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the characters of this story are made to live Laminectomy Two Years After Injury, again.

Keen's Surgery. Vol. VI: The Volume with the Newest Surgery. By 81 eminent surgeons. Edited by W. W. Keen, M. D., LL. D., Hon. F. R. C. S. (Eng. and Edin.), Emeritus Professor of the Principles of Surgery and of Clinical Surgery, Jefferson Medical College, Philadelphia. Octavo of 1177 pages, with 519 illustrations, 22 in colors. Philadelphia and London: W. B. Saunders Company, 1913. (Entire work, consisting of six volumes, per volume, cloth, $7.00 net; half morocco, $8.00 net.)

This volume brings out a new departure in the publication of surgical text-books. Originally Keen's Surgery contemplated five volumes; but the progress of surgery has been so rapid since Volume V appeared in 1909, that the various authors have supplemented their former articles by adding much new important subject-matter. This comprises many chapters, and constitutes in itself an up-to-date system of surgery. The new chapters on Thoracic Surgery are of particular interest. Some of the newer subjects fully discussed are, Anocia-Association, intratracheal insufflation a nesthesia, nitrous oxide and intravenous anesthesia, the surgery of the hypophysis, the treatment of cancer by fulguration desiccation, etc., the use of iodine as a surgical disinfectant, and the use of salvarsan in syphilis. This volume also contains a useful general index to the whole six volumes.

The Surgical Clinics of John B. Murphy, M. D., at Mercy Hospital, Chicago. Volume II, No. 1 (February, 1913). Octavo of 179 pages, illustrated. Published bi-monthly. Philadelphia and London: W. B. Saunders Company, 1913. (Price per year: Paper, $8.00; cloth, $12.00.)

In addition to the clinical talks of Dr. Murphy, this volume contains two excellent addresses: one upon the Open Treatment of Fractures, by Mr. W. Arbuhtnott Lane, of London; the other upon the Medicolegal Relations of Physician and Patient, by Dr. W.C. Woodward, health officer of the District of Columbia. Both addresses are authoritative and well worth reading. The clinical cases and comments exhibited in this number are instructive and cover a wide field of practical surgical knowledge. Among the subjects considered by Dr. Murphy may be found talks upon Ostectites of the Femur, Luxation of the Semilunar Cartilage, Floating Cartilage, Fecal Fistula following Appendectomy, Tuberculosis of the Knee (Treatment of Tuberculous Joints), Paget Disease, Acute Appendicitis, Abscess of the Neck, Broad Ligament Abscess, Cerebral Adhesions, Fractures and Luxation of the Neck of the Humerus, Laminectomy, Congenital Pyloric Stenosis,

Hour-glass Stomach.

Handbook of Diseases of the Rectum. By Louis J. Hirschman, M.D., President of the American Proctologic Society, Lecturer on Rectal Surgery and Clinical Professor of Proctology, Detroit College of Medicine. Revised and rewritten 2d edition. 338 Pages. Royal Octavo-172 illustrations including four colored plates. St. Louis: C. V. Mosby Company, Publishers. (Price, $4.00.)

The text is similar to that of the first

edition, with the addition of some excellent illustrations, among them being a number of radiograph plates of the colon in the chapter on constipation and obstipation. The book is well written, the operative technique made very plain and the general practitioner will find it a good book for ready reference. The chapter on Dysentery by Dr. J. L. Jelks, Memphis, Tenn., is especially worthy of mention, and while brief, contains much that is valuable.

J.M.F.

Formulas for Infant Feeding. Boston, Mass.: Mellins Food Company.

This booklet on infant feeding presents so much information of value, we feel it should not be dismissed without careful reading. It has been written with scientific exactness and much care. It will go far toward solving the problem of artificial feeding of infants and invalids. The carefully prepared tables will save physicians time and trouble, dealing as they do with food values and caloric estimations for all conditions. Copies are to be sent to physicians generally throughout the country. They meet a hearty welcome by all who meet these problems of artificial feeding.

J.M.B.

The Case of Jennie Brice. By Mary Roberts Rinehart. Illustrated by M. Leon Bracker. Indianapolis: Bobbs-Merrill Company. ($1.00.) Our readers will be interested in the fact that the author of this new fiction is the wife of Dr. Stanley Rinehart, a Homeopathic practitioner of Pittsburg, who has frequently collaborated with Mrs Rinehart in the production of her books. The mystery of "Jennie Brice" centers in the sudden disappearance of a prominent actress, and one finds the tale absorbing and interest deepening until it holds one in a vise. A startling case of mistaken identity; a network of circumstances pointing to the guilt of the actress' husband; a chain of evidence by which he establishes a substantial alibi; clues galore indicating a score of other possibilities; a striking jury trial; a strange love piot-all these go to make the book intensely urgent and mysti

fying. In addition to the intensity and urgency of the deep and mysterious in the book, there is a pretty love story unfolded, and a characteristic element of cheer that brings an inviting glow to the whole book and prevents the story from becoming uncanny or ghastly.

A New Book on the History of Medicine. W. B. Saunders Company, publishers, of Philadelphia and London, have in active preparation a work on the History of Medicine by Dr. Fielding H. Garrison, Principal Assistant Librarian, Surgeon-General's

office, and editor of the Index Medicus. Dr. Garrison's twenty years' experience in medical bibliography, and the unusual advantages derived from his close touch with the rich stores of the surgeon-general's office, fit him most admirably for such a work as this.

His book will present the history of medicine from the earliest ancient and primitive times; on through Egyptian Medicine, Sumerian and Oriental Medicine, Greek Medicine, the Byzantine Period; the Mohammedan and Jewish Periods, the Mediaeval Period, the Period of the Renaissance, the Revival of Learning and the Reformation; the Seventeenth Century (the age of individual scientific endeavor), the Eighteenth Century (the age of theories and systems), the Nineteenth Century (the beginning of organized Advancement of science), the Twentieth Century (the beginning of organized preventive medicine). There will also be appendices covering medical chronology, histories of important diseases, histories of drugs and therapeutic procedures, histories of important surgical operations, and bibliographic notes for collateral reading.

Dr. Garrison's work will undoubtedly be a valuable book to every medical man. In this one volume he will get a complete his tory of medicine from its earliest times, presented in a concise form.

The illustrations are intended to stimulate the reader's interest in the picturesque aspects of medicine and in the personalities of its great leaders. The biographies will be confined to the most important facts and to interesting personal traits. The original bibliographic references to the important discoveries, operations and experiments will be given. Each period is to be followed by a brief survey of its social and cultural phases. Altogether it promises to be a most important addition to medical literature. We await its publication with much interest.

ease.

Surgery

L. A. TODD, M. D., St. Joseph, Mo. The Thyrogenic Origin of Basedow's DisDr. J. H. Jacobson gives the following conclusions in the Annals of Surgery: 1. Basedow's disease can and has been produced experimentally in lower animals by the injection of thyroid pressure fluid (Klose), by implantation of the thymus gland (Bucher), and by the injection of the macerated thyroid gland (Baruch). Symp. toms closely resembling Basedow's disease can be produced in animals by thyroid feeding. 2. The evidence at hand indicates a close relationship between the thymus and thyroid glands. 3. That the symptoms of Basedow's disease are due to either an excess or perverted secretion of the thyroid, with the primary disturbance existing in the thymus gland, the action of the thyroid being that of a "multiplicator," according to the theory of von Mikulicz. 4. Basedow's disease has been produced in man by the excessive administration of thyroid extracts and preparations of iodine. 5. That there are changes in the thyroid gland, chemically, macroscopically and microscopically, which are characteristic for Basedow's disease. 6. Typical Basedow's disease or symptoms of hyperthyroidism (socalled secondary Basedow's disease) occurs after or in connection with other affections of the thyroid, such as simple and adenomatous goitre, cancer, and inflammations. 7. That there is a characteristic blood picture in Basedow's disease which disappears after the surgical removal of a sufficient amount of the diseased thyroid tissue. 8. The successful treatment of Basedow's disease by measures directed toward the thyroid itself, as well as by serum therapy, proves the thyroid origin of the disease. 9. Basedow's disease can be cured by the surapproximately 70 per cent of all cases. gical removal of portions of the gland in

New Officers of the Illinois State Medical Society. At the sixty-third annual meeting of this society, held in Peoria on May 20th, 21st and 22d, the following officers were elected: President, Dr. A. L. Britton, of Athens; first vice-president, Dr. Sumner Miller, of Peoria; second vice-president, Dr. D. G. Smith, of Elizabeth; secretary, Dr. W. H. Gilmore, of Mount Vernon; treasurer, Dr. J. A. Markley, of Belvidere, re-elected. Next year's meeting will be held in Decatur.

Department of Neurology

J. Elliott Royer, M. D., Kansas City, Mo.

An Examination of the Ductless Glands in Eight Cases of Dementia Precox.-Dercum and Ellis (Journal of Nervous and Mental Diseases, Feb., 1913) make an exhaustive report of the autopsies and microscopical findings. In the absence of definite scientific knowledge the view of the toxic origin of dementia precox must be regarded as only tentative. The features they outline suggest speculation as to the possible origin of the toxin. It is probable, if toxin exists, they are formed within the body.

The facts that dementia precox begins in the years when developmental changes are greatest, the years of puberty and adolescence, is extremely suggestive; it is associated with a period of great expansion and revolutionary metamorphosis, and during which extraordinary demands are made upon the vitality of the organism. That the development-the evolution-of cases of dementia precox is quite frequently delayed, incomplete or aberrant, every clinician, we think, will admit. How great a role the internal secretions play during the transformation and growth of the adolescent period, a moment's reflection will call to mind. That the glands are also closely inter-related is another fact of prime importance. This relationship is no longer a matter of theory and of speculation, but must also be regarded as established. Sexual evolution is dependent, as we today know, not only upon changes in the ovaries or testes. but also upon the pituitary, the pineal, the thyroid and possibly other internal glands. We have reason to believe that the organism in dementia precox is one which unfolds or evolves imperfectly and irregularly, and that at the time when this great change of adolescence takes place, the response on the part of the ductless glands is imperfect as well. Whether or not the physical signs in dementia preCox suggest an aberrant action of the internal secretions is of course open to question. The vagaries not infrequently observed in the one gland exposed to observation, namely the thyroid, as well as the facts of the circulation, especially of the surface and extremities. strongly suggest such condition. Perhaps other symptoms might be mentioned. It certainly cannot be claimed that the idea of the existence of a toxicity in dementia precox related to an imperfect development of the glands of internal secretion is inherently improbable.

One of the most notable points in their ductless gland findings is the underweight of the thyroid in seven of the eight

cases. In addition three of them showed abnormalities in the colloid, quantitative or qualitative, and four decided progressive changes in the aciner epithelial cells. The parathyroid findings cannot be regarded as of significance. This applies also to the carotid and thymus.

The most constant adrenal picture is the small amount of fat in the cells of the corIf tex, especially those of the fasciculata. this is to be regarded as indicative of funcity. In the hypophyses there is less colloid tional change, it indicates lessened activthan is usually found in a series of these glands, but we know so little regarding the morphologic attributes of function in this body that this, as well as the number of eosinophile cells, can hardly be regarded as pathologic.

Without attempting an interpretation of the histological conditions-a matter of extreme difficulty in the present state of our knowledge-we are at least justified in the conclusion that in their cases there was in all probability a disturbance of what Sajous has called the adrenal system," i.e., of the chain made up of the pituitary, the thyroid and the adrenals. Especially was change noted, e. g., striking departures in weight-in the thyroid and adrenals. Now Sajous has pointed out that in tuberculosis there is an inadequacy of this adrenal system, and the thought naturally suggests itself that these eight patients suffered from dementia precox for the same reason that they subsequently suffered from tuberculosis; that is, because of an inadequacy or abnormality of the adrenal systems. is rather a remarkable fact that the almost universal cause of death in dementia precox is tuberculosis and if the feebleness of resistance to the tubercle bacillus is due to a fault of the adrenal system, we have reason to infer that this fault pre-existed and that it is one of the factors in the make-up-the morphology of dementia preCOX. The conclusion is, of course, not justified that an abnormality of the adrenal system is the cause of the mental symptoms of dementia precox, but their findings are at least in keeping with the inference that anomalies of the ductless glands exist in dementia precox. The relation between such anomalies and the mental symptoms must remain an open question, but that the facts are most suggestive must be admitted and for this reason they venture to present their material in the form of a preliminary communication.

Gastric Aphorisms

J. M. BELL, M. D., St. Joseph.

Gastroptosis, not accompanied with a general enteroptosis, is frequently caused by emphysema of the lungs, producing downward pressure.

While surgery is needed in some digestive disturbances, it is not by any means a touch button which converts disease into health.

Alcohol, tobacco, tea and coffee are frequent factors in the etiology of dyspeptic diseases, and in many cases they alone maintain chronicity.

The digestive canal is void of tactile sensibility, consequently pathologic changes may be well advanced before painful symptoms present themselves.

Do not attempt to make a diagnosis of digestive disturbances without an examination of the entire abdomen, without, as far as possible within-from excretions; then examine the chest for obstructive diseases of the heart and lungs.

Gastric ulcer may continue to produce pain even after healing, by virtue of adhesions to neighboring structures.

¶ Gastretention and vomiting are frequently caused by a kink of the pylorus, from marked prolapse of the ascending colon. Restore the normal configuration of the colon and the vomiting ceases.

There is a clinical variety of gastric myasthenia which develop toward the time. of complete body growth and is very intractable. It is spoken of as "out-growing of strength."

In all forms of mucus gastritis lavage and massage are essentially necessary. Mucus is as offending to the stomach as it is to the nose in rhinitis or to the colon in colica mucosa.

Sixty-four per cent of chronic dyspepsia in old people is due to disease of some vital organ beyond the digestive tract, the remaining 35 per cent are due to progressive degenerate of the secretory structures within the digestive canal.

In vomiting of irregular type, not associated with the regularity of meals, consider the possibilty of brain tumor, basic meningitis or brain abscess. Examine the optic discs. Headache may or may not be a factor.

¶ Venereal excesses, normal or pernicious, are often the cause of a persistent gastric hyperesthesia.

¶ Constant and persistent hyperacidity tends to exhaust the pancreas and develops a chronic intestinal inflammation which interferes with the solution and absorption of food.

Intestinal sarcoma, unlike carcinoma, does not produce stenosis of the bowel, but a dilatation. They extend longitudinally and rapidly.

Multiple diverticula of the bowel occurs ¶ most frequently at those points were stasis from constipation is most marked, viz., the ascending colon and sigmoid. ascending colon and sigmoid.

¶ Diverticulitis may cause a circumscribed peritonitis or a general septic one from leakage. The stools in this condition are free from pus and blood; in carcinoma these elements are present.

A macroscopic examination of the stool is not helpful in early pancreatic disease. It is only in well advanced cases that we get the frequent, pale, offensive, greasy, bulky stools. The early examination must be chemical and microscopic to be of value.

If we use dietetics as an auxiliary to therapeutics-and it is a valuable one-we must be specific and not catagorical. A carbohydrate diet may be laxative or constipating; it may soothe or irritate mucus surfaces; it may possess high or low caloric value; it may be made nourishing or it can be a "bluff" meal, bulky yet low in nutrition. It may stimulate acidity or suppress it; it may increase gaseous distension or diminish it. There is the same range of influences with a protean meal or a fruit meal, or a mixed meal. Specify the food-. stuffs, for the purposes to be accomplished.

Prehistoric Relics of Missouri.-The Mis, souri Historical Society, organized in 1866is now at home in the Jefferson Memorial, St. Louis, on the site of the Louisiana Purchase Exposition. This is a half million dollar fire-proof structure. The society is making a special effort to collect, preserve and study Indian Relics found in Missouri. Ample case room has been provided for the collection. Specimens of Indian relics contributed to the archaeological museum will be placed on exhibition with due credit to the donors and become a part of the largest and most valuable collection of Missouri Indian relics ever made. Per. sons having specimens are invited to correspond with the Department of Archaeology, Missouri Historical Society, Jefferson Memorial, St. Louis. The museum is open to the public daily from 10 a.m. to 6 p.m.

Medical Progress

66

Hay Fever! Disease of Mystery."

Dr. S. Fuller Hogsett, of Pittsburg, in his excellent paper "An Experimental Therapy in Hay Fever," read at a meeting of the University of Pittsburg Medical Society, and published in the April (1913) issue of American Medicine. New York, points to some interesting facts respecting this "disease of mystery," as he not inaptly refers to it. "As far back as the year 1565, says the doctor, Botallus reported a Again, in 1673, von Halmont, and in 1698 Floyer, of London, called attention to this condition. In Good's 'Study of Medicine' there is reference to a case related by Timaens in 1667 of an attack of asthmatic nature caused by the odor of roses and ipecac."

Thus it will be seen that hay fever, instead of being a disease of modern origin, as many may have presumed, is in reality

centuries old.

tient usually sleeps comfortably. All cases that I have treated successfully have remained well through the season. I have yet to record only one failure, but I have not had a sufficient number of this class of cases as yet to warrant a positive claim that this remedy will act in all forms of the disease."

Clinical experience with mixed infection phylacogen in the treatment of hay fever is inconsiderable as yet. The product had its inception in 1912, when the season was well advanced, and the opportunities for its employment were necessarily limited. The next two months will undoubtedly tell the story of its applicability to this hitherto intractable disease, and the results of a more extended trial will be watched with a deal of interest.

The Relief of Rheumatic Pain.

For local pain, rheumatism, lumbago, gout or no matter what may be the etiology, I have been particularly pleased and Discussing the problems of etiology and rarely failed to give relief with colchi-sal treatment, Dr. Hogsett continues: Many internally, and betul-ol externally applied theories have been elaborated, and many (A. A. Wenneull, M.D., medical staff of forms of treatment have been called to the the Patterson General Hospital, April 26th, attention of the medical profession. A 1913). One case which came under my obstrain of pessimism regarding the possibil- servation in the hospital shows the efficacy ity of a cure in this condition appears in of the cutaneous method of absorbing the the writings of many authors. No one salicylates and is worthy of record: A bartheory accounts for all features of the affec- tender whose right hand fingers were swoltion and the many etiological factors." len to double their normal size and so painful that he was incapacitated, was treated by massage and local application of betul-ol. The following day when I saw the case, the pain had entirely gone, the swelling was very much reduced and in three days, he was entirely free from any symptoms. Patient was much astonished by such speedy relief. In a case of articular rheumatism, which had been treated by a number of consultants without results, yielded to colchi-sal and there has been no return of rheumatic manifestations since.

In 1912 Dr. Hogsett treated a number of cases successfully with mixed infection phylacogen. His observations as to methods and results are of interest and value. "In carrying out the phylacogen treat ment," he says "I have found that the initial dose should be small when given either subcutaneously or intravenously. It has been my procedure to begin with a 2 c.c. dose subcutaneously or one-half c.c. intravenously... In giving the subcutaneous injection I usually select the insertion of the deltoid or the area just below the scapulae. The latter seems to be the ideal spot as absorption takes place very readily and the complaints from the local reaction are much less. I repeat my injection either daily or on alternate days the interval to be determined by the clinical condition of the patient. It is seldom necessary to give more than four to six injections the symptoms often disappearing after the second or third injection. Almost immediate relief is noted by the patient. The irritating discharges from the eyes and nose are diminished in amount, the sneezing is lessened, the dyspnea is relieved, and the pa

Olive Oil as Food and Medicine.

"The trees went forth, on a time, to annoint a king over them, and they said unto the olive, 'Reign thou over us.""-Judges ix, 8.

There has never been a time, since man kept historical track of his affairs when olives and olive oil were not highly appreciated for their medicinal properties as well as food values. Scripture is full of allusions to the olive and oil. On the slopes of the Mount of Olives was the plantation

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