THE REVIEWER'S TABLE

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

COAKLEY'S LARYNGOLOGY.

A Manual of Diseases of the Nose and Throat. By Cornelius G. Coakley, A.M., M. D., Professor of Laryngology in the University and Bellevue Hospital Medical College,etc., New York. New (3d) edition, revised and enlarged. In one 12mo. volume of 594 pages, with 118 engravings and 5 colored plates. Philadelphia and New York, 1905: Lea Brothers & Company., Publishers. (Cloth $2.75, net.)

Dr. Coakley's two previous editions of his excellent manual have spoken for themselves. The present edition is thoroughly revised and considerably enhanced, retaining the original plan of the book with but little alteration in the nomenclature. Every page of the text is concise, clearly written and bears the mark of originality. Abundant illustrations serve to elucidate matters when

ever necessary. While the author mentions and briefly describes the different operative technicalities devised for the same condition, he only discusses in detail the methods he gives preference gained by personal experience. This necessarily obviates confusion to the student and practitioner, for whom the volume is mainly intended. As a manual

on nose and throat diseases, we regard it as abreast of the times, and it merits the popularity it has always been accorded.

H.S.

GRAY'S ANATOMY. Descriptive and Surgical. New American from the 15th English edition. Revised, enlarged and rewritten by J. Chalmers DaCosta, M.D., Professor of Surgery in the Jefferson Medical College, in collaboration with a corps of specially selected assistants. In one very handsome imperial obtavo volume of 1600 pages, with 1132 illustrations. 500 of which are new in this edition. Philadelphia and New York, 1905; Lea Brothers and Co., Publishers. (Price, with illustrations in black: cloth, $5.50, net. Price, with illustrations in black and many colors: cloth, $6.00, net leather, 87.00, net.)

It would be superfluous to speak in commendation of Gray's Anatomy, it is a familiar work to the whole American profession, and every practitioner is a witness to its worth. New editions come and with them changes. to increase its use and incorporate in it the very latest anatomical knowledge, but the fact remains that for many decades it has been, what it is today, the most serviceable work on anatomy at the command of student in medicine. It has guided the teaching of anatomy in all English-speaking lands so exclusively that the name "Gray" has become popularly synonymous with its subject. Henry Gray died young, but he left as his masterpiece this work, showing his profound grasp of human structure and his equal insight into the best methods of imparting knowledge to other minds. Far from stationary, anatomy is perpetually advancing, and any work designed to reflect its full development needs frequent revision. Gray alone enjoys a sale of sufficient magnitude to warrant the expense of a proper revision, as its merits at

Ac

tract practically the entire demand. cordingly, in its many editions it has enlisted the ablest anatomists on both sides of the Atlantic, but no revision has been so thorough as this by Dr. DaCosta. An anatomist, a surgeon and a teacher, he combines all qualifications necessary to place the book abreast of the latest advances, keeping always in view the requirements of students and practitioners as well. Every page has been revised and whole sections rewritten, notably those on the Brain, Spinal Cord, Nervous System, Abdomen and Lymphatics.

Of the magnificent series of over one thousand illustrations, no fewer than five hundred are new in this edition. They are so large that every detail is clear, and they bear the names of the parts engraved directly upon them (a feature peculiar to Gray), whereby the position, extent and relations are seen at a glance and impressed on the mind in a way otherwise impossible. Colors are used more freely than ever before to indicate the muscle-attachments, veins, arteries, nerves and lymphatics. The work is therefore an unrivaled dissector. The old and new nomenclature are both given, the new enclosed in brackets, thus serving all readers better than either system alone. The text has been most carefully arranged, so that its main and subheadings and its catchwords in heavy type will give the student a systematic grasp of all the subjects in their proper anatomical dependence.

In a word, Gray s Anatomy will remain in the future, as it has been in the past, the easiest book from which to teach, to learn, or to prepare for examinations for degrees or license to practice, and likewise the unrivaled reference book for the physician and surgeon.

In

A NATIONAL STANDARD DISPENSATORY. Containing the Natural History, Chemistry, Pharmacy. Actions and Uses of Medicines, including those recognized in the Pharmacopeias of the United States, Great Britain and Germany, with numerous references to other Foreign Pharmacopoeias. accordance with the United States Pharmacopoeia, 8th decennial revision of 1905 by authorization of the Convention. By Hobart Amory Hare, B.Sc., M.D., Professor of Therapeutics in the Jefferson Medical College, Philadelphia; Member of the Committee of Revision of the U.S.P.; Charles Caspari, Jr., Ph G., Phar. D., Professor of Pharmacy in the Maryland College of Pharmacy, Baltimore, Member of the Committee of Revision of the U S.P.; and Henry H. Rusby, M.D., Professor of Botany and Materia Medica in the College of Pharmacy in the City of New York, Member of the Committee of Revision of the U.S.P. Imperial octavo, 1858 pages. 478 engravings. Philadelphia and New York, 1905; Lea Brothers & Co. (Cloth, $7.25, net; leather, 88.50, net; thumb index, 50 cents extra.)

Along with Gray's Anatomy, a medical dictionary and a chief work on medicine and on surgery this should be one of the foundation volumes of every medical library, it occupying quite a position of importance in the matter of drugs and their action that Gray has in the structure of the human frame or

a dictionary to the understanding of language.

To practitioners of medicine and pharmacy this new work of the highest authority is of great importance. It contains, by authorization of the convention, every article in the new edition of the U. S. Pharmacopoeia, together with such explanatory notes and instructions as are necessary to a full understanding of the brief official statements. In addition it covers the essentials of the latest

foreign pharmacopoeias, and the very import. ant domain of unofficial drugs and preparations so largely in use. Of its authors, Dr. Rusby has treated the department of Pharmacognosy, including the minor as well as the major drugs of the entire globe, a service never before rendered; Prof. Caspari deals with Pharmacy, giving full information regarding methods and products, with descriptions and explanations of the most approved apparatus and tests, and Dr. Hare has written the section on Medical Action and

Uses giving a direct and compact presentation of modern therapuetics. An appendix of 60 pages contains all necessary tables, formulas, tests, etc., for practical use. The general index, of about 90 pages, contains full reference to every page in the text, making it a repertory of the world's knowledge of drugs, and the Therapeutical Index, of about 40 pages, contains, under the name of each disease, reference to all the medicines employed in its treatment, leading the reader to the points in the text where the conditions indicating their employment and choice will be found. In a word, the National Standard Dispensatory is a new, practical and authoritative work containing information on the substances used in medicine and pharmacy at the present day. The volume is embellished with no fewer than 478 new and instructive engravings in the text.

CORRECTION. -On page 579 of our last issue an error was made in the title of the first review, it should have read "Hall's Physiology" instead of "Hall's Pathology." The work is from the press of Lea Brothers & Co.

THE PHYSICIAN'S POCKET ACCOUNT BOOK, by J. J. Taylor, M.D., enables the holder to keep a complete financial record compactly and simply. As each account is made in ledger form, no ledger-posting is required. The complete contents are: accounts brought forward; accounts of professional services; obstetric record; vaccination record; record of deaths; cash account. The Medical Council, 1405 Walnut street, Philadelphia. pages. Leather, price, $1.

200

REPORTS ON PROGRESS

Comprising the Regular Contributions of the Fortnightly Department Staff.

DERMATOLOGY.

ROBERT H. DAVIS, M. D.

Coccidioidal Granuloma.- Ophüls (J.A. M. A., October 28, 1905) gives an interesting and exhaustive paper on this rare malady. Only thirteen cases have been reported, in. cluding three new ones reported by the author. The disease seems to be limited largely to California. The lesions as well as the parasites show certain resemblances to the tissue changes and organisms found in blastomycetic dermatitis. But, in the latter disease, the author states, the primary focus of infection is always the skin, and except in one case, in all the cases reported, the disease remained localized in the skin. (Eisendrath and Ormsby, in J.A.M.A,, October 7, 1905, report that four cases of systemic blastomycosis have been recorded.-Ed.) In coccidioidal granuloma, however, generalization of the disease beyond the skin is the rule, and the primary focus of infection is just as often to be found in the interior of the body as in the skin. The parasite also differs from those described in blastomycetic dermatitis; first, by the absence of budding during its development in the tissues; second, by its multiplication by endosporulation, and third, by certain differences in its growth on artificial culture media. The clinical and anatomic picture of the disease presents such a variety of symptoms and lesions dependent on the organs involved that no typical picture can be given. From the standpoint of dermatology, the lesions were varied, sometimes showing large tubers with more or less ulceration recalling the clinical picture of mycosis fungoides In other cases, the nodules were smaller, resembling a hypertrophic lupus. Again the lesions were more ulcerative in character, there was less tumefaction at the edges of the ulcers, and instead of more or less solid nodules, submilliary abscesses presented themselves. The trouble usually started in some exposed part of the skin, and extended from there discontinuously more or less all over the body. Of twelve cases reported, six had.skin lesions, and of these, the skin was the primary seat of infection in four. Regarding the anatomic changes, the disease belongs to the infectious granulomata, resembling tuberculosis closely, both micro and macroscopically, but still, at times, differing from it in certain respects. The most characteristic manifestations are "modules consisting of granulation tissue at hari.

ous stages of development, but, in addition to such lesions and mixed in with them, we find suppurative processes usually of a chronic character which, in exceptional instances, may be quite acute." The infection spreads both by the blood and lymph streams, and attacks the lungs, lymph glands, liver, etc., producing miliary nodules and small chronic abscesses (occasionally large ones) strikingly like the findings in miliary tuberculosis, for which the disease is probably often mistaken. The disease also attacks the meninges and bones, producing in the former a condition strikingly similar, both clinically and anatomically, to that of tubercular meningitis, and, in the latter, suppuration and caseation, also a tubercular picture. The parasite occurs in the form of "spherical bodies that grow to about thirty micra in diameter, consisting of an irregularly staining protoplasmic body with a double contoured capsule, which, in the larger forms, is thick and often covered, on the outside, with prickles, or even long spines." They multiply by endosporulation. It is probable that the disease occurs more often than would now seem likely, as it is so easily mistaken for miliary tuberculosis. Cases may, therefore, have occurred outside of California and not been recognized, though the majority have apparently occurred there.

The Use of the Solar Cautery in the Treatment of Diseases of the Skin and Its Appendages.-Thayer (Pacific Med. Jour., October, 1905) gives an interesting account of his experience with a specially made solar cautery (burning glass) in the treatment of various malignant and benign new growths. He had previously experimented with various forms of cauterization with variable results, but claims far more success with the method mentioned than with any of the others. He says a pure clear atmosphere, free from mists and vapors, is indispensable, and that if the rays used pass through a window pane even the results as a rule are not so good. The advantages he claims for the method are, that it can be applied with safety upon the most delicate tissues, and is at all times under the control of the operator; that the inflammation, and irritation following its application is surprisingly slight, and of short duration, the pain subsiding immediately on removing the lens. Blistering is avoided, the burning being carried beyond that point. The tissues are carbonized. The author has applied this remedy in over 2000 cases, and has never had a permanently injurious effect.' He claims that this cannot be said of any other potent remedy used by the profession. In malignant growths, the morbid tissues, having less vi

tality than the normal, succumb to the cautery before the natural structures adjoining are injured. Excellent results have been obtained by this method in cases of chancroid, external hemorrhoids, and indolent ulcers. The latter show healthy granulations in a few days after the treatment, and go on to a favorable termination. Granular surfaces which are inclined to bleed from the slightest touch, are changed to a healthy state. Carbuncles, if seen early. can often be aborted and in their later stages, in the author's experience, are more successfully treated by this method than by any other. In the treatment of epitheliomata of the face the results were surprisingly good, several cases completely recovering which had been treated by other forms of cautery, and by X-rays, without effect. Several of these cases were of six to eight years standing, but one or two applications (several days apart) destroyed the diseased tissues, leaving an aseptic wound which healed in from one to two months. The resulting scar is usually slight, and little noticeable. He reports also one case of lupus vulgaris of fifteen years duration which was treated four times. The resulting wound healed in six months, and there has been no return of the disease in two years. length of time of the application varies according to the indications of the individual case. About twenty minutes seems to be his average. He exposed a chancroid two minutes, but in each case, of course, the carbonization of the diseased tissues is what is aimed at. The first few seconds are the most painful, the pain gradually lessening as the treatment continues.

The

The Practical Treatment of Lupus Erythematosus.-Lusk (N. Y. Post-Graduate, Oct., 1905) reviews the symptomatology and treatment of this very stubborn affection. At best the results are discouraging. Crocker trys "first calamin lotion; collodion, with or without salicylic acid; mercurial plaster, ben. zolin, and sometimes the spirit soap treatment, and, if good results are not obtained, linear scarification." Internally, wholesome diet, sound hygiene, and whatever remedial measures are necessary to put the patient in the best possible condition are to be used, as, for instance, the compound syrup of hypophosphites in anemic cases with feeble circulation. Thompson's solution of phosphorus, given in gradually increasing doses, and iodoform pills of one to two grains, given after meals, are beneficial in some cases. Externally, it is generally conceded that mild measures should be used in highly erythematous patches. Boric acid with calamin lotion, lotio alba, friction with tincture of green soap;

tion. As compared to cocain a much stronger dilution is effective and the virulence is much smaller, letal dose in dog or cat is about double that of cocain. Alypin has no deleterious influence on the heart, it dilates the vessels in large doses.

The Treatment of Suppurative Otitis by Hyperemic Engorgement.-(W. Keppler, Zeitschrift fuer Ohrenheilkunde.)-The favorable results that are obtained by hyperemic engorgement in suppurative processes of the extremities suggested the use of this new method on the head, especially in suppurative otitis. Simple cotton rubber bandages were used, for adults three centimetres and for children

two centimeters wide. The elasticity of the bandages could be varied by hooks and eyes. fastened at intervals. The bandage must be removed every second day as the elasticity suffers from the perspiration. Duration of stasis twenty to twenty-two hours, then pause of two hours. When suppuration improves, shortening of the period of stasis. The proper degree of engorgement is accomplished when the patient's face shows a light bluish red and somewhat bloated appearance. In inflammatory complications of the mastoid a fire red edema appears. One of the main advantages of stasis is the almost immediate relief from pain. The stasis causes a free discharge of pus. If membrane is bulging, do a paracentesis, if too small a perforation it is widened, in abscess of the mastoid a small incision is made. After the incision the wound is cleaned of pus by pressing and sterile gauze bandage applied, no drainage or tampon is used. The history of twenty-one cases, eleven acute and ten chronic will give an indication as to the value of the treatment. The acute cases were, with one exception, which was an otitis externa, in the abscess formation, complicated by mastoiditis, pain on pressure, edema, abscess and congestion. All made a splendid recovery. The time for The time for recovery varied from two to four weeks. Less pleasing were the results in the chronic cases, only two healed without operative interference, the one after removal of a polyp, the other after incision of a mastoid abscess. Striking were the conditions found in those cases that after a lengthy stasis were operated on. The bone was very vascular, the diseased parts sharply defined, and the recovery was more rapid in proportion than in those cases were stasis had not been tried.

Treatment of Acute Suppurative Otitis Media by Means of Hyperemic Engorgement after Bier's Method. (Heine, Berliner Klinische Wochenschrift.)- The engorgement was done exactly as Bier prescribes in about nineteen cases, of which four were on both

sides. There were two cases of acute otitis media without perforation, three cases with perforation, six cases of otitis media with pain on pressure over mastoid, five cases of mastoiditis with infiltration of the soft parts, three cases of mastoiditis with abscess formation. the mastoiditis with abscess formation, four Nine cases were cured, among them cases are still under observation, eight cases were operated and in two cases the mastoiditis receded, at least externally. One case of acute otitis media non-perforative, recurred after fifteen days with mastoiditis, as also another case in twenty-four days, an acute otitis media with infiltrated mastoid process. Both cases were operated. Heine agrees with Keppler in one point, namely, that mastoiditis with infiltration, abscess formation, are the best cases. operation, and thereby do damage. The staThe engorgement can retard the sis or engorgement should always be done. under supervision of an aurist.

Epidemic Cerebro-Spinal Meningitis. (Lenhartz, Archiv fuer Klinische Medicin.)-Contrary to the protracted course of the meningitis caused by the Weichlselbaum bacillus is the rapid and within a few days usually fatal course in those cases of meningitis appearing as a part of the septic pneumonias, after a pneumonia or an otitis. As a diagnosis of cerebro-spinal meningitis the microscopical proof of the presence of the diplococcus in the intercellular substance in the fluid withdrawn during a lumbar puncture, is sufficient. The culture examination of the fluid withdrawn, while always agreeable, is not absolutely necessary unless the coccus is As a culture Schottfound extracellular. mueller's human blood agar plate are recommended. Author emphasize the useful result of the lumbar puncture, as he claims the frequent and regular withdrawal of fluid relieves the cerebro-spinal canal, and may bring about a cure of the meningitis. Lenhartz recommends the withdrawal of from 25-40 ccm., but stops as soon as the pressure sinks too rapidly. In those cases in which only a small quantity of the fluid escapes there may still exist a hydrocephalus, and if the cerebral symptoms, on account of the insufficient discharge still presist, a ventricle. puncture may be resorted to. Lenhartz has performed as many as fifteen punctures in one case. Only once in forty-five cases did deafness and blindness occur which improved by the use of the Seton application and the inunction treatment.

IN typhoid fever spontaneous rupture of the spleen may simulate intestinal perfora

tion.