Examina

February 16, 1896. tion showed distance vision for both eyes, and reading distance normal. He has no paralysis of the ocular muscles; pupils react promptly. Ophthalmoscope showed the fundus normal, with the single exception of hyperemia of the disc.

Hearing in the right ear is normal. Left ear has perforated and retracted drum. Politzerization showed that both Eustachian tubes

were open. The tuning fork tests in the left ear yielded negative results. The tick of the watch is only heard on being pressed, and ordinary conversation is scarcely heard at a distance of six feet, and a whisper at two feet.

The profuse hemorrhage from the ear indicates that there was a fracture at the base of the skull. Aside from the defects described, he made a perfect recovery.

Amid the tremendous impetus of scientific thought which has been given to the progress of modern medicine by the researches of histology and bacteriology, developing results almost wiraculous and suggesting possibilities almost infinite, there is a danger of overlooking those inorganic principles which go largely to make up the structure of the universal organism and upon which these "vital units" must necessarily depend for their formation of structure and their ultimate design of function.

When we consider that of the fourteen elements which enter into the composition of the body a very large proportion is drawn directly from the inorganic world, entering into the system as such and passing out unchanged except so far as the

functions they have executed, it will at once suggest to the conservative mind and the true rationale of investigators, which recognizes every principle of structure and of function as it operates to fulfill the complement of physiological development. From time immemorial it has been a recognized fact that natural death apart from all extraneous influences comes to man or animals by the steady encroachinent of the inorganic elements of the body upon those that have been organized upon vital processes, under the influence of hereditary diathesis. Recognizing this important factor in the process of animal life, it would seem strange to ignore the power of these inorganic agents to determine, control or arrest the functional activities of

any living organism. To the practitioner of medicine who conscientiously and carefully differentiates the symptoms of every case he is called to treat, it need only be remarked that the very fact that certain inorganic elements are wanting in the organism is proof sufficient that either they are not offered to the absorbent system in a receptive condition or that there is some want of absorptive power in the tissues themselves. It is very easy to say to an anæmic, chlorotic patient, "Your blood needs iron.” Wise statement that! Of course it needs it. But why does it need it? What are the conditions now existing which prevents its appropriating iron from the ordinary channels of food-nutrition that did not exist before the anæmic condition was observed? It is just this which must be corrected, and no amount of medication containing these wanting ingredients will prove of any value until the osmotic relations are re-established upon which all metabolism depends.

It is just here that inorganic therapy comes in to solve the problem. It is a well known fact that excess of carbon dioxide, the result of retrograde metamorphosis in the organism will render albumen osmotic and permit its infiltration into the uriniferous tubules. Chemistry comes to our aid and shows us that if phosphates can be brought into the blood in a proper relationship they will correct this condition; will arrest albuminuria and reestablish the osmotic balance, re

ducing the albumen to a condition of suspension instead of the pathological condition of solution. Ordinary phosphates will not do this. They must be reduced themselves to a condition of assimilation.

This has been accomplished in the combination known as Melachol, which is none other than a reduction of these principles to a physiological character. Again, we have another and more startling evidence of the power of inorganic agents thus rendered physiologically assimilable, in the withdrawal by direct chemic influence of the livery placed upon nerve centers by the habitual use of opium and its alkaloids. No one who has not witnessed the magic effect of this physiological inorganic preparation upon the habitues of this drug can fully appreciate its value.

Aside from its general tendency to the re-establishment of the nutritive functions, its orderly action upon the intestinal tract (which, by the way, is applicable to many other torpid conditions of the body), it has remarkable power of substituting an investment about the nerve centers which renders the withdrawal of the drug almost painless and without material discomfort. We have tested this upon animals to an extent which is marvelous in the extreme. Animals rendered imune to an almost indefinite quantity of morphia have, under the influence of Melachol, been reduced to a perfectly normal physical condition.

Patients who have taken as much

as fifteen grains of morphia daily have been deprived of it, with the use of melachol, without anything more than a temporary nervousness, nor has the craving for its use returned.

Its action upon the alimentary canal is in perfect rapport with physiologic principles-relieving chronic constipation, restoring the osmotic balance of nutrition and waste, and regulating the secretory and excretory functions of the organism.

Not only so, but it sustains the therapeutic action of those agents which are now absorbing the attention of the scientific world.

All

antitoxines, of whatever nature or origin, are rendered active by its aid. It opens the way for a physiologic leucocytosis-the basis of all true therapeutic action in the administration of antitoxic agents. It sustains the normal relations of the organism and lays a solid physiologic foundation for all therapeutic

measures.

The mode of preparing these inorganic agents as found in Melachol is simply the reduction to physiologic relations; and the range of its adjuvant power is only equaled by its direct effect upon the osmotic relations of the blood.

Hay-Fever.-M. Joal has issued a most important work, in which he arrives at the following conclusions (La France Médicale, January 24th, 1896): "Hay-fever is strictly a reflex neuropathic affection of the nose. The predisposition to it is established by three distinct factors: arthritism, nervosism, nasal hyperexcitability. By far the greatest number of persons affected with the disease have all the characteristics of defective nutrition, and the evident signs of neurasthenia. There is a decided incompatibility between hay-fever and the more serious nervous affections.

"Vaso-motor disturbances of the nasal mucous membrane pre

The vaso

dominates at the beginning of the paroxysmal attacks; they may appear independently of all hyperthropic changes; but usually a certain degree of hyperesthesia of the pituitary is present. motor and spasmodic phenomena are subject to secondary reflex action of the nose. These reflex changes arise spontaneously (1) from excitement of the sensorium; (2) from excitement referable to general sensibility. Among the former of these, a preponderating influence is attributable to special odors; among the second may be placed luminous impressions. On the other hand, heat and dust have their share, either by irritating the

skin or by acting mechanically on the nasal mucous membrane.

"The specific action of pollen and of certain micro-organisms cannot be admitted. That the disease shows itself in an irregular or periodic manner depends on two classes of facts, very different in action and originating in the same general conditions of constitution, united with the same generic conditions of the pituitary and the nerve centres. The following are the principal occasional causes: odors, light, and heat, which, by occurring regularly at the same season of the year, determine the periodicity of the attacks."

The above statement presents the disease under an aspect very different from any which has been held heretofore, and is entirely at variance with the ideas that gave origin to the name. How far these views may be found correct will depend on careful observation, and may lead to an entirely different method of treating the disease. It is evident that the methods heretofore employed have been far from satisfactory. The Sanitarian.

Pulsatory Tinnitus.-Dally (British Medical Journal, No. 1820). The author, at the British Medical Association, reports the case of a female aged 15 years, in whom a loud, grating sound in the left tympanic cavity could be heard by the bystanders. The sound was like. the loud tick of a watch; and was synchronous with the pulse for several beats, then stopped for an in

Cerebral Complications in Relation to Middle-ear Disease. Macewen (British Medical Journal, No. 1820).

M., in speaking of the case in which the pyogenic organisms will invade the intracranial cavity from the tympanic, says it reminds one of the words which Shakespeare puts into the mouth of Richard II.:

"For within the hollow crown

That rounds the mortal temples of a king,

Keeps Death his court; and there the
antic sits;

And, humored thus,
Comes at the last, and with a little pin
Bores through his castle-wall, and fare-
well, King!"