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Literary Lore

MESSRS. P. BLAKISTON'S SON & COMPANY, Philadelphia, announce the forthcoming publication of A Manual and Atlas of Orthopedic Surgery, by Dr. James K. Young, professor of orthopedic surgery, Philadelphia Polyclinic.

THERE is an autumn snap and spice to be found in the humorous department of Lippincott's Magazine called "Walnuts and Wine." People have been heard to say that they begin at the back and read forward, because they want to see the newest jokes.

THE F. A. DAVIS COMPANY, Philadelphia, announce the early publication of a Treatise on the Motor Apparatus of the Eyes, embracing an exposition of the anomalies of the ocular adjustments and their treatment, with the anatomy and physiology of the eye muscles and their accessories, by Dr. George T. Stevens, of New York.

LEA BROTHERS & Co. announce the publication of a new edition of "Gray's Anatomy," under the editorship of Dr. J. Chalmers DaCosta, of Philadelphia, together with a special corps of assistants, who have been laboring for the past two years. Several important changes have been made in the revision. Old nomenclature is used, with new names given in brackets following the old terms; the sections on embryology and histology have been distributed throughout the new edition as references bearing directly on the part under consideration. More than 400 new and elaborate engravings in black and colors have been added.

JOHN LANE COMPANY, London and New York, are issuing a series of medical and surgical handbooks, under the title, The Practitioner's Handbooks. They are written by specialists for the use of general practitioners and are under the general editorship of Harry Roberts. The first volume of the series is devoted to "The Rheumatic Diseases" and has been entrusted to J. O. Symes assistant physician and bacteriologist to the Bristol General Hospital. The second is concerned with "Hysteria and Neurasthenia," and is the work of J. Michell Clarke, physician to Bristol General Hospital and professor of pathology, University College, Bristol.

THE October Cosmpolitan has arrived, and even a glance at its contents shows it to be more welcome than ever. The new management has certainly done wonders in rejuvenating the old magazine. Every article has a timely interest or makes a strong personal appeal to the reader. First of all comes Booth Tarkington, W. W. Jacobs, Alfred Henry Lewis, Edwin Lefevre, James L. Ford, Ambrose Bierce and Herbert Quick are contributors to the October Cosmopolitan-an unusually large number of prominent names for a popular magazine. Needless to say, the entire issue is well worth reading, and the illustrations are attractive, being contributed by Will Owen, famous in England for his character work, W. L. Jacobs, Frank Tenney Johnson, Orson Lowell, Frank Ver Beck, Phillips Ward, Henry Raleigh, F. T. Richards and Seymour M. Stone. On the whole, it is a very beautiful magazine.

THE first pages of the October St. Nicholas are given up to the memory of Mrs. Mary Mapes Dodge, the magazine's editor for so many years, whose death occurred just as the October number was going to press. Mr. Richard Watson Gilder writes sympathetically:

Many the laurels her bright spirit won:

Now that through tears we read "The End,"
The brightest leaf of all-now all is done-
Is this: "She was the children's friend."

ECONOMY IN FOOD.-More and more attention is being given to diet based upon scientific knowledge rather than upon habit or perverted cravings; and the question of economy in food-meaning temperance in diet, with a due appreciation of the dignity of the body and the necessity of meeting the daily wants without imperiling a high degree of efficiencyis one of general interest and vital importance. The October Century prints a discussion of the subject by Russell H. Chittenden, director of the Sheffield Scientific School of Yale University and author of "Physiological Economy in Nutrition." Professor Chittenden's conclusions, arrived at after much study and many careful experiments, are that a daily diet, characterized by simplicity and temperance, so constructed as to harmonize more fully with the true needs of the body with habitual avoidance of undue excess of food, will lead to physical and mental betterment and to length of life.

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Surgery

L. A. Todd, M. D., St. Joseph, Mo.

Final Results in the X-Ray Treatment of Cancer, including Sarcoma.(William B. Coley, Annals of Surgery, August, 1905.) The author's statistics are interesting and important, covering as they do a period of over three years. From 1902, there have been treated with the X-ray 176 patients, as follows: 68 cases of sarcoma; 36 of carcinoma of the breast; 44 of epithelioma of the head, face and neck, including tongue; 14 of deep seated abdominal growths, probably carcinoma; 5 not classified; 3 of tuberculous glands of the neck; 3 of Hodgkins' disease; 3 of lupus. In all there were 167 malignant cases. In the 68 cases of sarcoma, complete disappearance of the growth was noted in five, only to be followed shortly by a recurrence in each. Two of these patients were again given the X-ray treatment, and are apparently free from the disease today. The other three died. From a careful study of these cases, and those reported by other observers, Dr. Coley believes that, although improvement may be very striking, especially when the disease originates in the lymphatic glands, the influence of X-ray upon sarcoma is rarely, if ever curative. In the 36 cases of breast carcinoma in which the X-ray was employed both as a curative and a prophylactic measure, the results were very discouraging, the writer claiming that in all of his experience with the X-ray he had seen only one deep seated carcinoma in which the tumor disappeared under X-ray treatment. Out of 44 cases of epithelioma of the head, face and neck, including tongue, in only four did the disease entirely disappear. The X-ray had absolutely no effect in cases, which presented involvement of the glands of the neck. There was no improvement noted in four cases of malignant disease of the larynx and esophagus. had the X-ray any effect upon four cases of carcinoma of the abdomen. In Hodgkins' disease improvement was noted in one case, but a recurrence of symptoms followed by death occurred in six months. Of the three cases of lupus the disase disappeared entirely in two and there was marked improvement in the third. The studies of Vose and Howe of the Caroline Brewer Croft Cancer Commission, are quoted. Their investigations cover 120 cases. They fail to report a single case of deep-seated carcinoma or sarcoma that has disappeared under X-ray treatment. They conclude that the X-ray cannot be used strongly enough to effect destruction of anything, but the shallowest tumor without serious injury to the overlying tissue, or in other words, producing such a burn as experience shows in all probability would never heal. The practice of using the X-ray as a preoperative measure, as advocated by Morton of New York is condemned by Dr. Coley as pernicious and fraught with grave peril to the profession. Such a plan presupposes (1) that the X-ray is a curative agent and (2) it takes for granted that no harm can come to the patient by reason of the delay entailed in a trial with the treatment. Both of these suppositions are obviously incorrect as is well shown in the essay. Many cases are given in detail after which Dr. Coley sums up his experience with the X-ray treatment of malignant disease as follows: 1. That the X-ray exerts a powerful influence upon cancer cells of all varieties but

Neither

most marked in cases of cutaneous cancer. 2. In some cases chiefly in superficial epithelioma the entire tumor may disappear probably by reason of fatty degeneration of the tumor cells with subsequent absorption. 3. In a much smaller number of cases of deep-seated tumors chiefly cancer of the breast and glandular sarcoma tumors have disappeared under prolonged X-ray treatment. In nearly every one of these cases, however, that has been carefully traced to final result there has been a local or general return of the disease with in a few months to two years. 4. In view of this practically constant tendency to early recurrence furthermore, in the absence of any reported cases well beyond three years, the method should never be used except in inoperable cases, or as prophylactic after operation, as a possible, though not yet proven, means of avoiding recurrence. 5. The use of the X-ray as a pre-operative measure in other than cutaneous cancer is contraindicated, first, because the agent has not yet been proven to be curative; second because of serious risks of an extension of the disease to inaccessible glands or to other regions by metastases during the period required for a trial of the X-ray.

TYPHOID FEVER IN CHILDREN. Dr. W. C. Hollopetre, Philadelphia (Journal A. M. A. September 23) mentions the difficulties of diagnosis in typhoid in children and some of the characteristics of the condition, such as the frequent enlargement of the spleen, which is an important point. The Widal test and the diazo reaction are of value only at the beginning of the second week, when other characteristic symptoms aiding in the diagnosis are also present. In most cases he thinks the disease is only recognized about the tenth day, and then only by a process of elimination. For clinical purposes, typhoid fever may be regarded as a general sepsis and the two elements necessary successfully to combat it seemed to him to be reduction of the toxemia and a sufficient supply of food and fluid. The first step in treatment is quiet for the patient and the administration of calomel. He emphasizes the value of enteroclysis, which he orders daily unless contraindicated. It reduces the toxemia and the temperature and supplies the much-needed fluid to the body. He insists on the importance of the physician giving special attention to this and instructing the nurse as to its proper administration. The solution for washing the bowel he varied to suit the needs of the patient, adding such medication as seems proper. Other methods more or less to be depended on are ice bags to the head, and to the heart if fever is high, careful attention to the condition of the nose and mouth, change of position to prevent pneumonia, etc. He has practically abandoned sponging every two hours, when the temperature goes above 102.2 in favor of the ice bags and hot water. Diet is reduced to petonized milk and albumin water, and Hollopeter believes in a free administration of liquids. He keeps the patient in bed and on a liquid diet for ten days after the temperature falls to norinal. The chief point of his paper, however, is the value of enteroclysis in typhoid, and its careful technic by the attending physician.

Concerning the Doctor

His ups and downs; incomings and outgoings; haps and mishaps.

DR. L. J. DANDURANT of St. Joseph has been honored with the degree of Master of Arts by Conception Missouri College.

DR. JACOB GEIGER recently presented the medical department of the St. Louis University with a complete set of Virchow's Archives, 170 vol

umes.

DR. CLARENCE A. GOOD, of St. Joseph, was married on September 14th, to Miss Sophie Evans, the ceremony taking place at the home of the bride in Erie, Pa. Dr. and Mrs. Good will be at home to friends at 2224 Faraon street.

MISSOURI STATE SANATORIUM.-The Board of Commissioners appointed by the Governor to select a site for the sanatorium for the treatment of incipient pulmonary tuberculosis, has decided on Mt. Vernon. This town offered 165 acres of ground, seven thousand dollars in cash, water and electric light free of charge for five years, and free telephone services.

DR. PETER J. KIRSCHNER died at his home in St. Joseph, on September 22. Dr. Kirschner had been failing for several years and his condition became critical a few months ago. Dr. Kirschner was one of St. Joseph's leading practitioners, having served as county physician in 1880-81, as coronor from 1882 to 1886, and was again county physician in 1889, serving until 1891. He was elected Mayor of St. Joseph in 1898, filling the highest position in the gift of our citizens with honor. Dr. Kirschner was born near St. Joseph, June 13, 1853, attending the public schools of this city until he reached the age of seventeen, then going to Cincinnati for two years, where he pursued his studis. Returning to this city he read medicine in the office of Dr. Jacob Geiger, attending the Louisville University in 1877 and was graduated from Bellevue in 1879. Dr. Kirschner leaves a wife and three children to mourn his loss. The funeral services which were held on September 25, were in charge of the Masons, of which order Dr. Kirschner was a prominent member.

UNDERTAKINGS

The undertaker man he makes
His living out of death;
Takes in the more he undertakes,
His gain our loss of breath.

When breathless we, then breathless he

To batten off of us-

Our bitter bier his goodly cheer

The wretch necrophagous!

HARRY COWELL, in October Lippincott's.

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