DERMATOLOGY. 609 solved without metastases. Brieger reports one case, a man, aged twentytwo years, in which recovery ensued rapidly after generous opening of the lateral sinus, though all the above-named serious symptoms were present before the operation. Isolated otitic thrombo-phlebitis of the cavernous sinus has not been suc¬ cessfully treated by the Krause method of exposing it as in intracranial resection of the trigeminus." " The sinus has been repeatedly reached and injured by Krause,

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... ney, and Czerny in trigeminus resection." DERMATOLOGY. A Case of Dermatitis and Periostitis due to the X-rays-T. C. Gilchrist (Johns Hopkins Bulletin, February, 1897) records the case of a man, aged thirtytwo years, who, after he had exposed his right hand, wrist, and lower portion of the forearm for three weeks for four hours daily to the X-rays, noticed that the skin turned red and swollen, without being accompanied by pain. The swelling first occurred on the back of the hand, from the knuckles to the wrist, then active inflammation set in, and he was compelled to discontinue hi3 demonstrations. Three weeks later the hand, wrist, and lower fourth of the forearm gradually became more inflamed and swollen, and the lesions spread to the fingers. There were aching, darting pain up the forearm, and throbbing pain, preventing sleep. Under the use of hot-water applications and the internal administration of bromides the swelling and the other signs of acute inflammation subsided. Three weeks from the beginning the dorsal aspect of the hand was deeply pigmented, being of a dark-brown color, and the epidermis was exfoliating, the skin beneath being dry and of a dull reddish color. Ten days later the skin was stretched and glossy, and there was a dis¬ tinctly thickened state of the first and second phalanges of all the fingers. The metacarpals were also tender on pressure, and the hair of the back of the hand was scanty. All movements of the hand were painful. Sensation was ranch impaired before exfoliation of epidermis took place. An excised portion of the skin examined histologically showed the vessels of the corium to be dilated and the pigment-cells of the papilla to be almost as numerous as are usually found in a section of negro skin. Photographs were at this stage taken of the sound as well as of the affected hand, and revealed a distinct osteoplastic periostitis and probably an ostitis, particularly of the first and second rows