have received their first instruction from its | physiological action of various alkaloids of opium pages. In order to keep pace with the progress other than morphine, and a succinct compilation of clinical experience and physiological research of the literature of the subject is given in this the author has, from time to time, been compelled volume, arranged under the respective heads. to add and revise, and the ninth edition has just Hyoscine is discussed separately from hyoscybeen issued. Matter which seemed of doubtful amus and hyoscyamine, and the author might have value and statements which had failed of satis- acceptably, we think, been more explicit upon factory verification, have been eliminated. The the vexed subject of the solanaceous alkaloids. results of investigations of new drugs, or new and Among somnifacient remedies the writer includes improved studies of old drugs, have been incor- short accounts of chloralose, trional, tetronal, porated in this edition. Professor Wood lays hypnone, and methylal, in addition to those great stress upon a knowledge of the action of which have been longer in use. Tropacocaine medicinal substances upon the lower animals, is another new substance briefly discussed by and accordingly he has, from the first, devoted the author. This volume, furthermore, treats of much space to a detailed account of medicines a number of unofficial substances, more or less upon the circulatory, respiratory, and glandular recently introduced, such as strontium, chlosystems of animals and men in a state of health. ralose, piperazin, and cresol. In accordance Such knowledge constitutes the scientific basis of with the plan of the work the author gives much therapeutics and is deserving of prominence. attention to the subject of toxicology. The every-day needs of the practitioner, however, compel him to give his most serious attention to the action of remedies in disease occurring in the human subject. Part I of the ninth edition is devoted to a con sideration of remedial measures or agencies other than drugs and treats of massage, diet, heat, cold, and electricity. The section descriptive of massage is rather brief considering the range of adaptability of this procedure. The pages in advocacy of the use of cold applications, especially in febrile states, are of decided interest. The section which treats of electricity is lucidly written and of practical worth. Part II, by far the larger portion of the volume, Ideals with the various remedial substances, or drugs, employed in practice. These, divided into systemic and local remedies, are arranged according to the classification adapted in former editions. The progress of discovery, both in botany and chemistry, has brought to our notice, during the past few years, many agents capable of being advantageously employed in the treatment of disease. Some of these have proved of such marked value that they have already been made official. In regard to the physiological action of chloroform,-a subject so much agitated of late,-Professor Wood adheres to the belief that the vapor causes a direct depression of the heart or its contained ganglia, and that the fall of blood-pressure depends, in great part, at least, upon this direct depressant effect. The depressant effect of pental is pointed out, and the ratio of deaths in proportion to its use is noted to be higher than that of any other anæsthetic. The author might well have given more space to a description of bromoform, not as a general anesthetic by inhalation, but as an internal remedy, as which it has proved itself a valuable addition to our resources, particularly in whoop. ing-cough. Much study has been given to the Professor Wood has given us a scientific textbook which particularly appeals to those who have sufficient leisure to study the details of physiological experimentation. Hare's Text Book of Practical Therapeutics. A Text-Book of Practical Therapeutics; with Especial Reference to the Application of Remedial Measures to Disease and their Employment upon a Rational Basis. BY HOBART AMORY HARE, M.D., Professor of Therapeutics and Materia Medica in the Jefferson Medical College of Philadelphia. With special chapters by DRS. G. E. DE SCHWEINITZ, EDWARD MARTIN, and BARTON C. HIRST. New (4th) edition, thoroughly revised and much enlarged. In one octavo volume of 740 pages. Cloth, $3.75; leather, $4.75. Philadelphia: Lea Brothers & Co., 1894. In the fourth edition of his work Dr. Hare has, in accordance with the directions of the United States Pharmacopoeia, given the doses of drugs and preparations both in apothecaries' and metric weights. In all essential respects the present edition is constructed upon the same general plan laid down in the original issue of the work. Additions have been made to the text to correspond with the results of recent physiological and clinical experiments. Some statements have required modification in the light of increasing knowledge, and a number of medicinal substances lately introduced to use have been described in the present issue. Dr. Hare gives us, in compact and brief sentences, the main facts relative to the physiological and therapeutical action of the various drugs. In many parts of the work he has been able to avail himself of the results of the laboratory researches to which he has devoted much of his time. The arrangement of his material is simple and well adapted to suit the convenience incident to age. Three chapters are devoted to the therapeutics of the senile heart, and the final chapter of the book to prognosis. The effects of exercise, rest, and diet are thoughtfully considered. Digitalis is regarded by the author as a valuable drug, but he enjoins the caution that some substance capable of unlocking the arterioles, such as iodide of potassium, nitrous ether, or other nitrite, be simultaneously given. Dr. Balfour looks upon strophanthus as of less universal application than digitalis. The uses of strychnine, arsenic, and iron are pointed out, as well as the importance of combining vascular with cardiac stimulants. The effects of varying conditions of blood pressure are clearly described. Among hypnotics, preference is given to chloralamid and chloralose. and the needs of those who consult the work. | chapters describes the various organic affections The praiseworthy aim of the author has been to cause the scientific physiological basis of therapeutics to throw light upon the employment of medicaments in the treatment of disease. Ef fective therapeutics can never depend solely upon laboratory investigations or upon clinical studies, but must be founded upon a correct appreciation of the respective spheres and limitations of each of these departments of knowledge. Dr. Hare has given us, in the present edition, concise descriptions of a number of new remedies, of botanical or chemical origin, which have now been in use for a sufficient time to enable a judgment to be formed as regards their value. Methyl-blue, methyl-violet, or pyoktanin, is, as is proper, described separately from methylene blue, though the similarity of title may beget confusion, especially when we remember that both substances have been used for the purpose of checking the growth of inoperable malignant neoplasms. Duboisine, pyrogallol, condurango, and convallaria are other remedies discussed in the present edition. So many drugs have been brought forward of late years that it is a matter of delicate judgment, in many instances, to decide which have shown themselves of permanent value. Those which possess decided properties are worthy of being admitted into new treatises on materia medica and therapy. The popularity of Dr. Hare's work is suf ficiently attested by the call for four editions in as many years. It has, therefore, evidently filled a need, and we doubt not that many more editions will be required. The Senile Heart: its Symptoms, Sequela, and Treatment. By GEORGE WILLIAM BALFOUR, M.D. (St. And.), LL D (Edin.), F.R C.P.E., F.R.S.E. New York and London: MacMillan & Co., 1894. J. B. Lippincott Co., 717 Market Street, Philadelphia, Pa. Price, $1.50. The subject of this work is well chosen. We are all aware of the cardiac weakness which accompanies the later years of life, but the immediate causes of this debility are often too imperfectly understood. Valvular disease, angina pectoris, and fatty heart are marked by such prominent features as to have demanded close study. A host of minor ills, however, depend upon an enfeebled state of the central organ, due either to failing innervation or actual loss of power in the heart-muscle. Dr. Balfour shows in this work that the loss of elasticity of the arterial system induces a certain degree of normal hypertrophy. In his second chapter the author gives a brief but clear résumé of the manner in which the senile heart is weakened. After a description of the symptoms and signs of the senile heart, the writer in succeeding The book is well written and the publishers have issued it in good style. Syllabus of Lectures on Human Embryology. An Introduction to the Study of Obstetrics and Gynecology. For Medical Students and Practitioners. With a Glossary of Embryological Terms. By Walter Porter MANTON, M.D., Professor of Clinical Gynecology and Lecturer on Obstetrics in the Detroit College of Medicine, etc. Illustrated with numerous Outline Drawings. Philadelphia: The F. A. Davis Company, 1894. eral biology, as well as particularly with obstet Embryology is so closely connected with genrics, that it is, in many directions, of fundamental importance. It is a study to which much attention has been given of late years and which has called forth a number of original investigations from various authorities. The essential facts relative to the evolution of the human embryo are briefly but clearly given in this methods of practical work, and the volume will book; an important chapter is given to the be found useful to students. The general arrangement is modeled upon that of the author's lecture course, and the book contains a number Nurses. of blank pages upon which notes may be made. From standard text-books the author has made a judicious compilation of the capital facts concerning the structure and function of the human body, a knowledge of which will be of great service to the professional nurse. The subjectmatter is so arranged that it can be mastered by the pupil during her attendance upon a firstyear course. The book is well illustrated, and the author deserves much credit for preparing a book well suited to its intended purpose. The text is followed by a glossary and index. A Synopsis of the Practice of Medicine. By WILLIAM BLAIR STEWART, A.M., M.D., Lecturer on Therapeutics and Late Instructor in the Practice of Medicine in the Medico-Chirurgical College of Philadelphia, etc. New York: E. B. Treat, 1894. The author has had experience in the art of teaching, and is well adapted by attainments and training to prepare a useful manual. He has aimed, in this treatise, to bring together the leading facts regarding the symptoms and treatment of those diseases belonging to the domain of medicine, as distinct from surgery,-obstetrics, and specialism. Dr. Stewart has certainly succeeded in compressing into a volume of mod. erate size a mass of reliable information representing his own experience and the writings of the best authors upon the subject. He has taken up, in the first place, the fevers; after which he considers the general infectious and contagious diseases, general non-infectious diseases; while the remainder of the work is devoted to diseases of the various organs and systems of the body. The author's style is clear and concise, and the work should be useful to the student and young practitioner. He has saved space by omitting methods and drugs which, though worthy of mention in elaborate treatises, have been largely superseded by other modes of treatment. He has avoided mention of treatment by means of organic extracts, serum, nuclein, etc., because the subject is yet under investigation. The matter included in the work may be looked upon, therefore, as the best therapeutical methods at present employed. A Manual of Modern Surgery, General and Operative. By JOHN CHALMERS Da Costa, M.D., Demonstrator of Surgery, Jefferson Medical College, Philadelphia, etc. Philadelphia: W. B. Saunders, 1894. Saunders's New Aid Series. Price, $2.50, net. In this work Dr. Chalmers Da Costa has given us an excellent representation of sur gery as practiced at the present day. It will, therefore, often be preferred, for purposes of reference, to the more bulky treatises before the profession. It is calculated to be of special service to the undergraduate and to the physician who, graduating before aseptic surgery was systematized, is anxious to be informed as to modern methods. A number of sections upon bacteriology, inflammation and its results, precede the more special chapters of the work. Very ju diciously the author has not attempted to treat of surgical specialties, with the exception of such affections that, like Pott's disease, hip-joint disease, etc., may be claimed by the orthopædist, but necessarily often or generally come under the care of the general surgeon. Fractures and dislocations receive, comparatively, much attention on account of their great practical importance. The illustrations are good. Landmarks in Gynecology. By BYRON ROBINSON, Professor of Gynecology in the Chicago Post Graduate School, etc. Volumes i and ii. Detroit: George S. Davis, 1894. These volumes belong to the Physicians' Leisure Library Series. The author is well known as an enthusiastic laborer in this field of work. The book is an abstract of some of the author's lectures which are founded upon work in the operating-room and dead-house. The "landmarks" considered are anatomy, menstruation, Robinson is always an interesting writer, and the labor, abortion, gonorrhea, and tumors. Dr. bearings of his landmarks are given in a very suggestive manner. A Manual of Hygiene. By MARY TAYLOR BISSELL, M.D.. Professor of Hygiene in the Woman's Medical College of the New York Infirmary for Women and Children. New York: The Baker and Taylor Company, 1894. Professor Bissell has written a work which will prove of service to undergraduate medical students, and also to liberally-educated persons of other callings, who desire, in the interests of public health, to inform themselves concerning the fundamental principles of preventive medicine. The facts as regards ventilation, food and drink, heating, disposal of garbage, exercise, personal hygiene, etc., are given in a style ready of comprehension. A Manual of Human Physiology. Prepared with Special Reference to Students of Medicine. By JOSEPH H. RAYMOND, A.M., M.D., Professor of Physiology and Hygiene in the Long Island College Hospital, and Director of Physiology in the Hoagland Laboratory. With 102 illustrations in text and 4 full-page colored plates. Philadelphia: W. B. Saunders, 1894. Price, $1.25, net. Physiology is a vast subject, and a thorough understanding of it, as far as it can be said to be understood when there are still a number of dark chapters, involves a knowledge of physics and organic chemistry. Professor Raymond's aim, in this manual, is to present the cardinal principles of the subject, the elementary truths with which we cannot dispense, in the view of laying a groundwork for future study. In this object he has been very successful. COMMERCIAL NEWS. COCA ERYTHROXYLON. me that the faulty metabolism is more quickly remedied with this drug alone than with any other or combinations. Mrs. G., aged 55, was for years subject to uric acid storms, and without getting relief. I exhibited the aromatic fluid extract Cascara, made by Parke, Davis & Co., in 10- to 15manded, finally settling down to one single drop doses, two or three times daily as dedose at the close of the day. The effect was there was marked amelioration of the aggrapluck-not at once apparent, but within two weeks vated symptoms, and in four weeks the swollen joints had almost resumed a normal appearance, the soreness having nearly disappeared. At the soreness having nearly disappeared. At there is no complaint whatever, but the remedy this writing (two months having elapsed), this writing (two months having elapsed), is continued. No change was made in the diet, as I desired to more fully test the remedy, and am fully satisfied that the good results were due solely to the Cascara. I have tried other brands of Cascara, but they have not been satisfactory; hence I have come to regard the fluid extract above alluded to as the only one upon which I can confidently rely. It never fails; hence my preference. DR. W. H. WALLING, in the Medical and Surgical Reporter, July 14, 1894. We need not enter into a full description of the history of the Erythroxylon coca, as we believe that most medical men are fully acquainted with the principal facts concerning the plant. We may, however, recall to mind that the leaf is the only part of the plant used. Very much depends, therefore, upon the plucking of the leaf and the time at which it is plucked; the subsequent care of the leaf being matter of considerable importance, and affectmatter of considerable importance, and affect ing very materially the preparations made from it. M. Mariani was the first in Europe who took up the study of the plant, and over thirty years ago commenced manufacturing for the medical profession the various specialties associated with his name, viz., "Vin Mariani," "Elixir Mariani,” "Pâte Mariani,” “Thé Mariani," "Pastilles Mariani," etc., prepara tions which are known all over the world, and which have acquired their well-known reputation by their purity and efficacy. The stimulating and strengthening property of the leaf in its natural state has been tested by experienced travelers and botanists during several centuries, and it is this invigorating property which the physician wishes to bring into use, and which he is enabled to do in a palatable form by means of "Vin Mariani," this wine being indicated where there is great depression, longcontinued exhaustion, and where a special stimulative action is desired. "Vin Mariani is agreeable, palatable, imparting by its diffusibility an agreeable warmth over the whole body, and exciting functional activity of the cerebro-spinal nerve-centres. We have frequently prescribed this wine, and we can, from practical experience, recommend it.-The Provincial Medical Journal, London, Eng. CASCARA SAGRADA FOR THE ELIMINATION OF It seems to be the accepted opinion that the pathology of uric acid is more a matter of defective elimination than of excessive formation. Osler says: "Certain symptoms arise in connection with defective food or tissue metabolism, more particularly of the nitrogenous elements, and this faulty metabolism, if long continued, may lead to gout, with uratic deposits in the joints, acute inflammations, and arterial and renal disease." Not getting the desired results, I was led to drop all the so-called antilithics, and rely simply and solely upon a single remedy-Cascara Sagrada. Repeated trials have convinced THE ETIOLOGY AND TREAT. MENT OF APPENDICITIS.* By W. EASTERLY ASHTON, M.D., No. 12 or its lumen occluded by a stricture that free communication with the colon is cut off. The contractile power of the walls of the appendix is amply sufficient, under ordinary circumstances, to keep the fæcal matter in motion. I have often seen the appendix, after it has been Professor of Gynecology in the Medico-Chirurgical College of cut away from the colon, instantly contract I Philadelphia. SHALL limit my remarks, in the address which I have the honor of presenting before the distinguished members of this so ciety, to a brief consideration of the etiology and treatment of appendicitis. The causes of this disease are better appreciated if we classify them; first, into those which are permanent or constantly present; and second, into those which are temporary or exciting. The conditions which are permanent factors in the predisposition to appendicitis are the constant presence of bacteria, the anatomical position of the appendix, and the retrograde changes taking place. That the bacillus coli communis and other germs normally inhabit the vermiform appendix has been fully shown by my own observations and those of others upon the healthy organ. This fact is easily understood when we remember that the colon bacillus is invariably found in the intestinal canal after birth, and, as the vermiform appendix is simply a continuation of the intestine, it is but natural that the germs living in the former should also find lodgment in the latter organ. and expel its contents. Indeed, so strong are these contractions, in some instances, that, placing the appendix upon a cold surface, it will squirm about in all directions. Hodenpyl has shown that "the bacillus coli communis is harmless in its natural habitation, but that it becomes distinctly pathogenic when it escapes into the tissues or into situations where it does not naturally belong." The rôle played by the colon bacillus in the etiology of appendicitis, as demonstrated by recent bacteriological observations, places the entire subject in a new light and enables us to appreciate more fully the nature and dangers of the disease. Sordoillet states that "the bacillus coli communis often gives rise to peritonitis without perforation of the intestinal wall. The passage of the bacillus through the intestinal walls is favored by the simple desquamation of the epithelium from the mucosa of the gut, accompanied by high intra-intestinal tension, by more profound alterations of the walls, and also by a simple falling off in nutrition." Again, Hodenpyl says: "Certain malpositions and structural changes in the gut facilitate the escape of bacteria through the Again, the interior of the appendix is nor-intestinal wall without either ulceration or permally occupied with fæces in a more or less fluid state, and it is only when the organ is diseased * Read before the District Medical Society, County of Hunterdon, N. J., October 16, 1894. foration, as has been shown by finding the colon bacillus in the sac in cases of strangulated hernia." Recently, Arnd has demonstrated the es |