of this period, the house has been intimately connected with medical publishing. The American Journal of the Medical Sciences, founded by them, is next to the oldest medical journal published in the English language. It is so seldom that a house continues in the same family for such a long period, especially in this country, that the event deserves to be commemorated in some way.

Manual of Nervous Diseases, and an Introduction to Medical Electricity. By A. B. Arnold, M.D., Professor of Diseases of the Nervous System and Clinical Medicine in the College of Physicians and Surgeons, Baltimore. With illustrations. New York J. H. Vail & Co. 1885. Pp. 170.

:

Professor Arnold presents us an exceedingly useful manual on a very important class of diseases. He gives the anatomy and physiology of the nervous system, with a succinct account of the modern researches on brain localisation; general symptomatology; medical electricity; and articles on special diseases. Among his illustrations are plates giving Ziemssen's motor points.

The author's style is vigorous, and the various diseases are graphically described. To the student attending lectures, or to the busy prac titioner who is unable to consult more bulky works, this manual can be confidently recommended.

Diagnosis and Treatment of Chronic Nasal Catarrh.

Three clinical

lectures delivered at the College of Physicians and Surgeons, New York. By George M. Lefferts, A. M., M.D., Professor of Laryngoscopy and Diseases of the Throat, in that college, etc., etc. 12mo. Cloth, beveled boards. Pp. 50. Lambert & Co., St. Louis, Mo. 1884. Price, $1.

The first lecture is devoted to the Examination of patients. The difficulties to be met with, and the methods of overcoming them, are fully described. Full directions are given for every procedure. The second lecture gives the Diagnosis, with a description of each particular disease to be met with. The last lecture contains the Treatment. The essential principle in this is cleanliness, with the application of some efficient antiseptic. A simple jet of an alkaline solution, or the following, he recommends highly. R. Sod. bicarb., sod. borat., aa. 3ss; Listerine, 3j; aq. ad 3iv. M. For intra-nasal hypertrophies, he recommends nitric acid, or the procedure devised by Dr. Jarvis. The book is profusely illustrated.

INAUGURAL THESIS OF C. E. HAWORTH, M.D., RAVENSWOOD, W. Va. Presented to the Faculty and Censors of Starling Medical College, March 4, 1885.*

As the fires of the Infernal had found an expression for their invisible forms through the soul of Dante, one of the most classic and beautiful of bards, so Syphilis sought its darkest expression in his native land, unrivaled in the beauty of her classic wealth. This is no breach of consistency. Out of one extremity is born its counter extreme--and among the contras to that extremity of estheticism which once gave to Italy her fairest title to worth, must be classed the syphilis for which she served as an unhappy nidus. Syphilis is the grand negative electrode in the battery of human sociology ;- —a monster of hideous mien, which we may first endure, then pity, but never consciously embrace. The universality of syphilis, both in extent and interest, has justified the vastness of labor bestowed upon it by the best of modern talent. From this extravagance of research, it is but natural that much of the truth in syphilis should have been revealed; and but natural that much must necessarily remain hidden. Between the extremities of the absolutely known and the absolutely unknown,

*The prize of $25, for the best thesis, was awarded to this paper by the Censors.

there are various problems, hovering somewhere beyond the confines of revelation. To this intermediate realm, involving points which may be regarded as strictly sub judice, I have chosen to confine myself.

ORIGIN. Of all that may be involved under the head of theoristic syphilis there are two problems in particular enveloped in mysticism. These are the origin and the source of syphilis. Apparently, the light of advancing civilization and science only obscures. Three hundred and fifty years ago the origin of syphilis was easy of explanation. It sought many a temporarily accredited solution thro' the spirit of superstition. This was a prolific source, and opinion fluctuated with the emotions inspired by superstitious or religious sentiment. When one theory was supposed to be crystalizing into truth-another sprang from the domain of pseudoscience-especially astrology, which in its turn satisfied a too credulous people. But the spirit of inquiry and research destined-not yet the defeat-but the moderation of superstition, and to-day every once flourishing and erudite solution of the problem by medieval chronicler is either dead or in articulo mortis. The theories now extant regarding the origin of syphilis are generally moulded according to the tenor of that particular profession in which the advocate is engaged. The cause, the motor-motive, was itself the result of purely pathological, chemical, or it may be theological processes according as the advocate is a pathologist, a chemist or a theologian. The germ theorist insists upon bacteria. The moralist points to syphilis as a product of divine vengeance. Without hoping to maintain ground in any direct theory of the cause of syphilis, a process of exclusion will at least approach truth.

In the first place, it is fair to infer, in the light of history, sacred and profane, that syphilis was not born through excess of venery. If this were the cause, we would have constantly recurring cases of syphilis generated de novo. This, according to the united testimony of all observers, never Occurs. So uniformly true is this, as far as human observation has yet extended, that the fact is regarded as one of the most distinctive differences between chancre and chancroid, and constitutes one of strong holds of duality.

Furthermore, it is asserted on the authority of Dr. Livingston that in Central Africa, where licentiousness and libertinism are at a maximum, syphilis is absolutely unknown. Simple excess then could hardly beget syphilis, otherwise in the course of a generation the whole world would be syphilized.

Nor is it probable that syphilis could result from any form of abnormal or unnatural coitus. If this were true, it is fairly reasonable to suppose that somewhere, among the "hundred nations" of the earth, this cause would repeat itself, and too frequently to escape the notice of mankind.

Did syphilis result from a degeneration of leprosy? There may be some plausibility attached to this theory from the fact that the early writers frequently confounded the two, and also that at the time of the Neapolitan epidemic of syphilis there was an appreciable decline in the spread of leprosy. But is the theory not impracticable and unscientific? It is not the nature of a specific disease to undergo any sudden, universal and unaccountable transformation. The distinctive features of the two diseases are incompatible. The differentiation of the two is based upon pathological and historical characteristics too prominent to justify the theory. Moreover, Phrisius states that lepers were afraid of infection from syphilis, and the inoculations of Danielssen later proved conclusively that leprosy does not afford immunity from syphilis. As far as has yet been observed, the genesis of syphilis may be referred to an efficient cause, single, definite and unique, and one which, the moment it formed the poison, ceased to operate.

SOURCE.-But what of the source of syphilis? This is a subject of very considerable dispute. It sustains about the same relation to medical history as the source of the Toltec race does to the history of nations. But little is proved, and much is but obscurely inferred.

The history of syphilis is directly traceable to the Neapolitan outbreak in 1494. Here the historian arrives at an abrupt terminus, and he

asks: To what source shall we attribute this initial Italian epidemic? What people are reponsible? Was the cause indigenous, or was it of foreign import? To answer this query, it is necessary to inquire into another, viz. Was syphilis known to Italy, or even Europe, prior to 1494? While the negative of the question would seem to be unpopular, yet a careful study of Italian history and the nature of the epidemic of '94, will suggest not an unintelligent support for such a position, and will at any rate force the impression that if syphilis existed at all in Italy it was to a limited and ill-defined extent.

First, the virulence and suddenness of the outbreak are not without significance. It surpassed any epidemic in severity that has occurred subsequently, and it sprang up almost without warning. It pervaded all the strata of society irrespective of social caste. Now it is directly stated

by Baumler that the virulence of any epidemic is in direct ratio to the freshness or newness of the locality which it invades. The virulence of the attack, then, would argue the freedom of Naples from the disease at any time antecedent, and what is true of Naples itself, would likely be 、 true of the country of which it is an exponent. If the disease had been naturalized there would have been nothing to justify an epidemic of such a distinctive character and type.

Again, according to the testimony of many observers, the effects of transmitting the poison are much more severe if communicated by one race to another. This consideration would contribute to the belief, judging from the severity of the epidemic at Naples, that it had found a new soil-that it was a product of foreign importation.

And yet, again, it may be insisted with some emphasis that the disease was new and strange to the people. All the medical faculty, says Ricord, were stupified, and on the authority of Baumler, Acton and Lanceraux, especially, who cite numerous quotations from writers contemporary with the epidemic, it was "to every one," to quote Baumler “a new and strange affection." The medical profession confessed utter ignorance of its nature-so much so that they abandoned it to pursue its own ravages. Indeed, their unwelcome visitor assumed so much the character of a phenomenon, that the frightened populace attributed its advent to an unhappy conjunction of the stars. If syphilis had existed previously in Italy, what grounds would there have been for such a universal surprise? And is it probable that a disease of the specific and specialized nature of syphilis, if it had existed, would have escaped observation?

In the next place may be observed the habits, manners and customs of the race. Italy, especially in her early history, ranked among the first of nations in "adultery, incest and crime." Licentiousness, lubricity and debauchery were not favored by climate and inherited passion alone, but were made right royal, solemnly legalized by the state and countenanced by the church itself. Prostitution in its most lascivious forms was honored by "imperial favor." "The crowned monsters," says Ricord, "wallowed in licence and debauchery." She who could make of herself the most profitable courtesan would win the deserved honors of an admiring nation. Daughters were sent to professional prostitutes to acquire an art so universally popular. If the history of Ricord may be believed, at one time it would seem that all Rome undressed herself. Through this frightful excess of luxury the home went down and with it went the solid governmental machinery of Rome. What, then, should have been the status