Mississippi Valley and Atlantic States; one in eighty; Western States, one in one hundred and fifteen, and Northwestern States, one in one hundred and twenty.

Setting aside a wide margin on the score of incomplete and inaccurate data, and in the face of the fact that various European localities have acquired a world wide reputation for healthfulness, it appears evident that the climatic conditions found in favored portions of our own country, as well as throughout the entire Union are more conducive to health, enjoyment and longevity than any found in Europe.-The American Therapist.

TREATMENT OF LIGHTNING STROKE.

Professor Oliver Lodge writes to the Liverpool Post to warn the public against the notion that a lightning stroke is necessarily fatal. It stops the vital organs, he says, but it rarely destroys them. If respiration can be maintained artificially for a sufficient time, there is a fair chance that the heart will resume its suspended action, and that the stricken man will recover. The practical outcome of this is never to pronounce a lightningstruck person dead until the well-known method of resuscitation from drowning has been practised upon the apparent corpse for two or three hours. Experience has justified this teaching both in America and in France, where it has been strenuously urged and practised by Dr. d'Arsonval. This is a matter of great importance. Comparatively few people are killed by lightning in this country, but it seems probable enough, if we are to believe Professor Lodge, that the number could be still further reduced if artificial respiration were practised.-Br. Medical Journal.

TRAUMATOL IN SURGERY.

In the Journal des praticiens for September 26, M. L. Floersheim calls attention to a new substance which is likely to enter into ordinary surgical practice. It is a substitute for iodoform, the antiseptic qualities. of which it possesses even to a greater degree, and has the advantage of being less toxic and exempt from the disagreeable cdor which is so unpleasant to patients. The conditions in which it may be employed are the general indications for all antiseptics. Its preparations are as numerous as those of iodoform and its employment is as simple. It may easily be incorporated with vaseline in the following manner:

This ointment may be employed in cutaneous affections or in the surgery of the eye. Gauze may be impregnated with traumatol as easily as with salol, iodoform and boric acid. Traumatol pencils have been suc

cessfully used by certain surgeons in fistulous tracts and in endometritis; their preparation is as follows:

This is to be mixed with a sufficient quantity of water and glycerine. Traumatol may be also mixed with oil and collodion.

This new antiseptic, says M. Floersheim, is endowed with an active microbicidal power; it is inodorous; it does not give rise to erythema or to pruritus; it produces perfect occlusion and hastens cicatrization; and its employment so far has given very encouraging results.-N. Y. Med. • Journal.

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MISCELLANEOUS.

THE HEALTH DEPARTMENT AND THE SERUM DIAGNOSIS OF TYPHOID FEVER. Dr. Hermann M. Biggs, the pathologist and director of the bacteriological laboratory, in a communication, dated November 7th, to the Hon. Charles G. Wilson, president of the city board of health, says:

"I desire to direct the attention of the board to a new laboratory method for the diagnosis of typhoid fever, which, judging from the data available at the present time, promises to be of very considerable practical value in the diagnosis of early or ill-defined cases of this disease.

"The investigations of Pfeiffer and Widal have shown that the blood of persons suffering from typhoid fever, when mixed with active cultures of the typhoid bacillus, has the power of arresting the active movement of these organisms and of producing peculiar and characteristic clumping of the bacilli. It has been shown that this reaction occurs frequently very early in the course of the disease, that it is found throughout its course, during convalescence, and often for a considerable period after complete recovery. It does not occur with other organisms than the typhoid bacillus, and it does not occur with cultures of the typhoid bacillus when the blood of persons suffering with other diseases is employed. As has been shown by Widal and Johnson, this reaction occurs as well with specimens of dried blood as with fresh blood, and thus can be employed practically for the diagnosis of this disease in municipal laboratories. Observations on this matter which have been in progress in the laboratories of this department for some time past have thus far confirmed the conclusions of previous investigators.

In order that more numerous data shall be at the command of this department and that physicians of New York may at the earliest moment have facilities for testing the reliability of the observations thus made, I

would respectfully recommend that arrangements be made to place facilities for such examination at the command of all physicians in this city, it being distinctly understood that this action of the department is for the purpose of gaining information on this important subject, at the same time of placing at the command of physicians opportunities for observing the results. If the data already obtained are entirely confirmed by subsequent observations, this method will undoubtedly prove of great service in the diagnosis of early and obscure cases of typhoid fever.

"Should this action be determined upon, circulars of information as to the method of collecting blood and slides for this purpose may be left at the depots already established for the collection of diphtheria culture tubes and the distribution of diphtheria antitoxine."

Accordingly, the following resolution was adopted by the board at a meeting held on November 6:

Resolved, That the recommendations of the director of the bacteriological laboratories of this department, contained in the communication dated November 6, be and are hereby approved, and that he is hereby authorized to place facilities at the command of physicians of this city for the diagnosis of cases of typhoid fever, in accordance with the method prescribed in said communication.

The following notice to physicans has been issued by Dr. Biggs:

"Circulars of information regarding the method employed and slides for collection of blood may now be obtained at the various druggists where diphtheria culture tubes are kept. Physicians desiring to make use of this method in the diagnosis of early or obscure cases of typhoid fever can procure these, and after collection of blood as described, may leave the slides with the data relating to the case, at the various depots. They will be collected each day, examined the following day, and the report of the result forwarded to the physician."

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REVIEWS.

A System of Gynæcology. By many writers. Edited by Thomas Clifford, Allbutt, M.A., M.D.Camb., LL.D., F.R.C.P.Lond., F.R.S., F.S.A., Regius Professor of Physic in the University of Cambridge, Fellow of Gonville and Caius College, and W. S. Playfair, M.D.Edin., LL.D., F.R.C.P.Lond., Professor of Obstetric Medicine in King's College and Obstetric Physician to King's College Hospital. London: Macmillan & Co., Limited. New York: The Macmillan Company. 1896. Price 25s. net.

We had occasion in considering the first volume of Allbutt's System of Medicine to speak of the curious fact that, as a part of the system, a

special volume on gynæcology was going to be issued. This volume has now appeared, and constitutes volume II. of the system referred to. Playfair's system of midwifery is already so well known in this country that nothing else would be necessary to give the stamp of merit and worth to a work on a kindred subject, and yet our publishers in this country have shown unusual zeal and great ability in producing gynæcological works in the last few years, and it is not easy to persuade Americans that the foreign point of view in matters gynæcological is at all superior to their own. The editor has himself written very little for the volume, and we confess that we are considerably surprised to find no American selected as a contributor to its contents. On the other hand, the text does not fail to note a number of Americans to whom special credit is due for work in this line. In order, however, to obviate any question of prejudice, we take pleasure in presenting to our readers the review given in the Lancet for November 28, 1896:

"We think the editors have been well advised to arrange in a separate form, in the present instance in one volume, the information on gynææcology which they intended to include in their 'System of Medicine.' As Dr. Playfair says, this department of medicine has grown largely within the last few years, and we are inclined to doubt whether a work of the scope indicated by the title, 'A System,' should not have required one more volume, or perhaps, indeed several more volumes, in order that the whole subject might have been adequately treated. There are several small books on gynæcology, besides many of a size similar to the one before us, and it seems a matter of regret that the opportunity afforded by sub-dividing the labor among twenty-six contributors should not have resulted in the production of an exhaustive dictionary on gynæcology thoroughly representative of the position of that department of practice in the United Kingdom at the present time.

"Dr. Playfair says in the preface that 'it is obvious that a collection of independent essays written by men on topics which they have specially studied must carry more weight and be more useful than any work compiled by a single writer.' No doubt there is a great deal of truth in this. Many of the articles, however, are necessarily on subjects that must be regarded as equally familiar to all competent gynæcologists; such, for instance, are the articles on 'Diagnosis in Gynecology, the Disorders of Menstruation, Diseases of the External Genital Organs,' and some others, which, excellent as they are, would probably have been equally good if written by any of the contributors other than the actual author in each case. On the other hand the principle referred to in the above quotation from the preface has force as regards the article on the 'Anatomy of the Female Pelvic Organs' by Dr. Berry Hart, in that on 'Extra-uterine Gestation' by Mr. Bland Sutton, in that on 'Pelvic Inflammation' by Dr. Cullingworth,

and in some other cases. The article on the 'Etiology of the Diseases of the Female Genital Organs,' by Dr. Balls-Headley, strikes us as one of the least satisfactory in the book; much of it is so much a matter of assumption that, however creditable to the writer's imagination, the result cannot be otherwise than unsatisfactory in a scientific treatise, where conclusions should be based on facts. Take, for instance, the following passage (p. 118), speaking of the 'congenital apparently granular os,' by which the author presumably means a slight erosion. He says:

""The effect of this exposure of the glandular structures at the external opening of the cervix to the influences of the acid vaginal secretions, and to friction against the vagina on movement, intensified by fixation due to abnormal abdominal pressure, is the production of an excessive supply of blood, which causes congestion and inflammation of the glands and increased secretion of their strongly cohesive mucus which plugs the canal; the uterine vessels thus becoming enlarged a varicose state may be induced, and the whole uterus become congested, so that general endometritis ensues. Also, the connective tissue at the face of the cervix becomes hyperplastic, the lips are compressed, and thereby the secretions, which are usually plentiful, find difficulty in escape; the uterus becomes irritated by distention so that endometritis is increased and evolutionary disease of the tubes, peritoneum, and ovaries, and (under the concurrent influence of excessive abdominal pressure) anteflexion or retroversion ensue: hence result virginal menorrhagia and dysmenorrhoea and sterility on marriage.'

"Dr. Balls-Headley evidently holds strong views on the subject of stays. Without for a moment denying the danger of tight lacing (it does not necessarily follow that every woman who wears stays laces them too tightly), there can be little doubt that the whole thing becomes a little ridiculous when almost everything, from ulcer of the stomach and jaundice to peritonitis, is gravely ascribed to the habit of wearing stays. The following extract will serve to illustrate the author's method:

""The Fallopian tubes are liable to be bent at their junction with the uterus by the misplacement of the uterus in combination with pressure downwards of the intestines by the stays and dress. This in the sexual engorgement in love-making, with or without union, in women of warm appetite, this abnormal relation of the tubes to the uterus may induce effusion of their secretions into the peritoneum, particularly during menstruation, and a local peritonitis; otherwise, they would pass in the normal direction through the genital canal.'

"In the preface Dr. Playfair disclaims all responsibility other than that involved in having selected the contributors; but in doing so we think he has taken an unusual view of the duties of an editor. The editor of a journal who invited contributions, and published everything sent him by his staff, without selection. or emen