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SYMPOSIUM ON CHEMOTHERAPY AND BIOTHERAPY IN OTOLARYNGOLOGY Chemotherapy. Presented by Dr. Daniel S. Cunning (by invitation). During the past ten years great strides have been made in the treatment of suppurative disease of the ear, nose and throat by means of chemotherapy. Although we have heard a great deal about the sulfonamide drugs and penicillin of late, chemotherapy itself is not new. The first chemotherapeutic agent dates back to the fourteenth century, when mercury was brought out for the treatment of syphilis. In the fifteenth century quinine was given to the medical profession for the treatment of malaria. Nothing further was done along this line of therapy for almost five hundred years. Then, in 1910, Ehrlich introduced arsphenamine for the treatment of syphilis. In this same year Gelmo discovered sulfanilamide but did not apply it clinically. It remained for Domagk, in 1932, to notice the potency of sulfanilamide in combating

Some Interrelationships of Modern Hematology and Otolaryngology. Dr. Thomas Fitz-Hugh Jr. A brief review is presented of the more important hematologic disorders affecting the nose, oropharynx, larynx and auditory apparatus. Lingual mucosal strophulous glossitis and dysphagia in connection with anemia respond favorably to treatment directed toward the special type of anemia and the underlying cause. In the Plummer-Vinson syndrome curious veils of mucous membrane partly obstruct the lower part of the pharynx. Here, too, treatment directed to the disease is more effective than esophageal instrumentation. Aplastic anemia is frequently associated with oropharyngeal ulceration, necrosis and bleeding, and any severe anemia may produce vertigo, tinnitus and even deafness. In leukemia, lymphosarcoma and Hodgkin's disease, not only the oral mucosa but also the tonsils and cervical nodes may present ulcerative and necrotic lesions. Epistaxis and gingival bleeding may occur, and in cases of mediastinal involvement recurrent laryngeal nerve palsy has been observed.

Orbital Cellulitis .Dr. Horace James Williams. Patients with orbital swelling (cellulitis) are likely to be seen at irregular intervals by every otolaryngologist. Knowledge of its anatomic, etiologic, pathologic and clinical features is essential to proper management. Improper conduct of a case may lead to an untimely or inexpedient operation, with impairment or loss of vision, or even to death from meningitis or thrombosis of the cavernous sinus. The present concept of the cause of orbital cellulitis is comparatively new. Such terms as "primary" and "idiopathic" are seldom used in connection with this pathologic condition, while "thrombophlebitis" and "secondary to paranasal sinusitis" have become common. The most common place in which an abscess may form is between the superior and the mesial bony wall of the orbit and the periorbita. An abscess in this location loosens the periorbita, which strips away easily, and points in the upper lid or on the

The introduction of a problem of physical diagnosis to otolaryngologists may seem like turning back a number of pages in the history of medicine. In reality, the urge to present this subject comes from a realization that much of the art of medicine is being lost with the development of other diagnostic methods. Younger practitioners are reported to be deficient in physical diagnosis by chiefs of tuberculosis sanatoriums. Graduate students in otolaryngology are entering the specialty with less of the background of general medicine than formerly. The time of the otolaryngologist is so limited in studying his patients that short cuts are used and the opinions of others are too often taken at face value. Except by a comparative few, practitioners in internal medicine, the art of physical diagnosis is being neglected, and its loss is not fully compensated for by the substituted methods. Of the classic methods of physical

Traumatic Perforation of the Right Frontal Sinus with Pneumocephalus and Brain Abscess: Report of a Case.Dr. Philip A. Marden. M. W., a 10 year old white boy, was admitted to the Hospital of the University of Pennsylvania on Feb. 16, 1941. Two days previously, while he was coasting, an iron runner on the preceding sled had been driven into his skull at the superior inner angle of his right orbit. He extricated himself and was able to walk home unaided. A local physician closed the wound with clips. The boy was never unconscious. During the next few hours fever and vomiting developed. The wound was reopened, revealing a cerebrospinal fluid leak and traumatized brain tissue. Tetanus antitoxin (1,500 units) was given intramuscularly, and the administration of sulfanilamide by mouth was begun. He was brought to Philadelphia forty-eight hours after the accident. Examination on admission revealed a pale frightened querulous boy

Infections of the Middle Ear as Related to Other Respiratory Infections.Dr. George S. Frauenberger. (The presentations were from the Central Institute and the National Forum for Deafness.) Of the 2,529 patients admitted to the Inpatient Department of the Children's Hospital of Philadelphia, in 1939, 320 (13 per cent) had otitis media. Of this group 126 had acute purulent otitis media. The cases of these patients were selected for review. Cases of patients with contagious diseases were not included in the group. The highest incidence of acute infection of the middle ear occurred from January to May, during which period 85 of the group were admitted. The majority (110 patients) were under 5 years of age, and 49 were under 2 years of age. The group included 77 boys and 49 girls, of whom 96 were white children and 30 were Negroes. Cultures of purulent discharge taken from the external auditory