C. METHODS OF EXAMINATION AND TREATMENT.

170. Gutzmann, H. On hearing exercises with the phonograph. O., 1902, No. 8.

M. f.

171. Marage. Scientific treatment of deafness. Arch. internat. de laryngol., d'otol. et de rhinol., Juillet-Aôut, 1902.

172. Bayer and Pennickx. Static electricity in otology. Journal médical de Bruxelles, 1902, No. 39.

173. Harris, Thos. J. Prognosis of chronic catarrh of the ear. Annals of Otology, Rhinology, and Laryngology, August, 1902.

174. Gomperz. On improved hearing after suppurating otitis. Arch, des mal. de l'or., du lar., 1902, No. 8.

175. Bentzen. On improving the hearing with the artificial ear-drum. M. f. O., 1902, No. I.

176. Oaks, J. F. On the use of hot air in Eustachian catheterization. Laryngoscope, Sept., 1902.

177. Spiess, G. Anesthesin, the new, local anesthetic, with remarks upon the routine action of anesthesin. Münch, med. Wochenschr., 1902, No. 39. 178. Lehmann. Adrenalin. Münch, med. Wochenschr., 1902, No. 49. 179. De Stella. Report of the physical action and therapeutic use of adrenalin. Bulletin de la société de médecine de Gand, Sept., 1902. 180. Taramasio. Toxicology of adrenalin. Romande, 1902, No. 8.

181. Escat. Adrenalin in nasal surgery. d'otol, et de rhinol., Sept.-Oct., 1902.

Revue médicale de la Suisse

Arch. internat. de laryngol.,

182. Schubiger-Hartmann. Adrenalin. Correspondenzblatt f. Schweizer Aerzte, 1902, No. 21.

183. Goldschmidt, A. The use of adrenalin in the treatment of nose and throat. M. f. O., 1902, No. 9.

170. The author recommends the phonograph for vocal training, to replace the hearing exercises, and especially in deaf-mute institutions. In one case, the patient was able to distinguish readily the vowels, by the hearing, with the aid of the phonograph. The author seems to regard the hearing exercises as of some value. BRÜHL.

171. As massage of the drum may be injurious owing to the excessive excursion of the ossicular chain which it produces, the author has advised a vibratory apparatus, on the principle of the siren, which communicates to the stapes vibrations of the same character as those of an enunciated word. The fundamental vibration of the German vowels “u, a, o, e, i," serves at the same time to measure exactly the hearing power. The author has employed his apparatus in various forms of deafness, and the results which he accomplishes are truly remarkable. RAU.

172. Treating the drum membrane with static electricity: Fifteen cases of deafness and partial tinnitus, usually produced by affections of the sound-conducting apparatus. An improvement in hearing and diminution of the noise were obtained. The accompanying case-histories do not, however, seem to be quite positive proofs of the author's statements. It seems that most of the affections were the subsequent conditions to chronic disturbances in the nose or naso-pharynx, where, as is well known, local treatment often produces a decided improvement of the symptoms. It is therefore not improbable that the improvement obtained was principally due to the preceding local treatment. RAU.

173. HARRIS believes that the progress achieved in the treatment of chronic catarrh of the ear has been small and our chief success rests in the ability to set aside the cause originating the nasal catarrh. Tubal therapeutics and pneumo-massage are at best only of temporary benefit and in the hands of some even harmful. Prophylactic measures are of greatest value, especially the early removal of adenoids. Naso-pharyngeal catarrh in every instance is capable of at least temporary cure by removal of some local cause, although the local cause may not turn out to be the real cause. Then we must look for it in some general dyscrasia, the removal of which is essential to success, although not possible in all instances. CLEMENS.

174. GOMPERZ speaks of the value of triacetic acid to close large perforations, and, in cases where this is unsuccessful, of the value of artificial drums. He has had good success with chemically pure silver and vaseline. In cases of adhesion between the malleus and promontory, these are to be released and to be kept separate by the introduction of celluloid strips.

ZIMMERMANN.

175. The author has examined seven ears with double defects of the drum membrane before and after the introduction of the artificial drum. The examination was with whisper, continuoustone series, Galton whistle, Weber's and Schwabach's experiments. The results are as follows:

2.

1. The hearing distance for whispering voice becomes greater. The lower tone-limit descends. 3. The upper tone-limit remains. 4. The quantitative hearing power is increased. 5. The bone-conduction is usually enlarged.

Thus, it is seen that the artificial drum serves for the better comprehension of the conversational voice. The author has

observed, after a prolonged use of the artificial drum, a permanent improvement in hearing.

PIFFL.

176. The apparatus described consists of a brass tube, around which is woven a coil of wire of high resistance. A packing of asbestos surrounds the coil, which is further encased in a brass tube of small dimensions. The distal end is in form of a metal tip, and the proximal end is made of black fibre. The heat generated by the high resistance wire causes the inner brass tube to grow sufficiently hot to heat the compressed air in its passage through it. A metallic catheter covered by hard rubber is used with no uncomfortable sensation of heat or burning to the patient. The catheter is of ordinary size and being flexible it can be bent almost as freely as a silver one. CLEMENS.

177. The difference in the action of cocaine and orthoform is discussed. That anesthesin acts similarly to orthoform is, however, to be proved. It may be employed after operations to relieve pain, and it is supposed to favor the healing of the wound. It is of advantage in whooping-cough and acute coryza.

SCHEIBE.

178. After a prophylactic injection of 1 to 2 ccm of 1:1000 adrenalin solution in the livers of rabbits, small pieces of liver could be excised without hemorrhage. A marked hyperæmia set in after this without hemorrhage. There were no symptoms of intoxication. Thus far, no toxic action has been observed in man. SCHEIBE.

179. The author reports on experiments with dogs and rabbits. After intravenous injection, the general action set in, even after ccm of the 1:1000 solution: excitement, then paralysis of the vagus centres. After the other method of application, the local action was the principal one. For operations in the nose, the introduction of the tampon soaked in a mixture of adrenalin and cocaine is advised. He thinks that thus the dangers of cocaine intoxication are also diminished. For operations in the mouth, adrenalin is to be injected in the tissue. It is also of service in the mastoid operations. No severe afterhemorrages have been observed. RAU.

180. After numerous experiments on animals, the author finds that adrenalin in subcutaneous injections is fatal for rabbits in a dose of 0.02 gram per kilogram, in some cases 0.004 gram. Corresponding doses in the guinea-pig varied between 0.01 and

0.004 gram. Death resulted in less than one hour from acute oedema of the lungs, with dyspnoea, fall of temperature, diminution of sensibility of the reflex and the voluntary motion. In the frog, a dose of 0.5 gram per kilogram is always fatal. RAU.

181. ESCAT always employs a mixture of adrenalin and cocaine. He thinks this is contra-indicated in some diseases: in cases of adrenalin intoxication, syncope (cerebral anæmia). Careful packing after operation is indicated to prevent after-bleeding. RAU.

182. The authors have employed adrenalin in acute empyema after coryza. It was introduced on pledgets of cotton and relieved the symptoms. The removal of polypi from the middle ear is always aided by the previous use of adrenalin. RAU.

183. This author has tested the hæmostatic action of adrenalin, and has found that it serves in acute epistaxis, as well as to prevent bleeding after operations. BRÜHL.

d.-DEAF-MUTISM.

184. Hammerschlag, Victor. A new subdivision of the various forms of deaf-mutism. A. f. O., vol. lvi., P. 161.

184. The objections to the present classification are:

1. The previous subdivision into congenital and acquired is not grounded on pathological or clinical differences.

2. Pronounced congenital forms of deaf-mutism may appear under the clinical picture of acquired.

3. Acquired deaf-mutism may be acquired intrauterine.

4. Endemic deaf-mutism cannot be grouped in either of these subdivisions.

A new classification is suggested. The author differentiates between (1) the deaf-mutism caused by local disease of the ear, and (2) constitutional deaf-mutism. The former is always acquired, usually in post-foetal life; the latter, just as the constitutional anomaly of which it is the rudiment, may be acquired or congenital. In the second group, the endemic are separated from the sporadic forms. HAMMERSCHLAG thinks that pathological research will succeed in finding characteristic marks for each one of these new forms. The observations are based on the research of Bircher. New investigations not made.

EXTERNAL EAR.

185. Broeckaert, J. Endothelioma of the auricle. gologique Belge, No. 8, 1902.

HAENEL.

La Presse otolaryn

186. Pooley, Thomas R. Epithelioma of the auricle and auditory canal. N. Y. Med. Jour., July 26, 1902.

187. Jürgens, E. Three cases of congenital auricular atresia with microtia. Monats. f. Ohrenheilk., 1902, No. 7.

188. Lamann, W. On pressure packing in furuncular otitis externa. Monats. f. Ohrenheilk., 1902, No. 6.

189. Wissiljew. Circumscribed external otitis. Wojenno medicinski Shurnal, Sept., 1902.

190. Ruprecht, M.

neus.

External croupous otitis caused by bacillus pyocyaMonats. f. Ohrenheilk., 1902, No. 12.

191. Ostino, E. Ulcerous tuberculosis of the external auditory canal. 192. Bogoslawski, D. On foreign objects in the upper ear-passages and in the nose. Wratschebnaja Gasea, 1902, No. 42.

193. Prota, N. Bilateral epidemic parotitis with suppuration and perforation into the external auditory canal. Meningitis. Death. Arch. ital. di otol., vol. xiv.

194. Treitel. Two cases of scalding of the ear. schr., No. 32, 1902.

Deutsche med. Wochen

185. Tumors starting from the vascular endothelium are very rare in the auricle.

A farmer, fifty-six years old, had had a small wart at the base of the right lobule since youth. The tumor had grown for two years. It is painless, though unpleasant on account of ulcerating. It is the size of a large strawberry, involves the entire lobule; the canal is free, and the function of the ear is normal. The tumor is removed: recovery. The growth shows an alveolar structure, and is composed of granular tissue with many leucocytes. The disposition of the epithelioid collection of cells, in round or oval alveoli or irregular compartments, suggests an alveolar or a plexiform sarcoma. With the high power the cells seem to be endothelial and not epithelial. The hyperplastic endothelial cells have caused a dilatation of the lymphatic spaces and capillaries, thus producing the alveolar structure of the tumor. The tumor belongs to the group of angio-sarcoma and is designated by the author as an interlymphatic endothelioma. BRANDT.

186. The patient, male, aged fifty-eight, some five years before seeing the writer, found a nodule on the auricle which subsequently broke down into an ulcer. The growth was situated in the upper part of the helix just about the region of the antihelix, and from the lower part of which extended whitish reticular tissue involving the concha, tragus, antitragus, and auditory canal. The growth was half an inch in length by three quarters of an inch in width. The case was operated upon and all suspicious tissue