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labyrinth was sluggish. The examination 25 mg phenergan of the fundi of the eye, and of the urine and blood, did not *Read before phenergan dm syrup the Section of Medicine. May 14, 1920. Otology of order phenergan the New York Academy Fio. 2. — Narrowing of the lumen of the esophagus as shown by the X ray. show any pathological phenergan buy changes. The Wassermann reaction was negative and the x ray showed a cir- cumscribed swelling in the zygoma region, and a considerable narrowing of the lumen of the esoph- agus. There phenergan online was dysphagia. The Iar^^^geal exam- ination did not show any pathological change. It was doubtful whether the swelling of the zygoma region was an extension of the preceding mastoid- itis into the zygomatic cells, or whether this swell- ing was a neoplasm. I therefore decided to explore it. An incision in the skin was made connecting this swelling in the zygoma region with the mastoid wound. A large amount of pus and granulation tissue was evacuated. Thereupon the mastoid bone was attacked with chisel and rongeur. The cortex- was found to be sclerosed, and did not show any softening. In entering the antrum large masses of neoplasm were encountered and these were evacuated. The wound was then packed and the patient returned to his bed. The diagnosis of the removed tissue made by the pathologist was squam- ous cell carcinoma. Six weeks later the patient died showing the symptoms of a purulent phenergan cream meningitis. In all cases of this kind it is very difficult to ascertain the time and place of the onset. It is difficult to state where the primary seat of phenergan mg the dis- ease was, whether in the tympanic cavity, the antrum ■ phenergan iv 676 irrELSON: TVrES OF X.IS.IL OBSTRUCTION. [New York Medical Journal. of the mastoid, the petrous bone, or in the inner ear. Most cases of carcinoma of the ear phenergan use show an early affection of the cheap phenergan facial nerve. In this case the paralysis phenergan and codeine of the facial nerve was accompanied by a paralysis of the abduccns nerve on the same side. The x ray picture seems to indicate that the dysphagia was probably caused by a metastasis in the esophagus, as the larynx did not show any patho- logical condition. 1261 Madisox Avenue. FREQUENT TYPES OF NASAL OBSTRUC- TION AND THEIR TREATMENT. By M. S. Ittelson, M. D., Brooklyn, N. Y., Assistant purchase phenergan phenergan syrup Surgeon, Manhattan Eye, Ear, and Throat Hospital. The impression is frequent that defective nasal breathing in the adult is due to a mechanical obstruc- tion within the nasal passages and that this symp- tom requires operation or local treatment. This is true only in some cases. The causes that are respon- sible for this condition are many. The treatment too is often puzzling, as is evidenced phenergan vc by the variety of opinion phenergan with codeine that is sometimes expressed in a given case. Difference of opinion is to be expected here as in most other conditions, but to some extent this could be avoided. From the numerous patients who seek relief from this condition certain types can be recognized as occurring very frequently. It is well to consider the pathological conditions, both local and general, that are often found to be present in these types. phenergan codeine Those patients who complain of obstruction when none exists are interesting. Those with atrophy of the nasal mucous membrane, not associated with scab formation or other complications phenergan 25 and where an intranasal phenergan dm examination reveals a wide breathing space, will often complain of blocked up noses. phenergan codeine syrup This symptom is also noticed in those on whom extensive nasal surgery has been performed. It is difficult to give a satisfactory explanation of this condition and probably several factors are involved. This is

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