The question of incision of the drumhead was discussed from a conservative and from a radical standpoint. The writer was radical in his views because of the lack of proportion between the earache and the causal infection. He was not inclined to believe that it aborts mastoiditis. As many cases of mastoiditis occur now as in the days of conservatism. The incision.in the drum should begin below, because the drumhead slopes downward and inward, and because the drumhead is less sensitive below than above. Pressure should not be exerted by the knife, since the pain of cutting results as much from tactile sensibility as from solution of continuity.

Local anesthetics are disappointing. General anesthesia or anææsthesia gained from compression of the carotids (Javanese method) are reliable. The after-treatment of the incision should be that prescribed by general surgery.

In conclusion the writer mentioned preventative treatment. Preventative treatment aims to diminish infection in the nose and throat during the course of infectious diseases by sprays of antiseptic oils or by applications; to treat colds in childrtn more rigorously; to remove adenoids and a catarrhal dyscrasia by appropriate local surgery and general medical means; to interdict forcible blowing of the nose, especially during a cold; to keep the head high in children whose ears are likely to be affected; to examine frequently the ears of children who have obscure diseases or who have symptoms unusual to the disease in hand. Aural diseases may exist and the child may not appear to have earache and not know how to express or to localize pain.

Statistics show that acute otitis media is more often thought to be pneumonia than any other condition. They also show that one-third or one-half of the babies with disturbances of nutrition develop middle-ear inflamation. Therefore the ears should be examined as a routine procedure.

Dr. D. S. Dougherty opened the discussion of Dr. Mc Auliffe's paper. He emphasized the necessity of free and early incision in a case of acute otitis media. He did not advocate making the incision immediately upon the occurrence of pain or of slight reddening of the drum, but in children this might be wise. He had seen several ears affected as a sequel to measles, and in some

of them he temporized, and on looking at them the next day, found the drum had ruptured itself. He also advocated making a wide, sweeping incision, opening the flap freely.

Dr. Abraham said it had been demonstrated by Geiger and Lannoys that the normal tympanic cavity is free from bacteria. Therefore inflamations of the middle ear following sea bathing must be due to the entrance of the water into the middle ear through the Eustachian tube, carrying with it pathogenic microorganisms from the nasal and naso-pharyngeal cavities. He thought the nasal douche the direct cause of many attacks of middle ear inflamations. The faulty method by which some persons blow the nose, holding one side and exerting pressure on the other also accounts for many attacks of otitis.

He differed with Dr. Mc Auliffe only with regard to paracentesis, and wished to add a few local applications that had proven very successful in his own work. He classified acute middle ear diseases into acute catarrh and acute inflamation and suppuration of the middle ear. In acute catarrh it is absolutely unnecessary to perform paracentesis in the majority of cases. Of fourteen cases of acute middle ear disease seen by him during the last few months, five were of a suppurative character and the others entirely catarrhal. In the former paracentesis was performed in every case, thoroughly and radically; in the remaining nine cases paracentesis was performed in only one. Dr. Quinlan said that a hot bichloride douche of solution of mercury would soothe the ear. He said that when incision was made in the drum a smear should be made at once to see whether any infection was present.

Dr. McAuliffe closed the discussion, saying that while the bichloride might relieve the pain, it relieved only the outside tissue and a great deal of inflammation might go on beyond these tissues and the bichloride would have no effect whatever.

AN EDITORIAL FOOTNOTE FROM THE DECEMBER (1903) ALKALOIDAL CLINIC. The ancestral foundations of all the liquid antiseptics before the medical profession is Listerine; happy in name, happy in formula, and happy in time of birth. It has been, is, and ever will be, first and foremost in this field. The Lambert Pharmacal Campany is to be congratulated on its success.

Beconds, Beqollections and Bęminiscences.

CIRCULAR LETTER FROM THE PRESIDENT OF THE ASSOCIATION OF MEDICAL OFFICERS OF THE ARMY AND NAVY OF THE CONFEDERACY.

MY DEAR DOCTOR :

Tazewell, Va., April 25, 1904.

The reunion of the United Confederate Veterans will be held in the city of Nasville, Tenn., June 14, 15, and 16., prox.

At the same time and place the Association of Medical Officers of the Army and Navy of the Confederacy will hold its annual session.

The annual meeting will be held in the Medical Department of the University of Tennessee, on Broad St., between High and Vine Sts., only three blocks from the Union R. R. Station, and will be called to order at 10 o'clock A.M., Tuesday, June 14, 1904. EXTRACT FROM THE CONSTITUTION AND BY-LAWS:

"The object of said organization is to cultivate a friendly feeling among the members of the profession who served in the Medical Department of the Confederacy, also to collect through its members all material matter pertaining to the medical service of the Army and Navy of the Confederacy.

"All members of the medical profession who served as Surgeon, Assistant Surgeon, Contract Physician, or Acting Assistant Surgeon, Hospital Steward, or Chaplain, during the late war between the States, shall be eligible to membership as members, and the Secretary shall be instructed to enroll their names as such when application in writing is furnished, together with a statement of the official position and rank held in the Army or Navy of the Confederacy by the applicant.

"All Confederate veterans who are regular doctors of medicine are eligible to membership as Associate Members; and all sons of Confederate veterans who are regular doctors of medicine shall be eligible to membership as Junior Members."

A membership fee of one dollar shall be required of all when they become Members, Associate Members, or Junior Members,

and all shall be required to pay the sum of one dollar at each subsequent meeting they may attend. The membership fee or annual dues, must be paid before participation in any meeting of the Association.

The railroads have established a rate of one cent per mile each way, and we have positive and reliable assurance that the rates of all hotels, boarding and lodging houses will not be exorbitant or extortionate.

It behooves each member of our body to be present and aid in building up our Association, and I hope you will contribute and present some historical fact bearing on our branch of the service.

Scarcely four decades have passed since we furled our banners. Our numbers are rapidly growing less, and unless strenuous efforts are made to collect material for preservation, we will be unable to place on record the services of our noble confreres who so faithfully and conscientiously discharged their duties in those dark days that tried men's souls.

Yours truly and respectfully,

JNO. R. GILDERSLEEVE, M. D., President.

SECRETARY'S CIRCULAR.

Association of Medical Officers of the Army and Navy
of the Confederacy.

Office of the Secretary.

Nashville, Tenn., April 25, 1904.

MY DEAR DOCTOR: The Annual Reunion of the United Confederate Veterans will be held in this city June 14, 15, and 16, prox., and while every one who wore the "Gray" in the terrible four years of the great War between the States will be most cordially welcomed, to none will that welcome be warmer and more sincere than to the surviving members of the Medical Departments of the Confederate Army and Navy.

The Association of Medical Officers will hold their annual meeting at the time of the General Reunion, and Prof. Paul. F. Eve, Dean, and the faculty of the Medical Department of the University of Tennessee have offered us the use of their College

Building located on Broad Street, between High and Vine Streets, only three blocks from the Union or Terminal R. R. Station, in which to hold our meetings. The building is readily accessible and admirably suited to the needs of the occasion.

The railroads have granted a rate of one cent per mile, each way, to all who may come.

The Nashville Academy of Medicine, the local medical organization, at the annual meeting held April 5, which was largely attended, by unanimous resolution agreed to take charge of our Association, and have appointed a General Committee consisting of Drs. Geo. H. Price, Paul F. Eve, Wm. G. Ewing, G. C. Trawick, and D. R. Neil, who will have charge of the matter, aided by such sub-committees as they may select to assist them.

The meeting will be opened at 10 o'clock on Tuesday morning, and the subsequent sessions will be so arranged as not to conflict with the other reunion features and exercises. Members of the Association and those desiring to become members, on reaching the city, are requested to come at once to the place of meeting, where members of the various committees will be found.

The work done by the commissioned and non-commissioned officers of the Medical Departments of the Confederate Army and Navy during that most remarkable epoch in the history of our great country, is to a great extent but a matter of tradition and recollection on the part of the survivors, and well worthy of perpetuation on the printed page. To those who are now, or may become, members of our Association is this duty left, a duty incumbent on them for the sake of their associates who are no more, and as a legacy for their descendants and ours. All that is asked is that the true facts of our history during those days may be preserved. Will you then, my comrades, my associates, my fellow-soldiers, come and meet with us and join in this important work?

Each and every one who can come is respectfully requested to prepare a paper containing some fact of the past that he may deem worthy of perpetuation. Short, practical statements of what you may have observed at some period of your service will be most heartily appreciated. All who will prepare papers or essays are respectfully requested to inform me before June 1, by