until the child has attained an age when the hearing-power can be tested with hope of success. When such a child has attained the age in which children react to external irritation of the auditory nerve, and it does not react to tones and sounds, there is evidence that the deeper structures are defective, and then the prognosis is unfavorable. However, it must be remembered that in some children the hearing-power commences at a late period. Gruber likewise recommends that the surgeon should be guarded in performing the operation at the desire of the parents, for it is very possible that it might be performed without any hope of success; and, when at a later period the indication for operation might present itself, the rules which he has laid down should be borne in mind. In regard to the acquired forms, he says usually they are the result of badly-treated inflammations, or of diseases whose effect is ulceration or cicatricial formation. Thus, Gruber once operated in a case of atresia occuring after lupus, in another after epithelial cancer. Though the occlusion may occur at any portion of the canal, the inner half is more often affected than the outer. Owing to the peculiar construction of the external canal in the new-born and in the young child, when the osseous portion of the canal is not yet fully formed, adhesions may easily take place between the already closely approximated walls of the canal; and this is also the reason why in children during the first years of life the walls grow together, a fact which has been sufficiently proved by statistics. The occlusion rarely takes place by means of the soft structures alone. As a rule, hyperostosis of the bony walls occurs during the progress of chronic inflammations, which finally occludes the whole canal. An examination then reveals the external canal closed by bony structures covered by cutis. In the two cases presented, this condition prevailed once on the right side and once on the left; while in the right ear of the younger patient the occlusion was made up of soft ciciatrical tissue. Prof. Gruber believed that the two cases were proper subjects for operation, which he intended to perform by means of galvano-cautery.-New York Med. Jour.

Proceedings of Societies.

ST. CLAIR, SANILAC, AND LAPEER COUNTY MEDICAL SOCIETY.

The quarterly meeting of the St. Clair, Sanilac, and Lapeer County Medical Society was held at Imlay City on the 23d of November, 1875, Hugh McColl, President, in the chair, a fair representation was present from Port Huron, Imlay, Lapeer and other places along the line of C. &. L. M. R. R.

After attending to preliminary matters the society entered upon the discussion of the subject referred from last meeting, viz: "post partum fevers."

Dr. Stockwell called for. Considers puerperal fever due to a septic poison, similar in its outward manifestation to that which produces erysipelas. There were many peculiar features common to both diseases, they very frequently prevail at the same time, and are amenable to the same general course of treatment. Antiseptics are always indicated, among which stand first in importance, iron and quinine, the former he prefers in the form of the mur. tincture, which he gives in 20 or 25 drop dose, repeated every four or five hours; gives this not so much for its tonic properties as for its well-known power to neutralize septic poisoning. Recommends the persistent use of large doses of quinine and enforces the most rigid hygienic measures.

Dr. McColl alluded to the three doctrines held by the profession as to its ætiology:

Ist. A septic poison generated in the decomposing tissues following parturition.

2d. An atmospheric influence prevailing in certain localities and predisposing to low forms of fever.

3d. A specific poison communicable from patient to patient, or from the attendant to the puerperal patient.

He thinks its pathology is not very satisfactorily settled; inclined to the belief that it is a specific disease dependent upon a

poison entirely distinct from erysipelas, scarlatina, or the low grades of fever. Whatever be its cause, the poison finds ready access through the laceration consequent upon labor, as well as through the abraded surface after the separation of the pla

centa.

He places quinine in the foremost rank as an antipyretic remedy, has great confidence in it also as an antiseptic administered in large doses, say from 15 to 20 grains. In early stages uses veratrum to lower the heart, also uses turpentine as an antiseptic.

Dr. Jones inclines to the belief that this fever is dependant upon the presence of a zymotic poison, identical in its character with that producing erysipelas. This fever belonging to the low types can only be successfully treated by commencing in its early stages with a general supportive plan of treatment; remedies are fruitless after the coffee ground vomit sets in.

Dr. Greenshields gave a brief account of an unexpected and quite sudden death occurring recently in his practice. He had the patient under treatment for uterine hæmorrhage which had been very profuse for several days, but which finally ceased under the use of ergot. He then removed a large putrid mass with the forceps, five days later, when he thought his patient out of danger. He was surprised to hear of her sudden death; was inclined to regard it as a case of pyæmic poisoning.

The majority of those present thought her death attributable to embolism; the formation of large clots in the uterine sinuses and portions of them becoming detached, carried in the circulation to the heart, where they accumulated and rapidly overcame the action of this organ.

Dr. McGuirk and Dr. Blake related accounts of interesting cases of sudden death from septicemia.

Dr. Jones urges the importance of thorough pophylactic measures in obstetric practice; never leaves a case till he is fully satisfied that the shreds of membranes are entirely removed and the uterus firmly contracted.

Dr. Nash asked the expression of the members in the use of intra-uterine injections following confinement to facilitate the

removal of putrid accumulations; was replied to by Dr. Stockwell, who seldom or never resorts to this as a prophylactic measure; considers it rather unsafe, even with the mildest injections that can be used. Others thought the measure perfectly safe if the double canula be used.

Dr. Stockwell cautions against downward pressure upon the fundus, to assist the expulsion of the placenta; thinks displacements frequently follow this practice. With reference to the use of cathartics following labor, he is in the habit of trusting largely to nature, abstains from active cathartics. The free use of pure air is of vital importance in the puerperal state, true cleanliness is not brought about so much by much washing. It consists as much in the healthful action of the skin, removing the vitiative exhalations and in supplying plenty of pure air.

Dr. Jones presented a case of nævus, occupying the scalp of a child of two years. Had been treated by injections of ferri. per sulphate with partial success; was recommended to ligate the the supplying vessels. Dr. McColl advised enucleating the entire mass.

On motion, the discussion on pneumonia was opened by Dr. Nash, in which all the members participated. Dr. Stockwell has great confidence in large doses of quinine, alternated with carb. ammonium, the latter to stimulate the capillary circulation, and to aid in equalizing the general circulation, and thus overcome local hyperæmia and blood stasis; he recommends very large doses of quinine.

Dr. Jones adopted the antiphlogistic plan of treatment when he entered the profession, then took up Prof. Flint's doctrine of trying to limit the exudation process by giving large doses of opium and a very liberal supply of diffusible stimulants; has since modified his treatment somewhat; now gives full doses of quinine from the first, and speaks in the highest terms of carb. ammonium in the treatment of this disease; thinks stimulating applications to the chest very important.

Dr. Kinny cautioned against over-medication, particularly in children. Nature will accomplish wonders in their diseases, especially if seconded by judicious nursing. He is governed

altogether by the character of the expectoration as to the time of commencing the stimulants. When the sputa is of the prune juice order, and readily saturates the cloth used, having little or no consistence to it, with a pinched or blanched expression, of the countenance, he gives quinine and alcoholic stimulants with a free hand, and persists in their use through the entire course of the disease. On the subsiding of the acute symptoms he almost invariably applies a blister over the affected part.

Dr. Yerex has recently given lactopeptine a trial in cases of dyspepsia and bowel complaint, with satisfactory results.

On motion, the subject of "puerperal convulsions," was made the topic for discussion for the next meeting, Dr. Stockwell to furnish the paper.

Also, "quinine as a therapeutic agent," was recommended as a subject for the next meeting, to be introduced by a paper from Dr. Kinny.

Dr. McColl read a very interesting paper on some of the causes which predispose to the development of phthisis, which was referred to the committee on publication.

On motion, the society adjourned to meet in February next at Port Huron.

A. NASH, Secretary.

VAN BUREN COUNTY MEDICAL SOCIETY.

The last meeting of the Van Buren County Medical Society was held at Bangor, October 12th, 1875.

Drs. J. Andrews, T. H. Briggs, and L. C. Woodman, were appointed a committee to draft resolutions expressing the sense of this society regarding the action of the Professors of the Medical College of the Michigan University.

The committee reported the following preamble and resolutions, which were adopted:

WHEREAS, The last Legislature enacted a law providing for the establishment of two Professorships of Homœopathy in the Medical Department of the University; and