While it is true that cases of screw-worm from the fly Compsomyia macellarla are rare in the United States, still they do exist and are exceedingly resistant to the treatment outlined in the text-books. The infection is invariably complicated by the pré¬ existence of an atrophie rhinitis or an ulcerated condi¬ tion, permitting the larva-screw-worm-to burrow, and thus escape the action of most solutions used to dislodge and destroy it. Chloroform (in solutions used as a spray and inhal¬ ant) is

more »

... atisfactory and sure for the worms that are hatched and lying in the open, but it does not pene¬ trate sufficiently, neither is its action prolonged enough to destroy the worm, after it has burrowed into the dis¬ eased tissues from an atrophie rhinitis, or the egg while it is being hatched. A thorough curettage of the nasal passages may be done under general anesthetic, but at considerable risk of rupturing blood-vessels and thus affording opportun¬ ity for entrance of an embolus or spreading infection to surrounding cavities, in some cases producing death. After struggling vainly with chloroform in varying solutions-from 20 per cent, to pure chloroform-and thus relieving the patient of some two hundred worms in several treatments, I discovered that the number of worms still increased daily. I therefore realized that I was but collecting the day's hatch, as no worms were visible after using a chloroform spray and picking out the resultant dead ones. Inspired by a recent article on the eradication of the hookworm by the use of menthol, I therefore instituted a treatment with sprays of men¬ thol. Preceding the menthol, peroxid of hydrogen was sprayed into the nose two or three times, the patient blowing his nose freely between applications. Then a 20 per cent, solution of menthol was sprayed into the nostrils very thoroughly under twenty pounds' pressure. Usually within half an hour numbers of the worms were expelled, and in three days, after spraying twice daily, they ceased altogether and showed no return. Weak solutions were first used but proved useless. The nasal tissue that is in condition to permit growth of this parasite has lost all sense of pain, thus permitting the use of strong solutions. Therapeutics [EDITOR'S NOTE: The following is the first of a series of five articles by Professor Osborne on the revision of the Pharmacopeia. These special articles will take the place of the regular therapeutic matter, which will be resumed on the completion of this series.]