his own experience and from recently published lists, especially from a series of 150 cases collected by Damianos and Hermann. Among the causes often ascribed for hemorrhage the author believes that hemophilia, or wounding of either carotid or an anomalous vessel, are very rare causes of this comparatively common accident. The tonsilar artery is seldom injured, nor even its larger branches, unless the extirpation is very radical. Obstinate bleeding seldom comes from the stump of the gland, but generally from some wound of the anterior or posterior pillar. In the majority of the author's cases the upper portion of the posterior pillar was the source of the bleeding. This is accounted for by the fact that in gagging the posterior pillar is pushed into the guillotine. This instrument has the disadvantage that the cutting is seldom done under as accurate observation of the parts as with other instruments. After tonsillotomy a patient should be kept for a considerable time in a sitting position and no fluids collecting in the throat should be swallowed. In regard to treatment the author is surprised that such means for stopping the bleeding as astringent and cauterizing fluids and powders should be so often recommended, or complicated and difficult manipulations such as suturing or the use of elaborate instruments. The most satisfactory method is by digital com pression. The bleeding point should first be found and it can then be controlled with certainty. In rare cases it may be necessary to take more radical measures, such as tying of the carotid, but generally the bleeding will stop within a few minutes under light pressure with the finger wrapped in gauze.- Boston Medical and Surgical Journal. ETHYL CHLORIDE THE November, 1905, Laryngoscope, a paper by Drs. S H. Large and Edgar D. Brown details the results of experiments in administering ethyl chloride to animals. The conclusions are that ethyl chloride is rapid in action, causing little struggling ; that it is not necessary to abolish the reflexes to establish in sensibility to pain; like chloroform it causes a lowering of blood pressure; it first stimulates, then paralyzes the respiratory center; it is practical as a general anesthetic for short operations and as a preliminary to ether and chloroform, but is not without actual danger when the administration is prolonged.— Brooklyn Medical Journal. MEDICAL HEPATIC COLIC AND GASTRIC CATARRH SUCCESSFULLY TREATED BY LAVAGE OF THE STOMACH WITH HYDROZONE. THE patient, an engineer by profession (St. Louis Med. and Surg. Jour., August, 1905), of fair size and weight, about fortyfive years old, of temperate habits, nervous temperament, has been a severe sufferer from hepatic colic and catarrh of the stomach for several years. Although having a fair appetite, the patient had frequent attacks of vomiting a large quantity of mucus and bile. In addition to the above symptoms, he was troubled with periodical attacks of hepatic colic, which were so severe that I was induced to diagnose his trouble as being caused by the presence of gall-stones. None of the remedies which were prescribed previous to Jan. 5, 1904, seemed to have any beneficial effect, while the periodical acute attacks made their reappearance more frequently (every four or five weeks). Having read in medical journals several clinical reports in which Hydrozone and Glycozone were highly recommended in the treatment of diseases of the alimentary canal, I concluded to prescribe Hydrozone before meals and Glycozone after meals. in varying doses for about two months without any appreciable benefit. A dose of castor oil was also administered every other week, while olive oil was given at bedtime. The patient was growing weaker quite rapidly until an acute attack of hepatic colic which occurred, beginning of April, 1904, plainly showed that the above treatment was not powerful enough to subdue the cause of his trouble. Then I persuaded him to resort to lavage of the stomach with diluted Hydrozone. I commenced treatment on the 5th of April, 1904, with Hydrozone, 100 grams, warm water one quart; the stomach was washed every third day in April and every second day in May, when the Hydrozone was increased to 150 c. c. (about five fluid ounces), and was kept at that amount throughout the treatment; during the month of June the stomach was washed out every day, July every fourth day, August and September once a week. The improvement was noticeable already at the end of April, when the quantity of bile and mucus was much lessened. In September the benefits derived from this treatment proved conclusively that it had not been used in vain. Internal treatment was by means of Glycozone, two teaspoonfuls before and after each meal, and every three weeks a good dose of oleum ricini. Up to date the patient has not had another attack of hepatic colic since April, 1904, while he is now enjoying good health. The results that I have obtained in this particular case are so gratifying that I resort now exclusively to Hydrozone and Glycozone in the treatment of all cases of stomach diseases, and I believe that with the exception of stomach and intestinal disorders resulting from the presence of a malignant growth, all other cases can be successfully treated as above outlined.- Francis H. Weismann, M. D., New York City. PNEUMONIA. The pneumonia season is rapidly approaching. Soon the various journals will be full of the statistics of past years in regard to the prevalence and fatality of this disease. The pathology and etiology will be thoroughly gone over, but, judging by the past, most writers will have very little that is encouraging to say as regards treatment. Several points, nevertheless, must be kept in mind. Whatever drugs are used internally (and this depends very much upon the individual case), the patient must have plenty of fresh air. Do not be afraid of his taking cold on account of the cold air blowing across his face. It is now considered that this is impossible. Also, whatever drugs may be used, keep the body warm with suitable clothing, and use externally some preparation which will cause a comparative lessening of bloodpressure in the lungs. Cold applications, besides lowering the vitality of the patient, cause a depletion of the superficial vessels and consequently increase the hyperemia in the lungs themselves. Our attention then would be drawn, per contra, to hot applications. To the most of these there are very great practical objections, such as their inconvenience, their tendency to grow cold very rapidly, and the fact that they must frequently be renewed, thereby disturbing the patient's rest to his manifest detriment. We have found but one form of hot application which seems to us to entirely fill the bill, and that is Antiphlogistine. By its means the vitality of the body is conserved, the blood is attracted to the surface and away from the lungs (its hygroscopic action remarkably enhancing this effect), and the tone of the heart's action is maintained. Besides this, its frequent renewal is not necessary, and the patient's rest is not thereby disturbed. Practically we know that by its use the patient is made much more comfortable, the fatality is much decreased, and if abortion of the disease is possible, we believe it can be accomplished better by this means than by any other.-Kansas City Medical Record, October, 1905. PULMONARY ATELECTASIS IN ADULTS. Contrary to what is usually taught and believed, William R. Huggard claims (Brit. Med. Jour., Oct. 14, 1905) that atelectasis in adults is extremely common at the apex. In order to elicit the physical signs of this condition a change in the orthodox order of examination is indispensable, since the deep breathing demanded during inspection clears away or diminishes the evidence sought. This is shown by the fact that if percussion is employed before and after deep breathing dulness will often be observed over the apex of the lung at the first percussion, whereas a clear note is elicited at the second. The usual physical signs in this form of atelectasis are dulness, with feeble breath sounds, the dulness diminishing or passing off after a few breaths, the breath-sounds at the same time becoming more distinct. A few stick rales can often be heard toward the end of the first few deep breaths, but they gradually get fainter, and then disappear. Most frequently pulmonary atelectasis is found, first, from the apex to the second interspace in front; next, the suprascapular, and then the interscapular region. The treatment of the condition per se is systematic deep breathing and exercise. - Medical News. TREATMENT OF PSORIASIS. Dreuw (Munschen. Med. Wochenschrift, No. 20) recommends a combination of chrysarobin with green soap in the treatment of psoriasis. The ointment consists of ten grammes of salicylic acid, twenty grammes each of chrysarobin and oleum rusci and twenty-five grammes of green soap, and the same quantity of lanolin. The treatment is as follows: The patches are painted by means of a bristle brush, on from four to six consecutive days. They are then dried by dusting with a little starch or zinc powder. After the fifth or sixth day, the parts are bathed daily for from one to three days, and anointed with petrolatum each time. This course of treatment lasts about eight days, and is repeated two or three, or at most, four times, according to the severity of the case. The eruption disappears. and the distinguishing feature of this method is that it does not. irritate the surrounding skin. The patient should wear old underclothes during the treatment, and afterwards destroy them. -Medical Fortnightly. THE RELATION OF PLEURISY TO TUBERCULOSIS. Von Ruck (N. Y. Medical Journal, Sep. 20, 1905.) Formerly the pleural cavities were regarded as exceedingly well protected |