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of the ovaries or puncture of small cysts and the great care that should be paid in conserving these organs, no elaborate pictures are shown demonstrating the fine arts of this branch of surgery.

In the last chapter the word “Gynecic” appears as clipped and maimed product of the parent root; and it is only a question of time when the connection, by such an alteration as this, will soon be forgotten. Professor's Hirst's book is sound, and may be recommended to student and practitioner alike.

Ocular Therapeutics. By DR. A. DARIER (Paris), translated

by SYDNEY STEPHENSON, M.B., Hon. Secretary of the

Ophthalmological Society. London: J. and A. Churchill. THERAPEUTICS can hardly be said to be one of the strong features of British ophthalmic practice. Many ophthalmic surgeons practically ignore the subject in its scientific aspects, being satisfied to prescribe the empirical remedies, of their predecessors, conveniently collected together in their hospital pharmacopæia. This apathy towards one of the most important branches of medicine is by no means peculiar to. ophthalmologists, but is equally common among practitioners generally. We hope that this indifference will soon give way to a desire for the investigation of the action of drugs and a proper appreciation of the value of scientific therapeutics. If the subject is given the attention it deserves, we have every reason to think that works on ocular therapeutics will not be exclusively continental in the future. We heartily welcome the publication of such a scientific exposition of the subject, by a man who is an accurate observer, one who is imbued with the spirit of inquiry and is blessed with a judicial mind which can weigh and estimate at their true worth the results of his experimentation. The book is remarkable for the large amount of instructive information which it contains. There is scarcely a page which does not contain some fresh fact-therapeutical, surgical, bacteriological, physiological, or anatomical-whilst our old stock-in-trade remedies are presented to us in a new light, and their applications established on a more rational and scientific basis. The first part of the book is taken up with the general principles of therapeutics and the discussion of drugs under the headings of

(a) Modifiers of superficial sensibility (anästhetics).
(6) Modifiers of profound sensibility (analgesics).
(c) Modifiers of vascular tone (vaso-constrictors and vaso-


(d) Modifiers of the muscular tone of the iris (mydriatics

and myotics).
(e) Modifiers of conjunctival secretion.

All the recent remedies which have found their way into our practices, and many more which we have not yet adopted, are fully discussed from their chemical, pharmacological, and therapeutic standpoints.

The second part is occupied with a detailed account of the application of these and other medicinal and surgical remedies to specific diseases of the conjunctiva, cornea, choroid. retina, etc.

Some of the most instructive chapters in the book are those on mercurial medication. The administration of mercury by hypodermic and subconjunctival injections seems to be greatly neglected by us. There is little doubt but that it would often be advantageous to our patients if we occasionally adopted these methods so highly spoken of by our continental confrères.

The mechanical and electrical treatment of eye diseases, as described by the author, are also worthy of our serious consideration.

It would be futile to attempt to specify in detail the numerous and valuable observations contained in this book. It should be carefully studied by every ophthalmologist, and it should be in the possession of every practitioner who takes an interest in therapeutics. It is undoubtedly one of the most important additions to ophthalmic literature in recent years, and it marks a distinct epoch in the history of ocular therapeutics. The profession owes a debt of gratitude to Mr. Stephenson for placing it within the reach of English-speak

ing practitioners. The translation is admirable, and the additional chapters by the author and the numerous notes by the translator greatly enhance the value of the book. The publishers have done much by good binding, print, and paper to make it an attractive volume, apart from the excellence of 'the reading material.

"The Sterilisation of Urethral Instruments, and their Use in

some Urinary Complaints. By HERBERT T. HERRING,

M.B., B.S. (Durh.), M.R.C.S. H. K. Lewis. London. In this short work we have the methods of modern surgical procedure demonstrated to us with extraordinary fulness, inasmuch as the urethral structures are concerned. Mr. Herring has done new and good work, and his ideal is an rextremely high one. It would be hard to live up to his

methods of aseptic surgery, and quite impossible to exceed them. We must confess that sepsis is not as guarded against as it should be in urethral surgery, and that blunders, and sometimes culpable blunders, are made, and that these are apt to have an unfortunate influence on the patient's health. We question, however, if Mr. Herring gives enough credit to tissue resistance as a bactericidal agent, for to our mind its importance in the prevention of inflammation is far greater than any artificial methods yet invented. However this may be, the work before us is capable of teaching a lesson in thoroughness to any surgeon who may chance to read it. To follow all Mr. Herring's procedures would be another matter, involving the expenditure of a considerable sum of money in special apparatus and a great deal more time than can be spared by private practitioners or ev

even in the out-patient department of a general hospital. Here we have accounts of various kinds of instruments, of cleansing them, of handling them, and of using them, all most exactly described. Other chapters are devoted to such symptoms and diseases as gonorrhoea, stricture, retention, urethritis, etc., and the several ways of treating the same. It is all very well done, and the perusal of these. 171 pages will refresh and interest the mind of anyone caring to peruse them. The book is of convenient size, and the letterpress and numerous illustrations are exceptionally good.

The Four Epochs of Woman's Life: A Study in Hygiene.

By ANNA M. GALBRAITH, M.D. Second Edition, revised and enlarged. W. B. Saunders and Co., Philadelphia,

New York, London. 1903. A VERY different book, appealing not to a class but to the whole female sex, is this which has been written by an American lady doctor of medicine. The style of the book suggests in the chapter headings and in its command of language a wide acquaintance with general literature as well as with the obstetric specialty.

The four epochs appear to be Maidenhood, Marriage, Maternity, and the Menopause, and a large amount of information, along with much advice, is given under each of these headings. The most remarkable portion of the book is that which is devoted to the sexual relations; to these forty pages, or fully one-sixth of the whole book, are devoted, and

the whole subject is treated with a fulness of detail and a wealth of imagination which cannot fail to arouse the admiration of the man of the world. This extended treatment, however, renders the book, in our opinion, entirely unsuitable for the majority of those for whom it is said to be intended. The present is the second edition of the book, so that presumably it has found a ready sale in America. We cannot wish for it an extensive circle of readers on this side of the Atlantic.

Transactions of the Royal Academy of Medicine in Ireland.

Vol. XX. Edited by JOHN B. STORY, M.B., F.RC.S. With
Index, Vols. I. to XX., compiled by E. J. McWEENEY, M.D.

Dublin: Browne and Nolan, Ltd. 1903. THE papers in the Section of Medicine in the twentieth volume of Transactions of the Royal Academy of Medicine in Ireland mostly consist of reports of individual cases. Exceptions to this statement are to be found in Dr. Conolly Norman's full and interesting notes of a series of cases of hallucination, Dr. Walter G. Smith's notes on urinary chemistry, Dr. C. M. O'Brien's record of his experiences of the Finsen light treatment of lupus, and Dr. W. R. Dawson's notes on a year's asylum work. Amongst the reports of cases may be especially mentioned the very interesting case of lymphadenoma associated with recurrent fever, reported by Dr. H. T. Bewley and Mr. Alfred Scott—a clinical condition of some rarity. Two cases of paroxysmal tachycardia are reported by Dr. R. Travers Smith and Dr. Joseph O'Carroll, the former associated with definite epileptiform attacks, and the latter with symptoms highly suggestive of petit mal, whose relationship with epilepsy seems to be shown by their disappearance under bromide treatment. A paper on strabismus convergens and its treatment, by Mr. J. B. Story, also appears in this section.

The surgical papers are of somewhat more ambitious scope than those above referred to. Sir William Thomson and Sir Thomas Myles both discuss the surgery of the prostate, the

former advoting enucleation according to Freyer's method, and the latter insisting on the advantages of the perineal route in the majority of cases, whilst also urging a more extended trial of the palliative treatment of enlarged prostate by the establishment of a permanent supra-pubic fistula. A very interesting series of cases of operation on the gallbladder are recorded by Mr. John S. McArdle, and Dr. W. S. Haughton deals with the primary treatment of fractures in plaster of Paris. There are also included in this section a number of reports of cases of interest.

The Section of Obstetrics contains Dr. R. D. Purefoy's annual clinical report of the cases dealt with during the year in the Rotunda Hospital, and this is always worth reading. Mr. E. H. Tweedy reports some cases of tubal disease treated by operation, and there are three other short reports of cases. The papers in the remaining sections of Pathology, State Medicine, and Anatomy and Physiology are all brief, the most important being those by Dr. Ninian M. Falkiner on the nomenclature of disease and causes of death, and by Sir Charles Cameron on the notification of measles.

Ailments of Women and Girls. By FLORENCE STACPOOLE.

Simpkin, Marshall, Hamilton, Kent, and Co., Limited,

London; John Wright and Co., Bristol, 1904. Miss STACPOOLE has succeeded in producing an exceedingly useful book, containing all that is necessary for women to know about themselves and their diseases. All the common symptoms and ailments to which the sex is liable are treated tersely in simple language, and common sense directions are given for the treatment of minor complaints. The authoress has solved in a fairly satisfactory manner the difficult problem of imparting enough information without going beyond the lines that should. separate a book intended for the lay public from a treatise intended for the medical profession. Occasionally, as might be expected, questionable quotations are given, such, for instance, as those on the uses of ergot on page 91, which are the business of the medical attendant, and

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