CULBRETH'S MATERIA MEDICA AND PHARMACOLOGY.-Third Edition. A Manual of Materia Medica and Pharmacology. Comprising all Organic and Inorganic Drugs which are and have been official in the United States Pharmacopoeia, together with important Allied Species and Useful Synthetics. By DAVID M. R. CULBRETH. M. D., Professor of Botany, Materia Medica, and Pharmacognosy in the University of Maryland Medical and Dental Schools, Baltimore. Third edition, enlarged and thoroughly revised. In one octavo volume of 905 pages, with 473 illustrations, cloth. LEA BROTHERS & CO., Publishers. Philadelphia and New York, 1903.

It is almost needless to speak any word of commendation touching "Culbreth," for it has already made a firm place for itself as a text-book by virtue of strong merits that were well noted in previous editions, and that have been perfected in the present one.

Conforming to the advance sheets of the new Pharmacopoeia; having a strong leaning toward the botanical in descriptions and illustrations (and in the classifications of organic vegetable drugs); being accurate and painstaking in so far as chemistry enters into such a treatise; and in not being too dogmatic in statement anent that which therapeutically is sub judice, this at once commends itself to the student of medical science.

THE INTERNAL SECRETIONS AND THE PRINCIPLES OF MEDICINE. BY CHARLES E. DE M. SAJOUS, M. D., formerly Lecturer on Laryngology in the Jefferson Medical College and Professor of Laryngology and Dean of the Faculty in the Medico-Chirurgical College, etc. Vol. I. Illustrated. F. A. DAVIS COMPANY. Philadelphia.

This book is the result of observation and study dating. back some dozen or more years, with the object in view, the author states, of collecting the necessary data for the construction of a foundation for medicine more stable than the hypothetical conceptions which now constitute temporary but artificial factors in the structure of medical science.

That this is a large-sized contract need hardly be disputed. The author is not the first pioneer in this field. Revolutionary movements in medicine date back to the so

called schools of philosophy and medicine founded by Anaxagoros of Clasomena, Pythagoras of Samos, the materialistic school of Democritus of Abdera, and mythically, we might say, back to the time of Isis herself.

The connection of internal secretions with various physiological and pathological processes is also as old as medicine. Witness the views of Heraclitus of Ephesus in relation to the nature of the seminal fluid. His ideas in regard to friendship and enmity of matter might even be reconciled with Ehrlich's "side chain" theory of immunity.

Whether the author's conclusions are based upon sound premises remains to be proven. Undoubtedly they will arouse interest and be subjected to active criticism. However, their experimental foundation and logical delineation along the lines of modern medical research as exemplified by the investigations of Ehrlich, Metschnikoff, Vaughn, and others, entitle them to careful study and consideration.

The conclusions arrived at by Dr. Sajous constitute a veritable Aladdin's lamp when applied to many of the physiological problems that have for so long baffled solution. He determines that the adrenal secretion endows both the hæmoglobin and the blood plasma with their affinity for oxygen, and that it is the oxygen-laden adrenal secretion dissolved in the plasma which carries on the oxidation processes of the organism, the red corpuscles being really secondary factors in the matter. Hæmoglobinuria and similar states indicate stages of hæmoglobin dissociation indicative of adrenal insufficiency. Various tissues, such as the axis-cylinders of nerves, dentrites of neurons, neuroglia-fibrils, muscular contractile structures, etc., constitute plasma channels representing the intrinsic circulation of these structures.

The anterior pituitary body was determined to be the most important organ of the body in relation to oxidation. processes through its governing action on the adrenals.

The thyroid gland was found to possess the physiological function of sustaining the functional capacity of the anterior

pituitary body by means of the secretion. Prolonged overstimulation of the anterior pituitary body from excessive secretion of the thyroid gland, causes "exophthalmic goiter," and the contrary condition results in myxedema. This interrelation of the anterior pituitary body, thyroid, and adrenals is termed the adrenal system." The manifestations of poisons, symptoms of infections, and the physiological action of remedies are due to overactivity or insufficiency of the adrenal system as controlled by the governing action of the anterior pituitary body.

Thus tetanus, for example, is due to reduced efficiency of the adrenal system and diminished oxidation, the convulsions being, not the result of the toxin, but of the accumulation of waste products because of the action of the toxin on the adrenal system. The treatment should therefore be stimulating and not sedative.

The posterior pituitary body was found to be the adjuster and controller of the functional activity of all organs through the nervous system.

The views of Schiff regarding the production of a proteolytic ferment by the spleen and pancreas are confirmed, and in addition the main function of this ferment in the blood stream is to destroy toxic albuminoids. Thus the internal secretion of these organs plays a prominent part in processes of immunization.

The author realizes and acknowledges the weak points in his theories and hopes to further establish the soundness of his conclusions.

Altogether a variety of rather novel ideas is presented, albeit logically and convincingly. Some of the conclusions appear to be rather more definite than the circumstances would warrant, at least until the experimental findings are substantiated and the conclusions upheld by other observers. These proofs of the accuracy of the author's conclusions will be looked for with interest.

THE INTERNATIONAL MEDICAL ANNUAL.-A Year Book of Treatment and Practitioner's Index. 1903. E. B. TREAT & Co.

This well-known annual has attained its majority, having reached its twenty-first year with this issue. Its many friends will rejoice that to the dignity of the position it has always maintained in this field of medical literature is added a record of time service to which few, if any, similar publications have attained.

The truly international character of this publication is one of its strongest points of value. Sectionalism is studiously

avoided.

The present issue contains, in a condensed form, a general summary of the special developments of the year, a feature that will be found of interest and value to its many readers.

THE AMERICAN YEAR BOOK OF Medicine aND SURGERY.— A Yearly Digest of Scientific Progress and Authoritative Opinions in All Branches of Medicine and Surgery, Drawn from Journals, Monographs, and Text-Books of the Leading American and Foreign Authors and Investigators. Edited by GEORGE M. GOULD, M.D. In two volumes: Vol. I., General Medicine; Vol. II., General Surgery. W. B. SAUNDERS & CO.

This publication is too well known to need any detailed description at this time. It is not a mere abstract of current literature, but is a critical review of carefully selected matter, by department editors who are best fitted for intelligent selection of matter and discriminating comment.

The thorough manner in which these editors of departments have fulfilled their various tasks will be satisfactory to all.

The illustrations are more 'numerous than usual, well selected and interesting, and add much to the attractiveness as well as to the value of the work. There is no Year Book that quite equals the "American."

Clinical Review.

JUNE, 1903.

Original Articles.

TYPHOID FEVER IN INFANCY AND CHILDHOOD.* By A. C. COTTON, M. D., Professor of Diseases of Children, Rush Medical College, Chicago.

Before the days of the Widal test, when the diagnosis, of enteric fever depended largely upon the symptomatology and was occasionally confirmed post-mortem by the intestinal lesions, the infrequency of typhoid in young children and the immunity of infancy afforded material for never-ending debate. The reporter of cases was immediately challenged for post-mortem demonstration to prove his claims. Atypical febrile movements were not even tolerated in evidence and even the typical symptoms, such as temperature curve, enlarged spleen, rose spots, characteristic facies, etc., if these occurred in an infant, were promptly set at naught, if the postmortem failed to show the actual ulceration of Peyer's patches. In other words, the profession had accepted the dictum of infantile immunity from typhoid, and learned disquisitions were advanced to show the reasons therefor. One of the most potent factors in the promulgation of the dogma of immunity in infancy was the report from the New York Foundlings Asylum of so eminent a pathologist as Perry W. Northup, who in his 3,000 autopsies of children in that institution, covering a period of ten years, failed to confirm in a single instance antè-mortem diagnoses of typhoid fever.

*Read before the Livingston Co. Medical Society.