STARR ON DISEASES OF THE Digestive oRGANS IN INFANCY AND CHILDHOOD.* In addition to the diseases of children's digestive organs this volume considers the investigation of children's diseases, and the general management of children. It would seem as if it were superfluous to devote nearly four hundred pages to this subject, but a careful reading of these show us that every page contains material both important and relevant. The medical care of children calls for thorough knowledge of the disorders of the nervous tract, and the relations thereto of food. The cases are numerous in which severe disease can be cured as well as prevented by the judicious application of the principles here indicated. Especially is it important that young practition ers should have at their command the latest modern methods for unraveling the mysteries of infantile digestive disorders, and the best means for their relief. The portion relating to the investigation of disease does not necessarily belong to this work, as it equally fits the investigation of any other disease of childhood. But it is important that it should be well understood by all medical men. None can read it without profit. It is a portion of the labor of every doctor to seek to unravel the ailments of the little people, and not a few fail because unfamiliar with the best methods. The author's style is attractive, so that the work will be read with pleasure, as well as profit. We quote a few sentences almost at random as illustrative. Speaking of the expression of the child's face at the onset of illness he says: "Pain most of all sets its mark upon the countenance, and by noting the feature affected it is often possible to fix the seat of serious disease. Thus contraction of the brows denotes pain in the head; sharpness of the nostrils, pain in the chest, and a drawing of the upper lip, pain in the abdomen. As a rule the upper third of the face is modified in expression in affections of the brain, the middle third in diseases of the chest and the lower third in lesions of the abdominal viscera. "There are three sets of furrows on the face indicative of the part of the body to be further examined. First, the oculo-zygomatic, beginning at the inner canthus of the eye and passing outward beneath the lower lid, to be lost a little below the most prominent portion of the cheek. This points to primary or secondary disorder of the cerebro-nervous system. Second, the nasal, starts above the ala of the nose, and, passing downward, forms a semi-circle around the angle of the *DISEASES OF THE DIGESTIVE ORGANS OF INFANCY AND CHILDHOOD. By Louis Starr, M. D. Illustrated. Philadelphia: P. Blakiston & Son. 1886. Cloth; pp. 335. For sale by John Macfarlane, Detroit, Mich. mouth. This may be associated with another line, the genal, which extends from its middle almost to the malar bone. These indicate disease of the gastro-intestinal tract, or other abdominal viscera. Third, the labial, commencing at the angle of the mouth and running outward, to be lost in the lower part of the face. This furrow is more shallow than the others. It directs attention to the lungs." Again respecting the cry. "Incessant, unappeasing crying is due to one of two causes, namely, earache or hunger, and the distinction may be readily made by putting the child to the breast or offering a properly prepared bottle." The latest suggestion of value concerning the subjects discussed are to be found in these pages. We trust that the book may have a wide circulation among all who have the care of children, as both doctors and patients will be more likely to be satisfied with the results. PHILLIPS' MATERIA MEDICA AND THERAPEUTICS -ORGANIC SUBSTANCES.* In 1882 the author published a work on materia medica treating exclusively of inorganic substances. The present work is a very thorough revision of his work on organic substances. It is scarcely too much to claim for this the merit of being an entirely new work. The separate plants are considered under the heads of their respective botanical families. Thus under the head of Ranunculaceae we find the aconite family, pulsatilla, helleborus niger, podophyllum peltatum, hydrastis canadensis, delphinium staphisagria, actæa racemosa. In a similar manner each plant is placed under its botanical genus. The treatment of the separate articies is as follows: First, we have a description of the plant, then its active principles; then an account of its absorption and elimination; then its physiological action, external and internal; then its physiological allies; then its physiological antagonists; then its therapeutical action; then its preparations and dose, and finally its adulterations. All these points are considered from the practical physician's standpoint. Besides the vegetable substances the author discusses the organic compounds made from vegetable substances, and used in medicine, as carbolic acid, alcohol, ether, etc., a long list of more or less important medicinal agents. These also are discussed from the standpoint of one who desires to use them for the relief of suffering humanity. Lastly, from the animal kingdom certain substances *MATERIA MEDICA AND THERAPEUTICS.-By Charles D. F. Phillips, M.D. Philadelphia: P. Blakiston, Son & Co. 1886. Pp. 1081. are derived which have a medicinal value. In this list are musk, pepsin, pancreatine, cod-liver oil, etc. These also are discussed in the same manner. Altogether the work is of great value, and will prove helpful to all who desire information concerning these several substances, for use in the art of medicine. The volume is handsomely printed in large type. EICHHORST ON DISEASES OF THE CIRCULATORY AND RESPIRATORY APPARATUS.* This is volume one of Eichhorst's Handbook of Practical Medicine. It is well known as a standard work of unusual value, and as such will be cordially welcomed by the subscribers to Wood's Library of Standard Medical Authors. The present volume contains over one hundred wood-cuts illustrative of the text. The author having been for a period of years teacher of pathology and therapeutics, and director of a medical clinic, it is clear that the results of such training would be made prominent in his writings. Hence we find running through this volume a rare combination of pathological knowledge, therapeutical skill, and clinical good sense. In short, his pathology and therapeutical knowledge is welded with his mastery of the objective and subjective phenomena of the diseases treated. As a result we have a definiteness and certainty in matters of diagnosis and treatment that is very satisfying to one seeking for light and aid in his actual work in treating diseases. BLANDFORD'S LECTURES ON INSANITY.† These lectures were delivered many years ago, before the students of St. George's hospital medical school. True, the work has passed through three editions, and each has been changed more or less to meet the changes occurring in the author's mind, but they are still in form and spirit lectures for medical students, with all the excellencies and defects of such compositions. It is unnecessary to point these out at the present time, as they will be readily grasped by each reader. Certain it is, however, that they form very attractive reading, and impressively inculcate important principles relating to insanity in its relations to the work of medical practitioners. This being a reprint of the third edition, it is needless to attempt any analysis. To it the publishers have added a reprint of Dr. A. * HANDBOOK OF PRACTICAL MEDICINE. By Hermann Eichhorst. L. Hamilton's monograph on the types of insanity which we noticed some years ago. BRAMWELL ON DISEASEs of the spINAL CORD.SECOND EDITION.* The second edition of this work was published in 1884. It, as well as the first edition, was received with marked favor, being translated into German, French and Russian. Now it appears as the January number of Wood's medical library. It does not appear that this issue is different from that of 1884. As such, it will prove of interest to hundreds of physicians to whom the English edition was inaccessable. The author's plates are also reproduced, and in such shape as to be satisfactory. These are so numerous and so truthful as to wonderfully enhance the value of the text. At this late date any full notice of the work is uncalled for. Unquestionably it has increased the sales of this series of Wood's library. ADAMS' TRANSLATIONS OF THE WORKs of HIPPOCRATES. This was first issued by the Sydenham Society many years ago. It was gratefully received by the subscribers of that society, and has from that time been one of the medical classics. Necessarily the edition was a limited one. To remedy this and place it among a larger number of readers, the Woods have begun its issue as a portion of their Library of Medical Authors. None will question the desirability of medical men and all medical students being acquainted with the beginnings of scientific medicine as shown in the writings of the father of medicine. HILL AND COOPER'S STUDENT'S MANUAL OF VENEREAL DISEASES-FOURTH EDITION REVISED.‡ This edition has been so changed as to present a fair statement of the principles upon which venereal diseases * Diseases of the Spinal CoRD. By Byron Bramwell., M. D., F. R. C. P. (Edin.). Forty-three colored plates and one hundred and two wood engravings. Second Edition. New York: Wm. Wood & Co. 1886. Cloth, pp. 293. Sold only by subscription in sets of twelve volumes each year. THE GENUINE WORKS OF HIPPOCRATES, translated from the Greek by Francis Adams, LL. D. Surgeon, in two volumes. Vol. I. New York: William Wood & Co. 1886. Cloth; pp. 390. Sold only by subscription to Wood's Library of Standard Medical Authors. THE STUDENT'S MANUAL OF VENEREAL DISEASES. By Berkeley Hill, M. D. and Arthur Cooper, M. D. Fourth edition. Philadelphia: P. Blakiston, Son & Co. 1886. Pp. 102. Cloth. Price $1.00. For sale by John Macfarlane, Detroit, Mich. are to be treated, and the details by which these principles are made useful in the actual treatment of disease. It may serve as an introduction to the study of larger works. As such it may prove useful to many students. STEVENS ON THE BEST PRELIMINARY EDUCATION FOR THE STUDY OF MEDICINE.* This little work constituted the Boylston Prize Essay for 1885. It is written from the American standpoint. In the main the positions taken will commend themselves to the well educated medical man. We could hope that it might be widely read and studied by all classes in and out of the profession. Abstracts from Exchanges. Prepared by A. B. Lyons, M. D., Walter P. Manton, M. D., and W. R. Chittick. M. D. DISEASES OF CHILDREN. RENAL CALCULUS FROM AN INFANT.-Dr. Partridge recently exhibited before the New York Obstetrical Society a stone as large as a hazel-nut which had been removed post-mortem from the left kidney of an infant 20 months old. The child had been admitted to the hospital, suffering from mild inflammatory diarrhea. Subsequently she had whooping-cough, and two weeks later developed a croupous pneumonia of the right upper and middle lobes, to which she succumbed. At the autopsy, besides the usual pulmonary appearances found in this pneumonia, etc., the calculus was found encapsuled, but not adherent, in the pelvis of the kidney. Stone of such size in so young a child is among the rarities. Am. Jour. Obstetrics, Feb., 1886. GYNECOLOGY. M. KOLPOHYSTERECTOMY FOR CANCER, WITH TABLES COMPARING ITS METHODS AND RESULTS.-The announcement of but an eight per cent. mortality in 24 consecutive cases by Fritsch, of but nine per cent. mortality in 55 consecutive cases by Martin, and of 16 cases by Staude, without one death, has revived a somewhat abated interest in this operation. Sänger's mortality of 28 per cent. obtained in 1883, had to the end of 1884 remained unaltered, notwithstanding the increased numbers of Mundé's, Doche's, and Duncan's list. The limits of success had been apparently reached, and the operation, even by its friends, abandoned to the opprobrium *THE BEST PRELIMINARY EDUCATION FOR THE STUDY OF MEDICINE. By Edward S. Stevens, M. D., Lebanon, O. Cloth; PP. 45. For sale by John Macfarlane, Detroit, Mich. of an extraordinary death-rate, which has in a degree been lifted in an elaborate paper by Dr. S. E. Post, which appears in the January number of the American Journal of the Medical Sciences. The article ably presents a brief history of the operation, the fact of a recently diminished mortality, with an analysis of its concomitants, and among them possibly its cause. The author shows: I. 1. The results of kolpohysterectomy for cancer have progressively improved with increase of the number of operations. 2. The total number of operations done up to the present time is approximately 341, with a total mortality of 27 per cent. Two hundred and twenty-two cases were treated with the open peritoneal wound, with a mortality of 22 per cent. Of the 222, 93 had the supravaginal wound covered by peritoneum, with a mortality of 18 per cent.; and of 93, 50 were operated upon during the past three years, with a mortality of 10 per cent. 3. Of 97 cases who survived operations done previous to 1883, 18, or 20 per cent., are known to have been well at the end of 18 months or two years. 4. The latest results of kolpohysterectomy for cancer contrast not unfavorably with those of the total extirpation of other organs for malignant disease. 5. The tendency of medical literature is to regard kolpohysterectomy for cancer as a legitimate operation, subject only to the restrictions common to other extirpations for malignant disease. THE TREATMENT OF HYSTERIA.-Dr. Chas. K. Mill recently read a paper before the Philadelphia Medical Society (Polyclinic), in which he considers chiefly the following points: 1. The moral treatment of hysteria. 2. The value of operative procedures. 3. The treatment of grave convulsive attacks. Under the head of moral treatment he discussed chiefly the best methods of applying this treatment; he discountenanced harsh methods, except in special cases, and believes that they should only be used after due consideration and by a well digested plan. With reference to oöphorectomy for hysteria he concluded: 1. It is only rarely justifiable. 2. It is not justifiable in the case of girls who have not menstruated. 3. When disease of the ovaries can be clearly made out by local objective signs, it is sometimes justifiable. 4. It is justifiable in some cases with violent nymphomania. The operation is sometimes performed without due consideration, and the statistics of the operation are peculiarly unreliable. The treatment of spasmodic seizures, he said, should differ according as they were purposive or involuntary. For the purposive or voluntary attacks, such measures as threats, holding of the nose, inhalation of ammonia, etc., might answer. Nerve pressure, inhalations of nitrite of amyl, and electrical currents to the limbs, feet, and, in well chosen cases, to the head were ENCEPHALOID SARCOMA OF THE RIGHT OVARY.— Gallozzi reports the following case (Gazetta degli Ospitail; Medical News.) A girl, 13 years old, came to him suffering from general malaise, and the history of a pain in the right iliac fossa, which had existed for two years. There was no disturbance of respiration or digestion, or history of hereditary tendency to this disease. The abdomen was enlarged, but there was no marked prominence nor alteration in color, or venous engorgement. The circumference at the umbilicus was 31.6 inches. An ovoid tumor, of uneven surface and moderately elastic, was discovered extending from the left costal arch into the basin of the pelvis. Vaginal examination was impossible. Twentytwo days after the patient entered the hospital laparotomy was undertaken. It was found that the tumor was so adherent that total removal could not be accomplished except with immediately fatal results, and accordingly the abdomen was closed, portions of the tumor being left in the cavity in two localities-one, the size of a fist, on the left hand side of the spinal column; another, somewhat smaller, in the cavity of the pelvis. Antiseptic dressings were applied, and the patient during the following day and night was in a satisfactory condition, with only a slight rise of temperature. Febrile symptoms, however, developed, and death from peritonitis ensued a day later. M. VAGINAL HYSTERECTOMY For Cancer.—Dr. Reeves Jackson, of Chicago, concludes his paper on the above subject with the following remarks: I. Any operation for cancer which does not completely remove the disease will be followed by recur rence. 2. During life, the diagnosis of the extent of cancerous disease originating in any part of the uterus is at present impossible; hence, no operative procedure can afford a guarantee of complete removal. 3. In view of this necessary doubt, no operation is justifiable which greatly endangers life, provided other and safer methods of treatment are available. 4. Vaginal hysterectomy has sacrificed the lives of more than one-third of those who have been subjected to it, the mortality of the operation when done by those of greatest skill and experience being over 36 per cent. 5. Other methods of treatment, attended by not more than one-sixth to one-fourth the mortality of vaginal extirpation, are equally as efficient in ameliorating the symptoms and retarding the progress of the disease; and they have been followed by as good or better ultimate results. Hence, they should be preferred. 6. Vaginal hysterectomy does not avert or lessen suffering; it destroys, and does not save, life. It is, therefore, not a useful, but an injurious operation; and being such, it is unjustifiable, and ought to be abandoned. (Jour. Amer. Med. Ass., Aug., 1885.) M. A REMARKABLE CASE. -Under the above title Dr. Aveling relates, in the London Lancet (Aug., 1885), the following history: The patient, a lady thirty-eight years of age, was struck in the left eye by the head of one of her children, in October, 1884. Six weeks later she experienced noises in the ears, tenderness of the nose, and pain at the back of the head when she stooped or had the bowels moved. Speech was also affected-she hesitated and stammered when she spoke. The symptoms continued, gradually getting worse until March, 1885. During this period she had been seen by seven distinguished medical men, besides her attending physician. March 22, she complained of having a constant feeling of weight in the pelvis-as if somthing was coming down-and that she could only pass a small quantity of water at a time, and with great effort. Examination revealed extreme anteversion of the uterus, with a full bladder, the fundus of the uterus resting on, and making, as it were, a bed for itself in the bladder. The uterus was replaced, and later a cradle pessary adjusted, when all the head symptoms disappeared. M. HYSTERECTOMY FOR UTERINE FIBROIDS.-Dec. 16, 1884, Dr. Lusk exhibited a large fibroid tumor together with a number of smaller ones, before the New York Obstetrical Society (Amer. Jour. Obstetrics, Aug., 1885). There had been much ascites, the patient was reduced in flesh and general health, and when first seen was passing from one to five ounces of urine, which contained albumin, daily. This latter increased under the use of acetate of potassium and digitalis; but on the withdrawal of the remedy, again diminished in amount. After waiting several months, the deplorable condition of the patient demanded more active treatment, and accordingly the abdomen was opened, allowing about a gallon of ascitic fluid to escape, and the uterus with the fibroids was removed. The patient made a good recovery. The point of interest in this case is the fact that as soon as the uterine tumor was removed the urine was secreted in normal quantity, and no longer contained albumin. This is noteworthy, because it is stated in obstetrical works that inefficient action of the kidneys in puerperal eclampsia is not due to pressure of the gravid uterus. A DRAINAGE TUBE LEFT IN THE PERITONEAL CAVITY. At a late meeting of the Berlin Obstetrical and Gynecological Society, Dr. Veit showed a drainage tube of the length and size of the little finger, which had been left in the peritoneal cavity by mistake during an DIFFERENT MODES OF TESTING HEARING-COMPARATIVE RESULTS.-Prof. Burckhardt-Merian (Archiv. f. Ohrenheilk; Amer. Jour. Med. Sciences) employs four modes of testing hearing. First, with Politzer's acumeter. Second, the use of whispered words. Six meters he regards as the maximum for the normal hearing of such spoken words. Third, high notes by König's rods. Fourth, the perception of Galton's pipes. The results of applying these tests he gives as follows: I. In a series of cases it is shown that in persons of all ages affected in hearing, bone conduction is so powerful that the finest closure of both auditory canals cannot effect a weakening of König's rods nor of Galton's pipes. 2. Generally, especially in children, a collection of cerumen does not reduce the hearing for the test rods or Galton's pipes, yet the reverse is not infrequently the case, so that when the collection of wax is combined with deafness for high notes, it is impossible to make a conclusion as to possible farther affection of the auditory apparatus. In cases of obstruction of the ear by collections of cerumen, the perception of whispers is chiefly interfered with while that for the acumeter is less so. 3. Exudation in the tympanic cavity interferes in the greatest degree with the perception of whispering, and often also that of the acumeter, but only in rare instances with the hearing of high notes, and then perhaps it is due to the pressure upon the round window. 4. Perforations in the membrana tympani, even when the malleus and anvil are destroyed, increase the perception of high notes, but disturb chiefly the hearing for whispers, less than for the acumeter. Conversely there occurs especially in the loss of the anvil a delicacy of hearing whispers, while loud words are heard with difficulty. 5. Excessive hydrostatic pressure in the labyrinth diminishes in the highest degree the perception of high notes, and also nullifies in general the hearing powers. If, however, in such cases the hearing remains normal or not markedly diminished it is to be referred to the regulation of the entotic pressure effected by the aqueducts. 6. If with relatively normal hearing for whispers and the acumeter high notes are not perceived, or only imperfectly so, it indicates an affection of the cochlea. Thus, after exposure to explosions, discharge of firearms, loud locomotive whistles, etc., in addition to the uncomfortable feeling in the ear, it is found that those thus exposed do not perceive accurately high notes, while they appear to hear normally both the acumeter or watch and whispered words. The author refers such lesions to the cochlea. 7. Adhesive processes which diminish the perception of whispered words, also impair the hearing for high notes. 8. When in those who are very hard of hearing there exists an abnormally acute hearing for high notes there is every probability that there is anchylosis of the stapes. 9. An equal reduction of hearing for the acumeter, whispers, metallic rods, and Galton's pipes, may be considered as an evidence of disease of the internal ear. 10. Relatively good perception for high notes with simultaneous deafness for low notes, sometimes accompanies the most intense forms of deafness. II. Galton's pipes are indispensable in the discovery of lacunæ in the scale of perception of notes. 12. Deaf mutes and very deaf subjects may still retain relatively good hearing for high notes. OPHTHALMOLOGY. PRIMARY GLAUCOMA IN RELATION TO AGE. Mr. Priestly Smith (Brit. Med. Jour., March 20,) gives the results of a study of one thousand cases of glaucoma. By a careful study of these he reached the following conclusions: 1. Primary glaucoma is extremely rare in childhood and youth. 2. Its frequency increases slowly at first, then more rapidly up to the sixth decade; between sixty and seventy it is about as frequent as between fifty and sixty; after seventy its frequency declines. 3. Cases beginning after fifty are about twice as numerous as cases beginning before fifty. |