and other symptoms showing the extension of the disease to neighboring organs. Exostosis of the osseous structures often is seen.

Atrophic rhinitis (ozena) is characterized by a sense of dryness in the nose and throat, a thick, purulent discharge and the expulsion of discolored crusts and an offensive putrid odor. The sense of smell is impaired and the patient is weak and anemic.

The mucous membrane is dry and glazed, but in advanced cases ulceration and necrosis are present.

The treatment consists of applications directly to the diseased area and the administration of such internal remedies as will correct any coexisting disease or morbid state. In some cases where there is occlusion by exostosis the resources of surgery must be invoked.

Let me examine more in detail the treatment of the types of nasal catarrh.

In simple chronic hypertrophic rhinitis the results of treatment will be most flattering. In a case attended with no constitutional disease nothing is necessary beyond having the patient spray the nasal mucous surface with a solution composed of equal parts of water and Hydrozone every three hours.

If the case has persisted some time and the patient has an amount of mucous discharge, I have him take twenty drops of balsam of copaiba four times daily. The Hydrozone is not only a disinfectant and germicide, but its curative action on the inflamed mucous membranes is speedy and is not equaled by any other drug I have ever used. When the patient is anemic I have him take iron, and any other drug is used when it is called for by any associated disease or morbid condition, but the Hydrozone spray is used in all cases.

In the atrophic variety we shall have to use the same local application. The Hydrozone at once overcomes the offensive odor and takes off the purulent crusts.

These cases must be treated with cod liver oil, iron and such other remedies as will bring up the general health.

Here are a few clinical histories:

Mr. R. H. M., age 60, had been a sufferer for two years. There was no exostosis, but when he had a cold he could breathe

only through his mouth. He was in good general health, so I had him buy an atomizer and use a spray composed of equal parts of distilled water and Hydrozone. He sprayed the mucous surface of the nose every three hours. On this he made rapid improvement and in three weeks had no further symptoms.

S. M. T., age 18, had chronic hypertrophic nasal catarrh in which the mucous discharge was very abundant, and this was associated with dryness of the throat and constant desire to hawk and spit. She used the Hydrozone and water spray, and took fifteen drops of balsam copaiba three times daily. I had the pleasure of seeing this young woman go along to complete recov ery in a period of six weeks.

Mrs. R. J. C., age 49. This lady had atrophic rhinitis and as soon as she came near you the putrid odor asserted itself. Her general health was lowered. I had her use the Hydrozone and water spray and take cod liver oil internally. She spent last winter in Cuba, and has just gotten home greatly improved in general health and her catarrhal disease is better.

She says the spray effectually destroys the disgusting odor and that scarcely any discharge now appears.

I expect to see this patient entirely well in several months.

Selections.

THE TREATMENT OF PNEUMONIA, WITH SPECIAL REFERENCE TO CREOSOTE.* It is not my purpose to write a paper upon the pathology and symptoms of pneumonia, nor to deal in a general way with its treatment; but, in as brief a manner as possible, to relate to you some results I have had from the use of creosote in the management of this disease.

In January last, I listened with much interest to a paper read before the Central Texas Medical Association by Dr. I. L. Van Zandt, of Fort Worth, Texas. His subject was "Creosote in Pneumonia." The paper was a resume of seven years' experience, and he cited a number of cases with their history and

*Read before the Brazos Valley Medical Association at the eleventh semi-annual meeting, at Calvert, Texas, May 14, 1901.

symptoms which had been treated by the use of creosote. According to his assertions he had been able to limit the duration of pneumonia to three or four days, with a few exceptions, and in some instances as short as two to three days.

I concluded that if such was the experience of Dr. Van Zandt, I would try the treatment myself, and should I succeed as well as he, I would be well paid for my investigations and my patients relieved of much suffering and anxiety.

Formerly I had treated pneumonia upon the expectant plan, meeting symptoms as they appeared, but constantly stimulating my patients with strychnine and supporting them with a light, nutritious diet.

Since January, I have treated twenty cases of pneumonia, using creosote in each, and out of the twenty cases I have had no deaths.

Of these twenty cases seven have reached the crisis in four days, seven in five days, two in six days, and two in seven days, and one each in eight and nine days.

This shows fourteen cases out of twenty that reached the crisis by the fifth day, while only one lasted as long as the ninth day.

Now, while we are taught by some of the best authorities that pneumonia reaches its crisis between five and ten days, my former experience has been that all my cases of lobar pneumonia lasted from seven to ten days.

I alse find that after I began the use of creosote the fever did not run as high as usual, nor did it fall so suddenly at the end of the disease, leaving the patient so prostrated, accompanied by the profuse sweat, but rather that the fever declined more gradually. Only one case showed any alarming symptoms at the crisis, and she had just recovered from a severe attack of la grippe when taken with pneumonia. Thus she was quite weak at the beginning.

Again, I find that the use of creosote lessens, to a great degree, the severity of the cough and pain, and my patients required but little medicine to produce rest or sleep. Not a single case ever vomited or suffered with nausea while the medicine was administered.

I do not make any special report of individual cases for the

reason that I did not begin by keeping accurate report in each case, nor do I care here to discuss the general symptoms or treatment in this paper. I will state, however, that each case of these twenty presented the typical symptoms of pneumonia, and I have included none which were doubtful as to diagnosis.

You will note that six of these lasted from six to nine days, and it might be said that they were not influenced by the creosote, or else they also would have yielded in a shorter time.

In nearly every instance where the fever lasted beyond the fifth day it was in cases to which I was not called until about the second or third day after the chill, These, however, ran a much milder course, and rested better than was formerly the case in my practice.

We accept the theory that pneumonia is a specific disease, caused by a specificigerm (dipplococci); which manifests itself by a local inflammation in the lungs, having first the stage of congestion, then solidification or hepatization, after which, resolution. We further believe that these organisms are responsible for the general symptoms, especially the fever, by the intoxication of the system from this local manifestation.

Now we know that creosote is an antiseptic and germicide, and that taken into the system, it is eliminated unchanged though the kidneys, skin and lungs,

Accepting the above two propositions, is it not reasonable to believe that the elimination of this antiseptic through the lungs will, to some extent, at least, destroy these pneumococci or retard their development, thus reducing the amount of toxins absorbed into the system, lower the fever and cut short their destruction of lung tissue?

If given in time and in proper doses it is my opinion that you can shorten the duration and make milder an attack of pneumonia.

Now, as to the preparation I use, and the mode of adminis tering it:

While you will probably get good results from the ordinary beech-wood creosote, I have used the carbonate of creosote, as suggested by Dr. Van Zandt, and 1 find that it is more easily borne by the stomach and can be given in larger doses without any systemic disturbances.

I begin with ten drops every three hours, and increase the dose five drops daily until twenty to twenty-five drop doses are given for an adult. When the maximum dose is reached I place it at futher intervals, say, four to five hours.

I might add that in all cases I use strichnine as a stimulant, beginning with small doses during the second stage and increase the dose as the patient approaches the crisis.

Now, gentlemen, I have not written this short sketch to show any particular originalty, nor to claim any special ability in the treatment of pneumonia, but simply to give you in a few words the results I have had in the use of this remedial agent with the hope that you will consider it of sufficient value to make some trials of it, believing that you will find in it an agent of much value in the treatment of pneumonia as well as other diseases of the respiratory tract. I regret that I have not been able to give a more minute history of these cases, but I trust I have placed the subject before you with sufficient weight to elicit your discussion of the subject and your trial of the remedy.

In conclusion, it is my opinion that if we are able to cut short the duration of the disease, lessen the fever, allay the irritable cough and carry a larger per cent. of our patients to a safe convalescence the remedy is worthy of a trial and investigation.Dr. H. W. Cummings, M.D., of Hearne, Texas, in Texas Medical Journal, Dec. 1901.

HEMOPHILIA AND NOSEBLEED YIELD TO THYROID TREATMENT.-Scheffler (Archives de Medicine et de Pharmacie Militaires) reports the case of a 22-year-old soldier, of good family history, who without obvious cause, was attacked by purpura and obstinate nasal hemorrhages. This hemophilic condition was absolutely unaffected by ordinary therapeutic agents, and the epistaxis became so persistent and exhausting that permanent blocking of the nasal fossa was necessary. Treatment by Thyroid extract exerted an immediate and beneficial effect, and was followed by cure. In three days the violent and persistent epistaxis had practically stopped. In six days, about eight grains of thyroid extract having been given daily, the purpuric eruption ceased and the old spots began to disappear.-Therapeutic Gazette.