It was more than an ordinary task, the writing of this book, and it may be that this fact will not be immediately appreciated; but eventually it will be looked upon as the first guiding light into a new field. The present day knowledge of clinical urinology and urinary pathology is sadly incomplete. Far less advancement has been made in this than in most other branches of medicine; but that a turn in the right direction has been taken and that rapid progress is being made is evidenced by the completeness, the novelty and the refreshing originality of Croftan's book, which is not alone a well-written work on the subject, but is just the bold, aggressive idol-smasher one might expect from a Chicago author; one who knows how to express himself clearly and possesses Lydston's Chicagoesque knack of carelessly tossing aside hoary and time-riddled fads and fancies which have been tolerated too long, and tolerated chiefly because we humans have been brought up to respect age in whatever form we meet it.

The chemic ingredients of the urine are grouped according to their chemic relationship, and the factors determining their excretion in normal and pathologic conditions are discussed broadly and without so much as "by-your-leave" to any tradition or former arrangement.

The author evidently, and very properly it seems, leans to the belief that too little attention has been paid in the past to the inorganic constituents of the urine, for he devotes considerable space to what he terms "these cinders of metabolism."

The chapter on the determination of renal function is particularly clear and of immense value, as is the chapter on sediments in which particular stress is laid on their origin.

Finally, it will come as something akin to shock to many to miss Ehrlich's diaze-reaction, together with several other things in the way of urinary frills, such as the fluctuating ratio between urea and uric acid; the phosphates and urea and total nitrogen. All these and several lesser lights emanating from French authors have stared us out of countenance from nearly every textbook too long. Urologists who are abreast of the times have long since discarded these fancies as being unimportant, unreliable and wholly lacking a basis of scientific fact. Croftan, however, is the first writer to publicly ignore these paste jewels of urinology. N. W. W.

THE PRINCIPLES AND PRACTICE OF GYNECOLOGY. For Students and Practitioners. By E. C. DUDLEY, A.M., M.D., President of the American Gynecological Society; Professor of Gynecology, Northwestern University Medical School, Chicago. Fourth Edition. Octavo, pp. 771. With 419 illustrations in colors and monochrome, of which 18 are full-page plates. Philadelphia and New York: Lea Brothers & Company. 1904. (Price: cloth, $5.00; leather, $6.00; half morocco, $6.50 net.)

When the first edition of this admirable treatise was sent out it commanded attention immediately, and very soon won the

favor of teachers, practitioners and students; so much so, indeed, that without disparagement to others, it may be termed with great propriety the leading American textbook on gynecology. But if this is to be said of the book as the sum of its first three editions, what is there left for remark regarding this-the fourth?

Briefly summarised, it has undergone a thorough revision which has served to incorporate all that is new of value in the text. This has rendered it necessary to rewrite many chapters, to rearrange others, and to reduce still others, until now the volume is as nearly an exponent of the gynecology of the present day, as it is possible for language to express in print. We are fully justified in accentuating this point, because the author is a master of correct English, including compactness of style and forcefulness of expression.

We need not take up this book in detail for it is already familiar to every gynecologist, as regards its general plan and its methods of dealing with the various topics, but we were impressed when it first appeared with the practical, scientific and systematic way in which the author dealt with the subject of gynecologic diagnosis. And now, with the additions and revisions that appear in this edition, we are more than ever of the opinion that it is the best delineation of this topic that has yet been published in a textbook. It is so important to acquire the habit of diagnostic precision as well as to attain diagnostic acumen, that it will repay the student and junior physician to study Dudley's methods most diligently, if they would become proficient in gynecological work.

There is another one of the many excellent features of this work, to which we would invite special attention—namely, the wealth of illustration that adorns its pages. The author has made technical study of the art of illustration, being possessed himself of an artistic eye, hence has been able to develop the greatest perfection in the pictorial presentation of gynecological art. More than three hundred new pictures have been added to this edition, all from drawings made specially for this purpose; indeed, we may congratulate the author on eliminating all borrowed illustrations, so that now every picture in the book is distinctly original. This gives the treatise a personality that does not belong to any other similar one and, besides, increases its value as a teaching medium.

The most important feature of the illustrations, and this is one in which the author takes special pride, is that all minor and major operations and procedures are shown in their several steps, beginning oftentimes with the initial cut and continuing through the several stages, until the last stitch is tied. For example, there are thirty-two drawings in explanation of perineal lacerations and the methods of their repair, while the various steps of hysteromyomectomy are described most graphically by twelve drawings.

The author of this work is regarded.-very properly so, too,as one of the leading gynecologists of the day, and being con

genitally possessed, withal, of an inquiring mind, it is not strange that he should have constructed a book without a rival as a guide in the lecture room and in the clinic.

TRANSACTIONS OF THE MEDICAL SOCIETY OF THE STATE OF NEW YORK, Ninety-Eighth Annual Session, held at Albany, January 26, 27, 28, 1904. FREDERIC C. CURTIS, M.D., Secretary. Published by the Society.

1904.

The annual meeting which this book records ever will be distinguished by the fact that it placed its unanimous approval upon the report of the committee of conference which, for two years previously, had been engaged in an effort to unite the Medical Society of the State of New York and the New York State Medical Association. It is a significant fact that notwithstanding differences of opinion not only as to details, but also in the minds of some as to expediency, these were all harmonised and the report was unanimously confirmed, not only by the state medical. society, but by all the county medical societies in affiliation with it. That there is failure to bring about union is regrettable; but it is a subject of congratulation that such failure was not due to any action of the Medical Society of the State of New York nor to that of any of its affiliating county societies, nor, again, to any member of either, acting in his individual capacity. All of the responsibility for this failure of union therefore must rest with the New York State Medical Association and its affiliated county organisations.

This volume is replete with excellent papers, one of which is by Dr. Arthur Twining Hadley, president of Yale University, entitled, The conflicting claims of general education and professional education. The president of the society, Dr. Algernon T. Bristow, chose as the subject of his anniversary address. The present status of the medical expert. A symposium on diabetes brought out as participants Richard M. Pearce, David L. Edsall, William H. Thompson, Frederic C. Shattuck and Heinrich Stern. A symposium on nephritis was participated in by Francis Delafield, Joshua M. Van Cott and Beverly Robinson. A symposium on abdominal pain was presented by John H. Musser and Frederick Holme Wiggin. A symposium on typhoid fever brought together as participants Henry A. Fairbairn, Henry L. Elsner, Egbert Le Fevre, Luzerne Coville and Cyrus W. Field. Finally, a Röntgen ray symposium included as participants Arthur Dean Bevan, Charles Lester Leonard, William B. Coley and Hon. W. W. Goodrich.

The official stenographer, Dr. Ogden C. Ludlow, of New York, died before his minutes were fully transcribed, hence the discussions are considerably curtailed.

In the minutes of the proceedings are to be found the usua! reports of committees and officers, among which is that of the State Board of Medical Examiners. It is difficult to understand

why this board, the most important creation of the society, should be compelled each year to present its report in abstract. The excuse is always that there is lack of space, and also there is manifested an indisposition to incur the necessary expense. Neither of these reasons would seem to comport with the dignity of this great society which has done so much to advance medical educational in this country, and which should not hesitate to spread the results annually before the country.

THE SURGERY OF THE HEART AND LUNGS. BY BENJAMIN MERRILL RICKETTS, Ph.B., M.D., Cincinnati. Octavo, pp. 526. Illustrated. New York:

The Grafton Press. 1904.

The author of this work has presented subjects of growing interest to all surgeons. It is scarcely ten years since it was deemed possible to attack the heart for the relief of penetrating wounds; pulmonary surgery, however, has had a longer career, and yet only lately has it become of recognised value. We have been impressed with the painstaking character of the work performed by the author in preparing this book. It has involved strenuous labor and will live as a pioneer treatise of inestimable value on the subjects of which it treats.

The anatomy of the heart, as given by Ricketts, is highly interesting and, withal, is one of the most complete studies of the structure of the organ we have seen. The researches in comparative anatomy deserve special mention, as also does the section on the mechanics of the heart-beat. This entire chapter could be studied with profit by every student of anatomy.

Gunshot, lacerated, and incised wounds of the heart, though not common, are of such comparative frequent occurrence as to make interesting studies relating to their surgical repair. A number of cases have been reported in which suture of the heart has been followed by recovery, reference to these being made in this book. In 1871, Callender removed a needle from the heart, which is the first recorded instance of an attempt at surgical relief for heart injury. In 1877, Roswell Park, in attempting to relieve pericardial effusion by aspiration, by accident thrust the needle into a myocardial abscess, and in this manner removed several ounces of pus, thereby affording the patient temporary relief,probably the first instance in which surgical aid was involved for disease of the heart structures.

The surgery of the lungs, though antedating that of the heart is, nevertheless, of absorbing interest, and the literature contains many instances of surgical cure of injuries and diseases of the lower respiratory tract. Ricketts has collected much of historical interest on the surgery of the lungs. The removal of foreign bodies from the lung, or bronchial tubes is frequently done, and lung surgery for disease is more common than for traumatism.

The illustrations are an interesting feature of this work, and very properly begin with a frontispiece of the heart and lungs of

a dog in situ. The anterior view of the heart from Deaver's surgical anatomy is a beautifully executed plate, and makes an appropriate beginning to the section on the heart. It is a work that will be found of great use to the surgical profession, and many physicians who do not practise surgery will be interested in its valuable contents.

We could wish the author had found occasion to use diphthongs with less freedom, thus making the text conform to more modern usages; for example, "sæptum" is an archaism that offends the eye in the extreme.

TRANSACTIONS OF THE AMERICAN ASSOCIATION OF OBSTETRICIANS AND GYNECOLOGISTS. WILLIAM WARREN POTTER, M.D., Secretary. Volume XVI. For the year 1903. New York: Rooney & Otten Company,

Printers.

Whoever will undertake the examination of this book cannot fail to be impressed with the conscientious nature of the work done by this association at the annual meeting of which record is herein made. Many of the papers are of more than ordinary importance, while the discussions develop a strength that accentuates their value to unusual degree.

Chicago is an excellent city to play the host to such a body; it is full of able physicians, who take interest in such gatherings, and who manifest their interest by attendance on the sessions, by participating in the debates, and by extending various hospitalities that serve to stimulate the members to their best efforts.

The paper of Dr. John B. Murphy on Tuberculosis of the female genitalia and peritorieum, which occupies eighty pages of the book, is one of unusual interest, and must have cost the author years of research and observation. It is the most considerable contribution to the literature of the subject that has yet been made, and will be quoted authoritatively for years.

Many other papers are of great value, but they should be read rather than described. It is doubtful if the association has ever put forth a more comprehensive or more practical volume than this, which is saying a good deal of a book that has so many noted companions.

THE PRACTICE OF OBSTETRICS. Designed for the Use of Students and Practitioners of Medicine. By J. CLIFTON EDGAR, Professor of Obstetrics and Clinical Midwifery in the Cornell University Medical College, New York. Royal octavo, pp. 1153. With 1264 illustrations, including 5 colored plates and 38 figures printed in colors. Second edition, revised. Philadelphia: P. Blakiston's Son & Company. 1904. (Price, $6.00 net.)

We can quite comprehend how such an excellent treatise as this should become promptly, not to say suddenly, exhausted in its first edition. This is the first instance, we believe, in the history of the JOURNAL, in which two editions of the same work on