of three years of experimentation upon animals, the operations being afterward repeated upon the cadaver for anatomical corrections. The result is a beautifullyillustrated and ably-arranged exposition of the technique of practically all operations upon the intestines and the stomach. The chapters are as follows: Chapter I, The Repair of Intestinal Wounds; chapter II, Suture Materials, Needles, Tying Knots, Sutures and Clamps; chapter III, The Anatomy of the Intestines; chapter IV, Operations Upon the Intestines; chapter V, Operations Upon the Stomach. Each of these subjects are profusely illustrated with the best cuts, and the entire book is printed upon lithograph paper, which displays the illustrations most effectively. If we had here only the series of illustrations and accompanying descriptive titles, we would have a valuable addition to our present works upon these topics. The text, however, is of equal excellence, clear, concise, complete and altogether satisfactory.

Every surgeon needs this book, even

PAMPHLETS

A CASE OF UNILATERAL CONGENITAL FISTULA OF THE LACHRYMAL SAC, WITH A REVIEW OF THE Literature. By Henry H. Tyson, M.D., New York. Reprinted from Archives of Opthalmology, Vol. XXXVII, No. 4, 1908. THE CLINICAL SIGNIFICANCE OF UTERINE DEVIATIONS. By Lucy Waite, M.D., Chicago. Reprinted from Transactions of International Medical Congress, April, 1906.

TRICHINOSIS OF THE UPPER RESPIRATORY

PASSAGES, WITH Report of CASES. By John Mackenty, M.D., New York. Reprinted from American Medicine, February, 1908.

though the intestinal and stomach operations are not often under his hand.

THE OPERATIONS OF GENERAL PRACTICE. By Edred M. Comer, M.B. (Cantab.), F.R.C.S., and H. Irving Pinches, M.B., M.R.C.S. Henry Froude, Oxford University Press.

This book treats mainly of the many small operations which lie on the borderland between medicine and surgery, and yet which the general practitioner may well elect to perform for the benefit and convenience of his patient. It therefore meets a deficiency in medical literature and education, since most systems of surgery concern themselves entirely with the larger operative field and ignore the steps of the humbler work. Our authors have given us an excellent guide for the general practitioner to keep for himself much work which really belongs to him. The gospel of surgical cleanliness has enabled the general practitioner to perform with success operations which formerly it were folly to attempt.

RECEIVED.

ON

ON THE CHARACTER OF THE STATE BOARD EXAMINATIONS AND THE COMPETENCY OF STATE MEDICAL EXAMINING BOARDS. By Willis G. Tucker, M.D., Albany, N. Y. Reprinted from Albany Medical Annals, July, 1908. PHYSIOGNOMY; POST-OPERATIVE TREATMENT OF ADENOID PATIENTS. By Byran DeF. Sheedy, M.D., New York. Reprinted from American Journal of Surgery.

PSYCOTHERAPY; WITH SOME OF ITS RESULTS. By Beatrice M. Winkel, M.D., New York. Reprinted from Journal American Medical Association, May 9, 1908.

THE SUPPOSED BENEFICIAL EFFECTS OF OZONE A POPULAR MEDICAL FALLACY. By Theo. Wm. Schaefer, M.D., Kansas City, Mo. Reprinted from Dietetic and Hygienic Gazette, July, 1908. MYALGIA LUMBALIS. By Samuel Earp, M.D., Indianapolis, Ind. Reprinted from Lancet Clinic, August 15, 1908. THE DIAGNOSIS AND TREATMENT OF RHEUMATISM AND ALLIED AFFECTIONS. By Albert C. Geyser, M.D., New York. Reprinted from Journal of Advanced Therapeutics, August, September and October, 1906.

THE X-RAY IN DERMATOLOGY; OR TRUTH AND FALLACY CONCERNING X-RAY DERMATITIS. By Albert C. Geyser, M.D., New York. Reprinted from American Journal of Surgery, May, 1908.

WHEN AND HOW SHALL WE USE CYCLOPLEGIES IN REFRACTION WORK? By Alexander Duane, M.D., New York. Reprinted from New York State Journal of Medicine, July, 1908. URTICARIA. By Edward B. Finch, M.D., New York. Reprinted from Medical Record, February 22, 1908.

New York Academy of Medicine.Stated Meeting, October 1, 1908. Dr. LeGrand N. Denslow read a paper entitled "Locomotor Ataxia, a Report of Thirty Cases," in which he ad

new theory concerning the ultimate cause of the changes of the nervous system observed in this disease, and reviewed the records of his operative interference up to date. Based upon clinical observation, he submitted the view that the dystrophic changes occurring in the neurons of the posterior roots and their connections in tabes, are the result of continuous sensory impulses conveyed from some peripheral point to the sensory roots in the cord. Kept up for a term of years, in certain cases, such continuous impulses may, in his opinion, exhaust the central nervous system, which, having no rest or intermission from such impulses, and no time or opportunity for recuperation, finally succumbs from complete exhaustion and undergoes dystrophic degeneration. In other words, the cause is not referable to a toxin, specific agent, bacillus, or

strangulation, but it is purely physical in character. There seems to be the support of facts, as illustrated by the past and present condition of his clinical material, in favor of the following arguments: (1) Peripheral irritation can produce pathological changes in the central nervous system, by creating continuous nerve impulses, which exhaust the substance of its nerve centers. (2) The peripheral nerve degenerations of tabes are probably due to the same impulse carried to parts. of the central nervous system, and expending its force upon the points of greatest vulnerability or least resistance. (3) Symptoms occur in certain cases of tabes with a severity out of all proportion to the actual pathological change that has taken place in the nerve centers, these symptoms being referable to the initial change creating a zone or aura of irritation beyond such change, which extends to the cerebrum, cerebellum, and sympathetic system, at times appearing to cover almost the entire nervous system, inclu ling the part which presides over nutrition. (4) The removal of this causative

irritation results in recovery from such grave symptoms as loss of balance, ataxia, incontinence of urine and fæces, sensory disturbances, etc., and this would appear to indicate the existence of some zone of functional irritation beyond the actual pathological change.

With special reference to the treatment, the speaker pointed out the importance of careful individualization in these cases. The existing state of affairs must be accurately ascertained, and as soon as this has been successfully accomplished, the condition is to be rendered as nearly normal as possible. In the patients subjected to the speaker's mode of treatment, the symptoms varied from slight vesical irritation to grave cystitis, with urinary incontinence. This annoying symptom, as well as the pain, was always relieved. Very often, lesions in shape of erosions are found in the middle third of the urethra, and these should be locally treated through the urethroscope. A word of warning is in place in this particular connection in regard to cases where the deep urethra and bladder are to be invaded, even for purposes of examination. Extreme caution is needed, not only on account of the well known danger of infection and shock, but because these tabetic patients have been found in the speaker's experience to possess a special sensibility to the slightest additional irritation. The line between relieving and aggravating the irritation is a narrow one, and careless manipulation exposes the patient to an exacerbation of the symptoms, probable precipitation of crises in certain cases, and the chances of an even more embarrassing situation as the outcome of the interference, instead of cause for mutual congratulation.

In the discussion, Dr. Starr, who was prevented from attending by absence

from the city, was represented by a letter to the speaker, in which he expressed his appreciation of the remarkable results achieved by Dr. Denslow in the treatment of locomotor ataxia by his own method, as demonstrated upon the seven cases sent him from the Vanderbilt clinics, and examined by Drs. Starr and Cunningham after three months' treatment by Dr. Denslow. All these patients had welldeveloped, long-standing cases of tabes, as proven not only by their history and symptoms, but by the existence of the physical signs of the disease. There is no doubt that all were suffering from locomotor ataxia, and to such a degree that they were unable to work.

In every one of these cases Dr. Starr was enabled to testify to the very astonishing improvement shown by the subsidence of pains, the improvement in walking, and the recovery of control of the sphincters, the raising of general nutrition and the psychical standard, the decrease in sensory disturbances, such as numbness, analgesia and psychroæsthesia, etc. While the physical signs persist, each of these patients is at present in a far better state of health and frame of mind than before coming under Dr. Denslow's treatment, and all have been able to resume their occupations. Upon the theory of the disease, which is a matter of opinion, Dr. Starr had no comment to make, but he congratulated Dr. Denslow upon the success of his method of treatment, which certainly seems to support the theory advanced by him for the causation of locomotor ataxia.

Dr. Cunningham expressed himself as gratified with the outcome of Dr. Denslow's treatment in eight aggravated cases of the disease, and hoped that the remarkable curative results achieved by him would stand the test of time.

25p Archivio di Psichiatria, etc. Turin. Q., $6.50-$2.

40c Zentralblatt für Innere Medicin. Bonn. W., $6-20c.

40d Centralblatt für die Krankheiten der Harn und Sexual Organe. M., $660c.

40e Centralblatt für Praktische Augenheilkunde. Leipsic. M., $3.60-40c.

40f Centralblatt für Nervenheilkunde und Psychiatrie. Coblenz. M., $6-60c. 40g Zentralblatt für die Gesammte Therapie. Vienna. M., $3.60-40c.

40h Centralblatt für die Grenzgebiete der Medizin und Chirurgie. Jena. Semim., $6-60c.

40 Centralblatt für Kinderheilkunde. M., $2.25-30c.

40j Dermatologisches Centralblatt. Berlin. M., $3.60-40c.

40k Zentralblatt für Stoffwechsel und Verdauungs-Krankheiten. Göttingen. Semi-m., $6-30c.

31

32

Bulletin of the American Academy of
Medicine. Easton. Bi-m., $3-50c.
Buffalo Medical Journal. N. Y.
$2-25c.

45

Cincinnati Lancet-Clinic. Ohio. $2.50-10c.

M.,

33 Journal of the Arkansas Medical Society. Little Rock. M., $2-25c. 33b Bulletin of the Northwestern University Medical School. Chicago. Q., $1-10c.

33c Bulletin of the Lying-in Hospital of the City of New York. Appears irregularly. $1 per volume.

M., $2-25c.

55a Colorado Medicine. Denver. M., $220c.

56 Columbus Medical Journal. Ohio. M., $1-12c.

56a Correspondenz - Blatt für Schweizer Aerzte. Basel. Semi-m., $3-30c.

57 Critique. Denver, Col. M., $1-10c. 57a Detroit Medical Journal. Detroit. M., $1-15c.

58 Denver Medical Times and Utah Medi sal Journal. Col. M., $1-15c.