motion of the membrane. Milk and soups were ordered as diet, and opiates given to alleviate pain. Quietude was enjoined, and the patient requested to report progress.

Three weeks afterwards the wad of cotton was easily removed, having already become detached, and the ends of the broken bone were seen to be united, a slight bulging of the membrane being evident at the point of union. The membrane was still slightly congested and abnormally concave.

Hearing power tested with the watch, right ear, three feet; left ear, sixteen inches. Catheterization caused air to enter freely into the tympanum, but did not increase the hearing distance, and the patient was discharged.

REMOVAL OF AN AURAL POLYPUS FOLLOWED BY A CROP OF CARBUNCLES ON THE ARM.-A printer, while engaged in setting the type in the article on Malignant Disease of the Ear, which appeared several months ago, became alarmed and applied for relief from an aural polypus which had existed in his left ear for about ten years. The growth had been removed some years ago, but at once returned.

When I saw the case there was a mulberry polypus in the left meatus, which entirely filled the canal, and was attached, as I afterwards found, to the anterior wall at the point of junction with the membrane. There was a constant flow of stinking yellow pus, and also occasional bleedings from the polypus. Just behind and below the auricle was a swelling about the size of a pigeon's egg which, when opened, discharged a quantity of ichorous matter. The man thought his case similar to the one described in the article alluded to (in fact it did present several points of similarity) and he expressed himself as having "malignant on the brain."

The growth was removed by means of the wire snare

and lever-ring forceps, and the pedicle cauterized with chromic acid, one of the best means of preventing a

recurrence.

The polypus was entirely destroyed, the discharge ceased, the swelling behind the auricle disappeared, and the hearing power tested with the watch was increased, from not being heard at all, to one inch from the auricle.

Hardly had the discharge ceased than the patient began complaining of headache, and in a couple of days a crop of carbuncles made their appearance on the left arm. These carbuncles, in all about thirty on the left arm, and. two on the right arm, of course disabled the patient for work for a few weeks, and he was placed upon tonics and iodide of potassium. Now he is as well as ever and there has been no reappearance of the polypus or of the discharge.

DIAGNOSIS OF A CASE OF BRIGHT'S DISEASE WITH THE OPHTHALMOSCOPE.-A woman aged 39, pale and anæmic, had been treated by her family physician for several months, the diagnosis being dyspepsia and some cardiac lesion not definitely known. Vision had gradually failed until she was able to distinguish large objects only, and in a moderate liaht-bright light proving too dazzling, and feeble light insufficient. Quantitative perception of light varied occasionally, being better at times, and worse at others; but no change in qualitative perception could be distinguished except as above stated, owing to the amount of light. Power of accommodation was lost. Pupils dilated and sluggish. Examination with the ophthalmoscope revealed the existence of retintis albuminurica. The optic papilla was obscured and surrounded by a yellowish patch, and the region of the macula lutea was dotted with white glistening patches of exudation which assumed almost a crystalline appearance. Both

eyes were similarly affected. The diagnosis was Bright's disease of the kidneys, and an unfavorable prognosis was given. The patient died about three months after the examination, of dropsy and uræmic poisoning.

Although the ophthalmoscope is not an infallible means of diagnosis in Bright's disease, yet it has been estimated that about one-fourth of the victims of the malady are afflicted with retinitis albuminurica. Graefe once made the error of pronouncing a case one of Bright's disease when the post mortem revealed the presence of a tumor in the brain, and no kidney lesion whatever.

Gleanings from Foreign Journals.

BY GUIDO BELL, M. D., INDIANAPOLIS.

On the diagnose of beginning carcinoma uteri, Prof. Spiegelberry says: If no ulceration can be found, a discrimination between carcinoma and induration is very difficult, even impossible. A difference of hardness and resistence is not always perceptible, but a more or less immovable mucous membrane over the indurated parts, and a rigidity of the neck of the womb, entirely unchanged by sponge tent are infallible symptoms of beginning carcinoma. Carcinoma originates from the Rete Malpighi after Waldeyer, very seldom from the glands of the neck [areolar cancer]. Excrescences are formed by epithelium with or without papilis growing up exuberantly; infiltration begins the same way, but takes the opposite direction to the deeper layers. Exulceration, a reduction of the infiltrated parts, can sometimes be induced. by sponge tent, and, considering the hopelessness of an operation for true cancer, its trial is recommendable. -Archiv f. Gynaek.

The influence of obstetrical operations, as to the number of still-born babies, has been examined by several

statistics. The more operations the more deaths, due to the cases, not to operating. Some countries show less deaths and less operations. The favorable influence of artificial interfering appears small.-Ibid.

Prof. Hildebrant mentions a case of spasm of the levator ani during sexual intercourse, and proves that Sims' hypothetical sphincter vaginae superior is nothing else than this muscle.-Ibid.

Tetanus of the womb, when the birth beginning, is not an active contraction. All authors agree in this. The fœtus is simple retained, not laced around. Dr. Lahs says: The water flows away by abdominal pressure, the womb lays then around the foetus and remains so, whether the labor commences or not. The unequal pressure to the uterine walls is the cause of unequal distribution of blood and of inflammation.-Ibid.

Prof. Binz recounts the noxious effects of quinine: 1. On the nervous system and the heart; weak convalescents and persons with organic heart diseases should not take large doses.

2. On hearing, it can be lost for a life time.

3. On the speech the same.

4. On the sight the same.

5. Bleeding in the lungs and eruptions on the skin

can ensue.

6. The intestines are undoubtedly the most irritated by large doses. Their secretion is alkaline during fever; quinine should be given a little acidulated.

7. Bright's disease and inflammation of the bladder can be caused.

Dr. Zeroni says in regard to this: It is stricking that convalescence after quinine treatment in typhoid fever is so much protracted, he refers to a post mortem section, where the spleen'was of 200 grammes weight, 100 per cent. lighter than an ordinary typhoid spleen, and some lighterthan in healthy state.-Deutsche Klinik.

In regard to bad events by the sponge tent v. Gruenewald says, inflammation of the womb and rigidity thereof are contraindications. Kuneke holds up Sims' rule, to leave it in not longer than 24 hours; Winkel recommends gentiana or laminaria for doubtful cases; Henning applies it with carbolic acid.-Memorab.

Dr. Lorey of Christ's hospital, at Frankfort, gives his experience with hydrate of chloral in whooping-cough. He used the following solution: Hydrate of chloral 5.0, water 150.0, orange-peel syrup 15.0, and gave a teaspoonful to half a tablespoonful in the morning and one or two at bed-time, so that 0.25 to 1 gramme was taken daily.

1. The remedy was well borne.

2. The attacks were diminished in frequency, about 12 in 24 hours.

3. The convulsive stage was very short; perhaps the epidemic was mild.-Deutsche Klinik.

Hydrate of chloral was successfully used in spasms of the wind-pipe by Dr. Behn. The prescription was hydrate chloral 0.53, syrup 20.03, a teaspoonful every four hours.-Iahrbucher f. Kinderkeil.

Dr. Heilberg publishes 300 cases of transplantation of skin the largest piece was of the size of three centimeter; he recommends the size of one centimeter and several pieces, the operation to be repeated every three days, the time when they commence to form adhesions.Berlin Klin. Wochensch.

In a case of lymphoma, where iodine and quinine have failed, Fowler's solution in ordinary doses was successful in about four weeks.- Wiener med. Wochensch.

On Niemeyer's thirst-cure of pleuritic exudation, Dr. Pinser publishes favorable results. Purulent exudation can not be absorbed.—Allgem militar. Ztg.

Pirogoff publishes his report on the last German-French