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for supplying them with a valuable book, the information contained in which must be put into use daily by every ophthalmic surgeon in active practice. The publishers are to be congratulated on the excellence of the paper and type, and upon the elegant appearance of the volume.

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Enlargement of the Prostate. By C. W. MANSELL MOULLIN. EXTENSIVE as has been the literature on this subject during the last few years, we can still welcome a little book which devotes itself to a review of the condition and the methods of treatment. We have become so accustomed to statistics of suprapubic prostatectomy with records of so many ounces of prostate removed, and the battle of what constitutes the capsule of the prostate, that we are in danger of losing sight of the fact that there are other methods of treatment, and that very often it would be better that we should try these methods, and not act upon the suggestion, “Here is a prostate ; let's remove it." The author gives a very good description of its anatomy and development, and attributes modern treatment to a proper understanding of the latter. He shows that the organ is developed independently of the bladder and in connecion with the Wolffian ducts, and that it is not in any way homologous with the uterus ; that the utriculus being incorporated with it is a mere accident of growth; that if one vas deferens is not developed, the corresponding half of the prostate remains undeveloped though the testis may be normal.

Another point insisted upon which is important in the consideration of the treatment, is the greater proportion of glandular tissue in the base of the gland as opposed to the apex. This results later in the projection of the adenomatous masses into the bladder, and therefore to a preference on the part of the surgeon for the supra-pubic route.

The author agrees that the enlargement is due to adenomatous masses for the most part, but holds that there is at the same time a true hypertrophy of the stroma, and that in the cortex the fibro-muscular layer increases from the first.

A most vivid picture is drawn of the symptoms of the enlarged prostate, especially in the later stages, when engorgement is added to hypertrophy, and the evils of cystitis supervene from catheterisation, as they do sooner or later, lespite the most stringent precautions.

The chapter on General Treatment is very well worth reading, as is also the Local Treatment. Various methods which the author has found of value are discussed, though McGill's operation--for, after all, it is to McGill that we owe our present position with regard to the supra-pubic removalseems to be rather shortly dismissed.

A point of supreme importance is insisted upon, and that is that prostatectomy should never be performed immediately after an attack of retention of urine, but the operation divided into two stages. First, a supra-pubic drainage until the urine has become clear and sweet, and, what is of much greater importance, the bladder and kidneys have recovered their tone; then the removal. When this is fully realised, the mortality of the operation will improve.

An impartial reader would gain the impression from pernsal of the book that indirect operations, such as removal of the testis or ligature of the cord, are of more value than the concurrence of opinion among surgeons seems to indicate. These operations, it is claimed, act by in some way removing a nervous influence, and cause an immediate diminution in the size of the corresponding half of the prostate ; but if they were even moderately uniformly successful, they would certainly not have been discarded in favour of such a severe procedure in old men as the supra-pubic removal undoubtedly is.

The author does not apparently favour the various perineal operations, nor the urethral ones, though he thinks the method of Bottini, which consists of burning away the obstruction by the galvano-cautery applied through the urethra, is deserving of more popularity than it has obtained. It is a method, however, which can never become popular with surgeons who prefer to see what they are doing.

The illustrations are somewhat few in number, and in this respect the book could be much improved.

The Care and Feeding of Children : A Catechism for the Use

of Mothers and Nurses. By L. EMMETT HOLT, M.D. Third Edition, revised and enlarged. London : Sidney

Appleton. 1904. In Dr. Holt's book the plan of question and answer is followed, and, as the book is intended to give instruction to mothers and nurses, the plan seems on the whole a good one. Even at the present day so much ignorance is displayed regarding the care and feeding of children, and so many old prejudices still hold their ground, that the careful study, by those who have the care of children, of a book of this kind is most desirable. The directions given are so detailed and so perfectly clear that anyone can understand them. Naturally, the most important section of the book is that on infant feeding, and it is here that we feel most inclined to differ from the author. He seems to us to carry the system of the modification of milk too far; and in our experience a much simpler method is quite effective, though, perhaps, not so accurate. At the same time, Dr. Holt's recommendations are perfectly sound, though we are afraid that few mothers and nurses will carry them out in detail. To the mother who can afford time and money sufficient to enable her to carry out the directions contained in it, Dr. Holt’s book cannot fail to be of the greatest value. It is the best book dealing with the subject that we have read.

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Edinburgh Medical Journal. New Series, Vol XV. Edin

burgh and London : Young J. Pentland. THE Edinburgh Medical Journal for 1904, January-June, contains several valuable contributions to current medical literature. Dr. J. N. Cowen (Glasgow) publishes an article on the “ Cardiac Muscle,” in which he emphasises the importance of this structure in diseased states of the circulatory system. He brings more evidence, if such were needed, to show that some of the most treacherous forms of cardiac disease are due to lesions of the myocardium. In particular

he refers to atrophy of the muscle fibres. “Hearts which by weight and to the naked eye give but little evidence of atrophy may microscopically show atrophied cells” (p. 130). This may be due to several causes which affect the general nutrition, and probably many cases of dilated heart are due to defective muscles. The etiology of cardiac fibrosis is also described. The article is illustrated by very good plates.

Another article of value is that by Dr. W. T. Ritchie, on The Etiology of Fibrinous Bronchitis," and which also bears evidence of considerable investigation. The writer believes that the disease in question is the result of pneumococcal infection.

Dr. Morison's article on The Neural Factor in Heart Disease" is very instructive. He is a strong advocate of carefully estimating the extrinsic causes of disordered heart action. Several cases are quoted showing the beneficial results of nerve sedatives in the treatment of heart hurry. Surgery is represented by papers on

“Hernia" (Mo. Rutherford Morison), “Bennett's Fracture” (Mr. Alex. Miles), The Treatment of Cleft Palate" (Mr. Arbuthnot Lane), and many others.

Medical history is enriched by an interesting chapter on Some Fifeshire Folk Medicine" by Dr. David Rorie. Some of the statements made seem hardly credible at this time of the world's history.

This collection of papers is of wide interest.

Medical Monograph Series. Insanity. By E. G. YOUNGER,

M.D. London: Baillière, Tindall, and Cox. DR. YOUNGER prefaces his book by saying that it is intended as a practical guide for the general practitioner. The author therefore begins by describing the various circumstances under which a medical man may be called to a case of alleged insanity. He then describes the causes of mental diseasea list which we need do no more than say is a full one. A section on the examination of the patient with a view to certification is followed by one on the legal bearings. In

these the characteristic is practical methods. In Part II. the author describes the types and special forms of insanity, illustrating his account by well-selected clinical examples from his own experience. These descriptions are admirably brief and clear, thus fulfilling the purpose of the book. The writer's views on mental diseases are quite of the modern type, though we notice in his description of general paralysis (p. 60) that he is inclined to consider the influence of syphilis in the etiology of that disease as exaggerated. Dr. Younger's experience of mental disease is known to be wide, and his opinion carries weight, but there are many who fell convinced of the great part played by syphilis in general paralysis.

In conclusion, we heartily recommend Dr. Younger's book to all practitioners of medicine as one which will give exactly the information they are likely to require in every-day work.

Patent Foods and Patent Medicines. By ROBERT HUTCHI

SON, M.D., F.R.C.P. London : John Bale, Sons, and
Danielsson, Ltd. 1904.


This small book consists of two lectures delivered by Dr. Hutchison, the first dealing with the subject of Patent Foods, and the second with that of Patent Medicines. In the first the author shows conclusively that none of the foods have the merits claimed for them by their manufacturers, and in the second he gives the composition of most of the wellknown patent medicines. It is a wonder that the manufacturers of some of the latter have not long ago been prosecuted for obtaining money under false pretences.

The Extra Pharmacopæia. By MARTINDALE and WESTCOTT.

Eleventh Edition. London : H. K. Lewis. THE Extra Pharmacopoeia has become such a necessity to the profession that the announcement of a new dition is sufficient to cause a wide demand. The eleventh edition, however, calls for some special notice. In the first place, the

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