ABSCESS IN THE MIDDLE EAR MISTAKEN FOR TOOTHACHE.-In the St. Louis Medical and Surgical Journal, March, 1888, Dr. A. D. Williams says: "Early in February a young man had what he took to be toothache on the right side of the upper jaw. He consulted a dentist, who could find nothing wrong with the teeth, and referred him to me. On examination I found a well-marked abscess in the right drum. The upper back portion of the membrane was bulged outward to the extent of a pea. When punctured, pus escaped at once, and when air was blown through the drum considerable more was forced out of it. I need hardly add that this promptly relieved the 'toothache.' Reflex irritation between the teeth and the ear is usually from the former to the latter. In this case the usual order was reversed."Medical and Surgical Reporter.

VIGIER'S CORYZA Powder.-This remedy, which is greatly prized and often prescribed by French physicians, has the following formula, as given by M. Vigier himself (in the Gazette Hebdom. de Méd. et Chirurg.): Finelypowdered starch, boracic acid, tincture of Siam benzoin, of each equal parts. To be used as a snuff, frequently and plentifully. We would remark here that powdered gum benzoin should not be used in lieu of the tincture, as is frequently done by American pharmacists in preparing snuffing-powders. When the gum is used, the resulting powder is tenacious, packs easily, and is difficult to draw into the nostrils. The same may be said of camphor. It is far better to use the tincture and allow the alcohol to evaporate, as in this manner a granular powder is obtained which has not the vice above referred to.-National Druggist.

CANCER OF THE BLOOD.-It has often been maintained more or less explicitly that the blood, although a liquid, is to all intents and purposes a tissue. Proceeding upon this doctrine, M. Bard (Lyon Médical, 1888, No. 7; Lancet, March 3, 1888) broaches the theory that leucocythemia is in reality cancer of the blood, and explains the absence of a definite tumor by the obedience of the neoplasm to the law of the preservation of the essential attributes, including the liquid state, of its parent tissue.-New York Med. Journal.

THE REDUCTION OF NITRATES BY MICRO-ORGANISMS-Mr. Percy Frankland, in a paper read to the Chemical Society on the 16th ult., gave an account of some observations he had made on the action of thirty-two micro-organ

isms on nitric acid contained as nitrates in nutritive solutions. About half of the forms (all of which were obtained from air and water and cultivated in a state of purity) reduced the nitrates to a greater or less extent to nitrites. No effect was produced by the exclusion of air. The author suggested that the difference in reducing power may in certain cases be available as a means of distinguishing micro-organisms morphologically very similar.-London Lancet.

ANTIDOTES TO STRYCHNINE, RESORCINE, AND PICROTOXINE.-Professor Anrep has proven experimentally that urethane possesses properties antagonistic to the convulsive drugs, such as strychnine, etc., and believes that urethane may be employed in cases of poisoning by these substances. It is superior for these purposes to hydrate of chloral; it is less dangerous, and may be administered in large doses with perfect safety. The author concludes that in the case of man it is necessary to administer it in doses of four to six grams as an antidote to the poisons above mentioned.

E. Koch states that butychloral hydrate is useless as an antidote in cases of strychnine-poisoning; in picrotoxine-poisoning it fails to overcome three times the minimum fatal dose, behaving in this respect like chloral hydrate. Picrotoxine may be successfully used as an antidote to the narcotic effects of buty chloral hydrate and chloral hydrate. According to A. Bockal paraldehyde is a powerful antidote to strychnine. Ten times the fatal dose of strychnine may be safely administered to dogs that have previously received paraldehyde. Strychnine is not, however, an antidote to paraldehyde. Boston Medical and Surgical Journal.

THE CORRECTION OF SQUINT.--Landolt writes that the agents for the correction squint are atropia, glasses, cessation from work, orthoptic exercises, and operative interference. He never operates without satisfying himself that he has gotten the full effect of non-surgical measures. If the correction is made in a child while young, without these precautions, divergence may occur later. It is difficult to determine beforehand just how much to do. It is easier to diminish than to increase the effect. Dr. Landolt never operates on two homonymous muscles at once. He rather does a tenotomy of one and advancement of its antagonist. The remedies for overeffect in operations for convergent squint are stoppage of atropia, removal of stitches from advanced muscles, and use of the other eye. No case should lose its power of convergence or di

vergence after operation, as without that power binocular vision would be impossible. If divergence persist, advance the tenotomized muscle. This can easily be done on the tenth or twelfth day.

THE TREATMENT OF OPHTHALMIC MIGRAINE. G. de la Torrette and P. Blocq (Progr. Méd.) report a case of the second form of ophthalmic migraine described by M. Charcot, in which the administration of bromide of potassium effected a cure. The patient was subject to attacks of migraine attended with disturbances of vision (scintillating scotoma) and with transitory motor aphasia. In addition to these symptoms, during the attacks he suffered with various disturbances of the sense of touch in different parts of the body. He took the bromide according to the following formula: 30 to 45 grains daily during the first week, 45 to 60 during the second week, 60 to 75 during the third week, and 75 to 90 during the fourth week. Then the series was begun over again. He took the medicine for nearly a year, and when seen, fifteen months afterward, he had been quite free from any attacks or from any symptoms of his former affection.

DR. OSLER, of Philadelphia, is quoted as saying that American physicians are much more pronounced as regards the style of their doorplate and professional cards than English physicians are. He thinks that a large card, say about five inches by three, with gilt and indented edges, and having at the top several specialities and below office hours and telephone number, stamps the man as on the border land, or already in the wastes of quackery. He is charitable enough to believe, however, that some men, particularly young graduates, err in this matter through ignorance, and thinks that medical students should receive, before graduation, a short course of lectures on medical ethics and on the business and legal relations of the doctor. This plan was adopted last year at the University of Pennsylvania.-Medical and Surgical Reporter.

HERNIA. From an analysis of 1,000 cases of hernia occurring in private practice, De Garmo comes to the following conclusions: 1. That by early mechanical treatment a large percentage of hernias occurring under middle age can be cured.

2. That, while there is no intent to underrate the value of surgical measures in suitable cases, it is believed that the greatest relief to the greatest number can be afforded by the more careful and scientific mechanical treatment of hernia.

The Lancet of the 7th instant contains an interesting and ingenious article on this. subject, from the pen of Dr. R. J. Shepherd. That the author has enjoyed unusual facilities for the clinical study of phthisis is evident from his statement that some fifty phthisical patients die under his care annually, and that this has been the order for the last dozen years. He further says that he does not pretend to have studied the question deeply, since his daily round of duty absorbs pretty nearly all his energies. It would seem, therefore, with such large experience with the disease, that a chapter devoted to its clinical history, prognosis, or treatment would have come with more force and fitness from his ready pen, or, if these themes had been too dolefully trite, that he would at least have given weight to his present argument by statistical data drawn from this experience.

This, however, he has not thought fit to do, but stating his propositions, which are by no means axiomatic, and indeed seem to have little support from a scientific study of the disease, he proceeds to demonstrate the problem of its etiology with the confidence

of the skilled mathematician, if not with like

success.

He says: "This is my opinion: Irritation is the cause of phthisis. There are various degrees of susceptibility, and it is important to notice that what will irritate one pair of lungs will not necessarily irritate another. We all know how much hereditary taint, diathesis, and the general surroundings of an individual have to do with the form and progress of the disease. But it seems to me that all these, and even the dread bacillus itself, play their part after the disease has begun. The starting point being irritation, people predisposed to phthisis will get it if their lungs be exposed to constantly recurring irritation; otherwise they will escape."

Having established, as he believes, this point, the author proceeds to make another, and puts his finger, so to speak, upon the constantly recurring irritation to which the vast majority of phthisical patients owe their disease. "It is simply cold air breathed at night." Not that cold air itself is irritant. "If the patient breathed air as cold by day as by night, it would be harmless. It is the change from the warm air by day to the cold air at night that does the mischief. Lungs predisposed to disease are compelled to accommodate their capillary circulation, night after night, to a temperature ten, twenty, or thirty degrees below that which they have enjoyed by day. This happens, too, when all the sensations are in abeyance. Lungs so exposed never get an opportunity to recover their tone. A slight cold perhaps starts the mischief, and then this constantly recurring irritation slowly but surely does its work. If the air be close and septic, as well as cold, matters are rendered thereby so much the worse. The secretions become vitiated, and bacilli begin to swarm." The author endeavors to clinch this proposition by the well-known fact that the disease is often arrested or its ravages mitigated soon after the patient is transported to an equable climate. He says: "To my mind this is demonstrated with the exactitude of an experiment. If people with undoubted phthisis.

do get well, and remain well while in these climates, the cause of their disease must be sought elsewhere than in heredity, diathesis, and bacillus, all-important as these may be in the course and progress of the malady. Conversely, I believe that there are certain favored climes where phthisis is unknown. But let us transport one of their inhabitants, man or beast, to this or a similar climate, and he is almost sure to die of phthisis."

He demolishes Dr. Hilton Fagge's foremost factor in the etiology of phthisis, to wit: "The habitual breathing of air rendered impure by overcrowding and defective ventilation, by citing the case of the Icelander, in whose dwellings overcrowding is common, and ventilation, as we understand the term, a sheer impossibility." Dr. Fagge says: "One would hardly send a patient with phthisis to Iceland, yet the natives escape the disease." Dr. Shepherd believes that if their huts were as warm as our houses by day, and as cold as our bed-rooms at night, phthisis would very soon appear among them. "Phthisis is a disease of the night. It is simply so because we inhabit hot rooms by day and cold rooms by night, and many lungs find it more than they can do to accommodate themselves to the constantly recurring changes in temperature."

This theory of Dr Shepherd would seem to hold an element of truth and carry with it some suggestions of positive hygienic

value. But its chief interest lies in the moral, which, from the paper's beginning to its ending, is thrust upon the reader. A large practice may make such demands upon the physician's time as to forbid him profound study and bar him of original research; but it will scarcely be allowed that a large daily clinical experience with the most important disease of the nosology is incompatible with a clear conception of the principles of its now universally accepted etiology and pathology.

PROFESSOR HATTIE ALLEN, who has just assumed an important chair in the Medical Department of the University of Michigan, is said to be only thirty years old, and is a Vassar alumna.

Notes and Queries.

AMERICAN ASSOCIATION OF GENITO-URINARY SURGEONS.-Preliminary programme of the meeting to be held in Washington, September 18, 19, and 20, 1888:

1. Clinical Observations on Diseases of the Testicles. By Dr. L. B. Bangs, of New York City, N. Y.

2. Clinical Observations on Chronic Gonorrhea; and,

3. Two Cases of Cancer of the Seminal Vesicles, with Pathological Specimens. By Dr. J. P. Bryson, of St. Louis, Mo.

4. Operative Treatment of Hypertrophy of the Prostrate; and,

5. Cases of Bowel Ending in the Urethra of a Child four weeks old; Relief by Operation. By Dr. A. T. Cabot, of Boston, Mass.

6. On the Effects of Rapid Changes of Altitude in an Advanced Case of Interstitial Nephritis. By Dr. Geo. Chismore, of San Francisco, Cal.

7. Connection Between Masturbation and Stricture. By Dr. S. W. Gross, of Philadelphia, Pa.

8. Operations on the Kidney. By Dr. W. H. Hingston, of Montreal, Canada.

9. Syphiloma of the Vulva. By Dr. J. N. Hyde, of Chicago, Ill.

10 The Curability of Urethral Stricture by Electricity; an Investigation; and,

11. The Comparative Value of Supra-pubic and Perineal Drainage in Curable and Incurable Bladder Disease. By Dr. E. L. Keyes, of New York City, N. Y.

12. The Filaria Sanguinis Hominis in the United States, Especially in its Relationship to Chylocele of the Tunica Vaginalis Testis. By Dr. W. M. Mastin, of Mobile, Ala.

13. A Case of Perineal Section for Traumatic Retention; Unusual Condition of the Bladder. By Dr. J. E. Michael, of Baltimore, Md.

14. The Prophylaxis of Syphilis. By Dr. P. A. Morrow, of New York City,

N. Y.

15. Unusual Case of Urethral Calculus. By Dr. H. G. Mudd, of St. Louis, Mo.

17. Demonstration of a Perfected Evacuator, and an Improvement in the Method of Removal of Debris from the Bladder. By Dr. F. N. Otis, of New York City, N. Y.

18. Pyemia as a Direct Sequel of Gonorrhea. By Dr. R. Park, of Buffalo, N. Y. 19. Retrojections in Gonorrhea. By Dr. E. R. Palmer, of Louisville, Ky.

20. Prostatotomy for Enlarged Prostate, at the age of forty-two. By Dr. Abner Post, of Boston, Mass.

wick, of London, England.

33. The Congenital Anomalies of the External Urethral Orifice. By Dr. C. Kaufmann, of Zurich, Switzerland.

R. W. TAYLOR,

Secretary.

AMERICAN SURGICAL ASSOCIATION.-Preliminary programme of the session to be held in Washington, D. C., September 18, 19, and 20, 1888.

President, D. Hayes Agnew, M. D., Philadelphia, Pa.; Vice-Presidents, N. Senn, M. D.,

23. Some Points on the Differential Diagnosis of Bladder and Kidney Affections, with Demonstrations of the Cystoscope and Other Instruments; and,

24. On the Physiology of the Bladder. By Dr. Alexander W. Stein, of New York City, N. Y.

25. Local Treatment of Chronic Urethral Discharges. By Dr. F. R. Sturgis, of New York City, N. Y.

26. Some Points on the Etiology of Stricture of the Urethra. By Dr. R. W. Taylor, of New York City, N. Y.

27. Operative Treatment of Hypertrophy of the Prostate; and,

28. Spontaneous Fracture of Stone in the Bladder. By Dr. F. S. Watson, of Boston, Mass.

York City; Recorder, J. Ewing Mears, M. D., Philadelphia, Pa.; Council, John S. Billings, M. D., U. S. A., Washington, D. C., L. McLane Tiffany, M. D., Baltimore, Md., R. A. Kinloch, M. D., Charleston, S. C.; Chairman of the Committee of Arrangements, John S. Billings, M. D., U. S. A., Washington, D. C.; Treasurer, P. S. Conner, M. D., Cincinnati, Ohio; Secretary, J. R. Weist, M. D., Richmond, Ind.

1. Excision in Articular Disease. By Dr. John Ashhurst, jr., of Philadelphia, Professor of Clinical Surgery in the University of Pennsylvania. The discussion will be opened by Dr. Lewis A. Sayre, of New York, Dr. R. A. Kinloch, of Charleston, S. C., Dr. T. F. Prewitt, of St. Louis, Mo., and Dr. F. S. Dennis, of New York.

2. Micro-organisms: Their Relation to Surgical Disease. By Dr. Nicholas Senn, of Milwaukee, Professor of Surgery in the Rush Medical College, Chicago. The discussion will be opened by Dr. Roswell Park, of Buf

30. The Value of the Tolerance of the Iodides as a Diagnostic of Syphilis; and,

31. Urethral Stricture and Enlarged Prostate in Their Relation to Vesical Calculus and Calculus Pyelitis, with Cases. By Dr. J. William White, of Philadelphia, Pa.

BY INVITED GUESTS.

32. The Prognosis of Stricture, based on thirty years' death record of stricture at the London Hospital, and the Practice at

Haven, Conn., and Dr. J. Collins Warren, of Boston.

3. Cerebral Localization: The Relation to Operative Surgery. By Dr. Stephen Smith, Professor of Surgery in the University of New York.

4. Case of Intercranial Tumor Removed (patient to be presented). By Dr. W. W. Keen, Professor of Surgery in the Woman's Medical College of Philadelphia. The discussion of the papers of Drs. Smith and Keen will be opened by Dr. C. B. Nancrede,