A book on diseases of the Nervous System. Much of the detail, references and authority quotations which fill up the average work on neurology have been omitted. The pathology, the essentials for differential diagnosis, the adjuvant and homeopathic treatment, are given concisely, yet completely enough for any one but a specialist. As a text book for the student and a ready reference book for the general practitioner, we believe it a valuable addition to our literature.

"Refraction," by Thomas G. Atkinson, M. D., Chicago, published by G. P. Engelhard & Co., Chicago. New edition, price $1.25.

True to its title the book is refraction pure and simple with only such ocular diseases added as unavoidably affect the refractive media. A strong, plain work-a-day book with a subtle note of sympathy for the beginner beset by complications, and evidence of appreciating his difficulties, and so the book contains many simple points of importance to him-points usually ignored by the expert. These first principles are so arranged as not to impoverish the effort at comprehension and are repeated often enough in sequence of added facts to drive home to the understanding. A book to make the student enthusiastic to proceed. The illustrations are unusual in simplicity and apt in serviceable elucidation.

Text Book of Nervous Diseases and Psychiatry, for the use of Students and Practitioners of Medicine. By Chas. L. Dana, A. M., M. D., LL. D. Seventh edition. William Wood & Co., New York. Price $5.00.

A revised edition of this justly popular work. Some few things that were old or unimportant have been eliminated and much that is new and approved has been added. A chapter on psycho-therapy has been added and the chapters on neurasthenia, hysteria, psychasthenia, neuritis, tabes, multiple sclerosis, brain tumors and some other affections which have been the subject of careful investigation recently, have been revised and added to. The illustrations are good and the chapter on cerebral topography is alone, worth the price of the book.

A Text-Book of Operative Surgery. Covering the Surgical Anatomy and Operative Technic involved in the Operations of General Surgery. Written for Students and Practitioners. By Warren Stone Bickham, Phar. M., M. D. Visiting Surgeon to Charity and Touro Hospitals, New Orleans. Third Revised Edition. Octavo of 1206 pages, with 854 illustrations, entirely original. Philadelphia and London: W. B. Saunders Company 1908. Cloth $6.50 net, Half Morocco $8.00 net.

An extended review was given this valuable work on operative Surgery when it was issued in 1903. That it has already reached a third edition is sufficient evidence of the hearty reception accorded it by the medical profession. The one feature that distinguishes this book from all others with which we are familiar is the systematic and concise arrangement with which the various subjects are presented. There are two general divisions, Part 1. the Operations of General Surgery. Part II, the Operations of Special Surgery. In dealing with each group of tissues, or class of operations (in Part I), or with each organ (in Part II), the following divisions of the subjects are taken up, in order: -(1) Surgical Anatomy (of the region or organ); (2) Surface Form and Landmarks; (3) General Surgical Considerations (in operating upon that region or organ); (4) Instruments (used in such operations)-all being introductory to the specific operations: -after which each operation is taken up in turn, under the following headings: (1) Title of Operation; (2) Description of Operation (including its general indications); (3) Preparation of Patient; (4) Position of Patient, Surgeon, and Assistant; (5) Landmarks of Operation; (6) Incision for Operation; (7) Steps

of Operation; (8) Comments. In the description of the technic of the operations the "Incision'' is given a heading to itself-to emphasize the importance of this step of the operation-recognizing that the operator who starts out aright is a long way ahead of the man who takes his initial step erroneously. Under "Operation' the various steps are given in numbered paragraphs-the different paragraphs usually indicating, in a general way, some change in the technic or in the stage of the operation. This edition contains nearly 250 pages of text and 300 illustrations not found in the last.

Practical Points in Anesthesia. By Frederick Emil Neef, B. S., B. L., M. L., M. D., New York. Price Semi-De Luxe-Cloth 60 cents, post paid. Library De Luxe Ooze Flexible leather $1.50 post paid. Surgery Publishing Co., 92 William St., N. Y. U. S. A.

This very practical monograph presents the author's impressions on the correct use of chloroform, ether, etc., is a simple and coherent working method, and is of particular value to those general practitioners who are so situated that the services of a trained anesthetist cannot be secured. Among the subjects covered are: Induction of Anesthesia, Cardiac and Respiratory Collapse. When shall the Patient be Declared Ready for Operation, Maintenance of the Surgical Plane of Anesthesia, Important Reflexes, Vomiting during Anesthesia, Obstructed Breathing, Use of the Breathing Tube, Indications for Stimulation, Influence of Morphine on Narcosis, General Course of Anesthesia, Awakening, Recession of Tongue after Narcosis, Post-Operative Distress, Minor Anesthesia with Ethyl Chloride, Intubation Anesthesia, etc., etc.

This extremely practical and useful little book is condensed to about fifty pages, but every page is replete with valuable data.

Notes and Comments.

Το

THE NEUTRALIZATION OF DYSCRASIA.-In a very excellent article on "Various Forms of Headache" which appeared in "Medical Progress" a short time ago, Dr. J. U. Ray, of Blocton, Ala., states that "We must not only be particular to give a remedy intended to counteract the cause which produce headache, but we must also give an anodyne which will relieve the pain until the constitutional dyscrasia to which this trouble is due, has been neutralized. answer this purpose, two antikamnia tablets will be found a safe and convenient remedy. Usually they relieve the pain within twenty minutes. When we have a patient subject to sick headaches, we should caution him to keep his bowels regular, and when he feels the first premonition of an attack, he should take two antikamnia tablets. Most all patients tell us they know by certain symptoms when an attack is about to come. To these patients we can do nothing better than give them antikamnia tablets to be carried around with them always ready for use. They are prompt in action, and can be depended upon to produce the most soothing anoydne action. In this country and also in England these tablets are largely employed, with results that have caused them to be depended upon by the best observers in both countries. The remedy, having none of the drawbacks common to other agents of this class, it is eminently fitted to be applied in the treatment of the cases just described."

IN ENLARGED PROSTATE OF THE ADENOMA VARIETY, if both lobes grow equally and there is no enlargement of the middle lobe, it may cause the patient very little trouble, and if carefully advised and with the administration of sanmetto and the use of sitz baths, may be much better off if allowed to

keep his prostate than if he runs all the risks of an operation, that should never be lightly undertaken, for one can never be sure that his patient will recover; some of the most promising cases suddenly develop uremia after operation, and die.

AN OPEN LETTER.

It gives us great pleasure to announce that we have secured another live Snake, a Lachesis Mutus, in fine condition, from which a quantity of venom has been extracted. This fact is attested by Professor Raymond L. Ditmars, Curator of the Reptile House, Zoological Gardens in this city. We are therefore prepared to furnish the profession with fresh triturations and dilutions of the various potencies of the Lachesis Mutus, (Bush-master) and Lachesis Trigonocephalus (Lance-headed Viper), under seal, whichever the physician may desire. We have no inclination to enter into a discussion in regard to the statements which have been made in certain trade journals controlled by a competing house, as to the correctness of the facts given in their own publication, the American Homeopathic Pharmacopeia, and other works published by them, our one aim being to furnish the profession with fresh preparations of exactly the remedies called for. Respectfully, 11 West 42nd St. N. Y,

November 12, 1908.

BOERICKE & RUNYON, Homeopathic Chemists.

This is to certify that we witnessed the operation of extracting the venom from the fangs of the live Lachesis Mutus (Bush-master) by Professor Raymond L. Ditmars and his assistant, Mr. Charles E. Snyder, at the Reptile House, Zoological Gardens, on November 8th, 1908, and the same livered to the owners of the serpent, Messrs. Boericke & Runyon, Homeopathic Chemists.

SIGNED

was de

Royal S. Copeland, A. M., M. D., Dean N. Y. Homeopathic Medical College & Flower Hospital; Wm. Tod Helmuth, M. D., Prof. Surgery, N. Y. Homeopathic Medical College & Flower Hospital; John B. Garrison, M. D., Director of Drug Proving, N. Y. Homeopathic Medical College & Flower Hospital; O. R. Long, M. D., Medical Superintendent, State Asylum, Ionia, Michigan. New York, November 11th, 1908.

ETHICAL ELEGANCE. To obtain an antiseptic and germicide the equal of Bichloride and Carbolic without their dangerous features, has been a great study with the friends as well as the foes of these two corrosive agents. Dr. Tyree believes the problem is solved by the clinical and scientific tests made with Tyree 's Antiseptic Powder. These tests, with the opnions of gentlemen eminently qualified to pass upon the therapeutic value of any chemical agent, are embodied in an interesting little booklet, which will be sent free. While Tyree's Powder has hitherto been largely confined to obstetrical and gynecological work, careful experiments in the hospitals of this country and London, indicate its equal value in general, rectal, laryngeal and oral surgery, whether of operative or mechanical application.

Should you feel sufficiently interested, the doctor will, upon request, mail a sample of this great antiseptic. In this connection he assures the profession that this is not done with a view of securing names for publication. This is never done, as his antiseptic is strictly an ethical one. His sole object is to acquaint the profession personally with the great value of this remedy. For samples and descriptive literature, write Dr. J. S. Tyree, Chemist, Washington, D. C.

WHERE HYSTERIA is the result of uterine troubles, Aletris Cordial Rio combined with Celerina is an excellent remedy.

THE FREQUENT, URGENT DESIRE TO URINATE in old men, with some mucus discharge, is relieved by a teaspoonful of sanmetto every three or four hours.

The mucous coat of the gastro-intestinal tract seems to be the intelligent one. When a portion of food comes along, the cells composing the glands located in this coat, at once know just what kind of ferment to send forth in order to digest it. If it is proteid food there is a plentiful supply of the agents necessary to change it into peptones. If carbo-hydrates, then there is selective secretion of those ferments required to produce maltose. Not only is there wisdom displayed by the secretory cells, but also by those of absorption. The fats, proteids and carbo-hydrates are properly and intelligently separated from each other, and carried to the various points where they can be further elaborated, according to their invididual, chemical peculiarities. That is, the mucous coat performs these functions when it is in a healthy condition. When not, "is another story," which will not be considered tonight.

The muscular coat of the gastro-intestinal tract perhaps does not possess as high a degree of intelligence as the mucous, but nevertheless is just as important, because of the physical work which it performs. It is "the man with the hoe," as it were, and food once having passed the voluntary muscles of the pharynx is picked up by this muscular coat, and carried along while it is being sorted, and its nutritive elements of various kinds are being separated and garnered into the store house of the human economy by the various agents mentioned as being stationed in the mucous coat. And finally those portions of the food rejected by all such agents are propelled out of the body as waste matter by this same muscular coat. This layer sometimes becomes tired and paretic, or something occurs producing obstruction which its strength cannot overcome, so its work may also at times be imperfectly performed.

But in this article it is the peritoneal coat, together with its mesenteries and ramifications, which is to be especially considered.

* Read before the Cleveland Homeopathic Society, Dec. '08.

The work allotted to this structure in the process of digestion, is rather of a passive than of an active nature. Enclosing the muscular coat in its embrace, it furnishes a smooth and lubricated surface to glide over adjacent structures during the movements of peristalsis. It also provides a sort of platform, or elongated nest, held in position by a number of guy ropes or cables in the form of the mesenteries, furnishes a foothold or support upon which the musculas and mucous coats may perform their more active functions.

The disabilities by which the peritoneum may be afflicted, and which may give rise to symptoms of chronic indigestion, are chiefly those which interfere with the mechanical activities of the muscular coat, and are of two kinds:

1. Adhesions between two adjoining surfaces of the peritoneum may form, thus preventing a free peristaltic movement of the parts, together with a painful pulling or dragging on such adhesions.

2. A relaxation or stretching of some of the cables or mesenteries, thus causing a prolapse or ptosis of some part or parts of the alimentary tube. Such ptosis gives rise to unnatural angles and grades past which the food must be propelled by the muscular coat. This results in delays and temporary stagnations of the gastro-intestinal contents, during which times the bacteria of fermentation. and putrefaction produce morbid changes resulting in abnormal ptomaines and organic acids.

Considering first the adhesions, there are two places where they are especially liable to occur. One is in the duodenal region, the other in the ilio-caecal. Those in the neighborhood of the duodenum may be caused either by an ulcer, beginning in the mucous coat and penetrating deep enough to cause a fibrinous inflammation of the peritoneum, which extending to the same coat of some contiguous organ results in the formation of adhesive bands between them, or the necessary inflammatory pathology may extend from a cholecystis or cholangitis, probably ignited originally by a deposit of gallstones. Whichever of these causes started the trouble, firm adhesive bands, or else slender web-like filaments exist, which tying the duodenum to surrounding surfaces, interfere materially with the passage of chyme.

The condition is one extremely difficult to diagnose, for the symptoms are practically the same as are found in both hyperchlorrhydria, and in ulcer. In fact the first of these, excessive acidity, nearly always co-exists with the adhesions, and as acid when considering the etiology an ulcer is in a large number of cases the original cause of the adhesions, and so of course is liable to continue