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close certain information without the consent of the patient concerned; such information is considered "priv- ileged communication." In other states, such exemption is not allowed. The physician, however, must obey the ruling of the court. 10. In expert testimony the witness may give his opinion on facts or supposed facts as noted by himself or asserted by others. Theoretically, this can only be done by those perfectly familiar with the subject in question; but practically viagra 100mg good any (or almost viagra 100mg good any) physician with a license to practise is accepted as an expert wit- ness. Hooka Hrrrrard. The Medical Record is viagra 100mg good pleased to receive all new publications which may be sent to it. and on acknowledg- ment will projnptly be made of their receipt under tins heading, but it must be viagra 100mg good with the distinct understanding that it is under no obligation to notice or review any publica- tion received by it which in the judgment of its editor will not be of interest to its readers. A Compend of Human Physiology. Especially adapted for the use of Medical Students. By Albert P. Brubaker, A.M., M.D. viagra 100mg good Fourteenth edition, with 26 illustrations. 262 pages. Price, $1.25 net. Published by P. Blakiston's Son & Co., Philadelphia, Pa. Pulmonary Tuberculosis. A Handbook for Stu- dents. By Edward O. Otis, M.D. 220 pages. Illus- trated. Price, $1.75. Published by W. M. Leonard, Boston, Mass. 1917. Rest, Suggestion and Other Therapeutic Meas- ures in Nervous and Mental viagra 100mg good Diseases. By Francis X. DERCUM, A.M., M.D., Ph.D. Second Edition. 395 pages. Price, $1.25 net. Published by P. Blakiston's Son & Co., Philadelphia, Pa. Clinical Bacteriology and Hematology for Prac- titioners. By W. D'Este Emery, M.D., B.Sc, Lond. Fifth Edition. 310 pages. Illustrated. Price $2.75 net. Published by P. Blakiston's Son & Co., Philadel- phia, Pa. Sanitation in War. By Major P. S. Lelean, C.B., F.R.C.S., D.P.H., R.A.M.C. With 54 Illustrations. 336 pages. Price, $2.00 net. Second edition. Published by P. Blakiston's Son & Co., Philadelphia, Pa. Diagnosis from Ocular Symptoms. By Matthias Lanckton Foster, M.D., F.A.C.S. 490 pages. Pub- lished by Rebman Co., New York City. The Nation's Health. The Stamping Out of Ven- ereal Diseases. By Sir Malcolm Morris, M.D., K.C.V.O. 152 pages. Price $1.25 net. Published by Funk & Wagnalls Co., New York City. Cancer: Its Cause and Treatment. By L. Duncan Bulkley, A.M., M.D. Price, $1.50. 271 pages. Published by Paul B. Hoeber, New York City 46 MEDICAL RECORD. [July 7, 1917 OUprajmrtic ifjutifi. Treatment of Diseased Nasal Sinuses and Ears. — William Ferguson gives some timely treatment for certain conditions of these organs to be em- ployed by the general practitioner. For the re- moval of cerumen, if it is too hard to syringe out, drops of a solution of sodium bicarbonate, sixty grains to the ounce, may be placed in the ears for a few days, then the ear syringed. This is both economical and satisfactory. For acute inflamma- tion of the middle ear when the drum has lost its lustre and is of a uniform, hyperemic shade in both the membrana vibrans and Schrapnell's, with the drum bulging, he advises a free incision in the drum with an upward and backward direction so as to establish free drainage. Syringe with a solu- tion of saline or boracic acid every three hours, and as soon as the discharge has lessened use a viagra pill delay solution of alcohol and boric acid. This solution may be used in the proportion of half and half, and dropped into the sick ear. In the early stages of the disease when the pain is severe, a dose of mor- phine may be given for relief. This is usually not necessary in children. Carbolic acid and glycerin one in twenty may be dropped in the canal for relief of pain also. Do not use oils. Dry heat is grateful. For purulent middle ear infection and mastoiditis viagra 100mg good in the early stages rest in bed, light diet, initial dose of calomel followed by salines and free incision of the drum under gas are indicated, followed by a syringe of saline or boric acid solution every two hours; a blood count and an .r-ray should be made. Ice bags or morphine are contraindicated as they mask the symptoms. viagra 100mg good viagra pill delay The indications for operation are: 1. The per- sistence of the acute symptoms in spite of the above treatment. 2. When the flow is so profuse that it could not possibly come from the middle ear alone. 3. When the symptoms show improve- ment but the viagra 100mg good blood count remains high viagra 100mg good and the .r-ray indicates a mastoid cloudiness. 4. When the condition seems improved but the patient does not sleep but suffers viagra 100mg good from a dull headache. 5. When the temperature manifests a septic type. 6. When mastoid edema or subperiosteal perforation occurs.