and discharge, pain ceased. When seen two days later temperature 100 deg., no pain, profuse discharge and slight mastoid tenderness. Ear irrigated every three hours, ice-bag, calomel followed by saline. Symptoms persisted and edema over antrum appeared. Operation was suggested and accepted. Antrum was opened and found full of pus. Cells of tip were also full of pus, but no softened bone found. A probe was readily passed into digastric fossa. Pressure on swelling in the neck caused flow of pus. Entire tip was removed and cavity packed with gauze. Wound dressed on third day, temperature normal; fifth day drain removed. Healing uneventful, ear ceased discharging seventh day, and on fourteenth hearing was normal.

Case III.-Boy, age 8, deaf and dumb, due to meningitis when five years old. After an attack of measles complained of difficulty of eating, jaws being stiff, swelling behind and above ear. Temperature normal for five days, when it rose to 103 deg. Examination: membrane destroyed, posterior wall of canal swollen, ear dry; large swelling over mastoid tender and fluctuating. Incision over swelling and carried well down to the tips caused discharge of offensive pus. Bone over antrum softened and discolored, antrum full of pus and granulations; no sinus found. All soft bone chiseled away and wound packed with sterile gauze.

Case IV.-Male, age 35. For eight days pain in left side of head, occasional pain behind ear worse at night. Canal normal, drum slightly congested. Temperature normal; tenderness over mastoid region upward to vertex. Membrane incised; free bleeding and some pus. Cathartic, irrigation with hot bichloride solution. Ice-bag to mastoid for seventytwo hours caused tenderness to disappear. Discharge scanty and serous in character; temperature 99 deg. F. Incision was made, antrum opened and found full of pus. Lateral sinus was exposed, lying just posterior to canal wall. In enlarging bony cavity sinus was pinched by spicula of bone, bleeding was slight and controlled by pressure. Diseased bone removed and wound packed with sterile gauze. Recovery uninterrupted.

Case V.-Female, age 25. Pain in left ear following an attack of measles. Examination showed membrane swollen, red and bulging in posterior half, tenderness over antrum; temperature 102 deg. F. Paracentesis, ear irrigated every three hours. Ice-bag constantly applied to mastoid. Pain ceased, temperature normal; free discharge, some tenderness over antrum. This continued for twelve days when tenderness increased, but disappeared after use of ice-bag for forty-eight hours. Discharge continued for a week, after two weeks hearing was normal.

From the foregoing report it will be seen that temperature give no clue to condition present it may remain normal, as in case IV, where abscess cavity was large. Bulging of posterior wall of canal was present in the advanced cases, but not in the acute. Pain, tenderness and swelling over the antrum was only symptoms of diagnostic value. Case I.-Time of infection of mastoid process not known, but probably existed two weeks. There was but little destruction of bone and abscess confined to anrtum. Case II.-Time between initial pain and operation but four days, yet there was infection of antrum, the cells of the tip, perforation through digastric fossa and pus well down in the neck, no severe pain and temperature ranged from 99 deg.-100 deg. F. Case III. Nothing to be

seen but cicatricial tissue due to previous ear trouble; ear now dry. Case IV. Marked infection of mastoid and but slight involvement of tympanic cavity. Case V.-Recovery a surprise, as operation was advised when pain and tenderness did not yield to ice-bag. In three cases operation was necessary, as presence of pus was well marked. Operation was urged in other cases when pain and tenderness continued after constant use of ice-bag for seventy-two hours.

Middle Ear Catarrh Due to Enlarged Tonsils.-C. P. Linhart in Columbus Medical Journal reports two cases of middle ear catarrh due to enlarged tonsils. (1) Young woman complaining of deafness, sore throat and susceptibility to colds. On examination found no trouble with nose, but both tonsils enlarged. Both ears discharging. Removal of tonsils advised and consented to. Boric acid used in both ears. In two weeks both ears were dry and perforations closed. Hearing improved considerable. No more trouble with colds. (2) Young man complained of deafness, tinnitus and pain in ears. Nose and nasopharynx clear, tonsils enlarged. Tonsils were removed; when seen after a month hearing had not improved and tinnitis still present, but promise improvement as treatment continues. Results following removal of tonsils are more gratifying in otitis media suppurative than in otitis media catarrh chronic.

PRENATAL SMALLPOX.-Dr. J. H. Franklin reports in the Medical Record the case of a woman seven and a half months pregant, who was vaccinated on account of having been exposed to smallpox. She did not take the disease, and developed no symptoms of any kind, At term she gave birth to a full term dead child bearing the lesions of smallpox in the pustular stage.

X-RAY BURNS.-A dressing which Dr. Engman has found serviceable for itching and burns of minor degree produced by X-rays is applied on absorbent gauze, laid over the surface and covered with a sheet of guttapercha. The following is the composition:

The powder should be well rubbed up in a mortar and the lanoline added. The olive oil and liq. calcis are well mixed, then this mixture slowly added to the powder and lanoline, constantly stirring. When this is thoroughly mixed the rose water is added and the whole beaten up in a mortar into a light creamy paste. If there is much pruritus, 1 per cent or 2 per cent of Calvert's carbolic acid can be added to the whole.

NECROLOGICAL.

Memorial of the St. Louis Medical Society to Dr. Armand Derivaux who Died October 4, 1903.

Dr. Armand Derivaux was born at St. Amarin, Alsace, September 19th, 1849. After entering upon the study of medicine at Strasberg, he left the school to accept the position of assistant surgeon during the Franco-Prussian War. At the termination of this service, he entered the Parisian school of medicine from which he took his degree in 1876. Soon after, he came to St. Louis and entered actively upon the practice of medicine.

Dr. Derivaux was a man of scientific spirit and many accomplishments and soon rose to a prominent place in his profession, where he sustained himself with exceptional success for the past twenty-seven years. He was for many years an active member of the St. Louis Medical Society and the St. Louis Gynecological and Obstetrical Society, having been at one time the honored president of the latter society. In each of these organizations, he was an interested and active worker and had endeared himself to their membership by his many personal charms. Dr. Derivaux leaves a widow and two children to mourn his death.

Resolved, That by the death of Dr. Derivaux, this society has sustained the loss of one of its most courteous members, a scientific worker and student.

Resolved, That this society extends to the family of Dr. Derivaux its heartfelt sympathy.

Resolved, That the above sketch of his scientific life, together with these resolutions, be spread upon the minutes and a copy be sent to the family.

J. K. BAUDUY,
FRANK R. FRY,

Committee.

WALTER B. DORSETT,

Memorial Adopted by the St. Louis Medical Society, October 7, 1903, in Honor of Dr. John Bates Johnson, who died Oct. 6. We have met this evening to pay a tribute of respect to the memory of a departed friend and professional brother, Dr. John Bates Johnson, who for more than sixty years occupied a conspicuous place in the front rank of the medical profession in St. Louis.

Dr. Johnson was born in Fairhaven, Mass., April 26, 1817. His preJiminary education was acquired at the celebrated Friend's Academy in New Bedford, Mass., and his medical education in Berkshire Medical College, Pittsfield, Mass., from which institution he was gradauated in the spring of 1840, and subsequently thereto, he was honored to having conferred on him the Ad Eundem degree, by Harvard University. Soon after graduating he was appointed, on competitive examination, house surgeon in the Massachusetts General Hospital, where he remained for one year, enjoying the superior advantage of association with many of the leading physicians of Boston.

He came to St. Louis in the Spring of 1841, just when the city was growing rapidly in population, and increasing in commercial importance, giving unmistakable evidence of its future greatness. He at once identified himself with the progressive men of the profession, and was active in whatever tended to the advancement of the medical interest of the city.

He was an active and zealous member of this society, then in its infancy, he aided in establishing the first public dispensary west of the Mississippi River, and was one of the founders of our State Medical Society, of which he was elected President in the early days of its existence. Very soon after arriving in St. Louis he acquired a large and lucrative practice among the best people of the city, which he steadfastly retained, until advancing years compelled him reluctantly to withdraw from active labor, greatly to the regret to his devoted patrons.

Dr. Johnson commenced his career as teacher and lecturer in 1846, when he was chosen as adjunct professor of Medicine and Pathological Anatomy in the medical department of Kemper College, which afterwards became the Missouri Medical College, in which latter institution he filled the same chair until 1854, when he was elected professor in the St. Louis Medical College, now the medical department of Washington University of this city, which he continued to occupy until the close of his wellrounded life, October 6, 1903.

Dr. Johnson was present in Philadelphia in 1847 and assisted in the formation of the American Medical Association, of which in 1850, he was elected as one of the vice-presidents. To him also is due the credit of having assisted in founding one of St. Louis' most worthy eleemosynary institutions, the memorial home for aged persons on South Grand avenue.

As a man Dr. Johnson possessed an unusually commanding presence, dignified, urbane and genial. As a practitioner of medicine, he was skillful, conscientious and considerate, commanding not only the confidence, but the affections of his patients as well; as a lecturer he was eloquent and impressive. All in all he presented a fine specimen of a Christian gentleman and physician.

Resolved, That a certified copy of this action be sent to the bereaved family of the deceased and spread over the memorial records of the society. W. M. MCPHEETERS,

INDUSTRIAL CONTAGION OF SYPHILIS.-The French courts recently decided a case admitting that an employer may be responsible for damages in case of the transmission of syphilis by the intermediation of a professional instrument. In the case before the court, a glassblower claimed that he had been infected by the tube passed from hand to hand, but the evidence was not conclusive, and his claim was not allowed.

OPIUM SMOKING IN FRANCE. A report from Paris says that the habit of opium smoking is greatly increasing among the lower classes of the population in the cities bordering the Mediterranean, such as Marseilles and Toulon. The dealers in oriental curiosities all keep opium in their stores and advertise it to the public. The government will be asked to pass a law prohibiting the sale of opium by such stores.

MEDICAL MISCELLANY

TRI-STATE MEDICAL ASSOCIATION.-Professional interest is centering in the meeting of the Tri-State Medical Association, of Mississippi, Arkansas and Tennessee, to be held in Memphis on November 17, 18, and 19, and which is regarded as the most interesting of all the medical gatherings in the south. At the annual meetings, which are always held in Memphis there are usually 300 to 500 representative practitioners from the territory of Mississippi, Arkansas and Tennessee contiguous to Memphis in attenddance, and a full scientific program is rendered. This association has made a record for the character of the papers on malarial fever and kinred subjects presented by its members. The association holds three sessions each of the first two days, and two the last day. The organization is strictly a working one, and indulges in none of the customary forms of entertainment. The next meeting is expected to be the largest and best that has ever been held, and the preliminary program shows forty titles of practical subjects to be considered. The sessions will be held in the Hotel Gayoso. The railroads will grant the usual special rates. The officers are: President, J. W. Hayes, Eureka Springs, Ark.; Vice-Presidents, Mississippi, G. Y. Gillespie, Duck Hill; Arkansas, J. P. Runyan, Little Rock; Tennessee, J. S. Rawlings, Danceyville. Secterary, Richmond McKinney, Memphis.

SHATTERED ARM REPAIRED BY BLOOD NUTRITION.-Dr. T. J. Briggs reports the following interesting case: George R.; age 28 years; American; diagnosis, compound comminuted fracture of right forearm. Patient came under my care August 21, 1903. An examination revealed complete transverse fracture of both radius and ulna; the lower fragment of the radius being shattered into fragments. The muscles and tendons, both flexor and extensor, were all divided with the exception of the extensor longus digitorum, and about an inch of the facie. I advised immediate amputation. This was absolutely refused. Consequently after assuring the patient that I would in no way assume any responsibility, I determined to see what might be done with the aid of bovinine. The extensor and flexor muscles after a long and tedious procedure were stitched, the fractured bone debris removed, the wound thoroughly cleansed, the facia brought over and stitched, with the exception of three points for drainage. The arm was put up in plaster of paris casts, which after hardening was trap-doored so that dressings and cleansings might take place without disturbing the splint. The wound was cleansed with bovinine and peroxide reaction, followed by Thiersch irrigation, and finally bovinine pure applications every four hours. On September 10 an examination showed that the muscles and tendons which had been stitched had all united. Likewise a bony union was forming. The facia had entirely healed. September 26 the cast was removed and a careful examination made, showing a complete healing, with the exception of the radius. A small spicular bone loosened and was removed. A light plaster cast was readjusted and trapdoored as before. The wound was dressed through this. The patient was discharged October 5, and instructed to return every third day for examination. The points of greatest interest in this case are that his arm was practically severed, and did not, in my judgment, present one chance of being saved, but on account of the great regenerative powers of the bovinine it was absolutely restored from death.