operative technics of other authors. There are ten hundred and forty-six of these illustrations, showing the procedures and operations without obscuring their purpose by unnecessary anatomic surroundings. Definite and precise instructions are given regarding the preservation of specimens of morbid tissues and secretions, and their delivery in good condition to the pathologist. The fore part of the work, dealing with antiseptic technic, shows great care in its preparation, Dr. Ashton wisely describing only those methods which he employs in his own practice, in order that the reader may have a clear and definite conception of the subject. Very special attention has been given to the consideration of visceral injuries, and we know of no other work on gynecology or general surgery discussing this important subject with the same amount of detail. This is decidedly a work for the general practitioner as well as for the student; and a good one.

HARRINGTON'S PRACTICAL HYGIENE. A Treatise on Hygiene and Sanitation. For Students, Practitioners, Health Officers, etc. By CHARLES HARRINGTON, M. D., Assistant Professor of Hygiene in Harvard University Medical School, Boston. New (3rd) edition, thoroughly revised. In one octavo volume of 793 pages, with 118 engravings and 12 plates. Cloth, $4.25, net. Lea Brothers & Co., Publishers, Philadelphia and New York, 1905.

No department in the realm of medicine approaches in importance Hygiene and Sanitation the science and art of conserving the health, energy, wealth, and welfare of the individual and of the community. An authoritative book, covering the entire subject clearly and comprehensively, is therefore an essential to the full execution of professional responsibilities. Dr. Harrington's work was accepted as the authority upon the appearance of its first edition. He treats his subject broadly and with careful attention to details, his purpose being to furnish a clear, complete, well-illustrated volume equally adapted to the needs of the student, practitioner, and health officer. The success of the work is well shown in the demand which has exhausted two large editions in less than four years. As the succeeding editions are called for, the author by careful revision, elision of ob

solete matter, and addition of new, keeps his work well abreast of the advances in a subject by no means stagnant. The new section on Infection, Susceptibility, and Immunity will prove a valuable and interesting feature of the present edition. Evidences of searching revision will be found throughout the book, and alterations and additions necessitating a considerable increase in both text and illustrations, although the price remains at its previous very moderate figure.

PATHOLOGY AND THERAPY OF DISORDERS OF NUTRITION.- Drink Restriction (Thirst-Cures), Particularly in Obesity. By PROFESSOR DR. Carl von NOORDEN, Physican-in-Chief to the City Hospital, Frankfort a Main. Part VI. 8 vo., pp. 86, cloth, price 75c. E. B. Treat & Co., Publishers, New York, 1905.

Professor von Noorden's monograph on Drink Restriction is most instructive, and of the highest practical importance. Many persons drink too little, of water particularly, but this distinguished author has proved a great many others drink too much, even water. Under a misplaced confidence in ill-advised persons suffering from dilated heart, dilated stomach, Bright's disease, and even anemia and chlorosis have shortened their lives, and it is in these cases that this little brochure will prove so valuable.

A TREATISE ON ORTHOPEDIC SURGERY. By EDWARD H. BRADFORD, M. D.. Surgeon to the Boston Children's Hospital; Consulting Surgeon to the Boston City Hospital; Professor of Orthopedic Surgery, Harvard Medical School; and ROBERT W. LOVETT. M. D., Surgeon to the Infants' Hospital and to the Peabody Home for Crippled Children; Assistant Surgeon to the Boston Children's Hospital; Assistant in Orthopedic Surgery, Harvard Medical School. Third edition, illustrated by 592 engravings, 8

vo. pp. 669, cloth, 1905. Wm. Wood & Co., Publishers, New York.

From the preface to the third edition of this most excellent work we quote: "In preparing the third edition of this work. it has been necessary to rewrite entirely several portions, to make extensive alterations in others, and to rearrange chapters and

subjects. These changes have been made in the endeavor to offer to the reader a description of the present condition of orthopedic surgery with its notable progress since the publication of the second edition in 1899.

The most marked differences between the second and third editions will be found in the chapters treating of congenital dislocation of the hip, of scoliosis, of traumatic and non-traumatic coxa vara, and of non-tuberculous diseases of the joints, as it is in the study of these subjects that the greatest advances have been made. Many original illustrations have been added and many of the old ones have been improved, making them more illustrative of the subjects mentioned in the text.

"A chapter giving the details of orthopedic apparatus, with descriptions and drawings of appliances found to be of practical efficacy, is added in the hope of giving to the general practitioner technical information which is of use in the treatment of orthopedic affections."

Books printed by Messrs. Wm. Wood & Co. always show the highest result possible to be obtained as to mechanical execution, and this one shows that they are not yet "laggards in that field."

Selections.

SANITATION ON THE ISTHMUS OF PANAMA.- As the Japanese army surgeons obtained surprising results in the maintenance of the health of their armies, so can the United States army surgeons obtain equally good sanitation on the Isthmus. The results secured by the Japanese were obtained through the application of sanitary laws which are the common property of the medical world. The magnificent showing was but the outcome of a successful and skilful application of them. The responsibility of attainment lay with the governors, the generals-in-chief, who saw or were made to see the possibilities of the application of sanitary science to the health of armies.

The ability of the United States, both in regard to skill in sanitary science and in financial power, leaves no excuse for any thing but the best sanitary conditions among the troops and the army of employees on the Isthmus.- Brooklyn Med. Jour.

WHEN NOT TO OPERATE FOR APPENDICITIS.- J. E. Moore, Minneapolis (Journal A. M. A., June 24), combats the dictum that all cases of appendicitis are operative cases, holds that while certain classes of cases, such as chronic appendicitis without acute attacks, those with localized abscess, and acute cases seen in the beginning of the attack, call for operation provided hospital facilities and a good surgeon are available, there are others, he believes, in which surgical interference is not advisable. The conditions in which the radical operation is not the best treatment are summarized by him as follows: "First, when the patient is evidently moribund; second, when the patient is evidently convalescing; third, when certain grave complications are present; fourth, in the midway cases beginning with the third day when the physician and surgeon are in doubt; fifth, in the extreme cases of suppurating peritonitis." Even in serious complications, or when general anesthesia is contraindicated by the condition of the patient, if localized abscess exists, he states that it should be evacuated under local anesthesia. Ochsner's starvation treatment, Moore says, has been badly misunderstood. Ochsner did not recommend starvation and lavage for appendicitis, but for spreading peritonitis due to neglected appendicitis. In such cases Moore, by opening abscesses locally and by using to a greater or less extent Ochsner's method, has been able to tide them over to a successful interval operation.

REGENERATION OF NERVES.-It is possible to functionate two opposing groups of muscles by a single nerve, which previously supplied one group only; it is possible to innervate fairly completely muscles with a much smaller number of motor horn cells than usually bring about this effect. When the central end of one nerve is joined to the peripheral ends of two nerves, there

are many more fibers in the peripheral nerves than in the central nerves, so that the nerve fibers in the proximal trunk divide on going to the distal trunks. In some cases at least some of the branches from one nerve fiber go to supply one set, and others the opposing set of muscles. This may prevent very delicate movement being restored. After this form of suturing, the arrangement of the nerve fasciculi in the peripheral nerves is considerably altered.-B. Kilvington in British Medical Journal, April 29, 1905.

THE DIAGNOSIS OF CUTANEOUS SYPHILIS.-E. A. Fischkin, Chicago (Journal A. M. A., July 8), concludes from his observations and studies that the elements of diagnosis in cutaneous syphilis have only an arbitrary value. The element of time is unreliable; it may happen that simple sores with consequent gland swellings will develop in intervals corresponding to the periods of syphilis. Regionary lymphadenitis is not absolutely pathognomonic of syphilis. Indolent and indurated inguinal and cubital glands may follow infection of simple wounds. The ensemble of all syphilitic symptoms may be closely imitated by nonspecific dermatoses. Syphilis can only be diagnosed with absolute certainty when based on positive as well as on negative findings, i. e., when we not only find the characteristic elements of syphilis, but when we can with certainty exclude all other skin diseases that may appear with similar symptoms.

GASTRIC ULCER IN CHILDREN.-W. L. Stowell was called to see a girl of eight years, who was found presenting the appearance of one dying from pneumonia. The epigastrium was hard and tender to pressure, and the abdomen was moderately distended. The day before she had complained of pain in the stomach with weakness and pallor, and she died after two hours of delirium during the night of the day when seen by the author. A partial autopsy was performed, and two perforated ulcers, each about one eighth of an inch in diameter, were found on the posterior surface of the stomach, about two inches from the pylorus, on the lesser curvature. Abstracts of thirty-five case