were incurable, 10 died, and 213 were continued to 1878. This is a large field for observation, and Dr. Shaffer has evidently worked in it carefully and to good purpose. But his otherwise very creditable book on Pott's disease is marred to a certain extent by the evident bias in favour of his own little tips as opposed to the method of Sayre, to whom he denies even the credit of originality.

Essays on the Treatment of Deformities of the Body. No. 1. The Treatment of Pott's Disease. By FREDERICK R. FISHER, F.R.C.S. London: J. & A. Churchill.

1879.

THIS is the first of a series of four Essays on Deformities, which Mr. Fisher has decided to publish. It is simple and clear in style, well printed, and so arranged as to avoid useless repetition.

The first part of the Essay is devoted to the pathology of the disease, which is, according to our author, a result of insidious inflammation in badly nourished subjects. He combats the theory that injury is the main cause, and refers to the statistics of the National Orthopedic Hospital to prove that more females than males suffer from Pott's disease. The chief object of the essay is to discuss the proper treatment; and here we have a very clear and good account of the details of the methods used. Considerable importance is attached to the Recumbent Method, i. e., the fixing of the patient in a supine posture, so as to prevent "all movement of the trunk" without causing an irksome feeling of restraint. This is effected by a Bed frame (see Lancet, February 23, 1878), to which the patient is to be strapped: and Mr. Fisher states that he has kept patients (children and others) so strapped down for weeks and even months without bad effects. He considers that, in the less severe cases at all events, the application of Sayre's or any other form of mechanical support should be preceded by a few weeks of the recumbent method.

As to the spinal supports, the preference is given to poroplastic jackets, made on a block of the shape of the body, and moulded to the body of the patient while soft. Steel instruments are seldom used, though their use is not by any means condemned.

The author prefers the recumbent treatment followed by the application of the poroplastic body jacket in cases of disease below the third dorsal vertebra. But when the disease is above

this point he uses the recumbent method until the acute stage of the disease is over, and then he trusts to a properly made and fitted steel frame for the body, with a firm head rest (Ernst's pattern). We are glad to be able to commend this book heartily. The discussion is candid and unaffected: the conclusions are sensible and free from extreme partiality to any one mode of treatment.

Address before the Rocky Mountain Medical Association, 6th June, 1877, containing some Observations on the Geological Age of the World, the Appearance of Animal Life upon the Globe, the Antiquity of Man, and the Archæological Remains of Extinct Races found on the American Continent, with views of the Origin and Practice of Medicine among the Uncivilized Races, more especially the North American Indians. By J. M. TONER, M.D. Washington, D.C. Published for the Association, 1877.

THE above pantoscopic view of literature, science, and art is comprehended in a pamphlet of 112 pages, written in a kindly, discursive, and, of course, very superficial manner. There is a useful list of works at the end of the book, which may serve as a "beginning to a bibliography of medicine among the American Indians."

L' Année Médicale (1878) Resumé des Progrès réalisés dans les Sciences Médicales, publié sous la direction du DR. BOURNEVILLE, Rédacteur en chef du Progrès Médical, avec la Collaboration de MM. A. Blondeau, &c., &c. Paris: E. Plon et Cie., Imprimeurs-Editeurs, Rue Garancière, 10. 1879.

To give an idea of the kind of information this work is meant to convey, it is well, perhaps, we should quote somewhat from L' Avertissement of the editor. After speaking of various annuals of literature, he says "In regard to the medical sciences such a work has been attempted with but little success. The only publication which has survived (but with the inconvenience of leaving to the reader the trouble of making a synthesis of all the material collected for him) is the Dictionnaire Annuel, giving, in alphabetical order, a more or less complete epitome of the publications for the year.

"The Année Médicale, such as our friends and we have constructed, has for its object, the summarising every year of any actual progress in the medical sciences. For instance, in surgery we have only concerned ourselves with the great questions which have attracted attention in 1878.

"Avoiding all the memoirs which add nothing new to the past, or at least only citing them as references, we have kept ourselves as much as possible to the really original researches, being desirous to furnish to the medical public, in a few pages, a precise tableau of the advances in Medicine, Surgery, Obstetrics, &c., appertaining chiefly to 1878.

"Certainly this experiment is far from perfect. We have come across numerous difficulties of various kinds. The first effect of these was to prevent the appearance of this volume at the date formerly fixed for its publication. The absence of any model, and the liberty left to every one of our contributors, had the further effect of giving to certain specialities a space sometimes disproportionate to their importance. This fault will easily be remedied in our next volume.

"Let us add that we shall cordially welcome any suggestions that may be made to us."

The book is one of 400 pages, small octavo, in clear large type, and its contents are arranged under the following heads: -Anatomy; Physiology; Diseases of (1) Lung, (2) Liver, (3) Kidney, (4) Urinary Organs, (5) Nervous System, &c.; Metalloscopy and Metallotherapy; Surgery; Ophthalmology; Diseases of the Eye; Obstetrics; Mineral Waters; Therapeutics. The important additions that have been made to our knowledge during the past year, on any special subject, are to be found under the heading in which it is classed. Under these headings the general results in each department are summarised; and the names of the contributors are mentioned, fuller references to the original papers being always given in foot

notes.

It is to be noted that the authors have made their collection from foreign as well as from French medical literature, which cannot be said to be a feature in the compilation of Braithwaite's Retrospect of Medicine.

At the end of each department is found a catalogue of works bearing on it, either published or in course of publication during 1878. The volume is furnished with a copious general index, as well as an alphabetical list of the authors quoted from, with reference to the pages where their opinions are cited. We wish every success to the forthcoming numbers of such a useful work.

REPORTS OF HOSPITAL AND PRIVATE

PRACTICE.

WESTERN INFIRMARY.

REPORTS UNDER THE SUPERVISION OF DR. W. G. DUN.

FROM PROFESSOR GEORGE BUCHANAN'S WARDS.

TWO CASES OF COMPOUND FRACTURE OF THE SKULL

RECOVERY.-Injuries of the head are, in their results, among the most mysterious of all the accidents to which the human body is liable. In some cases what seems an unimportant lesion is followed by a fatal result; while in others, an amount of destruction by violence from which recovery seems impossible, is attended with no untoward consequences. The following cases, though not uncommon in the experience of hospital surgeons, are noted as examples of the latter variety:

CASE I. S. C., aged 50, was admitted 20th June, with a scalp wound about 2 inches in length, situated a little behind the vertex, on the left side. He was quite sensible, although rather stupid, and replied to questions somewhat slowly.

On opening up the wound and introducing the finger, the bone was found to be fractured, a straight fissure being felt running parallel to the wound, and extending as far back, in both directions, as the finger could reach. The hair around the wound was shaved, and a wet pad applied. Some hours after admission he was found to be more stupid, but still able to answer questions. The pupils were equal, and quite sensitive to light. Pulse slow and regular, 60 per minute. Temperature 98.4° F. On the following day Dr. Buchanan enlarged the wound, and examined the fracture. The bone on the upper side of the fracture was seen to be depressed, but only an eighth of an inch. The wound was ordered to be dressed with iced cloths, the bowels to be regulated with salines, patient to be put upon low diet, and to be kept quiet. Recovery gradually took place, by degrees he became more intelligent, the wound healed up kindly, and he was dismissed on the 11th August, apparently quite well. The only complication was a slight erythematous attack, lasting for a few days, and entirely confined to the forehead.

CASE II. J. D., aged about 40, was admitted 26th June, 1879. While at work attending to a circular saw, a piece of wood was thrown violently from the machine, and struck him

on the forehead, felling him senseless to the ground. When admitted to the hospital he was in a half conscious, half delirious condition, and shivering with cold, in fact, in a state of shock. Pulse about 50. On examining the forehead there was found a valvular wound above the right eye, near the middle line. On feeling with the finger in the wound, the outer table of the bone was found to be completely smashed, so that the finger could be passed into the frontal sinus, here it was brought up against bone, but whether fractured or not could not be made out. There was no bleeding from the ear, but there had been more or less bleeding from the nose. Wet dressing was applied to the wound. The patient was extremely irritable and restless, so that he would scarcely allow himself to be touched. At the visit next morning, Dr. Buchanan removed the fragments of the outer table, and it was found that the inner table was broken, and a large fragment depressed; this was removed with the necrosis forceps; it measured more than an inch square, and showed on its inner surface rather more than an inch of the groove of the first part of the longitudinal sinus. Little shreds of grey substance, of brain matter, were seen in the wound, and the fluid lying in the wound communicated the pulsations from the brain.

Dr. Buchanan remarked at the time upon the hopeless character of the case, and expressed the opinion that the patient was not likely to live many hours.

After the operation he was rather less irritable, but did not seem to know what had happened to him, although quite

sensible.

28th June.-Head shaved; cold water dressings continued; temperature 98.8° F.

It is unnecessary to give daily notes of the case; for some days he continued irritable, restless, and slightly delirious. Occasional doses of bromide of potassium were given, and bowels opened by injections. He gradually recovered from the disturbance of the intellect, the wound healed up readily, and he was dismissed on 25th August quite well. No complication whatever occurred throughout the case.

FROM DR. GAIRDNER'S WARDS.

ANEURISM OF ABDOMINAL AORTA TREATED BY REST, IODIDE OF POTASSIUM, AND DIET; OBSTACLES TO TREATMENT—PARTIAL SUCCESS. The patient was a man of 32 years of age who, up till the Spring of 1878, seems to have been remarkably