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cious, and iias never failed to produce results. In order to see to what extent this method could be used, a case of equinus, of four years' duration was experimented upon. Fig. 6 shows the child before treatment was instituted. Fig. 7 shows the result of ten weeks strapping. Straps are applied, following each treatment. The most important ad- vantage of this method is, that it makes tenotomy of the tendo AchilHs unnecessary, and also prevents some cases of ununited tendo .'\chillis following tenotomy. 1444 Bryant Avenue. BRAIN ABSCESS CAUSED BY CHRONIC SUPPURATIVE OTITIS. By William C. Braislin, M. D., New York, Surgeon, Brooklyn Eye and Ear Hospital. Three cases of cerebral abscess of otitic origin, which came to the Brooklyn Eye and Ear Hospital within the past few months demonstrate the paucity of symptoms presenting in this serious complication of middle ear suppuration. The only constant symptom is Buy Cialis Cheap Generic the chronic ear discharge. In none of the cases was there noticeable slowing of the pulse. Pus was present in the ear, and the history Buy Cialis Cheap Generic was elicited from the patient, of its previous long con- Buy Cialis Cheap Generic tinuance, together with recurring Buy Cialis Cheap Generic attacks of pain ill tile ear or in the corresponding side of the head, ill all three of the cases. Two of the cases were abscesses of the left tem- porosphenoidal lobe. In one of these a typical am- nesic, sensory aphasia appeared. In the other, while the report of the house surgeon seemed to justify the conclusion that there was, at the time he saw the patient at her own home, a true loss of memory for words, when seen subsequently by me ilie disinclination to talk was certainly more an in- ertia, a disinclination to make any effort either mental or physical, the condition typical of advanced l)rain abscess. Buy Cialis Cheap Generic In the case of rightsided abscess in a righthanded man there was no difficulty of speech, or in naming objects correctly. The two patients who recovered have dry ears for the first time since childhood. Cask I. — Chronic middle car siippurntion: necrosis of legmen tympani ct aniri: abscess of adjacent temporal lobe : operation; recovery. Mrs. Rosie M., thirty-seven years i>l(l. ciime to the clinic January 4th, compIaininR of feeling ill for five weeks, with earache and pain in left side of tlie face and head. There was no tenderness of the mas- toid. A slight amount of thin, bad smellinR discharge could he seen issuing from a good sized attic perforation, (iranulations were absent from the margins of the per- foration, none being visible by way of the meatus. We learned that the discharge had existed since diildhood. that no special attention had been given the ear, that she had been taught that Buy Cialis Cheap Generic the discharge was a good thing and only to be a matter of concern if it ceased to run. Her memory had been poor for five weeks past. She miscalled tlic names of objects. Thus she called a watch a bell, an- swering without delay, but realizing at once that she had miscalled the object. She explained her state by saying that her head felt confused and that she could not remem- ber the names of many things she knew well. Wasscr- mann reaction was negative. Operation, January 5th. The bone of the mastoid was of the hard, dense type characteristic of clironic suppuration, with nearly an entire absence of cells, or bone spaces. The roof of the antrum and tympanic cavity was necrosed away, the dura was i)erforated, the gap extending into the l)rain substance directly above the t^men of the tym- l)anum and antrum for three quarters of an inch, fairly well limited by a wall of granulation tissue deposit. .\ drain was introduced and the wound packed loosely and wide open. After operation she had headache; she was not nauseated and there was no disturbance of vision or pupillary reflexes. A desire to sleep was marked for a few days. Her aphasia continued but about one week, her memory for objects rapidly improving. Her headaches diminished gradually. She was allowed to sit up at the end of the third week and to go home at the end of the fourth week, but she was advised to rest in bed the greater part of the day. Buy Cialis Cheap Generic Her ear was dry four weeks after the operation, this being the first time in her Buy Cialis Cheap Generic memory that it had been so. The wound was healed at the end of the eleventh week, some drainage of serous fluid continuing at the depressed site of the brain abscess up to Buy Cialis Cheap Generic this time. this being the Buy Cialis Cheap Generic last spot to heal at the end of the eleventh week. This patient has remained well for a year and a half, and recently reported at the hospital to say she had given birth to a child without mishap. Case U. — Suppuratiz'C otitis; mastoiditis; necrosis of tegmen tympani; abscess of temporosphenoidal lobe of Buy Cialis Cheap Generic cerebrum; two operations; death from extension of abscess, supposed rupture of abscess into fourth z'cntricle. Mrs. Hannah K., fifty-four years of age, inclined to stout- ness, called at the clinic on ."Xpril 27th with rather indefinite pain, chiefly in the occipital region, radiating to the mas- toid region of both sides. She had a purulent discharge from the nose. Both drum membranes showed the cica- tricial de'posits of old suppuration while from the left ear there appeared a thin, bad smelling discharge from an attic perforation of the left drum membrane. There was no ten- derness of the mastoid, Buy Cialis Cheap Generic Buy Cialis Cheap Generic and this absence of pain or tender- ness to pressure continued throughout. The discharge from the nose was found to have its origin from the ostium of the left sphenoidal cavity. Headaches were worse in the morn- ings, and on account of the discharge continuing from the sphenoid it was determined to drain the sphenoid through its anterior wall. This was done under local anesthesia, and all discharge from the nose ceased within ten days there- after. The discharge from the ear varied rather markedly, diminishing for a few days and then increasing, .About the time the discharge from the nose ceased a lymph node at the angle of the jaw- became enlarged. She had some head- ache, however, though not as much as when first seen ; she seemed to be losing weight and complained that she got tired easily. Though her hand grip Buy Cialis Cheap Generic was not very strong there was not noticed the typipal loss of grip of the hand opposite the affected side so commonly noticed in temporosphenoidal abscesses of large size. A certain slight hesitation of speecli was noticeable, though neither at this time nor later could a true sensory aphasia be demonstrated. There was no choked disc or optic neu- ritis. Wassermann reaction was negative.