an amputation with charpie, as they used to do in the dark ages, and the risk of pyæmia is so great as to render many valuable operations wholly unjustifiable.

The surgeons represented in the Congress generally admitted that ventilation favored escape from pyæmia, but the idea rested in their heads in a very sleepy, foggy manner. Not one of them seemed to be aware of the fact that this cause of death can be

completely removed by the means of fresh air. The papers which were read showed that the authors were blindly fumbling about in the materia medica, to find some medicament which would enable them to combat pyæmia without pure respiration. Some used a solution of perchloride of iron, applied to the flaps of amputated cases; others applied solutions of carbolic acid; others employed various measures, all very useful and valuable in themselves; but deadly blunders were committed in this respect, viz: they all invited the profession to rely on these secondary measures, instead of perfecting the ventilation of the hospitals.

On the fifth day, came up the famous question, "Is it possible to propose to the various governments efficacious measures for restraining the propagation of venereal diseases?"

This question received all sorts of elucidations except clear ones. Those most interested in the discussion, were evidently of the number of those who desired a system of licensed prostitution. Some of the statistics presented were horribly erroneous, as I happened to know from personal investigations, and, on the whole, the discussion of the real question "was loose, wandering, and inconclusive.

After the papers were read, verbal discussion upon the subject commenced. The veteran author on syphilis, Ricord, was in the chair. In a few minutes the hot blood of the disputants got the mastery over parliamentary order, the original question was forgotten, and the speakers plunged headlong into a dispute whether syphilitic inoculation was to be commended or not. M. Ricord, though chairman, took an active part in the contest, and pushed his opponents with a relentless vigor that was refreshing to behold, but not very parliamentary for a presiding officer.

The following gentlemen were named as the committee to address the governments on the subject: Messieurs Hebra, Vienna;

Scitz, Munich; Crocq, Brussels; Seco Baldor, Madrid; Galligo, Florence; Palasciano, Naples; Owre, Christiana; Barbosa, Lisbon ; Frerichs, Berlin; Huebbenet, Kiew; Fordyce Barker, New York; Wilson Jewell, Philadelphia; Upham, Boston; R. R. MacIlvaine, Cincinnati; Hingston, Montreal.

The facts brought out before the Congress on the subject of syphilization, may be briefly summed up as follows:

Prof. Boëck, of Sweden, treats secondary syphilis by numerous and long-repeated inoculations of the matter of soft chancre. The plan is this: Several inoculations are made at once upon the patient. When the sores are produced, another set is inoculated, and the first ones destroyed by caustic. Thus crop after crop of chancroids is produced, through a period of several months. At length, after an average of about three hundred and forty-five inoculations, a tolerance is produced, and the patient is found incapable of having any more chancroids. He is then pronounced "syphilized" and cured. During this long treatment, the secondary symptoms generally, or at least frequently, disappear.

Against this treatment, it is urged that some patients have been inoculated to complete insusceptibility to soft chancre, and yet have failed to be cured of their secondary symptoms; that thoroughly syphilized women have proved that they were not cured, by bearing syphilitic infants. As to the disappearance of secondary eruptions, it is urged that four months is a long time, and that in such a period these eruptions often recede from view, spontaneously. In a few instances, the most disastrous results, and even loss of life, have followed the treatment.

A banquet was held at the Grand Hotel, by such of the members who chose to subscribe for the purpose. About 200 subscribed. The feast opened with great eclat, and good feeling. M. Bouillaud was in the chair. Several short, pithy addresses were read, an awkward way of delivery in dinner speeches, but still, the time. went merrily on. In the midst of the festivities, word was brought that the great surgeon, Velpeau, had just died. This announcement cast a gloom over the assembly, which silenced its mirth and rendered the remainder of the evening a melancholy occasion.

At one of the evening sessions of the Congress, M. Milliot exhibited, upon a cat and a dog, a new method of physical diagnosis of tumors, etc., in the visceral cavities. His plan is to illuminate very powerfully the interior of the stomach, rectum, bladder, or vagina by electric light, and then to observe the translucency of the abdomen, on the same principle that we test the translucency of the scrotal tumor to diagnose hydrocele. For this purpose he introduces into the stomach, rectum, etc., small glass tubes, containing an arrangement of platina wires connected with an electric apparatus. In this way, he produces a powerful interior electric light, which renders the abdomen translucent, like a hydrocele. He hopes to use it for the diagnosis of ovarian cysts, but has not yet brought it to any practical usefulness.

At the close of the Congress, the venerable President pronouuced a brief farewell address, and declared the session finally closed. [Chicago Medical Examiner. EDMUND ANDREWS.

Editorial Department.

Books Reviewed.

The Tree of Life, or Human Degeneracy; its Nature and Remedy, as based on the elevatiug principle of Orthopathy. In two parts. By Isaac Jennings, M. D. New York: Miller, Wood & Co., 15 Laight street, 1867.

Dr. Jennings, although having arrived at the venerable age of four score years, does not allow himself retirement from active pursuits in his profession, but again enters upon the field of medical literature with a new work on "Human Degeneracy," treated according to the orthopathic or upright, upward tendency of natural law," and which he reviews in both its spiritual and physical aspects. The sections devoted to the spiritual decline of man are a series of religious discussions, which we certainly should not have expected to find in a treatise designed for medical gentlemen, unless they are to serve as a stepping-stone to the more purely medical part of the work. The causes, nature and remedy of the physical decline of the race, the author has made the subject of a candid but rather one-sided discussion. In his therapeutics the writer occupies a position far advanced to that of his profession; heretofore we have entertained some confidence in the efficacy of various remedies, such as the opiates, etc., but we are told that hygienic conditions, bread pills and water variously colored, will effect all that can be hoped for from any drug, cases being cited in which the most painful VOL, 7, No. 4-20,

affections were cured by this bread pill practice. While we are directing attention to some of the inconsistencies of the work, we would most cordially commend the chapters on "Alcoholic Stimulants" to the careful perusal of every reader. The character of Dr. Jennigs is clearly imprinted upon this work, and no one will open its pages but be impressed with the purity and honesty of purpose of the man. The publishers have discharged their task in a most creditable manner, the typographical execution being excellent.

Circular No. 7, War Department, Surgeon-General's Office, Washington, D. C., July 1, 1867. A Report on Amputations at the Hip-Joint in Military Surgery. The feasibility of coxo-femoral amputations in military surgery was placed in a most discouraging and doubtful light by the fearful results obtained during the Crimean, Italian and Schleswig-Holstein Wars, and but few surgeons at the beginning of the Rebellion were prepared to meet the exigency or undertake the responsibility of such an operation, with any hope of success. The interesting and elaborate report prepared by Assistant Surgeon and Br'vt. Lieut. Colonel George A. Otis, in an analytical investigation of all authenticated cases of hip-joint amputations thus far performed, but it is especially designed to examine “in how far the experience acquired in the war of the Rebellion has augmented our data for estimating the value of this operation," as a resource in military surgery. And with a view of determining in how far the experience acquired during the late war has increased our means of judging of the value of coxo-femoral amputations after gun-shot injuries, "this report has been divided into an historical summary, an account of individual cases, a citation of the opinions of surgeons and a discussion of results."

From the historical summary it appears that S. F. Morand, a French surgeon, educated in England, after having carefully studied various methods of disarticulation of the femur upon the cadavar, and reported its successful performance in several instances upon inferior animals, was the first to proclaim the feasibility of this operation about the year 1729, yet not until 1773 do we find the first application of it upon a man crushed between the poles of a wagon, by Perault. The patient survived the operation, being subsequently employed in the capacity of a cook at an inn. From this time until the late war 108 exarticulations have occurred in military surgery, there being ten recoveries, "one after a primary, four after intermediate, and five after secondary operations—a percentage of mortality of 96.66." In civil practice 111 operations are recorded, with 46 recoveries, or a mortality rate of 58.56. Of this number the French report eight recoveries and fifteen deaths; the Germans seven recoveries and six deaths; the Poles four operations, which proved fatal; the British sixteen recoveries and thirty-one deaths, and the Americans fifteen recoveries and nine deaths.

Hip-joint amputations in the war of the Rebellion were performed in fifty-three instances; thirty-four occurring in the service of the United States, and nineteen in that of the Confederate. These operations are described and divided into four categories, "primary, intermediate and secondary amputations, and re-amputations." Under the category of primary amputations are classed those which have

been performed "in the interval between the reception of the injury and commencement of inflammatory symptoms," which period will rarely exceed twentyfour hours. Intermediate amputations are considered those made during the period of inflammatory action. Secondary operations comprise those performed during the abatement of inflammation, and "when the lesion has in a measure become local and analagous to chronic disease." Re-amputations are those in which "an amputation in the coutinuity had preceded the amputation in the contiguity."

Primary amputations were performed in nineteen instances, the average interval from the time of the reception of the injury and the operation being seven hours. Eleven of the patients succumbed to the direct shock of the operation, three lingered for two and two for eight or ten days. In two instances the patients were known to have recovered, but their subsequent history has uot been traced. Oae has survived the operation for four years, enjoying good health. Of the eighteen intermediate amputations not one survived, the patients in all instances being ill-fitted to undergo the operation; exhaustion dependent upon surgical fever, hemorrhage and pyæmia being the chief causes of death, but five succumbing to shock. Nine cases, seven deaths and two recoveries are tabulated under secondary amputation. The category of re-amputations comprises seven cases, four of which recovered. Of the three fatal cases, two sank in a few hours, the third dying from pyæmia.

After a careful recapitulation of the citations of the operating surgeons and an analytical investigation of all the facts in each individual case, the accessions made to our means of estimating the value of coxo-femoral exarticulations in military surgery, Dr. Otis sums up as follows:

"1st. We have learned that the primary operation for traumatic causes is not uniformly fatal, as has laterly been taught, and are enabled to define three conditions under which it should be undertaken, while two other conditions in which it may be justifiable are left sub judice.

"2d.-Much evidence has been brought to counteract the prevailing doctrine that disarticulation at the hip is an exception to the general rule requiring all amputations deemed indispensable to be performed immediately, the eighteen intermediate amputations performed during the war having all resulted fatally.

"3d. We have proved that secondary amputations at the hip for necrosis of the whole of the femur or for chronic osteomyelitis following gun-shot injuries. may be performed with as successful results as hip-joint amputations for other pathological causes.

"4th.-It has been shown that when, after amputations in the continuity of the thigh, the stump has become diseased, re-amputations at the hip may be done with comparative safety."

Annexed to this report are chromo-lithographs of the seven successful amputations, and two lithographic plates representing the appearance of bones removed in two successful operations, while throughout the work numerous excellent wood cuts illustrate the appearance of gun-shot fractures of the femur, necessitating their removal.