of pain about left ear and side of face. Swelling of throat and neck. Dysphagia. Difficult respiration. Appearance of marked sepsis. Temperature 103° F. Pulse 120. Granulations and fetid pus in left ear. Marked swelling of posterior pharyngeal wall on left, covered with a dark bluish-red, almost black, mucous membrane. Operation evacuated three ounces of pus. A probe could be passed from the pharyngeal abscess cavity into and out through the middle ear. Later a more superficial cervical abscess developed, which communicated directly with the pharyngeal abscess. Opened by external operation. Recovery.

The second case was in a woman of

twenty-six years. Chronic suppurative otitis since infancy. Attacks of pain on right side of throat at various times for three years, but no objective symptoms. Granulations and pus in ear. Finally swelling in throat. At operation a considerable quantity of pus was evacuated, and a probe introduced into the ear could be felt by the finger in the pharyngeal ab. scess cavity. Considerable dead bone was removed by a curette. Recovery.

Healing Under the Moist Blood-Clot. F. L. Jack, Boston (Transactions of American Otological Society, 1906), reports sixty cases of mastoid operation in which healing was attempted with the moist blood-clot. The cases are taken from the records of the Massachusetts Charitable Eye and Ear Infirmary. Ten were Jack's cases and fifty those of his colleagues. The majority of these cases were suffering from acute suppurative middle-ear inflammation and acute mastoiditis. The average length of treatment in the infirmary was twenty-six days. At the time of discharge the condition of the mastoid wound was as follows: Granulating well in five cases, nearly well in thirty-eight and healed in nine cases. The blood-clot became disorganized in nine cases in two days, twenty cases in seven days, eighteen cases between seven and fourteen days, and one after fourteen days. The condition of the middle ear at the time the patient was discharged was continued otorrhea in twenty-two cases, healed in thirty-two cases, and unrecoved in six cases. Two deaths occurred. Uncomplicated healing was obtained in only four

of the sixty cases, after intervals of seventeen days, fourteen days, eight days, and twenty-two days. Of these cases, in one the condition of the middle ear is not stated, one had an otorrhea, and two were reported dry on leaving the infirmary. Jack says: The advocates of this method, for very obvious reasons, at the present time recommend the use of a wick drain inserted through the clot into the mastoid antrum. They are approaching the point upon which many of us can agree, namely, light packing. This custom we believe is at present very generally adopted among most surgeons."

Linn Emerson, Orange (The Laryngoscope, July, 1906), reports the following interesting case:

The patient was a married woman, aged thirty-eight years, and the mother of six children. Epilepsy for fourteen years, beginning after the birth of her third child without any assignable reason. Acute influenzal otitis in November, 1904, followed by mastoiditis. Soon after operation signs of brain abscess developedheadache, tenderness on percussion, left optic neuritis, divergence of left eye, insomnia, nausea, anorexia and progressive slowing of pulse. Temperature 103° F. The left temporal lobe was exposed by operation, and on incision of the dura several drachms of clear serous fluid escaped under considerable pressure, but no cerebral abscess was found, although the brain was explored. Rapid recovery ensued. Sixteen months later she had had no epileptic attack since the operation.

Results in One Hundred and Seventy-three Cases of the Radical Operation for Otitis.

E. B. Dench, New York (Annals of Otology, Rhinology and Laryngology, September, 1906), in a paper read before the American Laryngological, Rhinological and Otological Society, reports 173 cases of the radical operation for otitis media purulenta in which the result was known. Of these, 131 were cured, 29 with slight discharge, 5 with profuse discharge, 2 still under treatmeut, and 6 died. Of these latter, 2 died of pneu

monia, 2 of meningitis, I of cerebral abscess, and I of cerebellar abscess com. plicated by sarcoma of the auditory nerve. Out of 111 cases in which hearing records were kept, the hearing was good in 99, fair in 9 and bad in 3 cases. Dench has

a number of cases under observation operated a number of years ago in which the bearing has steadily improved, owing probably to a gradual mobilization of the stapes by sound waves. Out of the last 95 cases operated upon, facial paralysis occurred in 4. In all 4 cases function

Nervous Dyspepsia.

was restored. Dench advises the employment of large skin grafts to shorten the period of convalescence. In 95 cases primary grafting was employed 48 times. In 75 per cent. of the cases the grafts adhered in part or throughout. If there are no symptoms of acute suppuration and neither the dura nor sinus exposed, Dench advises primary grafting; otherwise, after an interval of from five to ten days. Where the sinus or dura has been exposed he inserts a gauze drain, which is usually removed at the first dressing.

Einhorn (Denver Med. Times) says that our main object should be to systematically increase the amount of food. Milk and its derivatives, kumiss, matzoon, clabber, buttermilk, cream, taken between meals, play a prominent part.

Epistaxis.

Adrenalin chloridi, gr. ss, or 0.03; acid boracici, gr. xlv, or 3.00; aquæ cinnamonii, aquæ camphoræ, aa, dr. x, or 40.00; aquæ dest. q.s. ad., oz. iii, or 90 00. M. S.-Instill a few drops into the nostril with a dropper. - Medical News.

Sciatica.

Potassii iodidi, dr. iv, or 16 00; sodii salicylatis, dr. vi, or 24.00; tinct. cimicifugæ, syr. sarsaparilla compositæ, aa, oz. ii, or 60.00; aquæ q.s. ad., oz. vi. M. S.-One teaspoonful in water after meals. Indicated in rheumatic subjects. Prescription.

Chronic Leg Ulcers.

The

Here is a new one on old sores. Boskowitz (Medical Bulletin) recommends: Fluid extract lobeliæ, fluid extract baptisæ, aa, oz. i, or 30.00; zinci sulphatis, oz. I, or 30.00; aquæ, destillatæ, Oi, or 500.00. M. S. - Filter and add one ounce to a pint of hot water, and wash the sore once a day with this in a douche bag. Then keep covered with cotton saturated with this same mixture and cover with rubber and bandage. If you

cure a fifteen-year-old case of this kind your reputation is made.

Diarrhea Immediately After Eating. Osler (Denver Med. Times) says correct diet, rest for an hour after meals, give bismuth one half to one drachm t. i. d. for abnormal conditions in the small intestinés, or napthaline preparations, ten to fifteen grains four or five times per day.

For Coughs.

Elixir terpin hydrate, N. F., contains one grain of terpin hydrate to the drachm. Elixir terpin hydrate cum codeine contains, in addition, one-eighth of a grain of codeia to each drachm. Elixir terpin hydrate cum heroin, N. F., contains one twenty fourth grain of heroin to each drachm. Mistura pectoralis, N. F., contains one grain per drachm of carbonate of ammonia with senega, squill, paregoric and syrup of tolu, and makes a very effi cient combination.

Flatulent Dyspepsia.

Creosoti, m. iii, or o.18; tinct. cardamon comp., m. xv, or 1.00; syr. auranti, dr. ss, or 2.00; aquæ q.s. ad., oz. i, or 30.00. M. S.-To be taken at one dose and repeated three times a day.-Med. Bulletin.

For the Cough of Lobar Pneumonia.

Dr. John V. Shoemaker finds that he gets much relief by administering internally every two hours till relieved, then

Book Reviews.

Peterson's Obstetrics. The Practice of Obstetrics. By Eminent Authorities. Edited by REUBEN PETERSON, A.B., M.D., Professor of Obstetrics and Diseases of Women in the University of Michigan, Department of Medicine and Surgery, Ann Arbor, Mich. Large octavo, about 1087 pages, with 523 engravings and 30 full-page plates in colors and monochrome. Cloth, $6.00, net; leather, $7.00, net; half morocco, $8.00, net. Lea Brothers & Co., Philadelphia and New York, 1907.

This is the third of the series of books known as "The Practitioner's Library," the two companion volumes on gynecology and pediatrics having met with great success. This volume bids fair to be the most successful of all, for it is seldom that a more practical book comes to the reviewer's table, though we do not mean by this that the theoretical part of the art has been in any sense neglected. While each contributor has been allowed to follow the lines of his own personal experience, there has been evidently arranged by the editor a very careful plan, insur. ing a complete covering of the entire field. The .contributors have been selected with the great. est care, and are all well known as skilful teachers. When it is stated that the fifty-nine chapters are divided among but ten authors, and these chapters have been classed under nine different sections, for the most part each man contributing a section, it will be seen that the greatest objection to a so-calied "system "' book has been removed. The usual plan of beginning with the embryo, following with the physiology of pregnancy, of labor, of the puerperium, then pathology, then obstetric operations, and concluding with the care and management of the new-born infant, has been closely adhered to, and the result is a work well balanced in every particular.

The reviewer cannot close without a word of praise for the illustrative portion of the book. Obstetric text-books are not, as a rule, well illustrated, but here the attempt has been made by drawings, in many instances by actual photographs, to show the conditions described in the text. The peculiar facilities of the editor in his position in the obstetrical department of Ann Arbor have been taken advantage of to the utmost, and we have a work which will be of particular advantage not alone to the practitioner, but to the teacher as well.

The Harvey Lectures. Delivered under the Auspices of the Harvey Society of New York, 1905-06. Philadelphia and London: J. B. Lippincott Company, 1906.

In the spring of 1905 there was organized in the city of New York a society the avowed ob ject of which was the diffusion of the medical sciences by means of public lectures. The organizers of this society, which they called the Harvey Society, felt that the profession would cheerfully support an annual series of lectures dealing with the so-called experimental side of medicine given by those who devoted themselves solely to this branch of medicine. That they were correct in their surmises is evidenced by

the enormous success of the first series of thirteen lectures, given under the patronage of the New York Academy of Medicine by the following distinguished experimenters: "The Theory of Narcosis," Prof. Hans Meyer; "Modern Problems of Metabolism," Prof. Carl von Noorden; "On Trypanosomes," Prof. S. G. Novy: "Autolysis," Dr. P. A. Levene; "A Critical Study of Serum Therapy," Prof. W. H. Park; "The Neurons," Prof. L. T. Barber; "Fatigue," Prof. F. S. Lee; "The Formation of Uric Acid," Prof. L. B. Mendel; "The Extent and Limitations of the Power to Regenerate in Man and Other Vertebrates," Prof. T. H. Morgan; "On the Nature and Cause of Old Age," Prof. C. S. Minot; "Modern Views Regarding Placentation," Prof. J. Clarence Webster; "Some Phases of Tuberculosis," Prof. Theobald Smith; "The Cause of Heart Beat," Prof. W. H. Howell.

The demand for this series of lectures in book form has been great, and has been gratified by the Lippincott Company in their best style. It would be difficult to conceive of a more fascinating series or one more adapted to a variety of tastes. It was a gentle tribute to the great discoverer after whom the society was named that at least one evening was devoted to a review and elaboration of his teachings by one of his modern and learned disciples.

A Text-Book on the Practice of Gynecology. By WILLIAM EASTERLY ASHTON, Professor of Gynecology in the Medico Chirurgical College, and Gynecologist to the Medico-Chirurgical Hospital, Philadelphia. Third edition, revised and enlarged in one volume, 1096 pages, and 1057 illustrations, by JOHN V. ALTENEDER. Philadelphia: W. B. Saunders Company, 1906.

In the preface Ashton says he believes in giving directions and making the illustrations so explicit that nothing is taken for granted in describing gynecological diseases, and how well he has succeeded the issuing of a third edition in so short a time following the first edition speaks for itself. This work is one which not only meets the requirements of the specialist but that of the student and general practitioner.

Ashton has tried to pick out what, in his judgment, is the best plan of treatment and the most satisfactory operation, and has excluded many operations advocated by many text books. Illustrations are made under his personal observation from actual apparatus, living models. dissections on the cadaver and operative technique of other authors, taking up operations step by step, and by so doing making them easily understood. Instruments, needles and sutures necessary for operations are shown by separate drawings. Ashton has introduced the metric system into his work.

The author has a chapter on the examination of the blood and another on the method of collecting curette findings. In the interesting chapter on constipation is found explicit directions on how to instruct patient to take a colon lavage. He devotes a chapter to hydropathy and one to X-rays. The old operation for cystocele is discarded and that performed by Dudley is described. In retro displacements the Montgomery's round ligament operation is advocated. A section has been added on chorio epithelioma of the uterus and on passive incontinence of urine.