myxomatous and purulent Nike Air Max ethmoiditis. These varieties are really simply successive stages of one and the same affection. As the disease progresses, the mucous membrane may project into the nasal cavity in the form of small polypi. Another result may be crowding out of the middle turbinated bone, from extension of the ethmoid cells. The final result is suppuration, and the pus may be The North Face Outlet Store discharged through the anterior or through the posterior cells.Treatment in these Polo Ralph Lauren Outlet conditions should be instituted early, if possible, before the occurrence of suppuration. In acute ethmoiditis, the ordinary measures employed in acute rhinitis are indicated. Of all measures, he regarded the douche as the most valuable. One or two gallons of water, rendered saline and as hot as can be borne, should be passed through North Face Outlet Store the nose twice daily. This is devoid of danger provided the patency of the nostrils is determined beforehand and the water is passed in the narrower nostril so as to obviate any interference with its discharge.In the chronic stage, surgical treatment is demanded when other measures have failed. Nike Australia The object of the treatment is to relieve the intra-cellular pressure. To remove the projecting portions, the snare answers the purpose best. In Nike Air Max 90 operating on the ethmoid cells a small burr attached to a dental engine is the best instrument. The operation usually requires several sittings, and care must be taken on account of the thin bone separating the cavity from the orbit and from the brain. The operation is not especially painful and can be done under the application of cocaine.Ninety-seven cases had been treated. Of this number three were cases of carcinoma, and one was a case of sarcoma. Excluding these, there were 93 cases. Of the simple inflammatory cases, 15 in number, 9 were cured, 3 improved, and 3 disappeared. There were 29 cases of myxomatous degeneration, North Face Outlet of which 12 were cured, 10 improved, and 7 were Oakley Sunglasses seen but once or twice. There were 22 cases of myxomatous change with polypi; 9 were cured, 10 improved, and 3 disappeared. There were 27 suppurative cases; 8 were cured, 12 improved, and 7 disappeared. In nearly all of these cases radical measures were employed.SURGERY OF THE MAXILLARY SINUS.DR.J. H. BRYAN,of Washington, read a paper on this subject.Of the surgical affections of the antrum, empyema is the most important, and the principal question that has arisen in regard to its treatment has been as to the method of opening the cavity. The washing out of the cavity through the natural openiug has been strongly advised. This is applicable to acute, but not to chronic cases, and the results are uncertain. In the majority of cases, an artificial opening is necessary. If there is a carious tooth present, it should be extracted, and frequently in this way the cavity will be The North Face Outlet opened. If not, it will be necessary to establish connection by a trocar or small trephine propelled by an engine. The opening should be large, and a metallic drainage-tube introduced. If the anterior wall of the antrum shows signs of weakening, it may be opened at this point. If it is desired to enter the cavity from the nose, it maybe done through the inferior meatus by a spear-shaped knife, but it is better to use the trocar or drill. After the cavity has been opened, it should be washed out with mild antiseptic solutions.Where the case is an obstinate one, the opening should be enlarged so that the cavity may be thoroughly explored with a probe, the little finger or the endoscope. This will often show the presence of spots of ulceration, necrosis, Bupernumary teeth, etc., as the cause of the trouble.DK.J. N. MACKENZIE,of Baltimore, also calledattention to the various methods of opening the antrum. Washing out through the natural opening is not applicable to many cases, for it is often difficult to find the opening, and this is so even after death. In order to obviate this difficulty, it has been proposed to remove Nike Shoes Australia the inferior turbinated bone; but that does not seem justifiable in the