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In the past the team has not been properly managed. Besides this, men have been allowed to play on the team who were not bona fide students. The team, from lack of support, was allowed to struggle along, without proper coaching and outfitting, getting from bad to worse, and I for one was glad to see it come to an end.

A good foot-ball team will earn money. A prominent lawyer in this city, who has had experience in managing college teams will manage our team for half of the net receipts and he told me he would expect to make $2,500 each season.

If we have a team, let us have a first-class one, properly coached and managed, well supported and an honor to the university.

The chief objection to foot-ball and kindred games carried on in the colleges at present, is the amount of time and money used on a small body of men, who really do not need the physical training, while the vast body of men and especially the bookworms, who really do need the exercise and recreating, do not participate. I admit this point, and on its face it looks like a very strong argument; but there is another side to the question. It is decidedly advantageous to the few who do participate and it pays for all the other varieties of gymnasium and athletic sports.

As I have mentioned before in this paper, the university does not offer to the students anything in the line of physical training; probably because there is no appropriation for it, for I am sure that it is not neglected because the authorities underestimate its worth.

My plan is to use foot-ball for the benefit of those who participate, and to make money which could be used to provide athletic opportunities for the rest of the students.

Last year with our poor team, which played five games here, and with very ordinary teams, we paid the Athletic Field, simply for the privilege of playing there, 30 per cent. of the gross receipts, and this amounted to $839.00. This could easily, with a good team well advertised, be tripled. Therefore I think even with this money we could run a field of our own and make it the campus for the entire body of students, where we could stimulate interclass foot-ball games, intercollege tug-of-war teams, a track for men so inclined, and a place to play a little base-ball in the early fall. With the first money earned, I would suggest that we put a series of hand-ball courts between the medical and dental colleges, a game which is of great value physically, requires no apparatus, and can be built for a small sum of money. Students could go there when they had a vacant hour during

the day, and take sufficient exercise to keep their bodies in excellent condition. Later we could increase the size of the building, so as to include some gymnasium apparatus, bowling alleys and possibly baths. Therefore, if we can make foot-ball pay and thus provide facilities of exercise for the body of students, I think the strength of the point that the game only benefits the few is largely lost.

151 FRONT AVENUE.

DISCUSSION.

Mr. W. B. WRIGHT, of law, agreed, in the main, with Dr. Simpson and declared that a poor team was worse than none at all. If the university has a football eleven it must be a winning team.

Rev. R. B. ADAMS was strongly in favor of a team for the university. He recalled the fact that the cadets at West Point had only one hour a day for practice, yet were able to put up a winning team. Out of the 147 students at the University of Buffalo he thought it should be easy to secure 25 men to play on the team.

Mr. Voght, principal of the Central High School, was heartily in favor of games and outdoor sports.

Dr. DELANCEY ROCHESTER was unequivocally opposed to football, but favored outdoor sports. He said the mortality and injury rate were too high for the game as a game; the exercise was too severe.

Dr. M. D. MANN did not believe football could be played well by a university team.

Dr. CHARLES CARY was heartily in favor of the plan and promised his support in the future as freely as it had been given in the past.

Mr. JOHN LORD O'Brien's opinion was that the sport had never been properly regulated ; that a university spirit was necessary and the best way to develop it was by means of football. The game should have at least one fair trial.

Mr. ADELBERT Moot had been opposed to the game on account of its professionalism ; but if this could be removed and the game kept free from it he was in favor of a university team.

Dr. JAMES A. Gibson, professor of anatomy, knew of several good men who had left the medical school because of the lack of university spirit. He was heartily in favor of a team.

Dr. GREGORY, of the pharmacy college, thought the whole question hinged on proper management. With that solved there should be a team.

Dr. Snow, of the dental school, is personally opposed to football; but if it is decided to have a team he would see that the dental department was represented.

Dr. LUCIEN HOWE expressed himself in favor of athletics and said the men should have a chance to rub elbows.

Dr. HOOVER said the 'varsity team had originally been started in good shape and under honest management; laxity in business affairs, the introduction of professionalism and general apathy on the part of the faculty had caused the game to fall into disfavor. Dr. Otto spoke along the same lines.

Following the discussion a vote was taken, on the proposition to secure an expression of opinion, which resulted in 29 in favor of football and against.

Empyemas of the Accessory Cavities of the Nose in

Children.

BY DR. B. PANZER,
Of Vienna University Children's Hospital.

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WISH to speak to you about the special form of a disease

which to state beforehand must be considered very rare. I shall speak about empyemas of the accessory cavities of the nose as found with children. I did not find more than seven cases in a material of about fifteen thousand subjects that came under my observation within the last ten years. Nevertheless, the cases presented typical forms which showed marked differences, however, when compared with similar diseases in adults. This latter affection may be taken as very frequent, for I have seen many hundreds of such cases during the same time. As the disease represented always the same well-known symptoms as regards its anatomical, pathological, and therapeutical features, it might be well to consider first the affection in adults as, by comparison, we shall be able to recognise best the special points of same.

I will recapitulate briefly the anatomy of the accessory cavities of the nose: the Highmore cavity, the frontal sinus, ethmoidal labyrinth, and the sphenoidal cavity. The antrum of Highmore, the largest of all, is situated in the upper jaw, is an irregular cavity, narrowing down toward the alveolar process. The exit is close to the roof which forms at the same time the base of the orbit. Later, I shall refer to the openings in the nose. The frontal sinus varies very greatly in its size, lies inward and upward of the orbit, but extends also outward as mentioned before, in

1. Presented at the meeting of the Roswell Park Medical Club, at the residence of Dr. Geo. F. Cott, August, 1904.

varying sizes. The duct leads obliquely from upward behind, to downward in front. The ethmoidal labyrinth is divided into two parts, the anterior and the posterior cells; they represent a number of irregular cavities which are partly in communication and are limited on the outer side by the lachrymal bone and the lamina papyracea of the ethmoid, in the interior by the upper turbinated bone. The sphenoidal cavity lies in the body of the sphenoid bone, and is a large, more or less, cubical space limited on all sides by bone; in front especially by the so-called ossicula Bertini.

Of great importance is the relation of the openings to the nose. Make a sagittal section through the skull, remove in the middle the septum and you will notice in the lower part the inferior turbinated bone and between this and the floor of the nose the lower meatus, over it the middle turbinated bone and between this and the lower turbinated bone the middle meatus; above this the upper turbinated bone and a portion of the anterior ethmoidal labyrinth. Remove now the middle turbinated bone and you will find two well organised formations on the outer side of the nasal wall,-in front, the processus uncinatus of the ethmoid, and behind this, the ethmoidal bulla. These two bones have special importance, for between these two there is a furrow,—the so-called hiatus semilunaris, on the upper end of which there is the nasofrontal duct, the opening of the frontal sinus. In the lower part of the ostium maxillare of the Highmore cavity further there are the openings of some ethmoid cells next to the hiatus, in irregularly situated parts; whereas the posterior ethmoidal cells open into the back parts of the upper nasal meatus. In the same way the opening of the anterior wall of the sphenoidal cavity leads into the upper meatus.

Let us contemplate now the sagittal section of the skull with the middle turbinated bone in the natural position, when we shall see that the Highmore cavity, the frontal sinus and the anterior cells of the ethmoid open into the middle meatus. The narrow fissure which we observe in examination of the nose from the front, between the lower and the middle turbinated bone, possesses the greatest practical importance. Whatever occurs in any of the said cavities must show up by indication in this fissure, as we cannot get a direct view of any of these cavities, whether of the Highmore cavity of the frontal sinus or of the ethmoid, but you will always find a strip of pus in the fissure between the lower and the middle turbinated bone, as the first symptom in examining the nose. The question arises how to make the differential diagnosis of the disease of the different cavities. The simplest way is to ask, which one is most frequent? The comparison shows that in the great majority of cases the affection lies in the Highmore cavity ; finding some pus in the middle meatus, you must imagine first an inflammation of this cavity.

The diagnosis is very easily verified. Remembering the anatomy, you know that the bottom of the Highmore cavity reaches to the alveolar process, consequently is somewhat deeper than the bottom of the nasal cavity. Take now a simple hollow needle and, under local anesthesia, introduce it underneath the lower turbinated bone about one-half inch to the back from the anterior end of the lower turbinated bone, right through the lateral wall of the nasal cavity which is at the same time the medial wall of the Highmore cavity, and you will reach with your instrument the Highmore cavity. Take now a syringe with warm water and adding 5 per cent. carbolic, and press it through the cavity; the fluid must come out through the natural opening and we are able to distinguish whether there is any pus in the cavity or not; when the watershows any pus you can be sure that there is an empyema of the Highmore cavity. When the fluid is clear the Highmore cavity is free of any affection, and it is only possible that there is an empyema of the frontal sinus or of the ethmoid.

The entrance to the frontal sinus is easily to be found: take a curved canula, introduce it below the anterior end of the middle turbinated bone and you will reach through the hiatus semilunaris into the end of the nasofrontal duct. Sometimes the anterior end of the middle turbinated bone is in the way, in which case you must remove it with the snare; and now you repeat the former proceeding, that is, you syringe some water through the tube; if you find any pus in the fluid you can be sure there is a frontal empyema; if you do not find any pus it cannot be but an empyema of the ethmoid.

But how will the case present itself if there should be a combined empyema in several of the above mentioned cavities? The diagnosis could not be difficult in such a case either ; should there be visible pus in the middle meatus after thorough washing out of the Highmore cavity, this is a clear indication that there is still suppuration either in the frontal sinus or in the ethmoid. If after washing out the frontal sinus there is still pus, the ethmoid must be affected. The general symptoms of the empyema visible besides the examination of the nose,—and I am speaking here only of the acute form of empyema,—are in the first line pains, pains of a neuralgic character which mostly, but not always, correspond to the seat of the trouble, pains in the infraorbital nerve in disease of the Highmore cavity, in the supraorbital nerve in those of the head. But also radiating pains of an affection of the Highmore cavity in the forehead. The region of the infraorbital

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