stove with funnel and sleeve to cover the ear has helped two recent cases greatly. In one, especially, there were all the symptoms of Ménière with profound deafness and vertigo, in which the use of hot air daily by the stove improved the hearing more than one half and entirely relieved the vertigo in the course of six weeks, after many remedies had been tried in vain for as many months. With the cylinder apparatus the patient is tied down to daily visits to the doctor, whilst with a stove for each case more regularity is obtained at home. If the patient must be under close observation, visits to the medical adviser can be made as often as needed. Hot air applied into the ear in this latter way is a distinct advance in otology and in the treatment of tinnitus.

A manufacturer in our city makes a handy atomizer for albolene solutions. By using this as an inflator, instead of the usual Politzer Bag, vapors can be gently forced into the middle ear as the patient swallows. Most of my patients get one of these and use it at home under proper instruction. Chronic cases find this more helpful in relieving the tinnitus than any other method.

Thiosinamine is unstable; yet it may be tried. It ought to be used more often daily than once, as advised in literature, if any effect is desired. Most people find no trouble in taking a grain or even two, three times daily, about an hour after meals.

Personal experience is always useful, and for the last time speaking personally, the late James Hinton relieved for me an annoying tinnitus by perforating the Mt, and syringing soda-bicarbonate through it into the naso-pharynx. The operation, without an anesthetic, was not very painful. The worst sensation was a frozen feeling at the tip and one side of the tongue, when the knife approached the chorda tympani. That tinnitus never returned, and the hearing was not injured.

Massage, as was mentioned before, can be more scientifically applied by the motion of the lips and tongue, than by mechanical motors, and is a useful aid in some cases of tinnitus.

The fact that the application of the galvanic current through the auditory nerve causes a tinnitus which varies in pitch in different persons, suggests its more exact use in the treatment of this affection. Discover the special intensity which produces certain notes in normal ears; then utilize that intensity in abnormal ears with a similar pitch of tinnitus.

Finally, an observation which I have made, that the exposure of an ear with tinnitus of a certain pitch to the prolonged action of the tone of an organ or reed pipe or violin string of the same pitch diminished and even removed permanently for a certain length of time the disagreeable subjective sensations, seems to open a new field in the treatment of this obstinate affection. This observation has been one of my principal reasons for bringing again before this Society the question of tinnitus, with a view to a more accurate and scientific localization of the pitch, combined with a more striking musical notation than has been commonly employed. It is only by leaving the old ruts and trying other methods that we may in time do better work in a series of mostly hopeless cases of tinnitus. Let younger men with good hearing and some musical education study their cases more carefully, and they may look forward hopefully to doing more efficacious work than their predecessors have done. For if it is true, as Zaufal has suggested, that there is a certain set of auditory cells more easily affected by irritations than others, what those cells are, and where they are situated in the labyrinth cannot be more probably discovered than by studying and investigating their location-pitch as exhibited by their tinnitus when they are irritated.

THE UNIVERSITY CLINIC FOR DISEASES OF

THE EAR AND THROAT IN ROSTOCK.

BY THE DIRECTOR, PROF. O. KOERNER.

(With appended Plates XI. to XIII., Vol. XXXVI., Zeitschrift f. Ohren

heilkunde.)

HE clinic is built so as to face the south.

ΤΗ

On the west

side there is a separate entrance for the dispensary patients. The main entrance is on the east side.

In the basement there is a room for storing the clothes of the patients, who put on the ordinary hospital wash clothing directly after the bath; closets, heating-apparatus, and coalbins. The heating is the low-pressure steam system. There are two furnaces of which each can be used alone. In connection with this heating-apparatus, there is a boiler for hot water which supplies hot water to all the floors. There is another boiler for the hot-water pipes to be used in the summer. In connection with the heating there are pipes which convey the heated air to all the rooms and shafts which carry away the exhausted air. The illumination is electric; the medical apparatus for illumination, trans-illumination, and galvano-caustic are in connection with the general electric current. Gas is only used for the sterilizers in the small rooms next to the operating-room and in the dispensary, the laboratory, and the kitchen.

The corridors and stairways are so arranged that daylight is admitted to all corners. The halls are unusually large and can be used as day rooms for patients, and also for the purpose of functional examination of the hearing. The staircase is of iron with oak steps.

The ground floor contains the dispensary rooms in the centre. The entrance leads into an anteroom which divides the dispensary proper and the waiting-room. This room serves for a cloak-room.

Next to the dispensary room there is a dark room for trans-illumination and a room for dressings. The dispensary is also used as a lecture room. There are further a bath-room and laboratory with a museum of normal and pathological specimens. Two rooms are assigned to the director (executive surgeon) which include a library. The residence rooms of the first-assistant are also on this floor.

A large wing contains the operating-room and a number of adjoining small rooms. The floor is of mosaic. The operating-room is furnished with a broad window looking north, reaching to the ceiling.

The two rooms over the operating-room are the children's wards and a room for the nurses. Each ward contains eight beds. There is a large space which can be used as a play-room. The large room over the dispensary is the male ward. This has room for eight beds. The rooms over the laboratory are the female wards and contain four and two beds. The remaining five rooms are for private patients. The furnishings are very simple but substantial. In the top story there are isolation rooms and rooms for the help. In a southerly direction there is a garden 50 x 15 metres which can be used as a play-ground. On the north side there is another open space four times as large, which also serves for a garden.

THREE CLINICAL COMMUNICATIONS TO

OTOLOGY.'

BY. EMIL AMBERG, M.D., DETROIT, MICH.

I. ADDITIONAL REMARKS TO THE REPORT OF A CASE OF SCOTOMA AURIS PARTIALE CENTRALE ET

TH

PERIPHERICUM.

HESE remarks constitute a supplement to the case reported before the Wayne County Medical Society, November 20, 1902, and published in the Journal of the American Medical Association, January 17, 1903.

February 25, 1903. After catheter: Both drum membranes retracted in their totality; convex, like the segment of a globe, toward the promontorium. Hearing for low tones diminished, especially on left side.

1 Read before the Eye, Ear, Nose, and Throat Section of the Wayne County Medical Society (Michigan), April 27, 1903.