RECENT LITERATURE.

REVIEWS.

OPERATIVE SURGERY.*

THE fourth revised edition of this valuable work is now on sale. Many improvements are noticeable in the illustrations. A number of new ones are introduced, and many of the old ones have been changed to conform to modern conceptions. The greatest changes are found in the second volume. One finds described here by text and illustration the latest methods of performing intestinal anastomosis, gastroenterostomy, pylorectomy, and many other new and important operations in the upper abdomen. One has only to read a chapter here and there to be convinced that the book is modernized.

We take pleasure in introducing it to our friends who do surgery because they can secure accurate knowledge from it, and to those who read surgery because of its charming style.

C. G. D.

*By Joseph D. Bryant, M. D., Professor of the Principles and Practice of Surgery, Operative and Clinical Surgery, in the University and Bellevue Hospital Medical College; Visiting Surgeon to Bellevue and Saint Vincent's Hospitals; Consulting Surgeon to the Hospital for Ruptured and Crippled, Woman's Hospital, and Manhattan State Hospital for the Insane, et cetera.

ACUTE CONTAGIOUS DISEASES.*

THE authors have given to the profession a work that has long been needed. We feel that in recommending it to our readers we are only doing our duty. It should be in the hands of every health officer and of those who have much to do with the acute contagious diseases. Every important phase of the subject is fully considered by men whose years of experience with these diseases cannot help but enable them to speak with authority. It is a book that should be read and reread. The illustrations are the best that have been produced. Those who have had experience with the acute contagious diseases will appreciate them, and those who are doubtful of the characters of the closely allied eruptions will receive much help from a critical differential study of them.

*A Treatise on Acute Contagious Diseases. By William M. Welch, M. D., Consulting Physician to the Municipal Hospital for Contagious and Infectious Diseases; Diagnostician to the Bureau of Health, et cetera, Philadelphia, and Jay F. Schamberg, A. B., M. D., Professor of Dermatology and of Infectious Eruptive Diseases, Philadelphia Polyclinic; Consulting Physician to the Municipal Hospital for Contagious and Infectious Diseases, and Assistant Diagnostician to the Philadelphia

Bureau of Health, et cetera. In one very handsome octavo volume of 781 pages, illustrated with 109 engravings and 61 full-page plates. Cloth, $5.00, net; leather, $6.00, net; half morocco, $6.50, net. Lea Brothers & Company, Publishers, Philadelphia and New York, 1905.

INTERNATIONAL CLINICS.*

THIS Volume keeps up the excellent record made by Doctor Kelly in the practical series it represents. Treatment, Medicine, Surgery, Obstetrics and Gynecology, Ophthalmology and Pathology are the topics for this number. It is difficult to select a few from so many articles-twenty-five in all-but among the most useful for the general practitioner may be named: "The Treatment of Some Common Gastric Disorders," by Norman B. Gwyn; "Empyema, with a Report of Thirty Cases," by J. N. Hall; "The Later Stages of Cirrhosis of the Liver," by Sir Dyce Dickworth; "The Thyroid Gland-Its Anomalies of Secretion. and their Manifestations and Treatment," by Thomas R. Brown; "The Results of Operations in the Treatment of Diseases of the Stomach," by John B. Deaver; "Phlebitis, Thrombosis and Embolism Following Abdominal and Pelvic Operations," by William A. Edwards; "The Etiology and Early Diagnosis of Acute Peritonitis," by Benjamin T. Tilton. Charles F. Craig has a very thorough paper on the "Symptomatology and Diagnosis of Malta Fever," and Aldred S. Warthin one on "An Experimental Study of the Effects of Röntgen Rays upon the Blood-Forming Organs, with Special Reference to the Treatment of Leukemia." As before, the series warmly deserves the study and support of the profession.

*A Quarterly of Illustrated Clinical Lectures and Especially Prepared Articles, et cetera, et cetera. Edited by A. O. J. Kelly, A. M., M. D. Volume IV. Fifteenth Series. 1906. Philadelphia and London: J. B. Lippincott Company, 1906.

THE PRACTITIONER'S VISITING LIST.*

THIS book is well adapted to make a physician's book-keeping reliable and accurate. It is complete in every respect. *Lea Brothers & Company, 1906.

PROGRESSIVE MEDICINE.*

PROGRESSIVE MEDICINE for June, 1905, contains the following subjects: Hernia; Surgery of the Abdomen Exclusive of Hernia; Gynecology; Diseases of the Blood; Diathetic and Metabolic Diseases; Diseases of the Spleen, Thyroid Gland, and Lymphatic System; and Ophthalmology. Each section brings into convenient form the year's work on the lines indicated. A comprehensive index makes the book valuable for rapid reference.

*Lea Brothers & Company, Philadelphia and New York.

PATHOLOGIC PHYSIOLOGY OF THE TRACTUS
GENITALIS.

BY BYRON ROBINSON, B. S., M. D., CHICAGO, ILLINOIS.

PROFESSOR OF GYNECOLOGY AND ABDOMINAL SURGERY OF WOMEN IN THE ILLINOIS MEDICAL COLlege.

FOR Over a decade I have been attempting to make prominent in gynecologic teaching, pathologic physiology, disordered function, rather than pathologic anatomy, changed structure. It seems to me. that disorder-functions or pathologic physiology of the tractus genitalis impresses itself more indelibly on the student's and practitioner's mind than pathologic anatomy. Besides, in gynecologic practice pathologic physiology occurs tenfold more frequently in the genital tract than pathologic anatomy. For the gynecologist pathologic physiology presents innumerable views of practical interest. Pathologic physiology teaches that the circulation of an organ is a fundamental factor in comprehending its disease and administering rational treatment. It takes an inventory of the volume of blood which streams through the organ as a fundamental factor in comprehending its diseases and administering rational treatment. It takes an inventory of the volume of the blood which streams through the organs at different stages and conditions. We wrote years ago that the arteries of different viscera were supplied with automatic visceral ganglia, and we christened the peculiar nerve nodes found in the walls and adjacent to the uterus, oviducts and ovaries, as "Automatic Menstrual Ganglia." The automatic menstrual ganglia complicates the blood supply of the tractus genitalis by changing its volume during the different sexual phases. In pueritas the blood stream of the tractus genitalis is quiescent as well as its parenchymatous cells; in pubertas it is developing as well as proliferating parenchymatous cells. In menstruation the blood stream is active with active parenchymatous cells. In the puerperium there is retrogression

of blood stream and an involution of parenchymatous cells. The climacterium is the opposite of pubertas-subsidence, the decrease of blood volume and parenchymatous cells. Senescence is a repetition of pueritas-the quiescence of the genitals, their long night of rest. The circulation of an organ quotes its value in the animal economy. It rates its function. Observe the enormous volume of blood passing through the kidney or pregnant uterus in a minute.

To study pathologic physiology of any visceral tract we must possess clear views as to its physiology. The physiology of the tractus genitalis is: (1) Ovulation; (2) peristalsis; (3) secretion; (4) absorption; (5) menstruation; (6) gestation; (7) sensation.

(1) On account of the numerous theoretic views connected with OVULATION and lack of space we will omit the general discussion on the pathologic physiology of ovulation. It is well known that ovulation has a wide physiologic range. We do not know the life of an ovum or corpus luteum. It was once supposed that a corpus luteum was a sign of pregnancy and the supposition gained legal or judicial position. We know that this is an error. I have found two corpora lutea on one ovary of a lamb which had not been pregnant. The internal secretion of the ovary is important and chiefly manifest by marked symptoms on removal of both ovaries-neurosis, accumulation of panniculus adiposus, extra growth of hair, diminished energy and ambition. These symptoms may occur in women possessing both ovaries, hence, we would conclude that pathologic physiology of ovarian secretion existed. The sensation of the ovary occupies a wide zone of pathologic physiology in the mental and physical being. Forty per cent of women visiting my office remark, "I have pain in my ovaries." On physical examination we find the following conditions: First and foremost in the vast majority of women who complain of pain in the ovaries palpation of the ovaries elicits no tenderness on pressure. However, the pain of such women is located bilaterally in the area of the cutaneous distribution of the ileohypogastric and ileoinguinal nerves. It is a skin hyperesthesia-a cutaneous neurosis. The bilateral iliac region of cutaneous hyperesthesia corresponds to the segmentation or somatic visceral (ovarian) area, and presents a frequent varying zone of sensory pathologic physiology. In the vast majority of women complaining of ovarian pain no disease of the ovary can be detected-it is cutaneous hyperesthesia of the ileoinguinal and ileohypogastric nerves.

(2) PERISTALSIS (excessive, deficient, disproportionate).

(a) Excessive peristalsis of the tractus gentalis (uterus and oviducts) may occur at menstruation, during gestation, parturition by the presence of myomata, during the expulsion of blood coagula, placenta during congestion. The phenomena of peristalsis in the uterus and oviduct differs from the form and distribution of the muscularis. The myometrium during gestation is in continual peristalsisuterine unrest. By placing the hand on the abdomen of a four-month

TRACTUS GENITALIS.

FIGURE 1.-SYMPATHETIC NERVES SHOWING THE ORIGIN OF THE

GENITAL NERVES.

S, abdominal brain; E, showing origin of spermatic (ovarian); F, shows origin of right genital nerve on the spermatic (ovarian artery); J, presents the plexus interiliacus which originates in the plexus aorticus. This illustration was drawn with extreme care from a It presents what I call the swan-shaped specimen which I dissected under alcohol. ureters which are dilated and prevents ureteral valves (V). IV, presents the anastomosis of the plexus ureteritis with the plexus spermaticus (ovaricus)."