Browne expressed his belief that, when authors reported that they had never had a bad result, such an experience showed that the injected fluid had never passed beyond the isthmus of the Eustachian tube. Again, there was the physiological objection. The tympanum was an air-cavity, whose office was impaired by the presence of a very little mucous fluid, when such was effused as a result of disease. It was often very difficult to disperse this fluid, and there was a great tendency for the lining of the cavity to become thickened, and, as a natural consequence, for its absorptive properties to become diminished. Why should one expect medicated fluids (necessarily, for safety, of very feeble quality) to have a good effect, and why not a bad one, considering the injury done by simple water when it entered the tympanum, as in bathing or on use of Weber's douche ? And supposing these fluids were not absorbed, nothing but harm could result, as many authors, Kramer and Bonnafont among the number, had agreed. When one considered the intimate relation of the mucous membrane of the throat and middle ear, and how frequently topical applications of strong mineral solutions failed to cure hypertrophic inflammatory conditions in the former region, what right had we to suppose that these feeble fluids would do good to similar affections of the middle ear? On all grounds, therefore, Mr. Browne objected to this treatment. He stated that after their use he had never, on subsidence of the increase of bad symptoms-in his belief the only proof of entry of fluid into the tympanic cavity -found the slightest gain of hearing power. On the other hand, he had often seen most alarming inflammation induced. If, therefore, they were to be employed at all, he could limit their use to suppurative cases in which there was already a pervious tympanic membrane, or he would, at the time of making them, perforate the membrane, a procedure now established as free from danger. The speaker concluded by pointing out that, by means of inhalations, Valsalvan, Politzer, and catheteric inflations, with either pure air or medicated vapors, by use of the postnasal douche, by faradisation, by use of the exhausting speculum (an improvement of Siegel's instrument being exhibited), and, lastly, by careful attention to the constitutional diathesis of each individual case, it was possible to greatly alleviate he doubted if they were ever cured-the conditions under consideration.

Dr. Cassells disapproved of the treatment, not because he feared putting fluids into the middle ear, but because he did not get good results.

The subject was discussed by Dr. Weber-Liel, of Berlin, in a paper on "Intra-tympanic Injections," which was read by the acting Honorary Secretary at the author's request. He said that his experience of sixteen years of aural practice had forced him to give up the idea that it might be possible to cure inveterate catarrh of the tympanic cavity by means of intra-tympanic injections of medicated fluids. 1. The symptoms of catarrh of the tympanum may depend upon extension of a simple catarrh from the Eustachian tube and the pharyngo-nasal cavity; then the latter only must be the object of treatment. In this treatmeut injections of strong nitrate of silver solutions into the mouth of the Eustachian tube, followed four days afterwards by the use of the air douche, will be found of the best effect in reducing the catarrhal symptoms. But in order to avoid inflammation of the tympanum, not more than a few drops of the solution must be blown in with force, by means of the Eustachian catheter; and the patient must be forbidden to blow his nose till four hours. after the injection. 2. Or, secondly, the symptoms of the intratympanic catarrh are due not only to a catarrh of the tube, but to a collapse of the walls of the Eustachian canal, dependent on insufficient or paralyzed action of the Eustachian tube muscles. In such cases, not intra-tympanic injections, but the awakening of the activity in the tubal muscles by intra-tubal electricity, must be the treatment, to cause the disappearance of the symp toms of the secondary intra-tympanic vascular stasis and catarrh. 3. Symptoms of congestion and catarrh of the tympanic cavity may arise from alterations of the vaso-motor and trophic nerves and of the sympathetic supplying the tympanic cavity. Dr. Weber-Liel had found solutions of nitrate of silver, corrosive sublimate, and common salt, to produce inflammation and perforation of the membrana tympani. Carbonate of soda, however, had not this effect. Mucus, incrusted and transuded purulent matter, may be diminished by it. Tissue (false bands, for instance) and intra-tympanic adhesions may be softened by it; so that it may become more easy to loosen intra-tympanic adhesions by means of the air-douche, and to cause absorption of hardened masses. For this kind of catarrhal affection, he had found intra-tympanic injections to have a really good result.

The injections, combined with air-pressure, were effected by means of his pharmaco-koniontron.

Among numerous other papers presented to the sub-section, was one on "Tinnitus Aurium," by Dr. Laurence Turnbull, of Philadelphia, giving the statistics of 166 cases in which it appeared as a prominent symptom. Mr. W. D. Hemming also read a paper on the subject. In the discussion which followed, electricity was generally recognized as useless, while hydrobromic acid has a positive value.

Section of Obstetric Medicine.-Dr. George H. Kidd, of Dublin, in the chair.

Dr. Robert Battey, of Georgia, introduced to the Association his use of iodized phenol, already familiar to the American profession.

Dr. E. J. Tilt, though not much in favor of intra-uterine injections, admitted, however, that intra-uterine medication was wanted in the following cases. 1. Incoercible blood-loss, resisting all remedies and menacing life. 2. When life or reason is menaced by the intensity with which internal metritis reacts on the system, rather than by the amount of purulent discharge to which it gives rise. 3. When internal metritis causes an aggravated complication of dysmenorrhoea by menorrhagia independent of ovaritis, and menacing life or reason. 4. Membranous dysmenorrhoea. 5. In habitual abortion, independent of syphilis and ovaritis, and seemingly caused by some morbid state of the lining membrane of the body of the womb. When internal metritis led to dangerous flooding, and in cases of membranous dysmenorrhoea, Dr. Tilt recommended intra-uterine injections with undiluted tincture of iodine. He deprecated the injection of a solution of nitrate of silver in such cases, and in other cases of internal metritis requiring intra-uterine treatment, on account of the severe pelvic diseases and death which had succeeded. In such cases he preferred to place in the womb five or six grains of solid nitrate of silver; but, as he had seen this followed by severe peritonitis, and as he knew this to have caused death, he expressed himself ready to welcome a better plan of treatment. Dr. Byford, of Chicago, believed that intra-uterine medication could be adopted in a great many instances with safety. When he applied it, he looked a good deal to getting the patient into a proper condition; made her live quietly for some time beforehand; and kept her in bed for two or three days after the ap

plication, which measures he found to secure success invariably. He thought that the application should be delayed after menstruation. He should hesitate to make an application of nitric acid to the uterus in a case where the canal and mouth of that organ were very much diminished in size; and he did not believe that this was the class of cases to which it was applicable. This treatment should be succeeded by more constitutional means. He used glycerine and extract of belladonna.

Dr. R. Battey gave an account of 15 cases of Battey's Operation. The mortality had been 133 per cent. Regarding the results obtained at the end of six months, separating the recovered cases into three classes, there were three cases (a) of removal of but one ovary, three cases (b) of imperfect removal of both ovaries, and seven cases (c) of complete removal of both ovaries, which compared as follows: Morbid conditions wholly disappeared in class a, 1; in class c, 6: partly disappeared in class a, 1; in b, 1: not benefited, class a, 1; class b, 2: too recent to determine, class c, 1.

Present Condition.-Perfect health, class a, 1; class c, 4: comfortable health, class a, 1; class b, 1; class c, 2: not benefited, class a, 1; class b, 2: too recent to determine, class c, 1.

Dr. Graily Hewitt spoke of vomiting in pregnancy. He believed that the vomiting of pregnancy was one of the reflex disturbances produced by resistance to the normal expansion of the tissues at and immediately surrounding the internal uterine orifice. The success that had attended dilatation by Dr. Copeman's method was to be explained in two ways: (1) by the change of the flexed condition of the uterus-which the author had pointed out to be a usual cause of the sickness-to a condition of comparative straightness; (2) by the relief of the compression and condensation of the tissues by the artificial dilatation. Relief from vomiting during pregnancy might be obtained (1) by elevating the body of the uterus, and thereby taking off the pressure at the internal os; or (2) by dilatation of the cervix, after the method of Dr. Copeman. His own opinion, based on observation, was that the postural treatinent was generally sufficient.

The President said he had learned at the beginning of his career, from Dr. Henry Bennet's book, that inflammation of the cervix uteri was a frequent cause of the excessive vomiting in early pregnancy; and he had since made it a rule to examine the uterus in such cases, and frequently found the condition

described by Dr. Bennet; and, on touching the inflamed surface freely with the solid nitrate of silver, the vomiting generally ceased.

Dr. W. H. Byford, of Chicago, read a paper on "Treatment of Fibroid Uterine Tumors by Ergot." His positions were-1. When properly administered, ergot frequently very greatly ameliorates some of the troublesome and even dangerous conditions of fibroid tumors of the uterus, e. g., hemorrhage and copious leucorrhoea. 2. It often arrests their growth, and checks hemorrhage. 3. In many instances it causes the absorption of the tumor, occasionally without giving the patient any inconvenience; while, at other times, the removal of the tumor by absorption is attended by painful contractions and tenderness of the uterus. 4. By inducing uterine contraction, it causes the expulsion of the polypoid variety of the submucous tumor. 5. In the same way, it causes the disruption and discharge of the intramural tumor. He said that, in administering ergot in cases of fibrous tumor, the action of the drug would depend on the degree of development of the fibres of the uterus, and on the position of the tumor with reference to the serous or the mucous surfaces; the nearer the mucous surface, the better the effect. A good result might be expected under the following conditions: smoothness of contour of the tumor, denoting uniform development; hemorrhage; a lengthened uterine cavity; and elasticity of the tumor. He would expect large fibrocystic tumors to resist the action of ergot; and a good result was not to be expected in cases of uneven nodulated tumor, absence of hemorrhage, shortness of the uterine cavity, and hardness of tumor. It was not essential to give ergot hypodermically, though this was a very efficacious method; it might be given by the mouth, in suppositories, etc. If the object were to cause painless absorption of the tumor, the dose should be moderate, and not too frequently repeated; if it were desired to have the tumor expelled, full and increasing doses should be given often, and continued till the object was attained. The preparation which he used was Squibb's fluid extract of ergot. He said, in conclusion, that he disclaimed any expectation that ergot would supplant all other modes of treatment.

The President stated that he had tried the ergot, but had no good result from it in this class of cases.