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type most frequently found in females in which there is often, with a fragile form, considerable facial beauty; in which the eyes are large and expressive, the complexion fair, with the blue veins visible beneath the skin. This is the not uncommon type which, without further description, will be recognized, and in which I have invariably found the teeth, although "well shaped and often uncommonly white and beautiful to look at, covered with the softest and most defective enamel."

Keally, what betwixt Dr. Crichton Browne and Mr. Henry So will, —too much education and perverted ideas of beauty,—civilization seems to be progressing too fast for the physique of the future.— J. Milner Fothergill, in Medical Times.

The Nutritive Yalue Of Branny Foods.—An important contribution to our knowledge of the value of branny foods is contained in a paper prepared by Drs. N. A. Eandolph and A. E. Boussel, and read by the former before the College of Physicians of Philadelphia. Their experiments and observations show that little or nothing that is nutritious is contained in three of the four bran coats of the wheat grain except the salts, and that, when taken as food, they induce a rapid peristalsis, which notably hinders the appropriation by the economy of the nutritious substance of the grain; and, furthermore, that the salts contained in the bran coats are not required nor appropriated, when succulent vegetables are eaten, and that therefore bran bread is not essential in a mixed diet. The nutritive relations of bran food were studied from its exact chemical composition, from the various excretions of the animal upon the diet in question, and from the effects exerted by a given diet upon the growth and nutritive processes of the organism under observation. From the facts presented the authors of the paper consider the following deductions justifiable:

I. The carbo-hydrates of bran are digested by man to but a slight degree.

II. The nutritive salts of the wheat grain are contained chiefly in the bran, and, therefore, when bread is eaten to the exclusion of other foods, the kinds of bread which contain these elements are the more valuable. When, however, as is usually the case, bread issued as an adjunct to other foods which contain the inorganic nutritive elements, a white bread offers, weight for weight, more available food than does one containing bran.

III. That by far the major portion of the gluten of wheat exists in the central four-fifths of the grain, entirely independent of the cells of the fourth bran layer (the so-called "gluten ceils"). Further, that the cells last named, even when thoroughly cooked, are little if at all affected by passage through the digestive tract of the healthy adult.

IV. That in an ordinary mixed diet the retention of bran in flour is a false economy, as its presence so quickens peristaltic action as to prevent the complete digestion and absorption, not only of the proteids present in the branny food, but also of other food-stuffs ingested at the same time; and,

Y. That, inasmuch as in the bran of wheat, as ordinarily roughly removed, there is adherent a noteworthy amount of the true gluten of the endosperm, any process which in the production of wheaten flour should remove simply the three cortical protective layers of the grain, would yield a flour at once cheaper and more nutritious than that ordinarily used.—Medical News.

Two Cases Of Suppuration In Antrum.—Arthur I)., aged 4 years, was admitted into the hospital on May 11, 1884.

Personal History.—He had measles in August of last year, and appeared to have made a good recovery. He was now strong and lively, and had not suffered from any other antecedent illness. Two years ago he fell, striking the left cheek sharply against the prominent edge of a fender, causing a deep lacerated wound just below the orbit. This wound healed very well, a doctor's assistance not being required or sought.

Family History.—The child's father, who had had several attacks of rheumatic fever, died of phthisis, at the age of 36. The mother belongs to a "consumptive" family. There have been two other children, one of whom died in this hospital of diphtheria a little while ago. There is no family history of tumors.

Present Illness.—The swelling on the face first appeared about Christmas last. It was bathed with warm water, and gradually increased in size. The swelling was lanced at another hospital some two months later, and subsequently poultices were applied. Since this there has been a constant discharge of pus. This incision is about in the place of the original lacerated wound.

Admission.—The left cheek is found much swollen, the greatest prominence being over the cuspid of the upper jaw; here the skin is stretched, but is freely movable. Just beneath the lower eyelid the skin is reddened and pus exuding. A hard lump is felt over the situation of the cuspid tooth, as large as a cobnut; the surface of the swelling is smooth, and it is rather tender when pressed.

May 15. On exploring the sinus on the cheek with a probe, bare bone is felt; but no opening into the antrum could be found, nor any loose bone; the amount of pus was small. Hot boracic fomentations were ordered.

May 21. Mr. Hill made a free opening into the antrum, over the left cuspid, and found some superficial necrosis of the superior maxilla and malar bones, which he scraped away. The antrum was plugged with boracic lint,

May 24. The cavity was syringed out with carbolic lotion, and iodoform applied to the sinus on the cheek.

May 27. Discharged; well.

Remarks.—In the great majority of cases, abscess of the antrum is produced by dental caries, or by alveolar abscess. But in the present instance we have a case which was apparently due to injury inflicted some two years previously. There was no difficulty in the diagnosis; while the success of the treatment was doubtless due to the free opening which was made.

Thomas N"., aged 47, a clerk, was admitted into the hospital under the care of Mr. Godlee. His personal and family history are good. He is of temperate habits, and there is no cancer or tendency to tumors in his family.

Present Illness.—Just before Christmas last year he received a blow from the leg of a couch over the left brow, which made him feel silly for a time. A large lump formed at the seat of injury. This became discolored, and lasted about ten days. A week after the injury, while eating his breakfast one morning, he noticed an offensively smelling discharge from his left nostril. This has continued for some time, and then goes away. He has had severe headache at times, lasting for several days and then going away. This pain begins over the spot where he received the blow; thence shoots up to his occiput. The discharge from the nose comes on after the headache. For three months past he has completely lost the sense of smell.

Present State.—Examined with a speculum, there is seen a yellowish discharge from the floor of the middle fossa of the left side ot the nose; the mucous membrane is red and congested.

He was ordered flying blisters over the position of the frontal sinuses, under which there was at first considerable improvement. He was then temporarily discharged.

September 3. On re-admission he still complained of the pain over the left frontal sinus, which extended backwards in a defined manner for about the length and breadth of a forefinger. There was very offensive discharge from his nose.

He was chloroformed, and it was determined to explore the antrum before opening the frontal sinuses, where the mischief was, however, expected to exist. A trocar and canula were passed in above the first molar, and a quantity of creamy offensive pus was evacuated. Mr. Godlee now gouged an aperture through the anterior wall of the antrum, after first separating the gum and mucous membrane from the alveolar border.

The cavity was scraped out with a sharp spoon, and it was plugged with wet boracic lint, dusted with iodoform, after being irrigated with chloride of zinc solution.

September 4. Patient passed a very good night; all pain from the frontal region had disappeared.

September 5. He was discharged greatly relieved.

Remarks by Mr. Godlee.—The interest of this case consisted in the fact that both the history and symptoms appeared clearly to indicate disease of the frontal sinus, whereas there was no swelling, tenderness or discomfort in the region of the antrum. The pain was referred to the inner part of the superciliary eminence, and was thus clearly not due to supra-orbital neuralgia, which not unfrequently accompanies suppuration in the antrum.— University College Hospital Reports, in Medical Times and Gazette.

Abscess Of The Antrum Of Highmore.—Mr. B., 64 years of age, was compelled to have a tooth, the upper last molar of the right side, extracted on account of a severe pain referred to that locality. This operation was performed by a dentist of this city on the 1st of May last. The tooth proved to be sound, and showed no evidence of any diseased action having existed in it. But the pain bad existed in the tooth, as the patient expressed, for eight or nine months, at intervals varying from a few days to several weeks, gradually increasing in its frequency and intensity until it seemed unendurable. The extraction of the tooth was followed by a &mall flow of pus, which kept up continuously, and prevented a closing of the opening from which the tooth had been withdrawn.

On August 16 the patient presented himself at my office, and, upon examination, I found an opening sufficiently large to admit of the introduction of a probe on the site of the recently extracted tooth. I used a uterine flexible silver probe for the exploration of the diseased territory. On introducing the instrument I found a tortuous canal leading into the antrum of Highmore; not directly through the socket of the tooth, but up around the alveolar process, entering the antrum at its zygomatic surface. This opening was quite small, and the canal leading to it filled with exuberant granulations, so as to impede a free discharge of the purulent formation. Introducing a grooved director, I laid open the soft tissues forming this canal with a blunt-pointed bistoury, and enlarged the opening into the antrum by means of a stout scalpel. • This was followed by a free discharge of pus. I next instituted the practice of washing out the antrum with warm water, repeated daily for ten days, at the end of which time the pus formation had about ceased.

On September 3 I again saw the case, and found that the antrum had again assumed its natural condition, and the opening into it was almost entirely healed.—Frank Warner, M. D., in Cincinnati Lancet and Clinic.

The Lancet And The Gum-lancet.—Mr. Edmund Owen says that the great diversity of opinion brought out by the discussion of his paper on lancing the gums alone justified him in having brought the subject before the Medical Society of London.

Happily, I notice that the opinions elicited almost all diverge from that suggested by his paper. Is it a fact that the gums are now rarely lanced?—that the gum-lancet is following the lancet into desuetude? Is there not a danger of consigning to the list of "good remedies out of fashion," enumerated in Dr. Hare's excellent paper (British Medical Journal, July 28, 1883), this all-valuable vade mecum of the practitioner, in having its utility called in question before a skeptical generation (a generation willing enough, indeed, to "prove all things," but not so ready always "to hold fast to that which is good ")? Is it only the family medical attendant, the dispensary or parish medical officer, who sees the cases which the gum-lancet, properly used, instantly relieves and cures? I should have thought no man could be in practice a month without having finally persuaded himself of the value of the gum-lancet. Cannot every practitioner look back on countless cases of convulsions— perhaps of hours' duration—cut short instantly; of intense reflex constitutional disturbance, high temperature, and general febrile condition, great restlessness, great evident pain and distress, perhaps threatened convulsions, at once subsiding on lancing the gums? Why do mothers—multiparas—call you at all hours, bring their children at all hours in all weathers, with the request that you should lance their gums,—nay, even provide themselves with gumlancets, and use them,—but that they know well, by experience, that they have in that operation an unfailing remedy?

No one, I notice, in the discussion that followed this paper, called attention to those cases which, on inspecting the gums, show one or more tooth-sacs distended with fluid, sometimes colorless, sometimes blood-stained, which, on using the lancet, wells out before the gum can bleed; where the lancet comes down upon a tooth that moves under it, and feels as if set upon an elastic cushion.

Dr. de Havilland Hall suggests that "the necessity for using the gum-lancet might generally be obviated by the administration of bromide of potassium." This is the most excellent adjunct in the treatment of such cases, I admit, that I know; but is it not like administering bromide of potassium to relieve a man of the agonies produced by a tight boot? and would not the child frequently die in convulsions whilst the bromide was coming into action? If disappointments occur in cases that should be relieved by the lancet, I submit that its insufficient use is often the cause, the incision failing to completely relieve the tension and free the tooth. After all, is dentition always a simple physiological process? Is there not frequently something pathological about it? The children who cut their teeth "with the large head" are, in my experience, those which specially want help in the process, often getting convulsions with every new tooth or batch of teeth. Again, instead of taking Mr. Owen's caution, to keep a careful lookout for that most insidious of ills—essential paralysis—for which we can do little, would it not be better to look out for, and relieve the brain from, sources of reflex irritation, for which we can do much? To me it is incredible, if other men's experiences be like mine, that, in looking back upon their work, they do not accord their chief and most obvious triumphs to the use of the lancet and the gum-lancet.

The poor lancet has suffered temporary exile from its misuse, but surely the gum-lancet can have little to answer for, even if misused. Both have been in my pocket since the days of my apprenticeship, when they were given me; and, if the use of my head and my hand be vouchsafed to me, they shall remain there till I die.—H. J. Hope, F.R.G.S., in British Med, Journal.

Anesthetics And Their Administration.—Mr. Woodhouse Braine contributed a paper on the above subject. He began by contrasting the relative merits of the various anesthetic agents now in vogue, saying that we had yet to discover an anesthetic which was absolutely safe; nevertheless, he thought it incumbent upon us to select some agents in preference to others for the reason that they were safer than others. Anesthetics might be divided into two classes: 1. Those which produced death through the lungs as well as through the heart; this class included chloroform, bichloride of methylene, dichloride of ethidene, and many others of the chlorine series 2. Those which produced death through the lungs alone, the heart's action continuing for some time after respiration had quite ceased. This class included ether and nitrous oxide. In the fatal cases under chloroform, death was usually instantaneous in the great majority of cases, and began at the heart; when the heart

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