the deaf albinotic cat. The changes can be regarded as compression of the labyrinth vesicle by the bony capsule.

II. KRETSCHMANN: Formation of bone in the tympanic cavity of a boy, eleven years old. He had suffered from otorrhoea and abscesses since his first year. A concretion as large as a pea was found imbedded in granulations. A description of the chemical and microscopical examination is added. The name otolithiasis, proposed by Bezold, seems proper.

12. BRUEHL: Pharyngeal tonsil and auditory organ in idiots.

Among many interesting details, this author found that 75% of the idiots suffered from enlarged pharyngeal tonsils; 28% with enlarged faucial tonsils. The drum membranes were normal in 32%; 5-7% suffered from chronic otorrhoea and 14% from the sequelæ of suppuration; in 306, 36% heard under Sm; 22% under 4m; 20% heard with both ears under 4m. These high figures for enlargement of the pharyngeal tonsil are explained by the idiocy-viz., the carelessness and indolence. Though ear and nose diseases are not etiologically important for idiots, they may be, nevertheless, injurious to these patients.

This is especially evident by the unusually large number of deaf persons in the poorer classes of the idiot schools as compared to the small number in the better classes.

The bodily harm to which the idiots are exposed by their nose and ear troubles should not be lost sight of.

13. MANASSE demonstrated microscopic specimens of purulent inflammation of the labyrinth.

14. RUDLOFF: The course of the sigmoid sinus in the temporal bone of the child.

According to Macewen, the course of the sigmoid sinus in the adult is shown by a line which connects the deepest part of the parietal incisure of the temporal bone with the apex of the mastoid process. The author can confirm the correctness of this statement after having examined a great number of skulls in the museum at Marburg.

The conditions in the child, however, are quite different and are not mentioned in literature. In the temporal bone of the child, the anterior margin of the sigmoid sinus is posterior to Macewen's line to a varying extent. To explain this course and to show the development of the mastoid process, the author demonstrated five skulls of children of different ages.

15. HÖLSCHER demonstrated the operating towels which he had already described, and which, while assuring thorough asepsis, prevent the soiling of the occiput and back of the neck with blood or pus.

16. HAUG: After reporting the twelve cases of gangrene of the auricle which are found in literature, the author presents two further cases occurring in two sucklings. They presented very highly developed pædatrophy and gangrene of the auricle. The one child was ten weeks old, and both auricles were symmetrically gangrenous, and there was a large gangrenous ulcer on the right half of the neck. The other child was six weeks old and presented the signs of gangrene only on one side.

The author believes that the condition is due primarily to the pædatrophy, and secondarily to a secondary infection of an eczematous condition of the ear region.

17. FRIEDRICH spoke on disease of the maxillary joint from caries of the anterior wall of the auditory meatus.

18. WINKLER describes the exposure of the tympanal tuba ostium in connection with the radical operation.

19. WITTMAACK demonstrated microscopic specimens of acoustic neuritis with involvement of the cochlear nerve and of the spiral ganglion in tuberculosis.

20. ROEPKE: Hysteria as a sequence or accompaniment of aural suppuration.

Cases which develop hysteria during the course of otorrhoea are not unusual. A number of factors can be made responsible. The nervous system of a patient suffering from otorrhoea may be damaged through irrigations, cauterizations, and curettings. In a similar way the trephining of the mastoid process and the aftertreatment may act injuriously. The important moment for the development of the hysteria is the anxiety of many people suffering from otorrhoea that an intracranial complication may terminate their life. The hysterical symptoms may in these cases simulate intracranial disease. The differential diagnosis is then discussed and five cases are reported; in each, hysteria has set in gradually or suddenly during otorrhoea.

21. HEINE: Amnesic aphasia and hemiopia in abscess of the right temporal and occipital lobes.

A man, thirty years of age, with right-sided fetid chronic otorrhoea, was admitted to the royal ear clinic in Berlin. At the operation, a broken-down cholesteatoma was found, a sequestrum

in the antrum, and the dura exposed; three days later, pronounced and amnesic aphasia, agraphia, alexia, and paraphasia. The patient is right-handed. The operation exposed a small deep-seated abscess in the temporal lobe. The aphasia disappeared. After fourteen days, the same symptoms recurred with the appearance of general cerebral compression and hemiopia. The wound in the brain was dilated and three to four tablespoonfuls of fetid pus were evacuated. The improvement was followed fourteen days later by severe headache, vomiting, general prostration. The occipital lobe was exposed and an empty cavity found. A very large collection of pus was evacuated; the abscess extended in a median direction.

After ten days, another operation was undertaken on the brain. The brain substance was found partly softened, but no pus. After this, two attacks set in, a very severe headache, vomiting, and general collapse, which lasted for twenty-four hours.

Four months after the first operation, the patient was discharged cured.

This is the first case in which in a right-handed patient disturbances of speech were found in an abscess in the right temporal lobe, and shows that in cases of double-sided chronic otorrhoea with aphasic symptoms it is not always proper to operate only on the left side.

Discussion.-KOERNER: The "distant action" is not rare in cases of small abscesses, though it may be absent in large abscesses. It is probably due to slight encephalitis.

PASSOW found this substantiated in two cases.

22. BLOCH recommends scopolamin narcosis for lengthy operations. Three subcutaneous injections of one gram each are made of the following solution: scopolamin. hydrochlor., o.012; morphin. hydrochlor., o.12; aqu. dest., 10.0; the first injection four hours, the second two, and the last one hour before the operation. If any pain is felt during the operation, the chloroform mask is applied for a short time. There is no reaction on awakening.

Discussion.-WOLF questions the advisability of scopolamin in

children.

23. ESCHWEILER: Transplantation and first dressing after the radical operation.

Vioform gauze prepared according to Schmieden is recommended for packing. The first dressing remains for fourteen

days, and in five cases the transplanted skin healed. The retroauricular wound is sutured primarily. Transplantation is contraindicated on exposed dura or sinus. This odorless gauze works very well in the after-treatment.

In the discussion, WERNER, SIEBENMANN, and SCHEIBE report favorable results with vioform gauze.

24. HOELSCHER spoke on pus retention and extension of the purulent process in sclerosed mastoid processes.

25. KREBS: The preparation for and after-treatment of intranasal operations.

26. WINKLER: On the surgery of maxillary empyema.

REPORT OF THE TRANSACTIONS OF THE NEW

YORK OTOLOGICAL SOCIETY.

By T. PASSMORE BERENS, M.D., ACTING SECRETARY.

MEETING OF MAY 26, 1903. THE PRESIDENT, DR. J. B. EMERSON, IN

THE CHAIR.

DR. LUC OF PARIS AND DR. BRYANT OF

BOSTON, GUESTS.

Presentation of Patients.

Dr. GRUENING presented a patient on whom he had successfully operated for brain abscess. The patient-a boy thirteen years old-presented himself at the Mt. Sinai Hospital on April 15th with a temperature of 102° F. He had been sick for four weeks, and had had a discharge from both ears for six years. The right ear was quiescent, the left was discharging fetid pus and cholesteatomatous masses. The mastoid region was red, œdematous, and tender to pressure. Shortly after admission, he had a severe headache on the left side, a chill, and a temperature of 102° F. A radical mastoid operation was performed. Extensive caries was found, which involved the upper posterior bony wall of the external auditory canal. The malleus and incus were absent, and the antrum, which was much larger than usual, was found filled with cholesteatomatous material. The tegmen of the antrum was carious and the dura mater was covered with granulations. The wound was dressed in the usual manner and the patient did well. Eight days after the operation, the patient vomited and had a severe headache on the affected side. The temperature was normal and the pulse ranged from 48 to 54. The eyes were examined: the papillae were swollen, presenting the appearance of a neuroretinitis. The next day, April 25th, the symptoms were more pronounced, but there were no localizing symptoms and no sensory aphasia. The wound was reopened, and under antisep