A. Peters, James J. Putnam, A. W. Mayo Robson, Wm. L. Rodman, Chas. A. Siegfried, H. Tuholske.

It is often a sad occurrence to read in the preface of these works in subsequent editions the death of some collaborator, marking as it does the passing away of a familiar writer or teacher as well as authority, but in these books their works are monuments more lasting than stone.

"Surgery of the Uterus" is written by our Dr. Lewis S. McMurtry, and The Influence of Age and Race in Surgical Affections" by Dr. W. L. Rodman, formerly of Louisville.

The present edition has been carefully revised, especially the chapters on Military and Naval Surgery, made necessary in the light of the recent war; the chapter on Diseases of the Lymphatic System and the Spleen.

The illustrations throughout are excellent and the typographical make-up all that could be desired.

Diseases of the Rectum and Anus.

By Samuel Goodwin Gant, M.D., LL.D., Professor of Rectal and Anal Surgery, New York Post-Graduate Medical School and Hospital; formerly Professor of Gastro-Intestinal Surgery, University and Woman's Medical Colleges, Kansas City; Attending Surgeon for Rectal and Anal Diseases, New York PostGraduate Hospital, St. Mark's Hospital, Hebrew Sheltering Guardian Orphan Asylum, and New York Infant Asylum, etc. Second Edition. Philadelphia. T. A. Davis Company, publishers. 1902.

Rectal surgery has received a great impetus in the last few years. In this line there has been no more earnest and competent worker than the author of this book. It has been but a short time since he removed from a Western State to New York City, but in that time he has succeeded in establishing himself, not only as a surgeon of ability, but as a teacher of great power. During his leisure hours he has rewritten his book on Diseases of the Rectum, and the second edition is now before us. It is a handsome volume, containing over 650 pages, and the subject matter is brought up to date. The book is splendidly illustrated, and bound in a substantial way. In a good many things, relating to both the etiology and the treatment of rectal diseases, the writer is constrained to

differ with the author, but he accredits him with being

but one of gre t not only a scholar. fore, in any pa experience. Theresimply a matter of belief on the part of both.

After the Introduction, which completes the first chapter, the second is devoted to the anatomy and physiology of this region. Much space is given to the discussion of the "rectal valve," and Dr. Gant's conclusion in relation to the same is given in these words: "Houston's 'valves' are permanent anatomic structures (made more prominent by distention), capable of demonstration in either the living or the dead fetus, infant, child, or adult, except in those instances in which they have been destroyed by disease, or in which, because of pathologic changes in the gut wall, rectal inflation is impossible.

Chapter IV. is given to the examination of the rectum and colon. It is lucid and clear, and will be read with much profit by those studying these diseases. The only criticism that could be made is that too much stress is laid upon the use of instruments in making these examinations. In the majority of such cases, a clinical history of the case, a digital examination, and close questioning will enable the surgeon to make a correct diagnosis.

Chapter V. is a description of congenital malformations. The subject is not exhaustively treated, but enough is said to enable the reader to make out a correct diagnosis.

Many valuable suggestions are made in the sixth chapter regarding the treatment of constipation. In the list of remedies the author deals with the operation of "valvotomy," but dissents as far as the cutting operation is concerned. An interesting table of fortysix cases of fecal impaction treated by the author is given in the seventh chapter.

One of the most interesting chapters in the book is that one devoted to Autoinfection and Auto-intoxication. It, however, is rather brief. The subject of chronic diarrhea is discussed from the standpoint of a rectal origin. This is very proper, for many cases that come to the proctologist for treatment

have been diagnosticated improperly, called dysentery, or chronic diarrhea, when the origin was strictly local-in the rectum.

Considerable attention is given to diseases, injuries and tumors of the coccyx, with good illustrations and the author's method of coccygogectomy. Venereal diseases are freely discussed. In speaking of syphilis, the author says: "A common manifestation of the earlier stages of syphilis is stricture," but gives no statement of the per cent. of cases so affected. Under the head of Treatment, it is advised to administer bichloride of mercury, and iodide of potassium. In the writer's experience, after a stricture of the rectum has resulted from syphilis, constitutional treatment is of no avail. Pruritis ani is treated both in a palliative and surgical way, giving preference to the thermo-cautery. He mentions, and has tried, the writer's plan of dissection, but says that it should be done only as a last resort. The writer would reverse the order, doing dissection in preference to the cautery. One of the most interesting chapters in the book is the one on Proctitis and membranous Colo-Proctitis. This chapter alone is worth the price of the book. The general practitioner, especially, should be better in formed on this affection, and fewer mistakes would be made in diagnosis. The author divides the treatment into palliative and surgical. The writer has never seen a case of proctitis that he thought called for surgical treatment. Stricture of the gut seldom results from a mere inflammatory condition of the rectum; and if it should, it it is best to allude to the operation for such condition under the head of stricture, to save confusion.

The chapter devoted to the consideration of fistula in ano is complete in every detail. He disproves, by the testimony of eminent authorities, that an operation for fistula increases the primary trouble in the lungs in the tubercular patient. For fissure of the anus, divulsion of the sphincter muscle is very properly recommended as the best procedure. Non-malignant ulceration and non-malignant stricture receive careful consideration.

In summing up, the author says: "If statistics are to be relied on, syphilis is the most common cause of stenosis of the rectum." The writer has long been convinced of this, and he is glad to report a similar opinion from so distinguished an authority as Dr. Gant. The chapter on prolapse of the rectum is well illustrated and concisely written. In it the author elucidates colopexy, and mentions the case that was recently operated on by the writer-the subject is brought fully up to date.

The subject of the most interest to the profession generally is found in Chapter XXVIII., viz. : Internal hemorrhoids. All of the most recent operations for this affection are given and fully described. The author gives preference to the clamp and cautery. Malignancy of the rectum is carefully discussed and the latest views are given. given. In the chapter given to Colostomy all surgeons will be interested. Every method of doing the operation is mentioned and fully described. It is both interesting and profitable to read it. The author's own method is fully given for the closure of artificial anus. This admirable book is to be recommended in every particular. Well written, fully up to date, and splendidly illustrated, it should receive a liberal patronage from the profesJ. M. MATHEWS.

sion.

Kirke's Hand-Book of Physiology.

Revised by William H. Rockwell, Jr., M. D., and Charles L. Dana, A. M.. M.D., New York, N. Y. Seventeenth American Edition. With upward of 500 illustrations, including many in colors. New York: William Wood & Co. 1902.

So long has this work been a standard text-book in medical colleges that it needs no introduction to practitioners of to day. In its freq ent edition it keeps pace with develo ments and discoveries in this important subject. In this edition it is announced the chief changes are in the chapters relating to physiological chemistry; on the Blood and in the introduction of many new illustrations.

The book will always be a standard

one.

SAUNDERS' MEDICAL HAND-ATLASES.

Atlas and Epitome of Traumatic Fractures and Dislocations.

By Prof. Dr. H. Helferich, Professor of Surgery at the Royal University, Greifswald, Prussia. Edited, with additions, by Joseph C. Bloodgood, M.D., Associate in Surgery, Johns Hopkins University, Baltimore. From the Fifth Revised and Enlarged German Edition. With 216 colored illustrations, on 64 lithographic plates, 190 text cuts, and 353 pages of text. Philadelphia and London: W. B. Saunders & Co. 1902. Cloth, $3.00 net.

This volume sustains the reputation enjoyed by the others of this series, showing as it does the visible deformity of fractures and dislocations, the X-ray shadow, the anatomic preparation and the method of dressing;

These illustrations are most varied

and complete, and with the excellent text comprise a book of great value to student, practitioner and surgeon.

A Text-book of Histology and Microscopic Anatomy of the Human Body, including Microscopic Technique.

By Dr. Ladislaus Szymonowicz, A. O. Professor of Hystology and Embryology in the University of Lemberg. Translated and edited by John Bruce MacCallum, M.D., Johns Hopkins University, Baltimore. Illustrated with 277 engravings, including 57 plates in colors and monochrome. Lea Bros. & Co., Philadelphia and New York.

We feel sure this work will be referred to by the translator's name and not by its author's, the average reader being apt to "shy" at Szymonowicz. With so unusual a name one might reasonably expect an unusual book, and this is what we find upon its examination.

The book is worth its price for the illustrations alone; they are individually and collectively most excellent, unusually distinct, and with the accompanying diagram the colored plates are specially instructive. One renews his college laboratory days by going through these beautifully illustrated pages.

The Germans have long led the world in microscopical technic, and the text of this book is no less of merit than the illustrations.

The only unsatisfying chapter is the one upon the blood, which is not up to the standard placed for it by the one,

for instance, on the brain and cord, the skin, etc.

The book is beautiful, scientific and useful.

The Treatment of Fractures.

By Charles L. Scudder, M.D., Assistant in Clinical and Operative Surgery, Harvard Medical School. Third edition, revised and enlarged. Octavo, 480 pages, with 645 original illustrations. Philadelphia and London: W. B. Saunders & Co. 1902. Polished Buckram, $4.50 net; Half Morocco, $5.50 net.

The third edition of this book on fractures has been necessitated in two years from its first appearance, each having met with a cordial reception.

The book emphasizes the importance of anesthesia, antisepsis, and the Roentgen Ray, in the treatment of fractures, making their treatment less complicated and knowledge of them

more exact. The author uses the term "open" and "closed" fracture, instead of "simple" and "compound.'

This edition includes a chapter on Gun-shot Fractures of the Long Bones, and the use of plaster-of-Paris, a rather too much neglected dressing, is more fully illustrated.

The illustration of the details of treatment and application of splints is to be commended, as this method is far more satisfactory to the student than simple word pictures.

Progressive Medicine.

Edited by Hobart Amory Hare, M.D., Professor of Therapeutics and Materia Medica in Jefferson Medical College, etc., etc., assisted by H. R. M. Landis, M.D., Assistant to the Out-patient Medical Department of Jefferson Medical College. Volume XIV. September, 1902. Lea Bros & Co., Philadelphia and

New York.

This volume treats of Diseases of the Thorax and its Viscera, including the Heart, Lungs and Blood Vessels; Dermatology and Syphilis, Diseases of the Nervous System and Obstetrics, the contributors being William Ewart. M.D., F.R.C. P., William S. Gottheil, M.D., Richard C. Norris, M. D., and William G. Spiller, M.D.

To the busy practitioner these quarterly visitors are of the greatest service, giving the opinion of the world's medical men upon every subject of importance in all the specialties during the year.

probability of malignant disease, that I decided to remove the entire uterus as well as the diseased adnexa. This was done and the abdomen closed, with gauze drainage per vaginam as usually applied in such cases. Convalescence was easy and uncomplicated, and the patient sat up at the end of two weeks, and left the hospital at the end of the fourth week in excellent condition. She has now regained her color, strength and flesh, and is quite well.

A bilateral section of the uterus disclosed a distinct elevated nodule on the posterior wall near the left cornu. This nodule was so closely attached to the mucous surface and wall of the uterus that it appeared as if it were a projection of the uterine muscularis through a hole in the endometrium. It was friable, bled freely when touched, and evidently was not practical structure. Its structure was not that of a uterine myo-fibroma. In view of the clinical history, and especially the persistent hemorrhage, the gross appearance of the tumor convinced me that the case was one of deciduoma malignum.

The specimen was submitted to careful microscopic examination by Dr. James Vance, Director of the Pathological Laboratory of the Hospital College of Medicine. Dr. Vance found the histological structure of the growth typical of deciduoma malignum, both syncytium and Langhan's cells participating.

In 1888 Prof. Sanger reported to the Obstetrical Society of Leipzig two cases of malignant disease of the uterus presenting distinctive pathological characteristics, and which had not been previously recognized. A growth appears upon the mucous lining of the uterine corpus, following abortion or ordinary labor, with profuse bleeding, and is succeeded by bloody and offensive discharges. Metastatic deposits in the lungs and vagina are very common and produce a fatal result. The cachexia is marked and the progress of the disease, if uninterfered with, is so rapid that the

time from the first symptoms to the death of the patient occupies only a few weeks or months. The diagnosis of the disease is not especially difficult, and the treatment is, with perfect unanimity, encompassed by a single decisive surgical procedure-early and complete extirpation of the uterus. The greatest difficulties center about the pathogenesis and true pathological classification of the disease.

num.

Sanger believed the growth originated from decidual cells, and accordingly gave it the name of Deciduoma Malig* Pfeiffer in 1889 reported a case and proposed the same name.+ The theory advanced by both Sanger and Pfeiffer attributed the growth to malignant changes in the decidual cells. In his second paper in 1893, Sanger submits a review of his case and a study of eleven additional cases reported, and suggested another name more accurately in accord with his interpretation of the pathology as revealed by more extensive investigation, suggesting "sarcoma uteri deciduo-cellulare. His conception of the pathology was that of sarcoma originating from the products of conception.

Gottschalk reported a case and proposed the name "sarcoma chorio-cellulare," believing the disease to consist in malignant degeneration of the stroma of the chorionic villi.§

In 1895 Marchand first published his studies upon this subject, and in 1898 made additions to his valuable contribution. These important investigations were exhaustive, and have done more than any other toward the elucidation of the subject. He demonstrated the epithelial character of the growth, and claims that it springs from the two kinds of tissue composing the epithelial covering of the villi. The tumor, in accordance with Marchand's views, arises from the syncytium and Lang

* Centrable f. Gyn. 1889. † Prager Wochen. 1890. Archiv. f. Gyn. 1893. Archiv. f. Gyn. 1894.

Monatsch. f. Geb. u. Gyn. 1895.