peated for five days. He directed attention to the great importance of careful manipulation in irrigating the urethra, reinfection from the surface of the glands being very apt to take place. Dr. Wood thought that a 20 per cent. solution of nitrate of silver, representing 96 grains to the ounce must be very irritating, considering that one per cent. is escharotic to the conjunctiva.

Dr. Blue referred to the advisability of the administration of the alkalies in gouty and rheumatic cases in order to correct the hyperacidity of the urine, itself an irritant to a sensitive urethra. In his experience gonorrhoea is frequently successfully treated by the zinc salts in from three to four weeks. Dr. Rand referred to the merots of hot bi-chloride in minute doses, one in 30 to 40,000, also of permanganate of potash solution, and that the quantity of this solution used at each period should be large, say a pint to a quart.

Dr. Binswanger thought that alkalinization of the urine emphasized the acute symptoms in gonorrhoea, that injections during the acute stages aggravates the condition and consequently should only be used after the acute stage has declined. It was pointed out that the urethral crypt orifices will drag forward and penile injection push the germs further up the passages, and that internal medication was more in accord with the anatomy of ae urethra. He did not believe that metallic salts are germicides. The microscopic test, said he, showed when a patient could be considered as cured, gonococci not being discoverable after a careful examination.

Dr. A. C. Panton said that he had great faith in the salts of silver, their value in gonorrhoeal ophthalmia had been fully demonstrated in many hospitals; that at one time it was very frequently met with, but since the salts of silver had been used as a preventive, cases of ophthalmia neonatorum are few and far between. Referred also to the beneficial effects of argentinin in chronic cases.

Dr. A. D. Walker said that he had used protargol and found it caused intense itching.

Dr. Maxwe found protargol in 2 per cent. solution irritating, the general results not prolonged; the discharge stops, but returns.

Dr. Saylor thought that the methods and means used by Dr. Wheeler are, insofar as time is considered, not much of an improvement after all. He considered that a discharge persisting over four weeks, under ordinary circumstances, suggested some defect in treatment. Had been using methyl-blue recently, supplemented oy hot astringent injections, and he thought with improved results comparatively.

Dr. Giesy said that the subject of gonorrhea was one of great imterest to the gynecologist, on account of the frequency with which it is met. For instance, the majority of pyosalpinx cases could be traced to gonorrhoeal infection derived from the male who had been treated but not cured. No physician has a right, said he, to pronounce recovery from the disease without employing the microscopic test. The present treatment of gonorrhoea was very uneffectual and Dr. Wheeler's

paper did not present any more brighter prospects than had been frequently promised before. Gave details of a case of pyosalpinx recently in practice, gonococci being present in large numbers.

Dr. K. A. J. Mackenzie said that he had often been tempted to try vaunted remedies, but so far had found nothing to equal the old time tried ones, such as aceate of zinc combined with opium, etc.; believed that injection could be given early even when patient was first seen, thought that the abortive method should we tried more frequently. Gonorrhda, he thought, was aself-limited disease.

The president, Dr. Tucker, in the course of some remarks, said that he believed gonorrhoea was a self-limited disease, and that cases recovered under all forms of treatment, some in weeks, some in months, some i years. This might be due to more or less susceptibility. Had investigated through a well known friend who has a large hospital practice and facilities for this kind of work, on the question of untreated cases. The reply to this question was that a large percentage got well under medical treatment that could not have exercised curative influence. Thought that the knowledge of gonorrhoea, in regard to its pathology and treatment, etc., was settled, but as or the question of treatment no one seems to be able to do much with this knowledge.

Dr. Wheeler closed the discussion. In replying to Dr. Binswanger he said that proof of a metallic salt being germicide is based upon the fact at the zone around silver sutures do not contain bacteria as a rule. Agreed with Dr. Walker as to the itching caused by protargol. In the course of some general remarks said that he believed he had aborted many cases in gonorrhoea by injections of nitrate of silver. and that the microscopical examination was a true test for diagnosing gonorrhoea as well as denoting its cure. Protargol is used because it is non-irritating and hot water injections are in line with modern progress, and the most of the medicine generally used with it, with more or less success, are germicidal in their action. Closed by giving clinical features of special cases.

After discussing some routine business, the program for next meeting was announced to be a paper by Dr. A. C. Panton. The meeting then adjourned.

BOOK REVIEW.

Practical Diagnosis. The Use of Symptoms in the Diagnosis of Disease. By Hobart Amory Hare, M. D., Professor of Therapeutics and Materia Medica in the Jefferson Medical College of Philadelphia. Third edition, enlarged and thoroughly revised. In one octavo volume of 615 pages, with 204 engravings and 13 full-page colored plates. Cloth, $4.75 net. Lea Brothers & Co., publishers. Philadelphia and New York.

The almost unprecedented success of Dr. Hare's "Practical Thera

peutics," is about equalled in this other work of his-"Practical Diagnosis." In reality the books are companions-the one being an aid to the other, and constituting, when taken together, an admirable practice. The same originality and cleverness in conception and execution which we noticed in reviewing the former, is as strikingly manifested in this later work. For instance, he makes symptoms his units, arranging them for maximum convenience, under two main heads, "The Manifestation of Disease in Organs," and "The Manifestations of Disease by Symptoms," the first part being under a regional classification, and the second dealing with general symptoms, such as fever, vomiting, etc. Under each disease is given a list of its symptoms and under each symptom a list of the diseases in which it occurs. The book is richly and usefully illustrated.

Manual of Chemistry. A Guide to Lectures and Laboratory Work for Beginners in Chemistry. Text-Book specially adapted for students of pharmacy and medicine. By W. Simon, Ph. D., M. D., Professor of Chemistry and Toxicology, College of Physicians and Surgeons, Baltimore; Professor of Chemistry in the Maryland College of Pharmacy. New (sixth) edition. In one 8vo. volume of 532 pages, with 46 engravings and 8 colored plates illustrating 64 of the most important chemical tests. Price, cloth, $3.00 net. Lea Brothers & Co., publishers, Philadelphia and New York.

The several editions of this well-known work have maintained the high standard of excellence at first obtained. Its popularity has continued to increase until it now occupies a place at the head of textbooks on chemistry offered to students of medicine and pharmacy. Nothing is neglected in the scope of the volume. The fundamental data, of organic and inorganic chemistry, are arranged so conveniently and impressively as to urge to a further examination of its pages. Considerable admiration has justly been won by the unique set of plates giving the actual colors and color changes of sixty-four of the most important tests. These plates are intended to serve as standards of comparison in the laboratory. It is difficult to conceive of a better or more practical text-book.

A Treatise on the Science and Practice of Midwifery.-By W. S. Playfair, M. D., LL. D., F. R. C. P., Emeritus Professor of Obstetric Medicine in King's College, London. Examiner in Midwifery to the Universities of Cambridge and London. Seventh American from the Ninth English Edition. In one very handsome octavo volame of 700 pages, with 207 engravings and 7 full-page plates. Cloth, $3.75, net; leather, $4.75, net. Lea Brothers & Co., Publishers, Philadelphia and New York.

It is evident to everyone, when a book is put through as many as sixteen editions, that it must possess considerable merit. That the

demand for it comes from the two most practical nations-America and England-is another very strong testimonial in its favor. Such is the history of Plairfair's Midwifery, the most widely known of texts on this subject. This new edition gives evidences of revision to date on every page, and as it is authoritative, clear, well illustrated and moderate in price it will continue to be the favorite student's text-book and the practitioner's trusted friend.

The Care of the Baby. A manual for Mothers and Nurses, containing practical directions for the Management of Infancy and Childhood in Health and Disease. By J. P. Crozier Griffith, M. D., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania. Physician to the Children's Hospital, to the Methodist Episcopal Hospital, and to St. Agnes Hospital, Philadelphia; Member of the American Pediatric Society and of the Association of American Physicians. Second Edition Revised. Phila.

W. B. Saunders, 925 Walnut Street.

The work before us is written for mothers and nurses. But the author points out in the book that it is not intended that this work should take the place of the doctor, but on the other hand its use in the household and by the nurse would relieve the physician from many unnecessary facts and details which constitute part of the work in his life so trying and wearing upon him. Matters of interest to mothers such as the hygiene of pregnancy, and similar data. The symtomatology of diseases of children is happily written to the layman and for the direction of the management of the various accidents alone gives the book a value far above its cost. Medical students migh. be well benefited by reading the book.

The Genesis and Dissolution of the Faculty of Speech. A Clinical and Psychological Study of Aphasia. By Joseph Collins, M.D., Professor of Diseases of the Mind and Nervous System in the Ne wYork Post Graduate Medical College Neurologist to the New York City Hospital; to the St. John's Guild Free Hospital ofr Children; and to the Post Graduate Hospital; Attending Physician to the St. Mark's Hospital. Awarded the Alvarenga Prize of the College of Physicians of Philadelphia, 1897. New York, The MacMillan Company. 1898. Price, $2.50.

Speech as stated by the author of this work is the distinguishing feature between man and the lower animals, and such speculations upon its nature, origin and character has been, and ever will be, a matter of sublime interest to the thinking human beings. Dr. Collins, although a young man, has had large experience with nervous diseases. and is able to speak somewhat authoritatively upon the subject. He is a keen student of medicine and a ready writer. It is no wonder

that the present book was thought worthy to be awarded the Alvarenga prize of the College of Physicians of Philadelphia, 1897. The book consists of 425 pages and is illustrated. The present chapter opens with an introduction and a general discussion of the subject of Aphasia, and is followed by chapters upon history, and analysis of the Genesis and functions of speech conception of aphasia, in which the anatomy of the brain and zone of language, and site of the revival of words in silent thought, and arguments relative to the specia. graphic motor center are discussed. The following chapters class motor aphasia cortical motor aphasia, subcortical motor aphasia, total aphasia. Then follow chapters upon these. A diagnosis of aphasia is then discussed in a separate chapter, and the intricacies of aphasia are certainly nowhere else more clearly unraveled than is given in this chapter eight. Etiology, so valuable to surgeons, relative. to head injuries, comes in for the next fifty pages in the book in which, while the morbid anatomy of this condition follows based upon the various causes for this condition, and treatment is well considered under chapter two, although the reference to this portion of the subject is largely of negative character. Remarks on the medico-legal aspect of aphasia, conuuction aphasia and a case of articulatory-kinaesthetic aphasia are given ample space in the book and so that any defect in speech was a case of aphasia and in this it is wherein many cases are discussed in court with diagnosis relative to their diseases are intimately associated with the symptoms found in a case of aphasia. Any reputable physician or one who desires to maintain his standing in the profession can not long be without this extremely valuable book.

A Text-Book of Materia Medica, Therapeutics and Pharmacology. By George Frank Butler, Ph. G., M. D., Professor of Materia Medica and Clinical Medicine in the College of Physicians and Surgeons, Medical Department of the University of Illinois; Professor of General Medicine and Diseases of the Digestive System, Chicago Clinical School; Attending Physician to Cook County Hospital; Member of the American Medical Association, Illinois State Medical Society, Chicago Medical Society, Chicago Pathological Society, and the Chicago Society of Internal Medicine; Fellow of the Chicago Academy of Medicine, etc. Second edition, revised. Price, cloth, $4.00 net. Sheep or one-half Morocco, $5.00 net. Philadelphia: W. B. Saunders, 925 Walnut street, 1898.

The verdict pronounced when this volume is perused is one that should gratify the author and publisher for all time. Students who consider materia medica a dry study at best will find in this treatise a departure from the unattractive details of the usual text-book on this subject. Precision and clearness are linked with authoritive statements and able descriptions, with a most inviting result. Since the publication of the first edition, which received such a favorable reception, a good many new drugs i.ave come into vogue, and our knowledge