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the organism producing the disease has but one, and goes direct from one person to another. In practical life, in the matter of prevention of disease, this is an important distinction, because the method which is necessary for the prevention of a disease must depend entirely upon whether the organism producing the disease can have and maintain an existence, and go through a cycle of life outside of the human host.

Moreover, in the change of the meaning of the two words, all the literature is lost that has gone before, and there is some excellent literature upon the subject.

DR. A. FERREE WITMER read a paper

upon

APHASIA FROM AN UNUSUAL CAUSE.

(See page 597, Vol. VII, No. 53.)

DISCUSSION.

DR. F. SAVARY PEARCE said he did not catch from the speaker's paper whether the case was one of complete motor aphasia (aphemia) or not. At all events a motor aphasia was present in a case of right hemiplegia, which would signify a lesion involving the Rolandic region.

The old theory has been that the flexor contraction is always greater than that of the extensors in any palsied member because the muscles are stronger in the flexor than in the extensor group, and which in health are controlled by volition. Dr. Witmer's theory as to flexure contraction is interesting.

DR. J. MADISON TAYLOR did not clearly understand the unusual cause of the aphasia, and inquired how it arose.

DR. WITMER, in answer to the inquiry by Dr. Taylor, stated that in the course of the paper it had been said that the boy's heart was normal, that there was no syphilitic taint in the family history, but that there was a decided neurotic taint, and the paresis resulted from a probable disturbance of the end-brushes in the cerebrum, causing retraction at that point and consequent loss of function. It is known that hemiplegia may follow upon an epilectic convulsion, but usually it is very transient. In this case the hemi-paresis had been noted since the latter part of January. At first it was complete, and was without question

a hemiplegia. The unusual condition in this case was the long continuance of the one-sided weakness, suggesting a hemorrhage consequent upon the excessive cerebral activity.

Another interesting feature in the case, a not unusual one, is the overaction of the flexor group. The reason that the flexor group is unduly active in diseased states of this type is probably because the flexor group is first developed and therefore less readily disturbed. In diseases of the brain we find hallucinations of hearing exceedingly common. In the ontogenetic development of man it is of interest to recall that the centers for smell are first, and those for hearing last, developed. It would seem that the overaction of the flexors is of a similar nature to that noted in these disordered brain states.

DR. A. J. DOWNES read a paper upon

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New Publications

A PRIMER OF PSYCHOLOGY AND MENTAL DISEASE. For Use in Training Schools, for Attendants and Nurses, and in Medical Classes. By C. B. Burr, M.D. Second Edition. Thoroughly Revised. 12mo, pp. 116. Philadelphia, New York, Chicago: The F. A. Davis Co., 1898.

We can heartily commend this book. A difficult subject has been condensed and treated in such a way as to be readily understood by intelligent persons with less than the full requirements of a medical education. That there is a good field for it is evidenced by the fact that a second edition has been so soon called for.

ELECTRICITY IN THE DIAGNOSIS AND TREATMENT OF DISEASES OF THE NOSE, THROAT AND EAR. By W. Scheppegrell, A.M.,M.D. With 161 Illustrations. 8vo, pp. 403. New York, London: G. P. Putnam's Sons, 1898.

This seems to be a full presentation of its subject, sufficiently illustrated. As is right, greater stress is laid upon the author's per

sonal methods than upon the methods of others. As to the wisdom of employing the various procedures described, good judgment must be applied to each case on its own merits.

PRACTICAL URINALYSIS

AND URINARY DIAGNOSIS. A Manual for the Use of Physicians, Surgeons and Students. By Charles W. Purdy, M.D., LL.D. Fourth Revised Edition. With numerous Illustrations, including Photo-Engravings and Colored Plates. 8vo, pp. 365. Philadelphia, New York, Chicago: The F. A. Davis Co., 1898.

We commented upon, criticised and commended the earlier editions of this excellent manual. In the present edition the merits have been preserved and additions and revisions made in accordance with recent progress. It is a good book for students and practitioners.

THE PHONENDOSCOPE AND ITS PRACTICAL APPLICATION. Lectures by Aurelio Bianchi, M.D. With thirty-seven illustrations. Translated by A. George Baker, A.M., M.D., Physician-in-chief of the Chinese Medical Dispensary. 8vo, pps. 77. Philadelphia: George P. Pilling & Son, 1898.

This pamphlet is well printed and contains a number of good illustrations. Those who desire to practise phonendoscopy will find it a useful guide. While we cannot confirm all the claims of the author, we meet many cases in which the phonendoscope offers an additional and necessary means of examination.

MANUAL OF THE DISEASES OF CHILDREN. By John Madison Taylor, A.M., M.D., Professor of Diseases of Children, Philadelphia Polyclinic; and William H. Wells, M.D., Adjunct Professor of Obstetrics and Diseases of Infancy, Philadelphia Polyclinic. Illustrated. 8vo, pps. 743. Philadelphia: P. Blakiston's Son & Co., 1898.

This book, the work of two authors of large experience and good judgment, should prove extremely useful to all who have occasion to treat children. Beginning with the physiology of the infant and child, it

treats of diseases occurring at or near birth, the general hygiene of infants and children, the feeding and food of infants and children, and then discusses in succession, in its twenty chapters, the different diseases to which children are subject, concluding with general considerations of physical development and diseases and accidents requiring surgical procedures. Its arrangement is good, its style clear and interesting, and while necessarily concise, it seems to be sufficiently full for the purposes of a manual. It is not an encyclopedia and no attempt at encyclopedic treatment of its themes seems to have been made. As one would expect from Dr. Taylor's reputation and special studies, the subject of diseases of the nervous system in children receives full attention, though perhaps less ample than one would like, despite the fact that the chapter occupies some 86 pages, or rather more than one-tenth of the bulk of the volume. The author has evidently subjected himself to considerable restraint in preparing this chapter. It is one of the best in literature upon its topics. Throughout the book one is impressed with the importance laid upon judicious management other than drug giving; while in pathology, in diagnosis, and in treatment in general, it is fully abreast of the times. The chapters on feeding deserve especial commendation in this regard, as do also the general dietetic recommendations in connection with the special diseases studied. We confidently predict for this book the favor that its merit demands, and in the second edition the authors will doubtless correct those few lapses of style and statement, which, infrequent though they are in this book, seem to be inseparable from any first edition. The typography and illustrations maintain the well-deserved reputation of the publishers.

In the Clinics

THE post-partum douche has been abandoned in the out-patient obstetric service of the Polyclinic. The patient's body is rendered thoroughly aseptic before she is put to bed. After this a copious vaginal douche of lysol or creolin is given. Following labor

the patient is again thoroughly cleansed, but no intravaginal douche is given. We are glad to be able to report that no case of septicemia has occurred in patients delivered by the assistants in the department during the past year. All the cases of infection we have had during the past year have been delivered outside the service and have come to us after infection has occurred. Nearly all of these were mild cases and promptly recovered with proper treatment. For the most excellent nursing in our out-patient service we are indebted to the Visiting Nurse Society.

DR. HANSELL called the attention of the class to the cylindric effect of tilting strong minus and plus spheric lenses and its practical bearing upon the prescribing of spectacles and especially of eye glasses. The degree of the alteration in the refraction of the lens when tilted has been computed by Dr. John Green and described in the Trans. Amer. Ophthal. Soc., 1896. The rotation of a glass in its vertical meridian will give it an additional cylindric refraction, axis horizontal. Therefore, high myopes with low astigmatism with the rule and hyperopes with astigmatism against the rule, learn unconsciously to correct their astigmatism by a slight forward tilting of the upper rim of the glass, and having formed the habit refuse to wear a glass that combines in its formula the astig matic correction. This fact has an important bearing also on the form of the nosepiece of the eye-glass. The compound formula requires an absolutely vertical adjustment, while the simple spherical demands one that will allow of moderate tilting.

*.* *

To illustrate those cases in which in his opinion a preliminary iridectomy should be performed some weeks before the extraction of cataract, Dr. de Schweinitz

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physician's, does it constitute a legal claim,
311, 319

Accounts, physician's, 340

Acne, cantharides in cases of, 342

Addison's disease, 372

Adenitis, chronic or subacute, 390

typical indurated chancre and characteristic
inguinal, 296

Advertisement writing, 285

Air, liquid, 183

Antitoxin, the Polyclinic's editor on, 199
Antrum, spontaneous opening of the carious attic
and, 220

Aorta, atheroma of, 420

rupture of the (without aneurysm or atheroma),
with evidences of former mesenteric in-
farction, 395

Aphasia from an unusual cause, 597, 602
Aphonia, cases illustrative of treatment of different
forms of, due to laryngeal lesions, 435

Appendectomy, pain after, 250

Appendicitis, 372

care of patients after the operation for, 231,
237

secondary to disease of the uterine adnexa,

504

some instructive cases of, 149, 156

APPLEMAN, LEIGHTON F., 369

Army, the need of physicians in the, 545
ARNOLD, W. F., 11, 24

Artery, hyaloid, case of probable remnants of the
sheath of the, 50

superheated, some results of a year's experi- Asphyxiated new-born, the resuscitation of the

ence with, 385

Alcohol, 270

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558

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Ataxia, acute, of childhood, 490

Atrophy, muscular, 73, 318
Ayer and others, 274

Bacteriologic study, the dangers of, 519

BAER, B. F., 571. See Clinics.
Baldy, J. M. See Clinics.

BALL, M. V., SS, 304

Barton's endorsement, Miss Clara, 490
BARTON, JAMES M., 231, 239

Bath-house, the Philadelphia Public, 333, 373
BAUM, CHARLES, 63, 463. See Clinics.
BEYEA, H. D., 447, 451, 459

Bladder, incontinence after operation on, 441
Blennorrhea, nasal, or catarrh, 506

Blood-changes, the, induced by altitude, and their
practical value, 259, 331, 335

Blood-count, altitude and, 251

Books of original entries, Notes on, with special
reference to use of physicians, 315, 325
Books Reviewed:

Auvard, A., M.D. A System of Obstetrics, 216
Bashore, Harvey B., M.D. Outlines of Rural
Hygiene, 56

Bianchi, Aurelio, M.D. The Phonendoscope
and its Practical Application, 603
Bice, Hiram H., A.M., and George D. Croth-
ers, A.M., M.D. Elements of Latin, 56
Burr, C. B., M.D., A Primer of Psychology
and Mental Disease, 603

Books Reviewed:

Crothers, George D., A.M., M.D., and Hiram
H. Bice, A.M. Elements of Latin, 56
Eshner, Augustus A., M.D., and James C. Wil-
son, M.D. An American Text-Book of
Applied Therapeutics, 74

Gould, G. M., M.D. Gould's Pocket Medical
Dictionary, 530

Brown, J. M., 576

Buboes, treatment of, 526

Bunce, M. A. See Clinics.
BURNETT, CHARLES H., 265, 365
Burr, Charles W., 362

The Biologic Basis of Ethics and Religion, Calomel fumigations in spasmodic croup, 257

589

Gygax, P., M.D., and Landolt, E., M.D. Vade

Mecum of Ophthalmological Therapeu-
tics, 92

Hollopeter, W. C., A.M., M.D. Hay Fever
and its Successful Treatment, 394
Klemperer, G., M.D. The Elements of Clin-
ical Diagnosis, 162

Landis, Henry G., A.M., M.D. A Compend
of Obstetrics, 570

Landolt, E., M.D., and P. Gygax, M.D. Vade
Mecum of Ophthalmological Therapeu-
tics, 92

Maddox, Ernest E., M.D., F.R.C.S. Tests and
Studies of the Ocular Muscles, 508
Mills, Charles K., M.D. The Nervous Sys-
tem and its Diseases, 170

Mitchell, S. Weir, M.D. Hugh Wynne, 116
Monist, The, 186, 364

Nettleship, Edward, F. R.C.S. Diseases of the
Eye, 136

Open Court, The, 186, 236, 298, 364, 434, 472, 520
Purdy, Charles W., M.D., LL.D. Practical

Urinalysis and Urinary Diagnosis, 603
Review of Reviews, American Monthly, 56,

136, 186, 236, 310, 394, 434, 472, 508, 560
Riley, James Whitcomb, Rubiáyát of Doc
Sifers, 106

Roberts, A. Sydney, M.D. Contributions to
Orthopedic Surgery, 508

Scheppegrell, W.. A.M., M.D. Electricity in

the Diagnosis and Treatment of Diseases
of the Nose, Throat and Ear, 603
Taylor, J. Madison, A.M., M.D. Manual of
the Diseases of Children, 603
Thorington, James, M.D. Retinoscopy (or
Shadow Test) in the Determination of
Refraction at One Meter Distance with
the Plane Mirror," 171

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Toutatre, Just, M.D. Yellow Fever, 374
Transactions of the Berks County (Pa.) Medi-

cal Society, for the Year ending Decem-
ber 31, 1897, 171

Transactions of the Pathological Society of
Philadelphia, 589

Wilson, James C., M.D,, and Augustus A.
Eshner, M.D. An American Text-Book
of Applied Therapeutics, 74

Boteler, Dr., an apology from, 135

Bottini operation, the, for enlargement of the pros-
tate gland, with report of a case, 591

Brain tumors, 342

Breast tumors, removal of certain benign, by
Thomas's trap-door incision and hidden
cicatrix method, 1

Bronchitis, acute, 41, 500, 506

opiates, in the treatment of, 272

Cancer, breast, 342

of the stomach, 107

CANTRELL, J. A., 141. See Clinics.

Carcinoma, two cases of, successfully treated by the
electro-mercuric method, 302, 305

Cardiac pain, the diagnosis and relief of, 563, 567,
573

Cataract, a case of congenital nuclear, 122, 131
the open wound, after treatment of, 513
traumatic, 573

Catheter inflation of the tympanum, the technic
and value of, 551

Catheterization of the male ureter, 404
Cerebral abscess vs. cerebral syphilis, 29
CHAPIN, JOHN B., 345, 346, 357, 361
Charities, abuse of the so-called medical, 117
medical, to limit the abuse of, 145
Chest-pains, for vague, 214
Chlorosis, 73

Chorea, a case of, 436

CHRISTIAN, H. M., 67, 113, 198, 595
Cirrhosis, tuberculous, of the liver, 270
CLARK, E. M., 417

Cleeman, R. A., 486

Cliffe, George, 293, 295

CLIFFE, W. L., 277, 280, 293

Clinics, In the, 10, 20, 26, 29, 40, 41, 72, 73, 92, 106,
114, 132, 147, 158, 172, 186, 200, 214, 228,
240, 246, 248, 257, 274, 284, 296, 304, 318,
332, 342, 352, 360, 370, 380, 389, 390, 402,
414, 421, 431, 444, 454, 458, 480, 500, 506,
507, 515, 530, 540, 550, 560, 570, 578, 604
Club-foot, inveterate, 506
scleroderma, 507

COHEN, S. SOLIS, 7, 20, 35, 43, 53, 105, 133, 159, 200,
215, 228, 242, 251, 262, 263, 274, 285, 293,
309, 323, 344, 353, 373, 381, 393, 403, 413,
423, 434, 443, 445, 461, 466, 468, 481, 489,
493, 527, 547, 548, 579, 587. See Clinics.

Coles, S., 213, 391

College of Physicians of Philadelphia,49
Colon, idiopathic dilatation of the, 229
Comedones, 458

Commercialism in medicine, the growth of, 201
Contagion, its meanings and its limitations, 582
Coplin, W. M. L., 67

Conjunctiva and lids, catarrh of the, 444
Conjunctivitis, chronic, thuja in, 538
Conner, P. S., M.D., 471

Constipation in children, 284

Contagion: its meaning and limitations, 600

Contagious diseases act, the possibility of modify
ing the, so far as it concerns diphtheria,
without lessening its protective power,
125, 131

Corneal ulcers, 172

Cornea, retained foreign body in the, 271

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