CORRESPONDENCE.

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Note From Our Oldest Subscriber

Three hundred years before Christ, Aristotle and the human race in general declared the human brain is so much stuffing to give shape to the cranium for appearance sake, but within the last century Gall and Spurzheim have launched the science of phrenology on the earth. I am convinced that there is much truth in it and that it cannot be eradicated from the earth. On page 645 of the BUFFALO MEDICAL JOURNAL, Vol. X, can be seen. an article of mine on the production of sexes. In the same volume can be seen an article of mine on the constitutions and temperaments. SILAS HUBBARD, M. D., E .Aurora.

ABSTRACTS.

AVULSION OF NERVES IN FACIAL NEURALGIA WITH REPORT OF FOUR CASES, Herbert P. Cole, M. D., Mobile, Ala., Charlotte Medical Journal, April, 1913. (Plates used by courtesy of Editor.) Simple section of the nerve offers the least benefit of the minor operations. The high mortality rate in resection of the Gasserian ganglion always warrants our first attempting minor procedures for the relief of this condition. Many cases present grave lesions contra-indicating the radical Gasserian ganglion operation. Of the Gasserian operations apparently Murphy's extra-dural section of the ganglion with the interposition of a wax plate pressed into the foramen ovale appears to offer all the benefits of the Gasserian resection with a greatly reduced mortality rate.

The permanency of cure from the avulsion method depends not alone upon the thoroughness of the avulsion and whether or not the ganglion itself has become involved, but also upon the thoroughness with which we block the proximal nerve root to prevent the regeneration so prone to occur in all sensory nerves. The silver screw fixed in the infra orbital foramen offers a successful obstacle to the regeneration of the infra-orbital division. The supra-orbital stump has been successfully blocked by rolling it in a flap of frontal periosteum which may be rolled. under the orbit. As yet we are unfamiliar with any method of blocking the roots of the inferior dental or lingual nerves.

Conclusion. The temporary relief obtained in all of these cases in periods from seven to thirty-three months, together

SCHEME OF OPERATION.-Note that the supraital branch is being slowly avulsed by twistupon a hemostat. The proximal stump will rolled up in a flap of frontal periosteum and ked under the roof of the orbit. A solid wer screw permanently plugs the infra-orbital amen from which the infra-orbital branch 5 been avulsed.

with apparent permanent cure in one case operated on nearly
three years ago, certainly justifies us in attempting this procedure
in preference to the ganglion operation in cases of tri-facial
neuralgia.

CASE 4.-Actual specimen-slightly reduced. 1. Right supra-orbital nerve. Note that only one of the terminal divisions was avulsed.

Left supra-orbital nerve.

2.

BUFFALO MEDICAL JOURNAL

INDEX FOR ANNUAL VOL. 68
From August, 1912, to July, 1913

Contributors of Original Articles.