Pittsburg, Pa., March 5, 1897.
To the Editor:
—The instructive report of a case of acute otitis media in the Journal of Feb. 27, 1897, by Dr. B. Merrill Hopkinson of Baltimore, Md., in which he figured and suffered as a patient, leads me to give to the readers of the Journal some instructions that I have for many years carefully enjoined upon patients and the profession who use the nasal douche in any form, viz., to blow one side of the nose only at a time after using the douche or after snuffing fluids up into the nares. It is a physical law that fluids will pass always in the direction of the least resistance. Hence, if one naris is left open as must be done to blow it in this manner, it is quite impossible to blow fluids into the Eustachian tube and thereby set up an acute