coming on suddenly and causing more or less temporary blindness, but 

 to a gradual diminution of visual acuity apparently due to the action of 

 quinine on the optic nerve. I am strongly of the opinion that quinine 

 should be given in the minimum dosage that will control the disease. 



Doctor Atkinson. — In reply to Doctor Phalen's statement concerning 

 the occurrence of amaurosis after the giving of quinine, all I can say is 

 that in my experience of practically hundreds of cases in which the 

 drug has been given, I have never seen this result. 



DISCUSSION ON THE PAPER, "SOME CLINICAL ASPECTS 



OF MYCETOMA, AN UNUSUAL FORM OF CALLOSITY 



COMPLICATING IT," BY MAJOR HOOTON. 



Dr. J. M. Atkinson. — During my stay in Hongkong I have seen three 

 cases of mycetoma, or Madura foot — one in a Chinaman, the other two 

 in Indians. The fact that we occasionally see these diseases in Hongkong 

 is due to the cosmopolitan nature of the population of that port. 



I would like to ask Major Hooton what treatment he adopted in case 

 number 2, and if scraping will cure the disease? 



In Hongkong the Chinese frequently suffer from a carinous affection 

 called "by-head." In this affection all the bones of the face and head 

 become enormously enlarged. It has occurred to me that this may be 

 due eithe/ to my tcr actinomycosis. 



Doctor Musgrai -I enjoyed hearing . Major Hooton's paper. The 

 subject of mycet' a is a very large one and I think that we will 



