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versity Hospital, solid carbondioxide with satisfac- tory results for a common malady not mentioned, that of warts or papillomata, and at the present time they had rather a large following by virtue of this therapeutical agent. Dr. M. B. H.-xRiZELL mister money slots free had used the cold cautery and had found it most convenient in appropriate cases, but it was far from being a cure all. It was a caustic and could accomplish only that whic-h any other caustic could effect. It acted rather super- ficially, which limited its usefulness and accounted for the slight scarring which followed its use. Its greatest use was in vascular nsevi. He did not be- lieve it to be effective in lupus vulgaris ; it did not go deep enough. The small tubes shown had a certain degree of convenience, but they were cer- tainly not cheap; for $1.75 you could buy twenty pounds of carbondioxide. A most convenient way of preparing the gas for use was by making a cyl- inder of thick blotting paper around a stick, and around this wrapping a towel. After moulding the carbondio.xide in the cylinder it could be with- drawn, when you had a stick of the cold cautery ready for use. He had not used the cautery in lupus erythematosus sufiiciently long to be sure of permanent results. He must take exception to the statement that the temperature of the carbondiox- ide was materially reduced by dipping in ether. Dr. Fr.\xk C. Knowees had employed the car- bondioxide snow in quite a number of cases and had had the best results in angeiomata. The port wine stains apparently did not respond as well as other discolorations, e. g.. the very deep seated angeiomata. The cases of lupus erythematosus had been improved, but not cured by this treatment. In the moulding of the snow he employed wooden pill boxes, using the size approximating the mister money slot machine area to be treated. \\'hen the lesions were small he shaped the snow into various sized ear specula. These simple devices answered admirably, instead of the very ex- pensive and unnecessary appliances so widely ad- vertised. Dr. Frescoln in closing: The patients whom he had treated did not have much pain at the time of the application of the snow. However, if the ex^ posure was long continued, and made under con- siderable pressure, there was apt to be pain over the blebs mister money bags slot machine similar, to the burn of frost bite, lasting for several days. The Treatment of 100 Cases of Suppurative Otitis Media (Scarlatinal) by Means of Bacterial Vaccines (Bacterins). — Dr. John A. Kdt.mer and (by invitation) Dr. P. G. Weston: The cases were observed and treated in the Philadelphia Hos- pital for Contagious Diseases. The best time for commencing bacterin treatment was found, as a rule, to be from the eighth to the sixteenth day after the discharge began. The organisms found were the staphylococci aureus and albus : streptococcus pyogenes ; bacillus pyocyaneus and a diphtherialike nonvirulent organism which we termed the pseudo- diphtheria bacillus. The latter organism was found in 57 per cent, of the cases, and its important rela- tion to otitis media and diphtheria of the ear was emphasized, .'\utogenous vaccines were used in all cases excepting one. If two organisms were found they were isolated and a vaccine was prepared of 756 BOOK NOTICES. each. Mixed vaccines were never used. The in- itial dose was small and repeated in from five to eight da3S. Frequency of dose was determined ac- cording; to the clinical course. During vaccine treatment ever\' other treatment was stopped, mister money slot game ex- cept gentle cleansing of the external auditory canal to insure free drainage, and to avoid inspissation •of pus and plugging. They believed syringing to be harmful unless performed very carefully. The real value of vaccine or any treatment could be de- termined only after a long lapse of time, because not infrequently these discharging ears stopped and commenced again later. Xo return cases were traced directly or remotely to any of these cases. By comparison with a large number of cases treat- ed in the usual manner, it was found that with vac- cine treatment, 21.66 per cent, of cases were cured in from one to thirty days, as compared with 7.46 per cent, under the usual treatment in the same pe- riod of time. Continued high fever, acute nephritis, tox;emia, and other intercurrent infections were ■considered to be contraindications to the treatment. Dr. B. Alexander Randall said that the re- sults reported in this paper represented about half of all the work done upon this subject, the aggre- gate of cases treated elsewhere having been hardly -more than the hundred cases reported to-night. He was a believer in the matter, but everything of the sort must be dealt with cautiously. The natural history of the disease must be distinctly taken in mind rightly to estimate the value of any treatment. The success of the treatment, together with the fact that other treatment was withdrawn, gave a strong support to the claims made for it. On the other hand, he could not refrain from feeling that more could be done in the simple measure of irrigation than had been intimated. mr moneybags casino If the amount of per- sonal attention requisite in the culturing, etc., were given to the older fashioned style of treatment we should have had a considerable amount of good re- •sults. If a child with scarlet fever or other exan- them was well protected as to the ears with a night •cap much could be done to forestall trouble. If the ■case was treated early he thought we could bring it to a successful issue in children in fair condi- tion of health, mister money slot review in something like three weeks; he "had done it in eighteen days. Dr. B. A. Thomas stated that, incidentally, he would like to criticise the employment of the term ■vaccine. He thought it proper that we should use as nearly as possible scientific terms. The thera- peutical agent referred to was merely a suspension of dead Ijacteria in physiological salt solution, mister money online to which had l)e;.'n added a minute quantity of phenol for preservative purposes ; hence "bacterin" was the term which scientifically and properly expressed the nature of the preparation. "Vaccine," the term un- fortimately employed by Wright, had by common usage become almost universally popularized, but strictly was a misnomer and should be restricted and relegated to the virus used in vaccinia, derived from the cow in accordance with the original sug- gestions of Jenner. Dtitis media could be divided into the acute sup- purative and chronic suppurative varieties for bac- terin treatment. The treatment had a definite ac- cessory effect in conjunction with other forms of treatment. Local measures should never be omit- ted. He felt that bacterin usage in otitis media mr moneybags slot machine online had a more restricted field as a therapeutic meas- ure than in the vast majority of affections in which it was commonly used. This was largely due to the fact that the middle ear was encased in a bony cage. Dr. E. J- G. Beardslev, when he thought of the weeks children were detained in the Municipal Hos- pital because of discharging ears following the average case of scarlet fever, felt that the work of Dr. Kolmer and Dr. Weston was epoch making. Dr. Kolmer in closing: He entirely agreed with Dr. Thomas regarding the use of the term vaccine. His reason for adopting it was its familiarity to the general practitioner. Local treatment in con-

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