Atoxyl (arsenic acid anylid) must be used in the form of a 10 per 100 solution, sterilized during two minutes at 100 C, and it must be always freshly prepared. Every other day 2 c. c. of this solution should be given by needle. While this dose, will prevent intoxication accidents, yet it is necessary to carefully watch for idiosyncrasies. Atoxyl undoubtedly acts on all syphilitic exanthemata, on all cutaneous manifestations, from the papule to the gumma, inclusively; its action on the latter is even very remarkable. It also influences most favorably the lesions on the mucous membranes.

The action of atoxyl is closely similar to that of mercury; but, in general, at the dose it is given the medicament is less efficacious than mercury. Moreover, arsenic is rapidly eliminated, hence the short duration of its action. As no more than from 15 to 30 injections consecutively can hardly be employed, it happens that when the treatment is suspended, a relapse of the syphilitic manifestations occur.

In early malignant syphilis atoxyl acts favorably, but not more intensely, not more rapidly than mercury. Summing up, since atoxyl ameliorates most positively the powers of the patient, it can be used in the intervals or pauses of the mercurial treatment. Atoxyl plasters, 10 per 100, are very active and are recommended in the local treatment of syphilitic cutaneous lesions.

THE BANANA IN THE TREATMENT OF DIARRHEA.-(Collin, Gaz. heb. des Sc. Med. de Bordeaux, and L. Gayard, Gaz. des Hopitaux.) Confronted by the slow and uncertain results obtained with the usual treatment of diarrhea, in general, namely, purges followed by mucilages, opium, antiseptics and astringents coincidentally with a milk diet, Collin, a surgeon in the French army. colonial division, resorted to the exclusive banana diet, on many occasions. Bananas are sterilized by thorough boiling and at the same time reduced to a pulpy cream, or purée. This treatment was pointed out to him by a physician from Java, who had treated it with success. In the absence of fresh milk, it is a good substitute in cases of diarrhea.

The quantity of banana cream or purée ordered varies from 300 to 1000 grams a day, according to the patient's appetite, with the addition at times of a small amount of light rice water or

lactic lemonade (2 per 100). In cases of simple acute diarrhea or uncomplicated chronic diarrhea, the banana cure works beautifully, but it barely acts favorably in severe cases complicated with dysenteric form symptoms. As soon as the banana cure is begun, the number of stools decreases, then consectomy increases, the abdominal contractions are attenuated, they even disappear entirely, finally the general condition is bettered very rapidly.

The properties of the banana seem due to its richness in sugar and starch.

Department of Ear, Nose and Throat.

In Charge of A. W. deRoaldes, M. D., and Gordon King, M. D.
New Orleans.

SINUSITIS AS A CAUSE OF SARCOMA.-Goris, of Brussels, advances the theory that sarcoma of the superior maxilla may be due to prlonged suppuration of the antrum or the ethmoid cells. In support of this he reports three cases in which he was enabled to observe the development of sarcomata in the course of sinus suppuration. The analogy is not obscure between the accepted theory of the development of malignant neoplasms from traumatism or prolonged irritation, and their outgrowth from continued suppuration from a cavity, such as the antrum.

Goris does not, of course, consider the observation of only three such cases to be at all conclusive, but thinks it something more than mere coincidence. He offers this as an additional reason for advising the radical operation for the relief of chronic suppuration of the nasal accessory cavities.-Societé Belge de Laryngologie, 1907.

SCLEROTIC OTITIS IN ITS RELATION TO ARTERIO-SCLEROSISSouleyre, in the Presse Medicale of July, 1907. reviews the question of the relation of middle ear sclerosis to general arteriosclerosis, and concludes that oto-sclerosis should be considered as a symptom of the former condition. The causes of the two conditions are practically the same, and the association of the ear sclerosis with the general arterial change is too frequently observed to be coincidental. It is difficult to ascribe the changes that take

place in the middle ear to any other cause. The author advises for the treatment of oto-sclerosis the same general measures of diet, hygiene, etc., indicated for the arrest of arterio-sclerosis. In addition to which lumbar puncture, pilocarpine, and high frequency currents to lower the arterial tension.

Department of Ophthalmology.

In Charge of DRS. BRUNS and ROBIN, New Orleans.

OPHTHALMIA NEONATORUM.-(Amer. Journ. of Obstels., July, 1907.) For the following very interesting abstract of Cragin's paper we are indebted to The Ophthalmoscope, December, 1907:

Cragin said that one of the burning questions of the day was how to reduce the number of those who go through life handicapped in the race, or perhaps a burden on the State, on account of an impairment or loss of vision, the result of ophthalmia neonatorum. The solution of this problem concerned the treatment of the baby's eyes immediately following its birth, and as various methods of treatment had been used by the writer in his service at the Sloane Maternity Hospital, and as each method had been followed in a series of one or more thousand confinements, the comparisons of the results of the different methods was of interest. Before taking up the individual methods of treatment, the writer noted the following general propositions:

"1. A baby which is premature, and of low vitality, is more liable to ophthalmia than one which is mature and vigorous.

"2. On account of the dangers of contagion, babies congre gated in a hospital are more liable to ophthalmia than babies. under the same treatment and under the same obstetrician in private practice.

"3. The number of cases of ophthalmia in hospital service will vary somewhat with the class of cases admitted, but whatever the treatment employed, judging from the author's experience, a certain number of cases of ophthalmia will inevitably occur."

In the five methods of prophylactic treatment used by him at the Sloane Maternity, the smallest number of cases of ophthalmia

in one thousand confinements had been seventeen, the largest thirty-four. Hence, with the present known methods of prophylaxis, in a hospital service of fifteen hundred confinements per year, in which emergency and ambulance cases were received, one must expect from fifteen to twenty-five cases of ophthalmia in each one thousand confinements.

By ophthalmia is meant a purulent conjunctivitis. The objects desired were, first, to reduce the number of cases, and, second, to have the disease as mild as possible when it occurred.

In cleansing the eye it was his custom to flush the eye from the inner to the outer canthus with boric acid solution by means of a medicine dropper; the outer surface of the lids being then bathed in the same direction with the same solution.

During the last seven years the writer had used a prophylactic measure in five different series of cases, five different silver solutions: nitrate of silver, 2 per cent; nitrate of silver. 1 per cent; protargol, 5 per cent; argyrol, 10 per cent; argyrol, 20 per cent. The results were as follows:

SERIES 1. In 1,000 confinements, 2 per cent nitrate of silver solution; cases of ophthalmia, 18; eyes lost, none; opacities, none. SERIES 2. In 1,000 confinements, 1 per cent nitrate of silver solution; cases of ophthalmia. 34; eyes lost, 1; opacities, none.

SERIES 3. In 2,000 confinements, 5 per cent protargol solution; cases of ophthalmia, 53; average per thousand, 26+; eyes lost, 1; opacities, 1.

SERIES 4. In 2,000 confinements, 10 per cent argyrol solution; cases of ophthalmia, 34; average per thousand, 17; eyes lost, 1; opacities, 2.

SERIES 5. In 2,000 confinements, 20 per cent argyrol solution; cases of ophthalmia, 54; average per thousand, 21+; eyes lost, none; opacities, none.

During the use of the two per cent nitrate of silver solution, the irritation of the eyes with the accompanying edema and discharge, the so-called "silver catarrh", was so great that not only did it occupy a great deal of the time of the nurses in applying compresses and irrigating the eyes of babies, but it seemed to him to be a source of danger, not only by leaving an irritated eye which might later become infected, but also by causing in the nur

series discharging eyes, from which the discharge might be carried by nurses to healthy eyes, and thus the infection produced. For this reason, although no eyes were lost in this series, and as far as known, no opacities produced, the strength of the nitrate of silver solution was reduced from two per cent to one per cent.

The original cost of the argyrol solution was much greater than that of the nitrate of silver solution, but when one considered the greater straining and injury to towels, sheets, etc., and the greater demand upon the nurses in the use of the solutions of nitrate of silver, it had seemed to the writer that, viewed at the end of a year, the tax on the treasury of the hospital from the use of argyrol was but little, if any, greater than from the use of nitrate of silver.

The author detailed a series of very careful investigations concerning the bactericidal power of silver salts used in the different series. The tests were made with the staphylococcus pyogenes aureus, the streptococcus pyogenes, and the gonococcus. From the tests made it was evident that in the solutions usually employed argyrol had practically no bactericidal powers over the streptococcus or staphylococcus, but with the gonococcus, in strength of 20 per cent and 30 per cent, it was perfectly efficient. So long as a 20 per cent argyrol solution was efficiently bactericidal with the gonococcus in thirty seconds, so long as the gonococcus was the coccus most feared in the etiology of ophthalmia neonatorum; and so long as the clinical results were practically as good as with the use of two per cent nitrate of silver, and better than with the one per cent nitrate of silver, and this without the annoyances of silver irritation and staining, the writer felt justified in using and in advocating the use of argyrol as a prophylactic against ophthalmia neonatorum.

In the curative treatment of ophthalmia neonatorum, the writer had also found argyrol of great value. The absence of irritation in strong solutions, the fact that these solutions might be dropped into the eye at short intervals by the nurse without injury to the eye, and the fact that these solutions were bactericidal to the gonococcus, were all in its favor. The writer's present plan of treatment consisted of frequent irrigations of the eye with boric acid solution (every fifteen to twenty-five minutes during the stage of active purulent discharge), cold compresses, and the instillation of argyrol, 30 per cent every two to four hours.