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atrophy must follow the extinction of this function by removing the testicles is equally clear and requires no further elucidation.

To what extent castration will be resorted to as a remedy for hypertrophy of the prostate is a speculation somewhat foreign, though it may be incidental, to the object of this paper. I cannot, however, help wondering whether this operation on the subject at present known as representing the male species will ever attain those proportions which have now been reached in what we still believe to be the female. What a state society will arrive at when both sexes are agreed as to the propriety and necessity of these respective mutilations. It is difficult to imagine what typical characteristics the human species of a century hence will present under conditions which seem to be imminent.

My objects in this paper are to show:

Ist. That the prostate, in connection with its associated parts, has an arrangement, and muscular function, which are not sufficiently recognized. That its hypertrophy is to be regarded as a provision against structural dilapidations in adjacent parts arising for the most part out of senile degenerations.

3rd. That these changes are mainly compensatory, whilst in others they are excessive and hurtful.

4th. That in the latter respects it resembles other provisional hypertrophies.-Tri-State Medical Journal.

Dr. William A. Morton Dead.-Dr. William A. Morton, one of the oldest and most respected citizens of Liberty, Mo., died December 10. He was born in Clark County, Kentucky, February 29, 1812. He graduated in medicine at Transylvania University, Ky., in 1837.

Elected Dean.-Prof. W. B. Rogers has been elected dean of the faculty of the Memphis Hospital Medical College, vice Prof. F. L. Sim, deceased. In choosing Dr. Rogers for this office the faculty has made a judicious selection. With his former experience in the same position, thorough knowledge of college affairs, and a general popularity with students and the profession, it is safe to predict for this institution a large measure of prosperity under his administration.

Dr. Paul Paquin.-Dr. Paquin will deliver four lectures in the Practitioners' Course which will be given at the St. Louis College of Physicians and Surgeons, in the two weeks following January 7th, 1895. The doctor will consider such practical subjects as The Early Recognition of Tuberculosis; Diagnosis of Gastric Diseases by the Ewald Method; and the Future of Serum Therapy. Dr. Paquin will, no doubt, present these subjects in his usual pleasing and effective manner.

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Report of a Case of Bifid or Double Uvula.

BY HAL FOSTER, A. D., M. D., KANSAS CITY, Mo.

Laryngologist to All Saints, Missouri Pacific, Kansas City, Ft. Scott & Memphis, Kansas City, Pittsburg & Gulf Hospitals; Fellow Kansas City Academy of Medi

cine, etc., Kansas City, Missouri.

READ BEFORE THE KANSAS CITY ACADEMY, OCT. 8, 1894

THE patient which I present here this evening for your inspection, is 23 years old, and is a mechanic by occupation. He was born in Ireland, came to the United States three years ago, all of which time has been spent in Philadelphia, Penn. About four weeks ago he came here to enter Park College, that great industrial school of Parkville, Mo., about ten miles from this city.

His family history is good, and is of no importance as far as his own case is concerned. He has always been well. None of his relatives have ever had a cleft palate, or any trouble with their throats. Several weeks ago he was referred to me by my friend, Dr. Jessie Woodside, of Parkville. He complains of some difficulty of deglutition and articulation.

The voice is rather fine for a man. On attempting to sing he notices a little accumulation in his throat; this is caused by the saliva adhering to the bifid uvula and sticking them together. He is a good patient to examine, and has such perfect control of his throat and opens the mouth so wide that every fellow here will be able to have a perfect view of this beautiful specimen of double uvula.

On looking in his throat you see two distinct uvulæ, side by side, separated all the way to the arch. As you see, there is not the slightest tendency to cleft palate in his case; in other words his hard palate is perfectly natural. If you will now look in his mouth you will see that each uvula is about the normal size. I am under obligations to my friend, Dr. A. H. Cordier, who so kindly has taken the perfect sketch of my case, which accompanies this article.

The patient insists on having one uvula removed, and I have promised to comply with his wish, thereby hoping to relieve the small amount of difficulty he has in deglutition and articulation,

This patient was exhibited to the Kansas City Academy of Medicine October 8th, 1894.

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Post Norsal Adenoids the Chief Cause of Deafness in Children and Young Adults.

By A. G. ALDRICH, M. D., ST. JOSEPH, Mo.

THE purpose of this article is not so much to advance new ideas, as to emphasize those already known. The significance of recognizing the accurate causation of deafness is of great and increasing importance, and demands the careful attention of the general practitioner who has children under observation at a time when as family physician, he can avert this disastrous condition.

I am aware that it has taken the aural surgeon some time to become convinced that those suffering from deafness are the victims, past or present, of post-nasal pathological conditions, chief among which are adenoid growths.

I well remember, and but a few years ago, how often medical men would remark, at the ear clinics of our great medical institutions, "Well, of all organs of the body the ear certainly is the most unsatisfactory for treatment." And so it seemed. We then examined and treated via the external auditory canal only. Inflating, if possible, the Eustachian tube according to the Politzer method. It was miserably "clogged up," how or why we did not, I am sorry to say, always ascertain. But coming to our senses, we began to make our researches at the pharyngeal end of the Eustachian tube, and at once a light dawned upon this department of medical science, which has led us up to a perfect understanding of the etiology not only of deafness but other ear diseases, and we who are ear specialists today would, indeed, find our occupation gone did we not recognize this fact and carry it out in our treatment.

That these vegetations in the naso-pharyngeal space would cause deafness has been advocated to the profession over a score of years through the writings of Myer, of Copenhagen, and also by several observers, both at home and abroad since that time, and it is to be regretted that we have been so slow in comprehending the value of their observations.

Fifteen years of a busy professional life, the last seven of which has been devoted almost exclusively to eye, ear and throat diseases, enables me to give close and honest clinical observation of these cases as they present themselves for treatment, the method of operation and results as appended, by a few illustrative cases.

The patients ordinarily consult us for the two prominent symptoms of fullness in the head with deafness, or deafness associated with suppurative aural catarrh.

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In seven cases out of ten the patient is a male. We observe that his articulation is defective and that he has that peculiar thickness and indistinctness of speech which vocalists term absence of vocal resonance, and which the laryngologist or any observing physiologist can readily locate as existing in the vault of the pharynx. He frequently catches his breath, his mouth is usually open, and he will endeavor to clear the mucus from his naso-pharynx by hawking while in your consulting room.

Upon inquiry regarding the history of the case, we are informed that early in life he was subject to "croup," that the parents have been frequently disturbed by his loud snoring and difficult breathing, especially when suffering from colds. He may or may not have had acute attacks of earache followed by an otorrhea. His appetite is capricious. He does not learn as rapidly as his companions, and in many cases his physical development has been slow. Heredity is not a factor. Climate influences these cases somewhat.

We proceed with our examination, and as he consults us for deafness or ear symptoms we will make our examination first via the external auditory canal. This we find, in many cases, absolutely normal, in other congested, eczematous, swollen and filled with pus. Upon inspecting the membrana tympani we find varying pathological changes. In some cases there is thickening with opacity; in others, depression with or without perforation, and in not a few, evidences of total destruction of not only the membrana tympani, but of the ossicles as well. Further technical examination reveals middle ear deafness and Politzer inflation is almost an impossibility. Regarding this latter condition we must ascertain the cause, if possible, and here we learn the expectant method and break the golden rule of old time otologists, by making at once a thorough examination of the post nasal space.

This is not always an easy thing to do. The invariably enlarged faucial tonsils prevent a satisfactory rhinoscopic view, and we, in most cases, must be content with a digital exploration, which is quite as satisfactory if skilfully made. The etiology of the case before us is no longer a doubt. A record of 100 cases shows 78 per cent due to these lymphoid masses, all of which were partially or wholly relieved by surgical removal of the tumors.

In some cases there has been a uniform cushion-like enlargement of Luscka's tonsil blocking the space, and in others lobulated masses of this tissue, which is absolutely a new growth, lymphoid in its nature.

Physiologically all can understand what the effect would be upon the ear when the Eustachian tubes were thus interfered with at their pharyn geal terminate, and space will not be taken for explanation.