two societies, representing the two great states of Ohio and Michigan take steps at once to make an organized and determined campaign of education against the social evil.

SOME NASAL REFLEXES.

H. M. FLOWER, M. D., TOLEDO, 0.

Reflex disturbances of the higher centers from irritation of the nasal branches of the 5th nerve, are anamnesia, aprosexia, vertigo, migranie, hemicrania, and scotoma scintillans, not to mention epilepsy; and of the lower centers, chorea, coughing, sneezing, temporary arrest of the heart beat, asthma and the sexual reflexes.

The reason the 5th nerve, which supplies the Schneiderian membrane, is the most frequent conveyor of peripheral stimuli, causing considerable central disturbance, including epilepsy, is, because it is a large cranial nerve with very extensive peripheral and reflex connections; practically the only sensory nerve supplying a region of the body which is, as a rule, pathological in civilized man.

The central connections of the 5th nerve bring it into peculiarly close relations with the higher and lower centers, also, because it is the sensory nerve of a large part of the brain and meninges.

Given a predisposition to epilepsy, the exciting peripheral irritation will probably first appear in the nose, and when it does occur, is fraught with serious consequences, because sensory stimulation of this organ has especial effect upon the central nervous system.

Nasal cough is more common than physicians generally suppose. The excitant is sometimes inhaled, as the case of the pollen causing hay-asthma, or is sometimes within the nose, such as polypi and other nasal affections.

Given a dry, convulsive, progressive, and irresistible cough, it might be well to suspect the nose as being responsible. In the treatment of asthma, many authorities claim cures by the treatment of the nasal chambers, others claim that the nasal symtoms are but the expression of a general asthmatic tendency, whatever that may mean. I certainly have improved the asthmatic condition by the indicated intra-nasal procedure. One case I cured by making local application; another, by surgical interference, was greatly benefited.

Paroxysmal sneezing or "rhinorrhea spasmodica" is a very stubborn and unsatisfactory reflex neurosis to treat. This condition re

sembles hay-fever in many respects, and my experience in the treatment about the same. One case that I have in mind appeared to point to the hypertrophied middle turbinates as the offenders, but after their removal, the same condition obtained, the attacks coming on without any apparent reason, any season of the year, sometimes as often as once a week, and again once a month. The man was well nourished, and I could find no constitutional condition as an underlying factor. However, his son has hay-fever. Another case, I think the disturbance of the vasomotor equilibrium is due to an overwrought emotional nature. Still another, I believe the attacks are brought on by sexual excitement.

Grayson, of Philadelphia, writing for the December number of the Medical Record, calls attention to the rhinitis of the newly married, and suggests the name of honeymoon rhinitis as a better term. It is well recognized that in certain individuals, sexual excitement will produce changes in the intra-nasal circulation. In women the menstrual period often reflects the ovarian excitement in the nose, and again it has been the experience of some of us, that treatment directed to the mucous membrane of the nose, has produced sexual excitement of a high degree. Cases of loss of smell have been reported as the result of the removal of both ovaries.

Chorea has been said to have been cured by the removal of adenoids or other growths in the nose or naso-pharynx. Congestive headaches and neuralgia permanently relieved as the result of reducing turbinated engorgement.

Hay-fever I will only mention sufficiently to say, that no antitoxin has been found that has proved other than a disappointment as a curative agent. There is something more profound in this disease than nervous temperament and an exciting rag weed. The causative factor may prove to be some form of auto-infection, or suboxidation of the blood. One writer says, he thinks had Maud Muller maried the Judge, and substituted the nerve shattering follies and vices of the modern society woman, for her free, healthful out-door life, the time would have come when the mere mention of a hay-rake would have set her to sneezing.

Nasal irritation giving rise to cardiac disturbances, has been reported by a number of writers. It is no uncommon experience for patients, especially men, to faint when the Eustachian catheter is passed for the first time. After a few treatments the nasal mucous membrane becomes tolerant to the instrument and there is no further trouble.

In an old edition of Ivin's work on the nose and throat, I found

this paragrpah: "Syncope, although very rare in operations upon the nose, once occurred to me while making an anterio-posterior incision through a deviated triangular cartilage. The knife had just completed its work and scarcely a drop of blood had escaped, when the patient suddenly sneezed and ceased to breath. The pulse grew so weak that it was hardly perceptible at the wrist, but persistent artificial respiration, continued for fifteen minutes, restored the boy."

I believe that my rectnt unfortunate experience was similar to the case just cited, only it was the prick of the hypodermic needle into the middle turbinate, that brought on the attack, and although restorative measures continued for two hours, it failed to start the heart's action or to develop the first signs of life.

Dr. Mann reports a case of laryngeal spasm and cough, which was completely relieved after applying chromic acid to a very large anterior hyper-trophy of the inferior turbinate. Internal remedies had utterly failed in this case.

Some of the conclusions to be drawn from this paper, are: That the nose is to be reckoned with in many of the neuroses of then general system, and in certain individuals, the disturbance of balance is profound and even fatal.

While the subject under discussion has been the cause of much special study and investigation, there remains a great deal of uncertainty as to why nerve irritation in some remote part of the body will reflect itself to the nose, or why nasal irritation will reflect upon such remote organs as the sexual, and not upon some nerve or apparently more nearly related ones.

Until we are able to reach a greater understanding of the nerve system as a whole, and its reflex connections in particular, we must be prepared for unusual manifestations of nerve energy, even to fatalities that cannot be accounted for by ordinary means.

ELECTRICITY IN THE TREATMENT OF SOME DISEASES OF THE FEMALE PELVIC ORGANS.

BY FRANK H. LOWER, M. E., M. D., CLEVELAND, 0.

If woman was fashioned from the rib of man, the result was better than we might have expected when we consider the material from which she was made. Although woman is the most beautiful animal in existence, so is she the most frail. As a savage or a field laborer she performed the function of child-bearing with little diffi

culty, pain or after effects, but civilization has weakened and produced abnormal conditions, which we, as physicians, are supposed to remedy. I think you will agree with me, that women of the present time should not be tillers of the soil or bearers of burdens. That she is more delicate than man in every particular is true. The bones are smaller and lighter with the exception of the pelvic bones; the muscles are smaller with the exception of the muscles of the thigh; the adipose and cellular tissue is more abundant, giving her that graceful outline with subtle curves indicative of delicacy and refine. ment. Her skin is finer in texture and lighter in color, the hair is more abundant. The special senses are keener and quicker than in man. The sympathetic nervous system is more highly developed in women than in men, and more intimately connected with the process of ultimate nutrition. The ganglia and connecting nerve filaments are found in greater abundance and more highly developed in connection with the pelvic organs. Woman has a larger number of symptoms indicative of the same morbid state. She has oftener a complication of diseases, a number of organs inter-connected, all undergoing similar pathological changes, which is undoubtedly due to the sympathetic nervous system. Some ovarian congestion, a malposition of the uterus or a lacerated cervix will many times bring on a train of symptoms difficult to reconcile with the seemingly slight cause.

The disordered womb can, by its nervous connections with the spinal and sympathetic nerves, disturb and vex any and every organ in the body, from the brain to the massa carnea on the sole of the foot. It can vex the pharynx and the esophagus with spasm or globulus, close the jaws through the masseters or temporals, jaundice the blood by its influence on the liver, cause ischuria or diabetes in a moment, bring on diarrhea or constipation, simulate apoplexy and eclampsia, set the hemispheres in a rage of insanity or excite the cerebellum to the manifesting of chorea, or abolish the sensorial and motor forces of the spinal marrow.

Any deviation from a normal menstruation is immediately telegraphed by the sympathetic nerves to the brain and the nerve centers, and then follows a train of symptoms and emotions entirely unknown and unsuspected by man. Women are always about to menstruate or they are menstruating or ceasing to menstruate. The womb is gravid or going to become so, or is just recovering from the parturient state; these organs have never an even tenor of life. They require a different and more complex system of innervation, more expensive to the nerve centers, more delicately sensitive and impressible than those of man. So it should not excite wonder, astonish

ment or anger in man when woman is sometimes a little queer, and if perchance some morning the coffee-pot misses his head by the fraction of an inch he should try to be philosophical and realize that there is some disturbance of the pelvic nerve centers which is the cause of the tempest in the pot.

In our choice of an electrical modality, we must be governed by the pathological condition we wish to treat and by the physiological action of the modality. Although some acute diseases can be successfully treated by physical therapeutics yet the domain of medical and surgical electricity is in subacute and chronic conditions, consequently the selection of the suitable modality, the technique employed, the duration of the treatments as well as the frequency of the application is a matter of the utmost importance, for upon these depends the success or the failure of our efforts.

The first question to be considered is the cause, a thorough examination should be made to decide the questions-Is there pregnancy? Are the ovaries or the uterus present? Is there an obstruction at some point in the genital tract? Or is there merely a backwardness of general development? If the latter is the case we hesitate to do very much at first except advise hygienic methods and out-of-door exercise with some tonic.

Most cases of amenorrhea are accompanied with constipated bowels, which should be corrected. But if the case becomes more urgent with accompanying nervous symptoms, headache and backache with abdominal colicky pains, some form of electricity should be advised, and there is nothing better to begin with than spinal galvanization.

The positive pole should be a pad 4x6 inches, wet with salt water. This is applied to the upper spinal region, while the negative pole, a pad 6x8 inches is applied over the lumbar region, with a current increased from 10 to 40 milliamperes, for 20 minutes, three times per week. This can be alternated with the positive on the back and the negative over the abdomen. This method helps the general nutrition and corrects the trouble.

The most common form of amenorrhea I meet with is in young women-married and single. They may be robust in appearance, with many times a large amount of adipose tissue. They are extremely nervous, verging toward hysteria. They have rush of blood to the head, functional cardiac disturbance, constipated bowels, and numerous other troubles. They generally menstruate in from six weeks to six months, scanty at that; the longer the between period