Drainage must be maintained in all cases, both through the Eustachian tube by catheter aspiration and through the drum by aspirating and drying. If the perforation in the drum is small or in the middle or upper part, it should be opened down to the floor so that the contents may be more easily removed and better drainage established. It is well first to thoroughly cleanse the meatus and tympanic cavity by syringing with salt mixture (salt 3 parts, borax 2 parts and soda 1 part, a teaspoonful to a half pus bowl of water) at from 116° to 118° F. After syringing, the meatus is carefully dried, and the middle ear cavity aspirated through the tube and drum opening. The advantage of this simple treatment is thorough cleanliness and drainage with the minimum of irritation. This treatment given daily or thrice weekly will often cure the case. Staphylococcus and streptococcus infections usually respond to the following treatment: After thoroughly cleansing as above, the meatus and tympanic cavity is syringed with a one to four or one to five dilution of Dakin-Carrel solution (Hyclorite may be used instead) followed by aspiration, the fluid being drawn through the tube, thus preventing reinfection from that source. Pneumococcus infections do not respond to either of these methods of treatment. The pneumococcus, because of its capsule, is not affected by antiseptics, but on the other hand the irritation of the tissues caused by their use, only gives the infective agent a better opportunity for growth. In pneumococcus infections we have found the following method efficient: Thoroughly cleanse the meatus and middle ear cavity by salt mixture syringing, aspiration and drying. The meatus and tympanic cavity is then filled with a neutral mineral oil. The oil is also pumped through the Eustachian tube. It is the purpose to fill the entire cavity and its openings so thoroughly that no air can enter. In some cases we have used bismuth paste after the oiling with excellent results. The pneumococcus is aerobic and if all air can be kept away for a considerable time, it furnishes an unfavorable culture environment with little irritation to the membranes. =Surgical treatment.=—The presence of bone debris indicates bone disintegration in the tympanic cavity or mastoid cells. If the mastoid cells are thus involved there is little chance for direct treatment. If such cases do not respond in a short time to any of the above methods of local treatment, ossiculectomy or mastoid operation may be necessary. Some specialist surgeons claim from 80% to 90% favorable results from mastoid operation in such cases. Non-Suppurative Otitis Media—Catarrhal Deafness