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of acetic acid. 4. That spirit vinegar should be vinegarobtained wholly by acetous fermentation of a dilute alcoholicliquor which has been obtained by distillation and containsnot less than 4 per cent. of acetic acid. Similar definitionsare suggested for wine vinegar, cider vinegar, and fancyvinegars. It is further suggested that a system of super-vision over the vinegar factories should be organised, a

system which would be welcomed by many vinegar makersas a necessary part of any proposal to require the nature ofdifferent vinegars to be stated to the public in terms whichconform to prescribed definitions.

A CASE OF PAPILLOMA OF THE TRACHEA.

ALTHOUGH the trachea may be involved by growths inorgans adjacent to it, such as malignant tumours of the

cesophagus or of the thyroid body, primary growths of thetrachea are of great rarity. Dr. M. Zondek of Berlinrecords an interesting case in the Berliner Kliniscke

Wochenschrift of Feb. 3rd. The patient was a woman,

aged 28 years, who for three years had suffered at intervalsfrom soreness of the throat, cough, and difficulty in breathing,usually as a result of catarrhal attacks, to which she wasvery liable owing to her home being in a cold, damp, marshydistrict. She never complained of hoarseness at any time.About 15 months before admission to the Jewish Hospitalin Berlin she began to suffer from persistent dyspnoes.which gradually increased until she eventually had a

severe asphyxial attack which lasted for some minutesand was only relieved after the expectoration of a

considerable quantity of muco-purulent sputum. On

admission the patient was pale, with cyanosed lips,and was breathing rapidly with marked inspiratory stridor.The muscles of the alas nasi and of the neck were stronglycontracted during inspiration but the larynx only movedslightly. The head was held forward and the chin wasthrown upwards. The voice was clear and natural but speechwas slow and interrupted. This position of the head and thismanner of speaking both dated from childhood. On

palpation of the trachea it was found to bulge forwardslightly on the right side. The thyroid was not enlarged ;there were no glandular enlargement and no difficulty inswallowing. The pupils were equal and reacted normally.On laryngoscopic examination a tumour with a rough surfacewas seen on the anterior wall of the trachea, on the rightside just below the vocal cords which appeared to be

natural. The tumour appeared to reach so far into thelumen of the larynx that only a small chink was seenbetween it and the left vocal cord; it did not, however,extend beyond the middle line and did not move either onrespiration or phonation. There were no signs of syphilisor of tuberculosis. An endo-laryngeal operation was out ofthe question, so tracheotomy was performed. The thyroidbody was pushed downwards. A large quantity of purulentmaterial escaped from the tracheotomy wound which wasthen prolonged upwards to the cricoid cartilage. The tumourwhen exposed was found to be of the size of a walnut andits base of attachment was about the size of a sixpence, itsupper margin being a thumb’s breadth below the vocal cord.The consistence was soft and there was no infiltration of the

surrounding mucous membrane. It was removed by meansof a sharp spoon, together with a small part of the adjacent tmucous membrane. There was very little bleeding. Re-

covery was rapid and uneventful. On microscopical examina-tion the tumour proved to be a papilloma. About fivemonths later the patient returned to the hospital and at thesite of the operation a tumour of the size of a bean had

appeared. This was removed, together with some mucousmembrane, by Professor Israel after tracheo-cricotomy.About three years later the patient again suffered fromthe same symptoms at her home and died under anesthesia

during an operation. The interest of the case lies in its

rarity and in the characteristic nature of the symptoms,demonstrating an obstructive condition of the main air

passage not involving the cords. Owing to the peculiarcarriage of the head and the interrupted speech Dr. Zondekis of opinion that the tumour originated in childhood. Thecondition is thus comparable to the laryngeal papillomatawhich occur in children.

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THE REEK OF THE CIGAR.

SMOKING nowadays is commonly tolerated in the house,and even in the drawing-room a cigarette is sometimes

permitted. The smoking of a cigar, pleasant though it

may be to the smoker, and however irreproachable its

quality, is banned- by most careful housewives in their sanctasanctorum because its reek is so persistent. The stale

smell of cigar smoke in a room is peculiarly unpleasantand peculiarly difficult to get rid of. It clings to the cur-tains and to most of the articles of furniture which

present any sort of an absorbent surface. It is not

so to the same extent with cigarettes or with pipes.In the case even of a single cigar books, papers,and textiles reek of its stale flavour and the room

requires abundant airing before that flavour is com.

pletely eliminated. Air is an excellent scavenger butozone is more active in removing the smell. The effect

may be traced to the fact that the smoking of a cigarproduces a larger quantity of pungent aromatic oils thandoes the smoking of a cigarette or pipe. In the case

of the cigarette oils are probably burnt even if they areformed, in the pipe they condense in the stem, while inthe case of the cigar they are probably for the most partdischarged into the air. In the form of a cigar tobaccowould appear to produce more oils than in the formof a cigarette or when burnt in a pipe. Such commonobservations are not without hygienic significance. Pyrri-dine, the most poisonous oil produced in the semi-com-bustion of tobacco, is an abundant product in cigar smoking,as it is also in the pipe, but in the latter there is condensa-tion while in the former there is little or none. In the

cigarette, so intimately in contact with the air is the

burning portion that the production of distilled oils

is, comparatively speaking, trifling. The symptoms oftobacco-smoke poisoning are not necessarily due to nicotine ;they are more often due to pyrridine, or poisoningfrom tobacco tar oils. The tobacco heart is more oftentraceable to free indulgence in cigar smoking than to a

similar indulgence in the pipe and the cigarette. Youngboys can smoke-to their great damage, nevertheless-aconsiderable number of cigarettes or even pipes, but an

equivalent in cigars more than satisfies their tobacco

appetite so soon are the toxic effects of cigar smokingmade apparent to them. The danger of excessive cigarettesmoking is that though no marked symptoms may be mani-fested or experienced, yet in the long run decided harm isdone and a dangerous habit, akin to "nipping," is cultivatedwhich it is often found very hard to abandon.

HIRUDIN AND BLOOD GASES.

THAT the blood flowing from the bite of the leech doesnot coagulate has long been known and has been attri-buted to the action of a material secreted by the salivaryglands of that animal. The advantages which it offersin the investigation of the gaseous exchange of the organsof the body by preventing clotting are obvious and haverecently been made the subject of a research (recorded inthe Journal of Physiology) by Mr. J. Barcroft and Mr. G. R.Mines who have set themselves the task of determiningwhether it produces any alteration in the gases of the blood.The quantity of the active principle, hirudin, prepared forthem in Leipsic, which they injected was 0.2 gramme