emptying the congealed contents, will afford the best manner of securing speedy recovery.

The sack should be thoroughly cleansed, the cartilages scraped if necessary, and the cavity packed with antiseptic gauze; should suppuration exist this is imperative. A posterior perforation to allow drainage in the most dependent part will aid very much in overcoming the deformity which is likely to exist.

Morbid Growths of the Auricle.-The most common of these growths is the fibroid tumor. These are usually observed in the

lobule, and are easily excised. This is one of the simple surgical operations; but the fact should not be lost sight of that when the operation has to be performed several times a malignant growth is liable to manifest itself.

Atheroma and cystoma are among the more frequent of the other forms. In these it is necessary, if possible, to dissect out the sac entire; a careful cauterization of the resultant cavity will insure their non-recurrence.

Malignant tumors have been successfully treated by the entire. removal of the auricle.

In performing this operation care should be taken that the internal canal is not closed up by the resulting inflammatory pro

cess.

This may be effectually prevented by keeping the aperture plugged up with a glass tube, which should be subjected to antiseptic cleansing at least twice a day.

CLINICAL MEMORANDA.

The Treatment of Warty Growths of the Genitals.-An abstract of Dr. William S. Gottheil, in a paper on Epithelioma of the Penis, read before the Society for Medical Progress, November 14th, 1896, concludes as follows:

1. Warty growths of the genitals, more especially in the male, are always to be suspected of malignancy, no matter how innocent they seem.

2. They should either be left entirely alone, or be thoroughly removed by knife or cautery.

3. Imperfect attempts at destruction, as with Nitrate of Silver, Carbolic Acid, etc., are especially to be avoided; there being

many cases recorded in which they have apparently stimulated a benign growth into malignant action.-International Journal of Surgery, January, 1897.

Contagious Impetigo. This is a self-limited contagious disease of children, appearing in localized epidemics, and first described by Tilsbury Fox in 1864. Accompanied by a moderate fever, and some gastric disturbance, there appear on the face and hands groups of flat vesicles, filled with transparent or cloudy serum. These dry up into characteristic golden-yellow crusts, which fall off in two or three weeks, leaving circular, reddened, non-ulcerated areas behind. Successive crops of vescicles may prolong the disease for two months or more. It is undoubtedly parasitic; but, though Kaposi claims to have found it, the etiological factor is still unknown. The treatment consists in removal of the crusts with Olive Oil compresses, cleansing the skin with hot water and soap, Boric Acid Solution, etc., followed by the use of Lassar's Paste: R. Acid, Salicylic, gr. xxx.; Petrolati, 3j. ; Zinci Oxidi, Amyli, aa., 3ss.-Abstract of William S. Gottheil, M.D., Pediatrics, October, 1896.

Protonuclein in the Treatment of Carbuncle.-In the International Journal of Surgery, Dr. Thomas P. Grant says:

"On Thursday afternoon Mr. L came to my office suffering with a carbuncle on his neck, which he said had been coming for three days, and that he "waited for it to get ripe" before consulting me. Having suffered from this worst of all furunculous tumors, he was not a little anxious and somewhat depressed, as he had an important business-trip arranged for the next week, and he was especially anxious for a speedy recovery. On removing the dressings from his neck I found an induration about two inches in diameter covered with pus. On cleaning it off there was brought to view six pustules in a space about threequarters of an inch in diameter; these pustules were oozing a thick pus, and I was satisfied that my patient was in for a siege with one or more carbuncles, as there were a number of other pustules on his neck, which looked bad, to say the least.

"Taking a knife, I made a free incision across the top of the carbuncle; after evacuating as well as I could, I washed it out

with a solution of Carbolic Acid, about three to five per cent. After this, with a pair of dressing-forceps I removed all the broken-down tissues I could-a plan which I have found to be of great service in many cases of carbuncles, as thereby whole colonies of micro-organisms are taken out that otherwise would increase and multiply until thrown off by suppuration. Having cleansed the

wound thoroughly, I packed it with dry Protonuclein Special; after which I applied a poultice of flaxseed meal, on which was a teaspoonful of fluid extract of Eucalyptus Globulus.

"As a tonic I ordered: R. Elix. Ferri. Quiniæ et Strych. Phosphat., jv. Sig.: A teaspoonful three times a day.

"The local treatment was repeated for two days, when the poultice was left off and instead this ointment was used: R. Sebi Ovis, Ol. Oliv., aa., 3ij.; Ceræ Flava, ss.; Zinc. Oxid., 3iij.; Ext. Eucalypt. Glob., 3j.; Acid Carbolic, grs. c. M. Fiat. Unguent. Sig. Grant's Comp. Zinc Ointment.

"I continued to wash the wound with the dilute Carbolic Acid and pack it with the Protonuclein Special; this dressing was renewed twice daily. So rapid was the recovery that on the following Monday evening the wound was healed and the induration was almost entirely gone, and I dismissed the case, with directions that he keep a dressing of the ointment on the seat of the carbuncle for several days to protect the tender skin.

"In an extensive and moderately successful experience—both personal and professional-with carbuncles, I have never seen a more threatening outlook for a serious carbuncle, nor one so quickly and satisfactorily cut short as in this case; and I am of the opinion that the results in this case are far ahead of the oldfashioned treatment of poultices alone or the more modern injection of Methyl Violet, or the treatment much extolled of late, of total extirpation and curetting, which leaves a great gaping wound to be filled up by granulations and skin-grafts or to become an open ulcer, followed by ugly scars. I am free to say that I am convinced that the success in this case is largely due to the use of Protonuclein Special, as with the same general line of treatment, which has been the very best I could find, I was never able to cure a carbuncle under two weeks, whereas in this case it was cured as quickly as a simple wound would have been.

Pulvis Ipecacuanha Compositus.-Synonyms: Pulvis Ipecacuanha Opis; Pulvis Doveri. There are few physicians who have not prescribed Pulvis Ipecacuanha Compositus, but there are still fewer who know much of Dr. Thomas Dover, whose name has passed down to posterity in connection therewith, and few, especially, who know that the same Dr. Dover was at one time a successful buccaneer and discovered Alexander Selkirk, of" Robinson Crusoe" fame. Dr. Dover was born in Warwickshire, England, about the year 1660, and was probably a student of Sydenham's. After taking his degree, he settled in Bristol, and, having made some money, joined with some other merchants in a privateering expedition. Two ships were fitted out, and Dover went as third in command, being styled "Captain Dover." He sailed to the Spanish Main, and in 1709 arrived at the island of Juan Fernandez. There Captain Dover went ashore, and discovered the sole occupant of the island to be a Scottish sailor named Alexander Selkirk, who had been left there alone four years and four months before. Selkirk was taken off and made an officer on one of the ships. The expedition afterward sacked the two cities of Guayaquil, Dover leading in the assault. They took a number of prizes, and cruised about the coast from Peru to California. They then sailed across the Pacific, and reached England in 1711. The expedition was very successful, realizing the large sum of $850,000, of which Dr. Dover received a considerable part. After his return home, Dover traveled again somewhat, but finally went to London. His most famous book is one known as "The Ancient Physician's Legacy," published in 1733. This was a popular treatise on medicine, and was intended apparently to get practice for its author. The full title of the book is "The Ancient Physician's Legacy to his Country, being what he has collected himself in Forty-nine Years' of Practice." The author says: "The diseases incident to mankind are described in so plain a manner that any person may know the nature of his own disease, together with the several remedies for each distemper, faithfully set down. It is expressly designed for the use of all private families." The "Legacy" is said to have made a great noise in London, and to have been the subject of debate in every coffee-house. It contained a description of about forty-two dis

eases, illustrated with cases which attested the author's skill. The later editions abound with letters from grateful patients, extolling Dr. Dover's virtues. On page 18, in the section on "Gout," is given the formula of his famous powder: "Take Opium one ounce, Saltpetre and Tartar vitriolated each four ounces, Ipecacuanha one ounce. Put the Saltpetre and Tartar into a red-hot mortar, stirring them with a spoon until they have done flaming. Then powder them very fine; after that slice in your opium, grind them to a powder, and then mix the other powders with these. Dose: from forty to sixty or seventy grains in a glass of white wine posset before going to bed, covering up warm and drinking a quart or three pints of the posset-drink while sweating." The same formula is repeated in the subsequent editions. He states that some apothecaries have desired their patients to make their wills and settle their affairs before they ventured upon so large a dose as from forty to seventy grains. "As monstrous as they represent this, I can produce undeniable proofs where a patient of mine has taken no less a quantity than a hundred grains, and yet has appeared abroad the next day."

Besides this powder, Dr. Dover's chief legacy to his country was quicksilver, which, in his opinion, was specific in almost every disease. He was accustomed to order an ounce or an ounce and a quarter of crude mercury daily. A case is reported of a man who took for his cough and shortness of breath, altogether, one hundred and twenty pounds weight. Dover was very naturally called the "Quicksilver Doctor," and received a good deal of, no doubt, well-deserved criticism. Dr. Dover, in his later days, appears to have carried the fighting-if not the buccaneering-spirit into his professional life, and, judged by modern standards, he would be considered very much of a quack. In estimating his moral and professional character, however, we must make due allowances for the times in which he lived.

Pulv. Ipecac Co., in Austria, has sugar instead of the Sulphate of Potash; in Germany and Prussia is termed Pulv. Ipecac Opiatus; in Denmark, Pulv. Ipecac Thebaicus; and in France and Belgium the powdered extract of Opium is used instead of Opium itself, which nearly doubles the strength.

Glasgow, Scotland.

DR. ALEXANDER CURRIE.