sis of the fluid do not concern us here. The chemistry of the fluid. will be touched upon, only so far as it relates to the products of myelin decay. The physical chemistry of the fluid (freezing point, etc.), the various proteids and the reducing body are all of interest, but their consideration would exceed the scope of this review. The most important chemical substance which passes into the cerebrospinal fluid is cholin, which is the nitrogen-containing methyl group of lecithin, and can be looked upon as one of its autolytic decomposition products. In the normal fluid it is found in mere traces, but in the fluid from cases of general paralysis, as first shown by MOTT and HALLIBURTON, large amounts are present. Since HALLIBURTON first demonstrated cholin in general paralysis, in his Croonian lectures on the chemical side of nervous activity, it has been found in a multitude of other pathological conditions, but principally where recent and active nerve degeneration is taking place. The lecithin of the myelin sheaths of nerves, is decomposed, probably through the agency of some enzyme, into glycerophosphoric acid, stearic acid, and cholin. This latter is found in the blood and cerebro-spinal fluid, while it is absent from the urine, except in experiments on animals, where the alkaloid is given subcutaneously or intracerebrally. When cholin appears in the fluid, there is also an increase of phosphoric acid therein (DONATH), this being another proof of its derivation from lecithin. In long continued activity of the central nervous system, as in convulsive seizures, lactic acid in large quantities appears in the cerebro-spinal fluid. Cholin is detected by means of its platinum combination, with which it forms a double salt, and crystallizes in single large yellow octahedral and occasionally twin crystals, and easily differentiated from the platinum salts of neurin and potassium, by reason of its solubility, percentage of platinum and large size and grouping of the crystals. Since HALLIBURTON first pointed out its occurrence in general paralysis, the work has been further elaborated by MOTT, WILSON, DONATH and CORIAT. As a result it is found in many pathological states, where there is an axonal reaction with corresponding fiber degeneration (central neuritis), general paralysis, brain tumor, tabes, HUNTINGTON'S chorea, delirium tremens, polyneuritis, epilepsy, senile dementia (especially where there is great wasting of the cortex), cerebral hemorrhage, beri-beri, POTT's disease, disseminated sclerosis, amyotrophic lateral sclerosis, focal myelitis, organic dementia, brain syphilis, chronic hydrocephalus (?) spina-bifida, neurasthenia (?) and hystero-epilepsy. It has also been found in the blood of animals after experimental sec tion of the sciatic nerve, and in the peripheral nerves, brain and cord in polyneuritis and in all these latter, the amount present was parallel with the extent of the MARCHI reaction. This is easily explained if we remember that the MARCHI reaction depends on the preciptation of metallic osmium by stearic and oleic acids which are decomposition products of lecithin. The action of cholin on blood pressure has been carefully studied by MOTT and HALLIBURTON, while DONA IH has shown that the injection or intracerebral application of cholin produces in animals, strong convulsive phenomena, and he concludes from these experiments that the seizures in general paralysis and epilepsy are due to intoxication by this alkaloid. In closing, we should like to say a few words on DONATH'S latest, and in many respects, his most pretentious paper, on the significance of cholin in epilepsy. He examined for cholin in sixty-four cases, detecting it by means of the platinum compound. In addition to the organic cases, where its presence would be expected, he finds it in those which we look upon as being functional in nature (neurasthenia). In addition, he finds the myelin forms of lecithin in two of his cases. This seems to us extremely doubtful and altogether inexplicable. Although using the platinum compound as a means of detecting cholin, yet according to the drawings and photomicrographs appended to his paper, he does not confine himself to octahedral or hexagonal crystals for a positive reaction, but labels anything and everything of crystalline nature as "cholin," while we have always hesitated, and then put down as negative, what DONATH in a large number of cases calls a positive cholin finding. The bibliography appended makes no claim to completeness; it merely gives those papers directly mentioned in this review, or those which have been consulted for the discussion of the material. Barrett, W. BIBLIOGRAPHY. On the Amounts of Water and Phosphorus contained in the Cerebral Hemispheres and Spinal Cords in General Paralysis of the Insane and in other Conditions. Archives of Neurology, 1899. Bethe, A. Archiv für exp. Pathologie und Pharmakologie, 1902, 48, 73. A Contribution to the Chemistry of Nerve Degeneration in General 1903, 59, No. 3. The Chemical Findings in the Cerebro-Spinal Fluid and Central Nervous System in various Mental Diseases. Am. Jour. of Insanity, 1904, 59, No. 4. The Cerebro-Spinal Fluid in Hydrocephalus. 1903, 10, No. 3. Am. Jour. of Physiology, The Production of Cholin from Lecithin and Brain Tissue. Am. Jour. of Physiology, 1904, 12, No. 4. Donath, J. Die Behandlung der progressiven Paralyse. Allg. Zeitschrift für Psychiatrie, 1903, 60, H. 4. Zeitschrift für physiol. Chemie, Oct., 1903. Der Phosphorsäuregehalt der Cerebro-spinalflüssigkeit bei verschiedenen insbesondere Nervenkrankheiten. Zeit. für physiol. Chemie, 1904, 42, H. 1 and 2. Die Bedeutung des Cholins in Epilepsie. Deut. Zeit. für Nervenheilkunde, 1904, 27, H. 1 and 2. Gutinkov, S. Zu Lehre von der chemischen Zusammensetzung des menschlichen Halliburton, W. D. The Croonian Lectures on the Chemical Side of Nervous Activity. The Coagulation Temperature of Cell-Globulin and its bearing on Halliburton, W. D. and Mott, F. W. The Physiological Action of Cholin and Neurin. Philosophical Transactions, No. 7, 1899. Hatai, S. The Effect of Lecithin on the Growth of the White Rat. American The Effect of Partial Starvation on the Brain of the White Rat. Koch, W. Zur Kenntniss des Lecithins, Kephalins und Cerebrins aus Nerven- The Lecithins. Decennial Publications, University of Chicago, 1902. Methods for the Quantitative Chemical Analysis of the Brain and Cord. Levene, P. A. On the nucleo-proteid of the Brain. Archives of Neurology and Psychopathology, 1899, 2, Nos. 1-2. On the Chemistry of the Chromatin Substance of the Nerve Cell. Jour. of Medical Research, 1903, 10, No. 2. On the Autolysis of Brain Tissue. Journal of Medical Research, 1903, 10, No. 2. Mainzer. Von der Beziehungen des Tigroids zu Kern und Plasma. Mott, F. W. Psychiatrie u. Neurologie, 1903, 12, H. . 3. Monat. für Note upon the Cholin Test for Active Degeneration of the Nervous Mott, F. W. and Barratt, W. Noll, A. Observations on the Chemistry of Nerve Degeneration. Archives of Ueber die quantitativen Beziehungen des Protagon Zum Nervenmark. Scott, F. H. On the Structure, Microchemistry and Development of Nerve cells; with special reference to their Nuclein compounds. dian Inst. 1898 and 1899, 6. Sicard, J. A. Le Liquide Céphalo-Rachidien. Paris, 1902. Thudichum, J. L. W. Trans. Cana Die chemische Konstitution des Gehirns des Menschen und der Tiere. 1901. Wilson, M. S. La Choline dans le Liquide Céphalo-Rachidien comme une signe de Wood, H. C. Jr., Rev. Neurologique, April 30, 1904. On the Toxic Action of the Decomposition Products of Lecithin. LITERARY NOTICES. Burkholder, J. F. The Anatomy of the Brain. A Study of the Human Brain from the Brain of the Sheep. A Manual for Students in Medicine, Biology and Psychology. With an introduction by Professor HENRY H. DONALDSON. 175 Pages, 32 Full Page Plates. Chicago: G. P. Engelhard & Co., 1904. This is a laboratory manual designed to meet the needs of those for whom human material is not accessible in sufficient amount for thorough demonstration purposes. It is well adapted to serve this purpose in medical schools and colleges, the text being clear, the figures good and the arrangement logical. There are unfortunately several misprints, some of serious nature, such as the confusion in the designations of Plates VIII and IX. Plate IX is defective also in that it does not show as clearly as such a dissection should show the ventricular boundaries. On the whole, however, the work is very well done and the book deserves a wide circulation. It should do much toward moderizing the instruction on the nervous system, both in medical schools and colleges. C. J. H. Smith, G. Elliot. Studies in the Morphology of the Human Brain with special Reference to that of the Egyptians. No. I. The Occipital Region. Records of the Egyptian Gov't. School of Medicine, Vol. 2, pp. 125-170, 2 plates and 47 text-figures. Cairo, 1904. The ultimate purpose of this series of studies the author states to be anthropological. And he adds, "The aim of these preliminary morphological studies is to enable us to discriminate between important and valueless features, between the kind of information that is worth collecting and that which it would be a mere waste of time to seek." This, then, is the motive underlying the present elaborate comparative study of the occipital region: to learn the relative value of the data upon which our conclusions are to be based." In reaching his conclusions regarding the homologies in this region (for which the original memoir must be consulted) the author studied more than 600 hemispheres of various Primates of every genus and about 2000 human hemispheres. The importance of the paper, however, lies not so much in the fixing of particular homologies as in the sifting out of the essential landmarks from the unimportant variations. C. J. H. |