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THE REVIEWER'S TABLE

Books, Reprints, and Instruments for this department, should be sent to the Editors, St. Louis.

THE EXAMINATION OF THE FUNCTION OF THE INTESTINES BY MEANS OF THE TEST-DIET. Its Application in Medical Practice and its Diagnostic and Therapeutic Value. By Prof. Dr. Adolf Schmidt, Physician-in-chief of the City Hospital Friedrichstadt in Dresden. Authorized translation from the latest German edition, by Charles D. Aaron, M. D., Professor of Diseases of the Stomach and Intestines in the Detroit Post-Graduate School of Medicine, etc With a frontispiece plate in colors. Crown octavo, 91 pages, extra cloth. Philadelphia: F A. Davis Company, Publishers, 19.4-16 Cherry street. (Price, 81.00, net,)

In this day of painstaking study of disease, wherein laboratory methods have become of such great aids in diagnosis, this book will find a valuable place in the physician's library. It is written to teach the methods of examination applicable in the study of the functions of the intestines in every day practice, and thus to study the diseases of the intestines in a more comprehensive manner. The diseases of the intestines will be better understood by following the methods advocated by the author, and a decided step in advanced diagnosis and therapeutics taken, if physicians will follow the methods of the author.

THE PHYSICAL EXAMINATION OF INFANTS AND YOUNG CHILDREN. Theodore Wendell Kilmer, M. D., New York. Illustrated with 59 half-tone engravings. Philadelphia: F. A. Davis Company, 1906.

This book is one which should meet with much favor, as it is along the line of more comprehensive and detailed study of disease from the standpoint of physical examination, a subject, by the way, which author emphasizes is not fully considered in text-books on pediatrics. Again, the apt and full graphic method of presenting the subject gives great value to its practical usage, and leads to a systematic investigation of cases and a more detailed record of observations. This book teaches how to examine children, showing fully the fact that methods applicable to the adult are entirely different when applied to the child, making it necessary, therefore, to evolve a system of examination wholly and individually useful in the study of children and their diseases.

The author has accomplished his object with great credit to himself and his cause which he advocates. The publishers likewise have with great credit to themselves performed their part in the printing and excellent illustrations. We unhesitatingly commend the book as one of great value to the physician and student. F.P.N.

CASE TEACHING IN MEDICINE. A series of graduated exercises in the differential diagnosis, prognosis and treatment of actual cases of disease. By Richard C. Cabot, A.B., M.D., Instructor in Haward Medical School, etc., Boston. Boston: D. C. Heath & Co., 906.

Every teacher of medicine will recognize the value of this book at once, and every stu

dent and physician will appreciate the methods outlined in cases presented, as means toward the end of systematic case records and study leading to diagnosis and treatment. The author presents in regular order the physical signs of disease in the actual cases reported, and then he teaches how to draw deductions from what has been observed; how to think clearly, cogently and sensibly about the data gathered by physical examination.

This book is of special value to the student and is the exposition of the method of case teaching, which should be used by all clinical teachers. It presents facts actual met with in practice; it teaches order in obtaining facts and in their arrangement and to group isolated symptoms in "well-knit diagnoses. The busy physician will profit by a study of this book, and the young practitioner will find help in bringing order out of the chaos in which he will find himself when he meets actual cases in practice. F.P.N.

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PROGRESSIVE MEDICINE. Volume VII, No. 4, December 1, 190. Edited by Hobart Amory Hare, M. D., assisted by H. R. M. Landis, M D. Diseases of the Digestive Tract and Allied Organs; Anesthetics, Fractures, Dislocations, Amputations; Surgery of the Extremities and Orthopedics; Genito-Urinary Diseases: Diseases of the Kidney; Practical Therapeutic Referendum. Philadelphia: Lea Brothers & Company.

The contents of this volume are up to. the standard of previous issues. The authors are J. D. Steele, W. T. Belfield, J C. Bloodgood, H. R. M. Landis, J. R. Bradford, who in a careful manner have gone over the literature of the year of their departments and presented that which of service to the phyiscian, as indicating advancement in the art and science of medicine and surgery.

We again commend this work to physicians as a necessity in order to keep in touch with progress and to have for ready reference when reviewing the best in literature on special subjects.

PROGRESSIVE MEDICINE. Volume VIII, No. 1, March, 19 6. Edited by Hobart Amory Hare, M. D., assisted by H. R. M. Landis, M. D. Philadelphia; Lea Brothers & Co.

This volume, No. 1, series of 1906, has for its contributors Dr. Charles H. Frazier, on the Surgery of the Head, Neck and Thorax; Dr. Robert B. Preble on the Infectious Diseases, including Acute Rheumatism, Croupous Pneumonia and Influenza; Dr. Floyd M. Crandall on the Diseases of Children; Dr. D. Braden Kyle on Rhinology and Laryngology; Dr. B. Alexander Randall on Otology.

The authors are recognized specialists in their several fields of work, and hence, their selection of the best out of the voluminous literature of the year, is that which is practical and serviceable to the physician in

general practice. Herein lies the value of Progressive Medicine, and which makes it a desirable work for the physician's library. F.P.N.

INTERNATIONAL CLINICS. Vol III. Fifteenth Series, 1905. Philadelphia and London: J. B. Lippincott Company, 1905.

This quarterly of clinical lectures and especially prepared articles on medicine and surgery and the specialties, contributed by leading members of the profession throughout the world, and edited by A. O. J. Kelly, A. M., M.D., with a staff of collaborators, continues to grow in favor with the profession. This is largely due to the growth of clinical methods of teaching and a desire to study actual cases.

The presentation of clinical cases with discussion of their special features and the comparative studies of the literature gives a broad working basis for physicians and students.

This quarterly therefore in each issue approaches the value of a post-graduate clinical

school in that each contributed article is carefully prepared and edited, and therefore, embraces all that is new and valuable on the subject under discussion. This present vol. ume includes among other valuable contributions, one by George C. Johnston on The Therapeutic Uses of the Roentgen Rays or Radio-therapy; one by Henry Huchard, of Paris, on The Musculo-Tonic and Diuretic Action of Formic Acid and the Formites; one on Renal Insufficiency by Prof. Teissier of Lyons, France; one of Mucous Colic or Membranous Colitis, by Alexander McPhedran, of Toronto, Canada; one on Addison's Disease, by Edward F. Walls, of Chicago; one on Fractures of the Patella, by J. S. Wright, of Brooklyn, New York; one on Acute Anterior Poliomyelitis, by Sanger Brown, of Chicago, and Notes on Hay Fever and Asthma, by Charles H. Knight of New York.

INTERNATIONAL CLINICS. Vol. IV. Fifteenth Series, 1906.

This volume contains twenty-five well prepared contributions by such well known writers and teachers as Wm. S. Gottheil of New York, on The Treatment of Psoriasis; J. N. Hall, of Denver, on Empyema; Sir Dyce Duckworth on the Later Stages of Cirrhosis of the Liver; Charles F. Craig on the Malta Fever; John B. Deaver on Surgical Diseases of the Stomach; Edward M. Corner on Post-operative Surgical Neurasthenia; J. F. Birnie on Cysts of the Lesser Peritoneal Cavity; Thos. A. Ashby on Study of Ectopic Pregnancy; Reynold W. Wilcox, the Medical Treatment of the Menopause, and others.

F.P.N.

THERE are 228, 234 registered doctors in the civilized world, according to statistics compiled in Paris. Of these, 162, 333 are in Europe. Great Britain has more doctors than any other country in the world.

"THE American Hero of Kimberley," the subject of a sketch by T. J. Gordon Gardiner in the June Century, was George F. Labram, of Detroit. Although a citizen of the United States and a non-combatant, Mr. Labram holds a unique, position in the military history of great Britain. His services during the siege of Kimberley received the thanks of the British Government and were publicly referred to by Lord Roberts as not only among the most momentous in the South African campaign, but in their way unparalleled in modern warfare. Under the most adverse conditions, Mr. Labram

helped besieged Kimberley to water, food and light, to telephone service, cannon and ammunition. He was killed by a "goodnight" shell, in his own room, just at the end of the siege. This story of American enterprise and resource in strange and dramatic surroundings makes inspiring reading.

DON'T NEGLECT CONSUMPTION. "It is news, in a way, to know that the Great White Plague is enormously more curable when it is taken in its very earliest stages than when it is allowed to run on a little while," says Eugene Wood, in his article "The Campaign Against Consumption," in the June Everybody's. "Don't lose time about it. When you don't come right back to par after having had pneumonia, or the grippe, or an extra hard cold; when you feel lassitude after any kind of lung trouble (and the best men are coming to look at pleurisy as something a good deal more serious than a mere stitch in the side; they are pretty sure it a tuberculous affection); when your afternoon temperature, taken at different hours, four, five, six and eight o'clock, is higher than it ought to be, don't imagine that you will save time by waiting. You will be a long time dead. Worse than that, you will be a long time dying. Consumption is a reasonably comfortably death, but an expensive one, since you hang on for so long without being able to earn anything. Find out if you have the least little touch of it. Then drop everything, except the business of getting well. You for the outdoor life, twenty-four hours out of the twenty-four! You for eggs and milk to the limit of your digestive capacity! You for rest, and the careless mind, and gentle exercise under medical supervision. (Easy to say, isn't it?)"

REPORTS ON PROGRESS

Comprising the Regular Contributions of the Fortnightly Department Staff.

OBSTETRICS AND GYNECOLOGY

W. H. VOGT, M. D.

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The Physiologic and Legal Status of the Fetus in Utero.-(W. H. Sanders, Jour. A. M. A., Feb. 24, 1906.)-If birth means the act of coming into life, as the dictionaries tell us, then unquestionably the baby came iuto life at the beginning of conception, and at the end of nine months simply changed its domicile. The author thinks we should abolish the term conception, which is liable to be more or less misleading, and substitute for it the more scientific and correct term, birth. 1. It would be essentially and scientifically correct to locate birth where and when it actually occurs, in spite of the fact that several months would usually elapse before it could be known that a birth had certainly taken place. 2. It would place a pregnancy, from the first day of its probable occurrence to its termination, or the high legal and moral grounds it deserves to occu3. It would dignify the position of the py. fetus in utero, and would establish beyond all doubt or confusion the right of the fetus to the same protection, moral and legal, as is accorded to human beings who have completed the period of the uterine existences. 4. It would unify the terms, fluxion, abortion, and miscarriage, under the one term, premature delivery; then, two expressions, premature delivery and delivery at full term, would cover the entire subject. 5. It would enable lawmakers to enact clear and definite laws, jurists and juries could administer without doubt or confusion. 6. It would have a strong tendency to promote virtue and to prevent crime, and to build up in every community a positive demand for the protection of human life at its tenderest and most helpless period; it would tend to educate the people on a subject in reference to which they stand in great need of education, and would thereby save the lives of many innocent and undelivered babes. He submits the following proposition: 1. The conjunction of male and female germs constitute, from a scientific standpoint, birth. term conception should be abolished and

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that of birth substituted therefore. 3. In dealing with all stages of pregnancy, even the earliest, physicians should realize the extreme gravity of the condition, and should never condemn to death a fetus, however young, without the maturest consideration, and without calling to their aid the high.

est professional authority within reach; in a word, without carrying the case to the nearest and wisest medical supreme court accessible. 4. The principles herein contended for should be impressed on the members of the profession, taught to medical students and promulgated widely among the people. 5. Medical men should interest themselves to see that the statutes of their respective state are ample for the protection of the fetus in utero.

The Surgical Treatment of Retrodisplacements of the Uterus.-(J. W. Bovee, American Jour. of Obstetrics, Feb., 1906.)—In addition to the ligamentous supports of the uterus the following conditions are important, according to the author: 1. The angle at which the uterus lies with reference to the vagina. 2. The potentiality of the vaginal canal as opposed to the idea of an actual space beneath the uterus. 3. The action of the strong perineal muscles and fascia in maintaining the supporting strength of the vagina, and converting an actual canal into a valvular slit in the structures. 4. A postulate balance between intra-abdominal pressure, and that of the external atmosphere. He comes to the following conclusions: That the complications rather than the uterine displacement furnish the cause for surgical interference. 2. All operations for the correction of uterine displacements should be based upon the pathological and anatomical abnormalities of the uterus and adjacent structures. 3. Any operation that changes one dislocation of the uterus into another is illogical, and hence unsurgical. 4. Most of the cases of retroversion which require special operations are best treated by appropriate operations upon the round and uterosacral ligaments.

The Treatment of Puerperal Eclampsia.(E. G. Zinke, Amer. Jour. of Obstetrics, Feb, 1906). The object of the treatment is (1) to control and abbreviate the duration of the seizures; (2) to protect the patient from injury during the attack; (3) to remove the cause. To control the seizures inhalations of chloroform, injections of veratrum viride and morphine, chloral per rectum and venesection are advised. The withdrawal of cerebrospinal fluid he believes is dangerous and a doubtful procedure. The uterus should be emptied as promptly as possible, deep cervical or vaginal Cesarean section being the operations usually made use of. Shock, excessive hemorrhage and prolonged operations should be avoided.

Dangers of Ventrofixation.-(A. Colmann, Zentralblatt fuer Gynaekologie, No. 6, 1906.)

-A case is cited in which a very difficult delivery followed a ventrofixation. The posterior lip of the cervix lay above the sacral promontory and could not be reached even with the whole forearm in the vagina. The pregnant uterus had grown at the expense of the posterior wall. When we consider the When we consider the large number of cases reported where difficult labor followed ventrofixation it becomes a question whether we are justified in perform ing this operation.

Immediate Examination of Uterine Mucosa and Myomatous Nodules after Hysterectomy to Exclude Malignant Disease.-(Thomas S. Cullen, Jour. A. M. A., March 10, 1906.)— In going over the large number of myoma cases that have been operated on at Johns Hopkins Hospital, the author finds a surprisingly large number of instances in which myomata were associated with carcinoma either of the cervix or the body, and a relatively frequent picture of sarcomata developing in myomatous tumors He advises the opening of the uterus immediately on its removal as a routine procedure to see if by any chance carcinoma of the body exists, and also a careful examination of the myomatous nodules. He reports a very interesting case demonstrating how valuable this procedure

would have been had it been followed out. The uterus in this particular case showed nothing unusual the mucosa of the uterine cavity was everywhere intact and apparently normal. Later on an examination was made in the laboratory, where a section was made through the tumor and some degenerative changes noted. Two years later at a second operation a sarcoma springing from the cervical stump was found. Cullen believes these tumors should all be examined carefully before the cervical stump is closed, and if malignancy is found the cervix should also be removed. The reasons for not doing a complete hysterectomy in all cases are giv. en as follows: The supravaginal operation is the easier one; it leaves a better support to the pelvic floor, there is less danger of tying off the ureters, and as the blood supply of the bladder is little interfered with, there is less likelihood of a postoperative cystitis.

Concerning Obstetrical Dilatation of the Cervix. (Professor Dührsen, Berlin. Translated by Ludwig Simon, Chicago, Surgery, Gynecology and Obstetrics, March, 1906.) In this paper the use of the Bossi dilator is generally condemned. He believes Leopold's praised clinical successes nothing extraordinay since in total of 24 viable children, 9 (37%) died as a result of the Bossi method. Leopold gives the maternal mortality as 22.6%, in which the Bossi method was used,

while in Dührsen's record of women confined by obsolete methods without the Bossi dilator the percentage was 23.75%. Leopold says that Dührsen has no right to criticise this method since he has never tried it, he also insinuates that Dührsen fears to use the instrument. The author, on the other hand, claims it is not the fear, but the impracticability of the method which keeps him from using it, and this has led him to use methods that are not burdened with all the drawbacks and dangers which are connected with the Bossi method. The methods made use of by Dührsen are: 1. Deep cervical incisions in cases of effaced cervix. 2. Vaginal Cesarean section in cases of ineffaced and rigid cervix. 3. Metreurysis with automatic traction in cases of ineffaced but dilatable cervix. ginal Cesarean section is reserved for specialists, the other two can be carried out by the general practitioner. Vaginal Cesarean secthe place of Bossi's method, but also that of tion and Gigli's pubiotomy will not only take induced premature labor, craniotomy to the living child, symphisiotomy, and the classical Cesarean section. In general Dührsen warns against the use of the instrument, or that recommended by Knapp, he says it is decidedly wrong to say of an eclamptic patient that she died of eclampsia and not from the lacerations produced by the Bossi method. They die of the combination of a severe illness and the injuries produced.

THERAPEUTICS.

W. T. HIRSCHI, M.D.

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Is it possible to Prevent Salicylic Nephritis by Administering an Alkali?-S. Moeller, Die Therapie der Gegenwart, April, 1906.)Various clinicians have observed cylindruria and albuminuria in patients receiving salioylic acid or its derivatives, and this has led to the term salicylic nephritis. Renal irritation is more easily produced in females and in old people, than in males, and during the prime of life. Active diaphoresis during the time of administering salicylates minimizes renal irritation. The writer also observed that if the urine was made alkaline by means of icylates, less albumins and casts are apt to sodium bicarbonate while administering saloccur. It is possible that the casts are quickly disorganized in an alkaline urine, and if they were present,, they may have been overlooked. This subject must be more thoroughly investigated before a definite conclusion is reached,

The Pharmacologic Action of Digitalis, Squills and Strophanthus on the Heart.—(J.

S. Hayes, The Biochemical Journal, Vol. 1, No. 2.) The cardiotonic effect of this group of drugs depends on glucosides, whose quantity and quality is variable, and it is advisable to triturate them according to the physi. ologic effect. The writer experimented with tinotures (British Pharmacopeia) and observed that the strophanthus tincture is usually more active in cardiac affections, but as it is at the same time the most dangerous, it must be used very carefully. Strophanthus is most readily absorbed and causes less gastric disturbances than either of the others.

In the conjunctiva digitalis and squills primarily act as an irritant, and later as an anesthetic. Strophanthus acts as an anesthetic, and before the introduction of cocaine, it was used for this purpose. All three drugs reduce the frequency of the heart's action, strophanthus again being the most active. Digitalis and squills cause a contraction of the coronary vessels, strophanthus has little effect on them. Squills has a more constant cardiostimulating effect than either of the others, and indirectly is a valuable diuretic.

The Present View of Cancer Research. (H. Apolant (Ehrlich laboratory), Die Therapie der Gegenwart, No. 4, 1906).-Numerous experimenters attempted to prove that a cancer is a parasitic disease, but the microscope and efforts of infecting others have not cleared up their views. Efforts to produce immunity by means of cytotoxins also have been unsuccessful. Transplantations of carcinomatous tumors from one mouse to another have been successful, but that is a metastatic affection. Ehrlich believes that a cancer cell should be looked upon in the same light as a bacterium, if one expects to discover the etiology. Transplantation of cancer from mice to rats reduces its malignancy and it is again increased by replanting on a mouse. This is very similar to bacterial experiments. Ehrlich believes animals of one species possess an unknown substance which is essential for the development of a cancer, but animals of another species do not possess this, consequently a tumor transplanted from mice to rats develop only as long as this substance which has been transplanted with the tumor is present, and then gradually degenerates. Transplantation of a cancer in a mouse which is already afflicted with carcinoma is usually unsuccessful and Ehrlich attributes this to the fact that the original tumor consumes all of the essential substance so the transplanted tumor must become disorganized. Some animals possess active immunity, and others can be rendered immune by repeated transplantations of malignant tumors. An ani. mal which is immune to carcinoma very

frequently is also immune to sarcoma, and this does not differ even if the immunity is active or passive, or natural.

The Treatment of Obstinate Cases of Sciatica with Perineural Infiltration.-Umber, The Therapie der Gegenwart, No. 4, 1906.)-The injection if made with a needle at least 10 cm. long at the site of the exit of the sciatic The panerve through the sciatic foramen. tient experiences a sudden severe pain, the moment the needle touches the nerve, after which the medicine is gradually injected. He chloride, of which from 70-100 ccm. may be uses a .1% eucaine solution in .8% sodium used. Most patients felt great relief after the first injection, some even felt entirely well. Several patients had a slight temporary elevation of temperature, and others a temporary peroneus paresis. The writer has observed

just as good results by using normal saline solutions in place of eucaine solution, which, however, also causes slight elevation of temperature, but is preferable to eucaine, owing to the idosyncrasy which many patients have for eucaine. The therapeutic effect of these injections is very likely mechanical, but permanent in many, and should always be instituted when other well established internal remedies fail.

The Aristol Therapy of Hay Fever.-Fink (Therapie der Gegenwart, No. 4, 1906) discusses the etiology of hay fever, and of the most common factors the direct toxin irritation and reflex irritation the latter is the most frequent. He believes the source of irritation in many cases is in the antrum, and he uses aristol with good success. A cannula is inserted into the orifice of the antrum and the aristol is introduced through the tube. He has also treated cases of asthma with this method and has obtained good results. In most patients one to three treatments were sufficient, while others required more. In some patients it is very difficult to locate the orifice of the antrum, but patience will usually help to find it.

OTOLOGY.

ALBERT F. KOETTER, M. D.

Surgical Interference in Tuberculosis of the Meninges and the Brain.-Duret (Muenchener Med. Wochenschrift.)-1. Acute diffuse tubercular meningitis. Some authors try to effect a cure by opening the vault of the cranium and allowing air to enter, similar to tubercular peritonitis, others reducing the brain pressure by withdrawal of cerebrospinal fluid by means of lumbar puncture. The

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