A NEW AURAL FORCEPS.

544 Italian and Latin, will be of use to ment ; the upper blade, together with the handle, consists and chemists who have occasion to look at or of three portions. On separating the handles, the fine to make up prescriptions coming from several parts of the fenestrated end of the forceps is madeto gape and grasp the object to be removed, and on approximating them the Continent, many of the terms in Italian being similar to seizure is effected. The freely mobile portion of the blades is those used in Spanish, and a good many Latin terms being only about half an inch long; the entire blades to the angle, inserted which are used in several continental countries, about four and a half inches. The accompanying woodcut the above details; and after a considerable experience though almost unknown here, and therefore likely to puzzle reveals of such instruments, I have no hesitation in stating that an Englishman somewhat. For example: "Cianuro" in both this is the most convenient and efficient I have ever used. Italian and Spanish is cyanide-a perfectly obvious fact after ALEXANDER MORISON, M.D., F.R.C.P.E. one is told it, but not quite so easy to evolve from one’s inner consciousness without any hint to go upon. " Electuarium thericale magnum " is not a preparation of which most of us TREATMENT OF SCROFULOUS GLANDS. know anything, but by looking it out in Signor Di-Giorgi’s To the Editors oj THE LANCET. work we at once become aware that it mnst be treated with read in THE LANCET of Aug. 24th an have SIRS,—I caution, as one of its synonyms is " elettuario d’oppio com- article on the Erasion of Scrofulous Glands, and in your posta," which would convey to the mind of any medical man issue of this week a letter from Mr. Thornton on the same or chemist, even though he might be entirely innocent of subject. Surgeons interested in the treatment of scrofulous. any knowledge of the Italian language, that he had an opiate glands seem to be divided into three classes : (1) thoseto deal with. The work of course makes no attempt to who advise leaving the infected glands to the curative give the strengths of the various preparation, nor does it efforts of nature, or who advocate various medicinal say to what Pharmacopoeias the different terms belong, so remedies or local applications rather than operative measures. that the preparations grouped together as synonymous must for removal; (2) the advocates of erasion, amongst whom r only be taken as approximately so. This is, however, a may include the writer of the article ; and (3) those surgeons defect which it would have been impossible to have avoided who recommend excision. I have excised scrofulous glands for without very largely increasing the bulk of the little volume. many years, and certainly, if I were compelled to limit myself to one of these three lines, I should take the last-viz., exMechanics and Experimental Science, Magnetism and cision. But, fortunately or unfortunately, the matter does not Electricity. By ED. AVELING, D.Sc., Fellow of University lie in so narrow a compass; scrofulous glands present infinite College. London: Chapman and Hall.—Dr. Aveling’s books, variety, and the treatment which is best for one case may bethe worst for another. It appears to me that each is right or as we have already remarked, would seem to be designed to subserve the purpose of cramming, and even of cramming wrong according to the individual character of the particu-for the London University examinations. Hence they are lar case, and that to lay down a line of treatment, whether expectant or operative, without seeing the patient is to take very fragmentary, and although some of his expositions are a leap in the dark and to formulate a general rule which has highly successful, other parts of his work are of such un- no general application. It is a nice point to determine the equal quality that, upon the whole, it attains only a modest exact moment when a gland becomes scrofulous, and, this matter settled, the line of treatment depends so much on thestandard of excellence. and the state of his glands that no universal rule can be given. It is useless to say in a general and positive manner that scrofulous glands should be left to nature or treated with drugs, or that they should be scooped or cut out. Many glands cannot be scooped; others it is equally impossible from their attachments or position to excise; and fewer, if any, are amenable to drug treatA NEW AURAL FORCEPS. ment. Often it is better not to interfere for a time, but the of a THE instruments which mark growth specialty rather to wait till the general health has become estab-have a clumsiness directly as the development of such lished, till the disease has quieted down, and till such specialty. The instrumentation of aural surgery forms no inflammatory products as can be absorbed have disexception to this rule. Many forceps designed for the re- appeared. In other instances, a softening gland may bemoval of small polypi and granulations are so bulky as to causing so much irritation, and so rapidly infecting other that it must be dealt with at once. Occasionally obscure, on their introduction into the auditory meatus, the glands, which have uniformly softened may be scooped, with glands structure to be removed. Aural forceps have been con- the rosy results described by the writer of the article. In other cases the glands are such that they must either be excised or left alone. All that can be suggested generally is that it is not well to leave scrofulous glands for an indefinite time to increase and infect healthy glands; that scooping, is often the best method for cases of small or moderate enlargements with general and uniform softening ; and that excision, combined or not with some scooping, is the only method available for big enlargements, or for cases in which the glands have not softened, or for those in which caseation or softening has only taken place in limited portions of the glands. I am an advocate for excising scrofulous glands, but I should be very sorry to recommend excision as a universal practice, or, in fact, to lay down any general rule for the treatment of this troublesome affection. Each case must be judged on its merits and treated’

in other

languages than

medical

men

patient

New Inventions.

accordingly.

structed with the handles at various angles to the blades to obviate this difficulty, but the elements of delicate workmanship, strength, and appropriate shape are only met with in a comparatively small number of cases. These qualities, in my opinion, exist in an aural forceps which Messrs. Arnold and Sons of Smithfield have constructed for use. It is a modification of one which these makers supplied me with. at an angle of The instrument consists of two blades about 45° to the handles. The lower blade and handle consist of one piece, and are thus the fixed point of the instru-

placed

Margate, Sept. ist,

I am, Sirs, yours obediently, WM. KNIGHT TREVES. F.R.C.S. TREVES, F.R.C.S.

1889.

THE PROPOSED INFECTIOUS DISEASE HOSPITAL

AT’

BLACKBURN.-Energetic opposition is being offered by prominent citizens of Blackburn against the erection on the site proposed by the Health Committee of a hospital for the reception of patients suffering from infectious disease. Last week a meeting was held in the Audley district, at which a resolution was carried condemning the committee’s proposal.