Book Reviews.

OPHTHALMIC OPERATIONS AS PRACTICED ON ANIMALS' EYES. By Clarence A. Veasy, A. M., M. D. The Edwards & Docker Company, Philadelphia.

The author describes somewhat minutely common eye operations, prefacing his descriptions with a short account of the circumstances under which they are to be done. The book is well illustrated. Pigs' eyes are preferred to those of other animals, and directions are carefully given for the preparation and preservation of the eyes. The Vienna rubber operating mask is thought the best. Little, if any, fault can be found in either the indications for operation, as given, or in the technique. The latter is somewhat minute, but the book is written for special students. In speaking of the removal of foreign bodies from the cornea, the author mentions the danger of the removal of penetrating bodies injuring the lens. In such cases it may be necessary to introduce a keratome into the anterior chamber to furnish support to the foreign body from behind while it is being extracted." It seems to us that this contingency is too remote to merit a place in such a book as this and the advice bad, to beginners, under any circumstances. In our opinion there is no eye instrument so hard to learn to use properly and so easy to do harm with as a keratome. We incline to the opinion that the lens would stand a better chance against the foreign body than against the keratome, unless in the hand of an experienced operator.

REPRINTS, ETC., received.

Twelve Deaths. By Merrill Ricketts, Ph. B., M. D. Reprint from the Cincinnati LancetClinic.

Bronchial Cysts. By Merrill Ricketts, Ph. B., M. D. Reprint from the Cincinnati Lancet-Clinic.

Should We Treat Pulmonary Tuberculosis as a Contagious or as a Communicable Disease? By S. A. Knopf, M. D. Reprint from the Southern California Practitioner.

The Hygienic, Educational and Symptomatic Treatment of Pulmonary Tuberculosis, with a Plea for Some Provision for the Poor. By S. A. Knopf, M. D. Reprint from the Medical Record.

Current Editorial Comment.

FREE PUBLIC BATHS.
Buffalo Medical Journal.

THE great value of free public baths as a sanitary measure in large cities is already admitted. The success that has attended their establishment in Buffalo is somewhat phenomenal when considered in the light of novelty and prejudice. It was not a trifle to overcome the latter. Ignorance is always the stronghold of prejudice, and novelty serves as a feeder to opposition. At any rate, there are many people in the world, and especially among the ignorant in the large cities, who do not brook improvement or welcome reform.

RABIES.

Medical News.

IT must be remembered, as has been said, that rabies in a dog is an extremely rare disease. Probably not one dog in a thousand which is thought to be mad is really afflicted with the malady. It is important that not only the profession but the laity should understand that all dogs perspire excessively through the glands of the mucous membrane of the mouth and tongue during the hot weather. If a dog has been running, this perspiration may even be lapped into froth, and the dog may be said to be "foaming at the mouth." This, however, does not constitute rabies.

HYSTERIA.

Boston Medical and Surgical Journal. THERE is perhaps no subject in medicine about which so many hazy notions have grouped themselves as about hysteria, a disease which seems likely to enjoy its curious misnomer for many years to come. From its supposed association with the uterus it was quite natural that a popular conception should have gained ground that it was a disease peculiarly of women, an idea which is still deeply rooted, unfortunately, in the professional mind. Increasing knowledge, and the careful studies of the French school, have remodelled our ideas to a marked degree, until now we clearly recognize the existence of true hysteria, not only in men, but also in children, and, rarely, even in infants. Experience has amply justified such a widening of our views; but it should also have taught us a certain conservatism in our estimate of what constitutes hysteria, in its true sense.

PROGRESS IN MEDICAL SCIENCE.

APIOLINE IN NEUROTIC DYSMENORRHEA. -In the treatment of dysmenorrheal cases, where there is no tangible pelvic lesion demanding strictly local attention, or operative interference, I have of late come to rely on a single remedy: Apioline, the active principle of petroselinum sativum, introduced to the profession by Chapoteaut. The following cases are of the neurotic variety of dysmenorrhea and clearly demonstrate the value of the drug as a therapeutic agent: Case I.Miss F., aged 20, anemic and poorly nourished. For two years she had suffered greatly from painful and scanty menstruation. At times the pain was so severe that the hypodermatic use of morphia was resorted to. An iron tonic was prescribed; also Apioline at the menstrual periods, beginning three days before the flow was due. In three months the patient was much improved in general health and her menstruation was normal. Case II.-Mrs. R., aged 34, married ten years, three children, youngest two and a half years old. Had had painful and scanty menstruation off and on nearly four years. When I first saw her she had had four painful periods in succession. Apioline was ordered (one capsule three times a day) during the flow, beginning as usual two or three days in advance. The effect was immediate, pain being slight and the flow more copious. The second month there was no pain and flow was normal in quantity.-Dr. S. MADDOX, M. D., in Medical and Surgical Reporter.

EUDOXINE IN INTESTINAL AFFECTIONS.Dr. T. Rosenheim recently read a paper before the Berlin Medical Society on the employment of Eudoxine in derangements of the digestive organs, giving the chemical history of the preparation and narrating his clinical experience in a number of cases.

The results are substantially those obtained by English medical men in the treatment of

stomachic and intestinal troubles with this remedy. Eudoxine is the bismuth compound

of an iodine preparation, Nosophen, which develops its antiseptic effects without the liberation of any iodine in the organism. It is a reddish-brown powder, insoluble in water, and without odor or taste, and is taken willingly by patients of all ages. As it is only gradually decomposed into its constituents,

Nosophen and bismuth carbonate, without any liberation of iodine, it does not disturb the stomach, and may be tolerated even in large doses of 15 grains thrice daily. On account of its freedom from toxic properties, it is specially indicated for internal use in stomachic and intestinal troubles. In cases of infantile or summer diarrhea it has been specially efficacious, whilst in typhoid it has also been strongly recommended.

THE WALKER-GREEN PHARMACEUTICAL CO. -I have had an unusual influx of cases of late requiring your pharmaceutical preparations. Ihave used your Bromides for tinnitus aurium with excellent effect, by pushing it in double doses. I am using the Iodides on a man from Allen County, Kansas, with chronic trachoma and pannus. He is well broken out and says his sight is much clearer when most erupted; also, on a case in this city of plastic iritis, with much effusion and haziness of the cornea -the Iodides have done wonders for the young He was totally blind for three months, but now sees to read, and is now serving as office boy for me. I am also giving the Iodides to a lady suffering from atrophic rhinitis. She says she feels a hundred per cent. better in every way since commencing it. The Elixir Six Iodides is worth its weight in gold.-WM. CLARENCE BOTELER, M. D., U. S. Indian Service; Late Prof. of Diseases of the Eye and Ear, N. W. College, St. Joseph, Mo., and Prof. of Ophthalmology, College of Physicians and Surgeons, Kansas City, Kans.

man.

INSTRUCTION IN ORIFICIAL
SURGERY.

PROF. E. H. PRATT will hold his eleventh annual class for didactic and clinical instruction in Orificial Surgery during the week beginning September 6, 1897. The class will assemble in the amphitheatre of the Chicago Homeopathic Medical College, at the corner of Wood and York Streets, at 9 A. M.

The course of instruction will last during the week, occupying a four hours daily session.

TODAY we will introduce to you this colored boy, who is twenty years old, and the possessor of a very rare and unique form of syphilis.

You may never again see a case of multiple chancres. He was here some time ago, and we placed him on a "placeboic" plan of treatment. That is, we intended to have this interesting case photographed, and we gave nothing that would retard the development of the eruption.

You notice located on the body of the penis and a long prepuce, three large sores, about the size of, and resembling in a marked degree, our one cent pieces. Nature abhors a straight line. If these three sores had been arranged one above the other, it would have looked as if the boy had been trying to button the organ up. It is very pendulous, and swings to and fro like the pendulum of a clock. Dr. Warfield of the Howard University, who kindly photographed the patient for us, had some difficulty in taking a picture on account of the vibratory motions. These chancres form a right angle triangle, the hypotenuse being in the median line.

Open the patient's mouth and you will observe in the buccal cavity back by the molar teeth two opaline mucous

patches. You find induration of the sub-lingual, sub-maxillary, post-cervical and epitrochlear glands.

Pull up his shirt, and there you see on either side above Poupart's ligament a well-developed bubo, and all over his body an exquisite representation of the macular and maculo-papular syphiloderm.

These chancres are typical ones of the so-called "ulcus elevatum." The induration of each is so considerable as to raise the sores above the level of the surrounding skin. These chancres have been about six weeks in developing. The patient says they first appeared as pinhead pimples.

Fournier says that a true initial lesion, in its first appearance, is very trifling: "it is the smallest, the most superficial, the most benign, the most insignificant of all possible erosions."

As a rule, a chancre comes solitary and alone, and this is a very important point of diagnosis. Four times out of five, a true chancre is single; if multiple, it is so from the first, and comes from simultaneous inoculations at various points.

Of 456 chancres observed by Ricord in 1856, 341 were single, and 115 were multiple (Lecous sur le Chancre, 1857).

Clérc found in 267 men suffering from constitutional syphilis, the chancre, single in 224, and multiple in 43, or onesixth.

Fournier gives the following statistics, relating, however, to women only. Of 203 patients observed, 134 had a single chancre; 52 had 2; 9 had 354 had 4; 5 had 5, and I had 6 chancres. He also gives as extraordinary one case where 19 and another where 23 chancres occurred simultaneously.

You see in the patient before you today, the first multiple chancre that we have had in a period extending one year.

The most difficult form of chancre to diagnose is what is known as the "multiple herpetiform" chancre. I have known accomplished syphilologists wait until the development of a bubo and erythema, before they would positively state that an attack of herpes preputialis, where several crops of vesicles existed, with what appeared to be somewhat hardened tissues surrounding them, was the initial lesion of syphilis or not. I have furthermore seen them pronounced to be chancres when they were not, and vice versa.

My friend Dr. John H. Metzerott, in his article referred to in my last lecture, "A Popular Error in the Treatment of Syphilis," states: "We beheld three of the leading dermatologists (Finger, Neuman, Kaposi) baffled at a simple excoriation, not one of these learned gentlemen being able to assure their patients then and there that they did not have syphilis. Attempting to differentiate between different degrees of induration is a fallacy. Several of the greatest syphilologists have erred in this respect in attempting to differentiate between a chancre and a chancroid. It has been proved beyond any possible doubt through experimental investigation, by Prof. Finger, that a chancroid situated in the sulcus coronarius may be hard."

Last April a man consulted me who had a bubo in the right inguinal region, above Poupart's ligament, and his abdomen was covered with a macular erythema. He also complained of pains in his joints, and had night headaches, etc.

I asked him if he was married, and he replied that he was, and was very indignent when I asked him if he had broken his marital vows. He told me that he had not come to me to be treated for syphilis, as he had been assured by a leading dermatologist that he had an attack of herpes preputialis, which had been cured.

I examined the patient carefully, and found a small cicatrix involving the frenum on the right side, and so diminutive as to almost escape detection.

I advised him to go elsewhere, if he desired any other treatment excepting that for syphilis.

The next day he returned, and admitted that he had "fallen from grace," but that his amorita was, like unto the wife of the Roman Emperor, "above suspicion."

That is always the case. A man's vanity "surpasses all understanding." Women sell themselves to the highest bidder, and their contempt is in proportion to the size of the fornicator's bank account.

It is perhaps unnecessary to state that this man gave the disease to his wife, and another innocent victim was added to the long list of innocent syphilitics.

It is a most astonishing fact that in the last few months we have had 250 cases of syphilis, and I have been able to show you every form of the intial lesion, but we have not had a single case of the soft chancre or chancroid. Some years ago I was a regular attendant at another dispensary service, for a period extending over three years. There we had an abundance of chancroids, and the characteristic chancroidal buboes.

Everyone versed in venereal diseases coincides with Druitt in his statement that chancroid is the most common form of venereal ulcer, and is rarely met with except on the organs of generation. In man it is most common on the inner surface of the prepuce or in the furrow around the glans, and especially by the frenum; in woman, in the navicular fossa, just within the posterior commissure of the labia majora. It is most liable to attack some crack, excoriation,

or sebaceous or hair follicle, or moist mucous membrane; the poison is probably innocuous on dry cuticle. Hence Hence the preservation derived from circumcision and uncovered glans. This ulcer has no period of incubation, and prob ably acts continuously from the moment when the poison first takes effect. It is often multiple; it is very contagious, and easily inoculable, spontaneously or by art, up to the time when it begins to heal.

The pus from the original sore, or from the center of a suppurating bubo, if inoculated, produces an ulcer. This inoculation used to be done by way of diagnosis; but it proves nothing as to the really syphilitic nature of the ulcer, and is a thing not to be advised.

You can not inoculate a chancre on one who has had syphilis. (Cases of reinfection are extremely rare.) They are immune.

Fournier inoculated the discharge of 99 chancres upon the patients themselves, and succeeded in but one instance, in which the experiment was performed within a very short period after infection.

Puché states, as the result of his experience, that auto-inoculation of the chancre is only successful in two per cent. of cases.

Poisson obtained like results in 52 cases, and Savoyénne was unsuccessful in every one of 19.

Chancroidal symptoms (Druitt): These may be studied when this sore is produced by inoculation. During the first twenty-four hours the puncture reddens: in the second and third days it swells slightly, and becomes a pimple, surrounded by a red areola; from the third to the fourth day, the cuticle is raised

by a turbid fluid into a vesicle, which displays a black spot on its summit, consisting of the dried blood of the puncture; from the fourth to the fifth day, the morbid secretion increases and becomes purulent, and the vesicle becomes a pustule with a depressed summit. At this period the areola, which had increased, begins to fade, but the subjacent tissues become infiltrated. After the sixth day, if the cuticle and the dried pus, which adheres to it, be removed, there is found an ulcer; its depth equal

to the whole thickness of the true skin; its edges seeming as if cleanly cut out with a punch; its surface covered with a grayish pultaceous matter. (Ricord: Traite des Maladies Vénériennes.)

The discharge is purulent; the sore is often painful, and attended with inflammatory swelling, which gradually fades into the sound tissues, and is not very hard unless caustic has been used. It is tedious, lasting from three weeks to three months, and attended with a