will without producing a reaction. If the kawa-resin be injected into the connective tissue of an animal, anæsthesia ensues in the sphere surrounding the point of injection; mechanical and chemical irritation elicit no reflex response. At and surrounding the point of application no inflammatory symptoms appear, but, on the contrary, marked ischemia.

Constitutional Action.-Ingested, the kawa-drink produces a sensation of comfort, peace and felicity, and never, as in the case of alcohol, desires of altercation or fight. In the mouth a peculiar. pleasant sensation of coolness is received, and may last for one or two hours. Consciousness and reason are in no way depressed, as in the case of opium, but the mental facilities are rather heightened. Fatigue and hardships appear easier borne under the influence of the drug. If larger quantities of the kawa-drink are ingested, a state of happy freedom of cares. and a dreamy consciousness set in. The limbs grow feeble and powerless; gradually the will loses its control over the motor apparatus, rendering co-ordinate movements impossible. The person soon lies down, and gradually falls asleep, or rather in a condition of somnolency.

Nausea and headache, paresis of the extremities, and a nervous trembling are the usual sequelæ of kawa-ingestion after the somnolency has passed off. The system soon grows accustomed to the drug, and the kawa-habit is readily established.

Animal Experiments.—If kawa is administered to frogs per os or hypodermically, the animals soon grow feeble, the head sinks, and a state of motor incapacity ensues. Though voluntary motion has disappeared, reflex action is still active.

Lewin saw frogs in this condition for nine consecutive days; only the reaction to light and the slow cardiac action still testified to the life of the animals.

A general central paralysis is produced by kawa in a manner that the anterior horns of the gray substance, the

motor ganglia, are first attacked, and later the sensible elements in the posterior horns of the gray substance, and lastly the brain ganglia. In birds, rabbits, cats, we obtain the same physiological effects. At first motion is apparently increased, the animals endeavor to run or fly away; then this desire vanishes, and the animal lies down; temperature, respiration. and pulse fall gradually and simultaneously.

An alcoholic solution applied by the mouth or subcutaneously produces a deep sleep within a few minutes. Part of the kawa-resin is eliminated with the urine. The gastric mucous membrane shows, after death, an ischemic appearance. These interesting observations clearly demonstrate that in kawa we have to deal with a drug of a most energetic activity, and that its power to produce complete local ischemia and anæsthesia, reduction of the excitability of the spinal motor apparatus, and besides psychical quiescence, can be unquestionably utilized in therapeutics.

Kawa promises to become almost as valuable, provided it can be readily handled, as cocaine now is.

The resin is a semi-fluid body, with a peculiar aromatic taste, pungent and hot like pepper; when placed upon the tongue there is a momentary burning sensation, with increased salivary secretion, followed by local numbness, which may last for more than an hour. The kawa resin is too irritating to be applied to the human conjunctiva, but Dr. N. A. Randolph thinks that by first instilling cocaine, so as to render the conjunctiva insensitive, kawa might then be used to produce more prolonged anæsthesia. Its use in dental practice also suggests itself, and in the hands of aurists and laryngologists, though the facts that it is insoluble in water and glycerin, and that an alcoholic solution has serious disadvantages, will perhaps somewhat restrict its usefulness. It may also, perhaps, be used in suspension in mucilage.

Still another use for the resin of kawa or kava, is in the treatment of gonorrhoea and acute affections of the urinary passages. The pain on micturition becomes less, the discharged decreases, and cure in many cases resulted in from ten to twenty days.-Odontographic Journal.

Editorial, Etc.

ESOPHAGOTOMY FOR THE REMOVAL OF AN ARTIFICIAL DENTURE.-The following operation was performed before the students of the Medical and Dental Departments of the University of Maryland, by L. McLane Tiffany, M. D., Professor of Surgery.

On Sunday, November 14th, 1886, George K., (white), aged 32 years, residing in Baltimore county, Md, while at dinner, had the misfortune to partially swallow his artificial teeth, consisting of a rather narrow vulcanite plate for the upper jaw, to which were attached three incisor teeth, one lateral incisor having been lost from the plate. The denture was arrested in its passage downwards, producing intense pain and partially obstructing respiration, while deglutition, even of liquids, was rendered impossible. A physician was summoned, who detected the plate in the upper portion of the esophagus, but all efforts to remove it or force it into the stomach were futile. Sufficient opium to relieve the pain having been administered, on the following day, Monday, he was brought by his physician to the Infirmary of the University of Maryland, and placed under the care of Dr. L. McLane Tiffany, Professor of Surgery. On the same afternoon, the patient having been etherized, careful attempts to remove the plate were made, but it was so firmly impacted in the upper portion of the œsophagus that all efforts for its removal failed. On Tuesday, in the presence of the medical and dental classes, the patient was again etherized and efforts made to remove the plate through the mouth, but without success.

The patient lying on his back with his face turned to the right, so as to render the tissues of the left side of the neck tense, Prof. Tiffany made an incision about four inches in length through the integument over the depression between the trachea and the sterno-mastoid muscle. The anterior jugular vein was cut and ligated, and the incision extended from oppo

site the upper border of the thyroid cartilage nearly as low as the sterno clavicular articulation. The platysma myoides muscle, and the cervical fascia were then divided. The edges of the wound being held apart with retractors, the omo hyoid muscle was drawn outwards, and the sterno-hyoid and sternothyroid muscles inwards. The carotid sheath, with the contained vessels, was exposed and carefully drawn outwards, while the thyroid gland was separated as far as necessary and drawn inwards. The larynx and trachea were drawn somewhat forwards, and the finger passed behind where the foreign body could be distinctly felt through the oesophageal wall.

An incision large enough to admit the finger, was then made into the oesophagus, care being taken to avoid the recurrent laryngeal nerve, through which the exact position of the set of teeth was ascertained. Forceps were then introduced and the plate removed intact. The wound after being thoroughly cleansed, was dressed with antiseptic gauze and absorbent cotton, no sutures being employed. On the following Thursday, the patient was walking about his room with a normal temperature and pulse. He was fed by means of a stomach tube for six days, after which he was able to swallow liquid food with little or no pain, and the external wound had nearly closed.

MOUTH-BREATHING.-"The New York World prints an interview with a well-known physician on the pernicious mouthbreathing habit, "Why," said the doctor," you can tell one of those mouth-breathers anywhere the moment you see him. From disease of the nose his lips are retracted, his mouth is continually open, his gums recede and his teeth protrude, particularly those in the upper jaw; the flesh that forms the lower part of the nostrils is shrunken, the openings of the nostrils are diminished in size, there are wrinkles at the outer edges of the eyes, and deep lines run from the nostrils to the angles of the mouth. These all give the person an expression of either idiocy, silliness, or suffering."

It is said that a man can inhale mephitic air through the nose for a certain time in the bottom of a well without harm,

but if he opens his mouth to answer a question or call for help, his lungs are closed and he expires."

If such are the effects of mouth breathing, it would be best to choose the least of two evils and keep the mouth full of tobacco juice.-ED.

A NEW SUBSTANCE.-A new use has been discovered for potatoes. They can be converted into a substance resembling celluloid by peeling them, and after soaking in water, impreg nating with eight parts of sulphuric acid, then drying and pressing between sheets of blotting paper. In certain parts of France pipes are made of this substance scarcely distinguishable from meerschaum. By subjecting the mass to great pressure billiard balls can be made of it rivalling ivory in hardness.

Monthly Summary.

PIN-HOLE CAVITIES AND "CARIES INTERNA."-In practice we not uncommonly meet with cases where a very small opening through the enamel is the only external indication of a very large cavity in the dentine, and even when the enamel is apparently not yet broken through, we may find, on cutting into it, a cavity already forming, or at least a considerable softening in the dentine, giving rise to what I think has often been mistaken for "caries interna." We frequently ask ourselves the question: Can the small particles of food which may enter through so minute an opening bring about so extensive a decalcification? Recent observations have rather inclined me to the view that it must, or at least may, be so.

In explanation of the first case, I have seen the same appearance exactly in pulpless teeth, and have produced it artificially. I have a second temporary molar which was exposed for seven months in a fermenting solution. It shows three pin-holes on the grinding surface, one of them extending nearly