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appeal was set down too late for the spring sessionof the New Jersey " Court of Errors and Appeals."Among the many grounds relied upon by the appel-lant’s counsel were (1) that the dead child’s father(with other prominent persons unconnected with thecase) was present in the court throughout the trial,(2) that there were frequent demonstrations of

laughter and applause by spectators, (3) that mes-sengers and clerks disturbed the proceedings, and(4) that press reports and radio broadcasts weremade freely. The appeal court found no substancein these matters, especially as no protest was madeat the time. Another unsuccessful ground of appealwas that the jury had been allowed the use of amagnifying glass. "We see no more objection tothis," said the court, "than to the use of eyeglassesby an individual juror." The judges further declinedto accept appellant’s contention that the opinion ofhandwriting experts, based on mere comparisons,44 must be esteemed proof of low degree." In its

general procedure and egal attitude the New Jerseycourt is but little different from an English court ;but there is one striking exception. For ancient andhistorical reasons, based partly on mistrust of lawyersand partly on suspicions of the judges appointedby the Crown in the early days of the colony, theNew Jersey Court of Errors and Appeals includeslay judges ; the nine fully qualified lawyers on thebench had four laymen as their colleagues on thisoccasion. In one other respect there was a furtherdifference. The Attorney-General of New Jersey,when addressing the jury finally on behalf of theprosecution, was said to have expressed his personalbelief in Hauptmann’s guilt and to have used vitu-perative words about him. The appeal court tookno notice of this ; protest should have been madeat the time ; moreover, counsel for Hauptmannhas expressed a personal belief in his innocence. Inan earlier New Jersey case, cited on the appeal, aprosecuting counsel had described a defendant as.64 a monster in his passions, licentious in his desires,

beast in his love, brutal when thwarted, and cowardlywhen caught." Even these full-blooded denuncia-

- tions were ruled not to have been a ground for inter-ference with the subsequent verdict.The failure of all the points raised on Hauptmann’s

behalf is presumably final. His representatives aresaid to be considering an appeal from the New Jerseycourts to the Supreme Court of the United States.This could only succeed if the Federal Court thoughtHauptmann had not been tried, in the famous lan-guage of the United States Constitution, with " dueprocess of law "-e.g., if the atmosphere of the trialwas so charged with prejudice that the trial wasunfairly conducted.

LONDON MEDICAL EXHIBITION

(Concluded from p. 979)

WE gave some account last week of the exhibitionin the New Horticultural Hall where nearly 170stands, adequately displayed, afforded medical prac-titioners the chance of seeing the best and latest indrugs and pharmaceutical products, the wide choiceof new foods and vitamin preparations, and ofhandling the improved surgical instruments andappliances. A few stands of a more general characterremain to be mentioned.

Books and Journals

(21, 22) BAILLIERE, TINDALL AND OOX (7 and 8,.Henrietta-street, W.C.) had a display of medicalbooks from this country and America published by

themselves and other firms, and specially pointedout the fourth edition of Bigger’s " Bacteriology";Griffith’s " Injury and Incapacity"; Kohler’s

" Rönt-genology," a new translation of the latest Germanedition; and the fifth edition of J. L. Livingstone’s" Aids to Medicine(20) WILLIAM HEINEMANN LTD.(99, Great Russell-street, W.C.) specially selectedfrom their show of books " Woman," in threevolumes, by Pless and Bartels, a historical, gynceco-logical, and anthropological compendium; and alsomentioned Souttar’s " Radium and Cancer," and thesame author’s " Art of Surgery " ; and the Van deVelde series, of which the latest is " Ideal Birth."- (32, 40, 41) H. K. LEwis AND Co., LTD. (136 and140, Gower-street, W.C.), showed their range ofmedical stationery and furniture, especially the newUnix multiplying book-case unit; and from amongtheir general display of medical books pointed outthe catalogue of their lending library and the newedition of the " Extra Pharmacopoeia," ready imme-diately ; the first annual issue of " Reports on

Chronic Rheumatic Diseases," edited by C. W.Buckley ; Bailey and Love’s " Surgery for Nurses,"and " A Short Practice of Surgery " ; the collectedpapers of St. Mark’s Hospital; a new edition ofMoncrieff’s " Nursing and Diseases of Children";and " Urology " by Roche, an addition to the" General Practice " series.-(76) MEDICAL PRESSAND CIRCULAR (8, Henrietta-street, W.C.) showedtheir popular journal written by specialists forgeneral practitioners, with its symposia and fourspecial numbers on special subjects ; also a seriesof reprinted articles on Modern Treatment in GeneralPractice.-(25) O°ORD UNIVERSITY PRESS (AmenHouse, Warwick-square, E.C.) drew attention toRussell Brain’s " Diseases of the Nervous System";Samson Wright’s " Applied Physiology " ; Campbelland Poulton’s " Oxygen and Carbon DioxideTherapy " ; and the fourth edition of" Woodwark’sManual of Medicine. "-(156) THE PRACTITIONER(6-8, Bouverie-street, E.C.) reminded visitors of theirvaluable monthly journal, and specially pointed outtheir enlarged issue on recent advances in treatment,and other symposia in special numbers.-(98) JOHNWRIGHT AND SONS, LTD. (Bristol), publishers of the" Medical Annual," showed Bohler’s " Treatment ofFractures " ; French’s "Index of Differential Diag-nosis"; Hutchison’s " Index of Treatment " ; andSemon and Moritz’s " Atlas of the Commoner SkinDiseases."

Spas and Miscellaneous

(60) BATH had a stand to remind visitors of theonly natural hot springs in Britain, and showedillustrations of their mud pack, hot pool, and thermalvapour treatments, and of the deep bath with under-current douching.-(39) BuxTON said that the mostimportant new feature at this spa is the clinic forpatients of limited means which has been opensince midsummer. For an inclusive and moderatefee patients can now obtain board, lodging, medicaladvice, spa treatment, and all necessary pathologicalinvestigations.-(178) A. C. CossoR LTD. (CossorWorks, Highbury-grove, N.5) showed their improvedmodel portable electrocardiograph in which thecamera, amplifier, and recorder have now beenunited in one unit, with a small H.T. separate unitfor A.C. or D.C. mains or a car battery. Theypointed out the value of their apparatus, which hasno string to break, which is protected from all dis-tortion,and which suffers no ill-effects from overloading.They had also a mobile hospital unit designed chieflyfor students, as it is visual only and has no camera.- (9) Gins LIGHT AND COKE Co. (Horseferry-road,S.W.) showed some of the newest gas fires for con-sulting-rooms and wards, with self-lighting switcheswhich may be worked either at the fireside or at adistance ; and claimed that the modern fire changesthe air in the room four or five times an hour.-(152) HARROGATE informed visitors that short-wavediathermy is an important feature of the service

(0’ontinued at foot of next page)

1025

BRITISH MEDICAL ASSOCIATION

MEETING IN MELBOURNE

SECTION OF OTO-RHINO-LARYNGOLOGY

Mr. F. MUECKE presided over the meeting of thissection when Mr. L. GRAHAM BROWN (London)read the opening paper on the treatment of

Chronic Suppurative Otitis Media

He said that the first duty of the doctor was the

prevention of chronic middle-ear suppuration. Thisconsisted in (1) teaching rules for diminishing thelikelihood of aural infection; (2) its proper care andtreatment in the acute stage, especially when

complicating exanthematous fevers; (3)searching forand treating a focus in nose and nasopharynx, orin the mastoid itself. A less generally known causewas latent mastoiditis, especially in young children.This condition might be suspected when an acuteotitis media did not resolve in 10 to 14 days, noobvious exciting cause being present. In thesecases radiograms were of great value, enabling thesurgeon to make a diagnosis, and to intervene beforethe suppuration became chronic. A simple mastoid-ectomy was usually quite adequate. The aim oftreatment was to deal with the suppurative focus,at the same time preserving maximum hearing.For this reason, conservative measures were firstchoice and a cure was to be expected in 70 to 75 percent. of cases. The best response was obtained inthose cases where the infection was confined to theatrium of the middle ear, and the perforation was inthe centre of the tympanum. Many methods ofconservative treatment were available, but the

following " wet " method was considered very suitable:the instillation of hydrogen peroxide drops into themeatus, followed by syringing with boric acid solution.This was followed by guttse S.V.R., or pulv. boric. --1 per cent. iodine. No improvement after 2-3 monthsin adults, or after 1-2 months in children, usuallyindicated the necessity for surgical treatment.Minor surgery, to promote better drainage, to allowantiseptics to penetrate, and to remove diseasedtissue, cured only a few cases, but was neverthelessjustifiable, especially when more radical methodswere refused. When planning a major operation,the surgeon had to find the happy medium, and this

(Continued from previous page)offered to patients, and that Fango, the medicinalmud, is yielding very good results. Diet schemeshave been drawn up by the medical profession forhalf a dozen conditions and many of the hotelsundertake to enforce them when required.-(110 )INHALING DRUG AND APPARATUS CO., LTD. (87,Eccleston-square, S.W.), were present again withtheir Collison inhaler for the administration of oxygenwith vaporised liquids, used chiefly for the treatmentof asthma, bronchitis, and pneumonia and also forthe nasal passages.-(67) KOLYNOS INCORPORATED(Chenies-street, W.C.) showed their popular dentalcream and powder and liquid Kolynos mouth-wash.z(58) MEDICAL SICKNESS ANNUITY AND LIFEASSURANCE SOCIETY LTD. (300, High Holborn,W.C.) had their usual stand, where they profferedgood advice on all kinds of insurance.-(157) SPARK-LETS LTD. (93, Regent-street, W.) emphasised theirauxiliary atomiser for the Sparklet carbon dioxidehygienator, which provides an economical means ofsupplying small quantities of any desired solutionin a highly atomised form.

would mean dealing adequately with the pathologicallesion, but at the same time not unduly diminishingthe function of hearing. As the extent of internaldamage could often be assessed only at the time ofoperation, it was best, when the indications werenot precise, to proceed conservatively, extendingthe operation as found necessary. Complete radicaloperation would be found necessary in most patientssuffering from chronic otitis with threatened intra-cranial suppuration; in those subject to acuteexacerbations complicated by facial paralysis ofrecent onset, or with cholesteatomatous involvement ;in those which showed clinically definite saggingof the post-superior meatal wall, and evidence of

underlying osteitis ; and in those which had resistedconservative treatment.

Simple mastoidectomy was particularly indicated,the speaker continued, in most cases of early chronicsuppuration resisting conservative treatment,especially in children when latent mastoiditis hadbeen diagnosed. It would probably also sufficein cases where the tympanic membrane did not

appear unduly reddened, but where pus could beaspirated into the cleansed meatus from the antralregion, the perforation being situated in the posteriorportion of the membrane, even though it were centralor marginal. Three points were important in thisoperation : (1) The incision should be made somedistance behind the posterior auricular sulcus. (2) Alldiseased cells should be opened up. (3) No plasticoperation should be performed on the meatus.Mr. Graham Brown had adopted a method of post-operative drainage giving complete satisfaction.About 5 c.cm. of eusol were syringed in through asmall tube emerging at the lowermost part of thewound every 1-2 hours during the waking period for3-4 days. This gave great relief, promoted quickhealing, and caused no irritation. Sometimes heused two tubes. A modification of the conservative-radical operation, as first practised by Heath, wasused in attic disease. Here, if it was necessaryto remove the necrosed incus, it was advisable alsoto remove the head of the malleus, thereby providingbetter drainage. During the first week of after-treatment the meatus must be packed firmly withnarrow ribbon gauze. Persistent suppuration afteroperation might be due to faulty technique ; skinor muscle grafts, or some plastic form of operationon the meatus might then be found necessary. Inconclusion the speaker said that future advance couldbe expected in better prophylactic measures, and inrestoring the mobility of the oval and round windows.

Dr. ROBERT GODSALL (Sydney) favoured con-

servative treatment for as long as three months orlonger if there were favourable indications. He

thought zinc ionisation was useful and liked boricpowder with 1 per cent. iodine. Polypi should notbe removed surgically, but should be cauterised withsilver nitrate. Attic syringing was dangerous unlessthere was a large tympanic opening, as meningitismight result. Vesiculectomy was not indicated ;this was difficult to perform and the disease had

usually spread beyond the area concerned makingcure impossible. "Wet" ears after operation wereusually due either to involvement of the Eustachiantube-if this remained patent--or to the outer atticwall being insufficiently dealt with.

Dr. H. J. GRAY (Perth) thought X ray examinationsof great help in diagnosing the extent of chronicotitis media, and also in assessing the degree of cure.He thought that swimming was very dangerous inear infections and that no type of ear pad was efficient.