THE SELF-CURE OF CONSUMPTION WITHOUT MEDICINE, with a chapter on the Prevention of Consumption and Other Diseases. By Chas. H. Stanley Davis, M.D., Ph.D., Member of the Connecticut State Medical Society; Author of Training and Education of Feeble-minded, Idiotic, and Imbecile Children, etc. 8 vo., cloth. Price, 75 cents. E. B. Treat & Co., 241-243 W. 23rd Street, New York, Publishers. 1904.

Consumption is the most widespread of all diseases, as shown by the statistics of the various boards of health. The object of this little work is to show how from its beginning to its last stages, before actual decay of the lung takes place, it can be cured in at least 95 per cent. of the cases, and this without the use of medicine.

ORGANIC AND PHYSIOLOGICAL CHEMISTRY. (The Medical Epitome Series). A Manual for Students and Practitioners. By Alexius McGlannan, M.D., Associate Professor of Physiologic Chemistry and Instructor in Chemical Laboratory, College of Physicians and Surgeons, Baltimore; and edited by V. C. Pedersen, A.M., M.D., Instructor in Surgery and Anesthesia and Anesthetist at the New York Polyclinic Medical School and Hospital. Cloth; 246 pages; illustrated; Lea Bros. & Co., Publishers, New York and Philadelphia. 1904.

The purpose of this little manual is to select from the great mass of knowledge accumulated in its department such facts as are of essential importance to medical students and practitioners, and to present them in a style facilitating comprehension and retention. Brevity and clearness have necessitated plain and dogmatic statements, even though several different theories co-exist. This being particularly true as to physiological chemistry, however, in such cases, the most generally accepted hypothesis is given without comment. A number of leading, comprehensive and practical questions conclude the chapters.

THE PRACTICal Care oe tHE BABY. By Theron Wendell Kilmer, M.D., Associate Professor of Diseases of Children in the New York School of Clinical Medicine; Assistant Physician to the Out-Patient Department of the Babies' Hospital, New York; Attending Physician to the Children's Department of the West Side German Dispensary, New York. 12 mo. Pages xiv-158, with 68 illustrations; extra cloth, $1.00 net, delivered. Philadelphia, F. A. Davis Company, 1914–16 Cherry Street, Publishers. The author states in his preface that in writing this book "he has regarded the mother and nurse as knowing absolutely nothing about the care of the baby," consequently, he has gone

considerably into detail. His views are eminently practical, and will prove of value to even those who think they know something about babies. It is appropriately illustrated, intelligent to mothers and nurses, as well as to physicians, and will be found useful to all.

FISCHER-INFANT-FEEDING IN ITS RELATION TO HEALTH AND DISEASE. A Modern Book on all Methods of Feeding. For Students, Practitioners, and Nurses. By Louis Fischer, M.D., Visiting Physician to the Willard Parker and Riverside Hospitals, of New York City; Attending Physician to the Children's Service of the New York German Poliklinik; Former Instructor in Diseases of Children at the New York Post-Graduate Medical School and Hospital; Fellow of the New York Academy of Medicine, etc. Third edition; thoroughly revised and largely rewritten; containing 54 illustrations, with 24 charts and tables, mostly original; 357 pages, 534 x 834 inches. Neatly bound in extra cloth. Price, $1.50 net. F. A. Davis Company, Publishers, 1914-16 Cherry Street, Philadelphia, Pa. This work intended as a guide to the active practitioner as well as the student of medicine has undergone a thorough, complete and careful revision. A great many chapters have been changed, some new ones, including one on "Infant Feeding in Summer Complaint," have been added. A new diet for older children after weaning from the breast or bottle, has also been added. The preceding edition has received the most gratifying and complimentary mention by a large number of the leading medical journals. Many suggestions which have been offered for improving the practical value of the book have been carefully considered, and numerous important and valuable additions have been made. In the short space of six months, a second edition has been demanded.

THE AMERICAN YEAR-BOOK OF MEDICINE AND SURGERY FOR 1904. A Yearly Digest of Scientific Progress and Authoritative Opinion in all branches of Medicine and Surgery, drawn from journals, monographs, and text-books of the leading American and foreign authors and investigators. Arranged, with critical editorial comments, by eminent American specialists, under the editorial charge of George M. Gould, A.M., M.D. In two volumes. Volume I, including General Medicine. Octavo, 673 pages, fully illustrated; Volume II, General Surgery. Octavo, 680 pages, fully illustrated. Philadelphia, New York, London. W. B. Saunders & Co., 1904. Per volume: Cloth, $3.00 net; Half Morocco, $3.75

net.

The American Year-Book of Medicine and Surgery continues to maintain its high place among works of its class. Indeed,

the issue of 1904, now before us, if anything, is even better than the excellent issues of previous years. Such a distinguished corps of collaborators which the editor, Dr. George M. Gould, has enlisted as his assistants is sufficient guarantee that the essential points of progress are brought out, and the collaborators' notes and commentations are excellent. In the illustrative feature the 1904 issue fully maintains its reputation, there being fourteen full-page insert plates, besides a number of excellent text-cuts. We pronounce Saunders' YearBook for 1904 the best work of its kind on the market, as it has always been.

Selections.

Dysmenorrhea and Sterility.*-Dysmenorrhoea and sterility are, perhaps, two of the most common complaints for which women seek for medical advice. When these symptoms exist separately, they may be due to many causes; when they are associated, they result most frequently, I believe, from a congenital or a traumatic constriction of the canal of the cervix uteri. However acquired, there is thereby produced a definite mechanical obstacle to the egress of menstrual blood and the ingress of seminal fluid.

All gynaecologists have seen examples of what I may term traumatic stenosis; where after a difficult labor the woman has, perhaps for the first time, commenced to have severe menstrual pain and has not conceived again; and where on examination we find a hard cervix with small contracted orifice, and inspection shows dense cicatricial tissue where labor had evidently lacerated the cervical lips. These cases are equally amenable, I find, to the treatment I am about to describe; but as they are comparatively rare I will restrict what I have to say to the more common or congenital form of stenosis of the cervix. And, as that condition is relative— the narrowing being much more marked in some cases than in others-I would again contract the field by explaining that I

*A paper read before the British Gynecological Society on Dec. 10, 1903, by Richard Fenwick, M.D., Physician to the Hospital for Women, Soho Square, London,

will chiefly refer to the condition known to us all as a "conical cervix." It is, in fact, abnormally long, often measuring an inch to an inch and a half or even more. It tapers downward, and therefore the external orifice is almost invariably so small that it is described in the older text-books as the "pinhole os." This is, in fact, so contracted that it is often impossible to pass an ordinary uterine sound through the opening, and when a surgical probe is introduced it is found to be tightly gripped along the whole length of the cervical canal. With regard to the dysmenorrhoea in these cases, this almost invariably begins one or two hours before the menstrual flow is observed, and becomes gradually worse until the loss is established. It is often associated with clotting of the menstrual blood, and the passage of each clot through the contracted canal causes exacerbation of the pain. Although certain distinguished writers have denied that the pain is due to obstruction, I must confess that, to my mind, the mechanical cause of the dysmenorrhoea appears to be self-evident. When one remembers that behind the contracted cervix there is a distensile cavity in the shape of the uterine canal, and great propulsive power in the shape of the uterine walls, surely it requires equally little knowledge of physics or of physiology to realize that pain must be experienced at the point where there is sufficient obstruction to cause uterine contractions to secure the passage of the uterine contents. This natural effort at distension of a closed canal is accepted, indeed, as an obvious explanation of the pains in the first stage of labor; so that it is difficult to understand the grounds upon which the mechanical theory is disputed in these cases of cervical stenosis.

Passing, however, from theory to practice, I would first call attention to the historical fact that for nearly fifty years operative treatment of some kind or other has been employed to remove this contraction of the cervical canal, in the hope of curing the associated menstrual pain. Half a century ago, it was the custom to pass a bistoury up the cervical canal and incise what is called in the text-books the internal os. In the great majority of the cases so treated, the benefit, if any, was found to be entirely temporary; and the operation fell into disuse; the more so because in not a few patients such extreme and furious hemorrhage occurred-probably from the opening of some branch of the uterine artery-that they narrowly escaped with their lives. Then came the method of introduc

ing tents of compressed sponge, laminaria, and so forth, which caused dilatation of the canal, but, of course, extreme and continuous pain; and in not a few cases septic absorption was followed by pelvic cellulitis. At the best, the dilatation was never permanent, and in due course that treatment also fell into disfavor. Then came the more modern, and certainly more cleanly, treatment by glass and galvanic stems, solid or hollow, which were worn for weeks by the patient, and which certainly, in some instances, resulted in permanent softening and dilatation of the cervical canal. But, on the other hand, the constant irritation and pressure often induced inflammatory troubles in the uterus or in its surrounding cellular tissue; so that, I suppose, at the present day, this treatment is rarely adopted. Finally, there came into vogue the practice of dilating the contracted canal by means of graduated metal sounds; and, in patients who were averse to any more radical operation, there can be no doubt that the passage of three or four of these sounds-Numbers 6, 7, 8 and 9 being usually employed --and their retention for some ten minutes, resulted in a temporary dilatation, and, when the procedure was adopted just before the menstrual period, the pain was often alleviated. Unfortunately, however, such dilatation is, of course, quite temporary in its duration. The constant tendency of the tissues is to contract at once, and therefore the treatment must be repeated again and again. This fact led to a modification of the old cutting operation; the lips of the cervix were incised on both sides for a certain distance up the canal. The great difficulty always met with is that, performed with antiseptic precautions, there is left a perfectly clean cut, the lips of which naturally fall together at once, and the upper angles of which immediately unite. To prevent this rapid union, many methods have been tried. The divided lips were plugged, but the result of the irritation, of course, was to keep up granulation, and the moment the plug was removed those granulations fell together and immediately coalesced. Caustics were applied to the cut surfaces to prevent their immediate union, but the only effect of these is to stimulate the growth of granulation tissue, and, once again, to cause sooner or later the growing together of the severed surfaces. In short, whatever method was adopted, the result in nine cases out of ten was that in six months, or perhaps less, the severed lips of the cervix had reunited. And not only was the canal again con