Sputum 26: 10 positive, 16 negative. Widal 21: Io positive, II negative. One would suppose the long continued gloomy, rainy weather would have an influence upon the mortality rate, but such seems not to be the case. At least the effects of the weather conditions have not as yet manifested themseives. One hundred and twenty-six deaths occurred during the week as compared with 148 for the corresponding week in 1906.

There were 15S births reported. There were 8,108 births were returned last year; let this year show a marked increase.

Diphtheria-Fourteen cases were reported, an increase of 3 over the preceding week, and 5 less than for the corresponding week in 1906. There are now 22 cases under quarantine as compared with 30 this time last year.

Scarlet Fever.-Seven cases were reported, an increase of 5 over the preceding week, and of 4 over the corresponding week in 1906.

Measles.-Twenty five cases were reported, an increase of 16 over the preceding week. During the corresponding week of last year 147 cases were reported.

Typhoid Fever.-Forty-five cases were reported, an increase of 13 over the preceding week and of 17 over the corresponding week of last year. The high water ought certainly to dilute infectious material, and danger due to infection from the water supply be diminished.

Smallpox -One case was reported, the first for several months. This case moved here from Missouri two weeks ago. During the corresponding week of last year 6 cases were reported. Laboratory Report.

Seventy five examinations were made, an increase of 3 over the preceding week. Twentyone Widal tests were made, to positive and II negative.

Milk Examinations.—Thirty-five samples were examined, of which 12 were from wagons and 16 from stores, 5 from shippers and 2 citizens' samples. Thirteen samples were found to be deficient in fat, of which 3 were from wagons, 5 from tores, 4 shippers' and I citizen's sample. The short samples are being investigated in an effort to bring suit against the guilty parties. Five shippers, 35 wagons and 149 store, making a total of 189 inspections were made.

Ben. Grote, driver for August Muiter, Spring Grove Avenue, was fined $50.00 and costs for selling milk below the standard.

Very respectfully,
SAMUEL E. ALLEN, M.D.,
Health Officer.

AT the last meeting of the Mississippi Valley Medical Association it was decided to offer a prize of one hundred dollars for the best essay on some medical or surgical subject. The competition is to be limited to those who, at the time of entering the competition as well as at the time of the award, shall be members in good standing of the Mississippi Valley Medical Association.

The award will be made by a committee appointed for the purpose, consisting of Drs. Hugh T. Patrick, of Chicago; A. H. Cordier, of Kansas City, and Chas. H. Hughes, of St. Louis. The name of the author is to be enclosed in a sealed envelope bearing some motto or device and the essay is to be marked by the same motto or device. The name of the successful author and the title of his essay will be announced at the next meeting of the Association, to be held at Columbus, O., October 8, 9, 10, 1907, and the award will be made at that time. The successful essayist will be notified at least two

weeks prior to the meeting, and he will be expected to read his essay at that meeting. The essay is to be published in the organ of the Association.

All essays must be typewritten, and are to be sent to the Secretary, Dr. Henry Enos Tuley, III W. Kentucky Street, Louisville, Ky., on or before August 1, 1907, after which date no essay will be received. The Committee reserves the right to reject any or all essays.

MISSISSIPPI VALLEY MEDICAL ASSO. CIATION. The following Committee of Arrangements for the meeting at Columbus, O., next October, has been appointed: Florus F. Lawrence, Chairman; Charles J. Shepard, Secretary; William E. Davis,

Treasurer; J. W. Clemmer, Chairman Committee on Ways and Means; J. U. Barnhill, Chairman Committee on Entertainment; W. J. Means, Chairman Committee on Transportation; F. J. Blake, Chairman Committee on Exhibits; J. H.J. Upham, Chairman Committee on Reception; Frank Winders, Chairman Committee on Press and Information; Earl Gilliam, Chairman Committee on Halls and Meetings; J. E. Brown, Chairman Committee on Badges; Wells Teachnor, Chairman Committee on Registration; Mrs. W. D. Hamilton, Chairman Special Committee for Entertainment of Ladies. Each of these Chairmen will appoint a number of physicians as members of their special committees.

Brain Abscess Following Traumatic

Mastoiditis.

A. Wiener, New York (Archives of Otology, August, 1906), reported to the Otological Section of the New York Academy of Medicine a case of brain abscess following a fracture of the skull and acute mastoiditis. An Italian, aged forty-three, received a severe injury of the right side of the head. There was right aural hemorrhage, dizziness and pain. In the right ear, in spite of the bleeding and rupture of the drum, when spoken to in a loud tone he understood everything that was said to him. In the left ear the patient appeared to hear, but he could not be made to understand. The Weber test was uncertain. Rinne negative in right ear, uncertain in left. Bone conduction good, right and left, but length ened. An oval perforation was visible in posterior half of membrana tympani through which blood was oozing. Left ear normal. Eyes normal. Deep reflexes very much diminished. No paralyses. Steady improvement in condition, and in two weeks hearing in left ear entirely normal, discharge has ceased, and no discomfort remains but some tinnitus.

Then occurred an attack of tonsillitis.

In thirty-six hours an acute otitis media purulenta, right ear. Rupture of membrana tympani. Paracentesis, excessive pain in ear and mastoid. Temperature 102° F. to 103°.5 F., pulse So. Vomiting, eyes normal. Mastoid operation. The roof of the antrum and tympanic cavity had been entirely destroyed. The dura above this was covered with some granulation tissue. The sinus appeared healthy. After operation temperature ran to 104° F. and pulse 60; vomiting. Eyes normal. After fortyeight hours a secondary operation. The discolored dura over the site of the tympanum was opened and a subdural abscess half an inch by one inch was discovered. This was drained. Recovery uninterrupted. Amnesic aphasia in left ear due to blood-clot at site of fracture. This was subsequently infected by the onset of the tonsillitis and became the abscess found at operation.

Wiener also relates a case of hysteria in a young man following a secondary, operation for mastoiditis. The symptoms closely simulated intracranial involvement. There was collapse, with semicoma, followed by moaning and indications of pain in head. Mydriasis. Ophthalmoscopic examination negative. No paraly

ses. Pulse 50, temperature 100° F. Heart, kidneys and lungs negative. Deep reflexes diminished. No response to questions. Bowels and urine emptied voluntarily. Complete anesthesia with the exception of the soles of his feet and tips of his toes, within the palms of his hands and finger tips and within the vestibule of his nostrils. This condition continued about twenty four hours, when all these symptoms disappeared for three hours, to again recur for twenty-four hours. Thereafter uninterrupted recovery, but contined bradycardia. Pulse 60. The mother of this young man was highly hysterical.

Modified Use of the Blood-Clot in Mastoid Surgery.

W. S. Bryant, New York (Annals of Otology, Rhinology and Laryngology, September, 1906), reporting some operative cases, describes his modification of the use of the blood-clot in mastoid surgery. Blake, Sprague and Morn have closed the mastoid wound around a small drain, allowing the latter to remain for about a week. Bryant, however, uses a small cigarette drain, which he removes in twenty-four hours. The removal allows considerable flow of serum, which is followed by closure of the entire wound by first intention. Should the wound become infected it does so early, and the opening left by the removal of the drain furnishes free drainage through the clot. It insures a short convalescence, a good cosmetic result, and decidedly better hearing than slower methods. He now uses it in all cases except where a macroscopic amount of necrotic tissue for some reason must be left in the wound. In simple mastoid operations treated by the clot dressing healing of the post-aural wound has taken place on the average in six and one-half days. The middle ear has been dry in thirty-seven and one-fourth days. Treated by the temporarily drained clot, the healing of the post-aural wound has been complete in five and a half days and the middle ear dry in eight days. In radical operations treated by clot dressing the post-aural wounds have healed on the average in ten days and the middle ears have been dry in twenty one and a half days. Treated by the twenty-four hours drained clot the healing of the post-aural wound took place in nine days and the middle ear was dry

in twelve days. Cases of epidural abscess also did very well by this method; the post-aural wound healed in fourteen days and the middle ear was dry in seven and a half days.

Lightning Injuries of the Ear.

Wm. C. Braislin, Brooklyn (Brooklyn Medical Journal, April, 1906), reports two cases of injury of the ear caused by lightning. During a severe thunder-storm a large bathing pavilion at Coney Island, crowded with bathers seeking shelter therein, was struck by lightning. Five persons were killed, one of these being a young man who, with the two ear cases about to be reported, was just entering the shelter between the couple.

Case 1. Male, aged twenty-seven years, was unconscious for three hours, and had suffered from painful burns and shock. On regaining consciousness he noted a fullness in both ears, roaring tinnitus and impairment of hearing in both ears. The hair was burned from the left side of the occiput. A seared burn appeared on the back of the neck, thence across the left shoulder-blade and down the left arm to the elbow. The burned area on the shoulder was a superficial, irregular mark, the size of a spread hand, purplish-red in color. The symptoms of tinnitus and impairment of hearing left the right ear within three or four hours, but became more marked in the left, and so contined until seen by Braislin. Pain was also felt on the back of the auricle and at its attachment to the head. On the morning following the injury a bloodstained discharge from the left ear appeared, and was present at the time the patient came to the hospital. Examination of the drum revealed a perfectly round perforation one eighth inch in diameter, slightly anterior to and below its centre, its edges reddened and raw as though a loss of its substance had occurred at this point. The remainder of the drum membrane was pale. The following day the membrane presented an appearance of uniform redness, except at the margin of the perforation, where it was somewhat everted, raw, and swollen. Healing proceeded uninterruptedly.

Case 2.-Female, wife of Case 1. Injured at the same time and in same manner as her husband, but less severely; was only momentarily unconscious. She

immediately noticed that her hearing was defective; also a roaring tinnitus in both ears-worse in the left. She was exam

ined on August 2. The drum membrane presented a small perforation, now sealed with a scab of fresh, blood-red, but dry, extravasated serum. The perforation was in the centre of the drum just behind the umbo.

The right ear in both cases presented no visible lesion. As an explanation of the ear injuries, it is supposed by Braislin that both were due to the presence of water in the ears, as both had just left the surf. Water being a well-known excellent conductor of the electric fluid, it is believed that a small charge of electricity followed a track of moisture in the external auditory canal, and thus in each case caused a perforation of the drum, finding its way to the Eustachian tube.

Suppurative Otitis Interna.

J. D. Richards, New York (Archives of Otology, August, 1906), reported to the Otological Section of the New York Academy of Medicine a case of suppuration of the internal ear. The interior of the mastoid was filled with a cholesteatomatous mass which invaded both antrum and tympanum. The posterior wall of the bony canal was necrotic down to a level below the facial canal. This necessitated the complete exposure of the facial nerve from the floor of the auditory canal to the point of emergence from the inner tympanic wall. Pus exuded from the internal ear. The whole semi-circular canal system was removed; granulations were found in all the canals, but no pus. The petrous portion of the bone which was pneumatic was removed as far forward as the carotid artery. The internal ear, which was involved throughout, was ablated; the facial nerve was exposed as far inward as the internal auditory meatus. About one-quarter inch of the carotid artery was exposed as it lay in the carotid canal. No pulsation of the exposed artery was to be seen, demonstrating the importance of the carotid canal as a bumper in protecting the brain from arterial shock. In two other similar cases there was no noticeable pulsation in the carotid artery. On emerging from anesthesia there was a slight facial paresis, but neither vertigo, vomiting nor nys.

tagmus. Twenty-four hours later complete facial paralysis. Disturbance of equilbrium was at no time general. Facial paralysis continued three or four months, gradually improved and completely disappeared.

New Technique for the Mastoid Operation.

E. M. Holmes, Boston (Annals of Otology, Rhinology and Laryngology, September, 1906), in the course of a discussion before the American Laryngological, Rhinological and Otological Society, described his technique in the mastoid operation. His first incision is carried through the skin only. The skin flap is dissected forward, not injuring the periostium. The posterior superior portion of the cartilaginous canal is severed near its attachment to the bony canal and the auricle is carried forward. With a small angular knife an incision is carried through the skin and periosteum of the bony canal at about the junction of the superior and anterior quadrants above and the posterior and inferior quadrants below. An incision is carried through periosteum of the mastoid from the incision of the superior portion of canal backward over the temporal line. From the outer end of the lower incision in the canal the periosteum is incised on a line toward the mastoid tip. The periosteum is carefully elevated from the canal and mastoid, that from the canal is covered by the skin of the canal. The flap of skin and periosteum is rolled back and covered with moist sterile gauze. After the mastoid and middle ear have been exenterated, all rough bone is smoothed so as to leave a gradual slope and the periosteal skin flap is adjusted. The auricle is carried to place and fastened with gut sutures. The wound is closed and sutured and a gauze pad applied so as to keep the skin in contact with the periosteum.

Retropharyngeal Abscess of Otitic Origin.

E. M. Holmes, Boston (Fraenkel Festschrift number of the Annals of Otology, Rhinology and Laryngology, December, 1906), reports two cases of retropharyngeal abscess in adults of otitic origin and extensively reviews the literature of the subject and the anatomy of the region. The first case was in a girl of fourteen years. History of chronic suppurative otitis for about ten years. Acute attack