in the reflection "that the race is not always to the swift, nor the battle to the strong, nor yet wealth to men of understanding, but time and chance happeneth to them all."

"Impletus sed inceptus."

Not finished, but begun.

LOUISVILLE.

Reviews and Bibliography.

A System of Medicine. By Many Writers. Edited by THOMAS Clifford Allbutt, M. A., M. D., LL. D., F. R. C. P., F. R. S., F. L. S., F. S. A., Regius Professor of Physic in the University of Cambridge, Fellow of Gonville and Caius College. Volume IV. 1001 pp. New York: The Macmillan Company. 1897.

The following list of names of contributors to this volume is of itself a passport to the fullest on the part of the medical public. It embraces Drs. Thomas Clifford, M. D., LL. D., F. R. C. P., F. R. S.; Archibald E. Garrod, F. R. C. P.; George F. Still, F. R. C. P.; W. B. Cheadle, F. R. C. P.; Anthony A. Bailley, F. R. C. S.; Sir William Roberts, F. R. C. P., F. R. S.; R. Saundby, F. R. C. P.; Charles Henry Ralfe (the late), F. R. C. P.; W. Howship Dickinson, F. R. C. P.; W. S. Playfair, M. D., LL. D., F. R. C. P. ; W. Soltan Fenwick, F. R. C. P.; John Rose Bradford, M. D., D. Sc., F. R. C. P., F. R. S.; Louis Cobbett, F. R. C. S.; W. A. Wills, M. R. C. P.; Humphrey Davy Rolleston, F. R. C. P.; T. Lauder Brunton, LL. D., D. Sc., F. R. C. P., F. R. S., R. F. C., Leith, M. B., C. M., B. Sc., M. A., F. R. C. P. E.; J. R. Stocker, M. B., M. R. C. P.; Julius Dreschfield, B. Sc., F. R. C. P.; W. Lee Dickinson, F. R. C. P.; Frederick Treves, F. R. C. S.; W. H. Allchin, F. R. C. P.; Eustace Smith, F. R. C. P.; Patrick Manson, LL. D., F. R. C. P.; Herbert William Allingham, F. R. C. S.

The volume, like the previous ones, while unpretentious, is rich in the ripest knowledge, the soundest experience, and the wisest discrimination that has been brought to the service of medicine. The drift to the more moderate uses of drugs has not hitherto so fully appeared in any work of the regular school. In some things this change has become world-wide, as in the use of mercury and other powerful drugs. But one would have to conclude that the views of Lauder Brunton had dominated the writers of this work when we find five drops of laudanum every three hours prescribed in acute gastritis. To this and other instances of possibly extreme moderation there is yet remaining much material for possible converts; still with few exceptions the dictum is that of the most advanced forces in the war against disease.

One imbued with the appendicitis craze will be taken aback to learn that such an array of names is set against the use of the very term appendicitis. It is declared an uncouth name, and the term perityphlitis is retained,

with the explanation that, while it does not denote the seat of origin of the malady, it indicates with sufficient clearness the predominant pathological feature of an affection that may arise in more ways than one, and which has no precise clinical individuality until the peritoneum in the cecal region has become inflamed. It does not need to say that the wholesale cutting so common in this country is condemned.

D. T. S.

A Clinical Text-Book of Surgical Diagnosis and Treatment for Practitioners and Students of Medicine. By J. W. MACDONALD, M. D., Graduate of Medicine; Licentiate of the Royal College of Surgeons, Edinburgh; Professor of the Practice of Surgery and Clinical Surgery in Hamline University, Minneapolis, etc. With three hundred and twenty-eight illustrations. 798 pp. Price, cloth, $5.00; half morocco, $6.00. Philadelphia: W. B. Saunders. 1898.

Systems of surgery to cover the field of its science with satisfactory fullness have grown so large that the author of this work, without underrating the importance of a profound study of the principles, as well as of surgical pathology and bacteriology, has confined his efforts to putting in the hands of students and practitioners in a single volume the most practical part of practical surgery.

"The young practitioner," says the author, "is often embarrassed by not knowing how to make a systematic examination in a case of injury, and he may be placed at a disadvantage by the criticism of excited bystanders. The man who goes about the examination of his patient in a systematic manner, leaving nothing undone and guarding against all contingencies, will not only command the approval of the patient and his friends, but will protect himself against dangerous errors."

Great care is therefore taken throughout the work to make the examination of each disease or injury to the system systematic and comprehensive, and, when possible, directions are laid down as to the methods of examination. This is insisted on as all the more necessary since the universal popularity of surgery, especially among young practitioners is such that there is an ever-present danger that the attention being fixed too intently on the operation that may be required, the mind of the surgeon dwells too lightly upon the diagnosis of the disease. There only remains to be said that the author has done his work well, and that emendations in future editions, and future editions there certainly will be if the author lives, will have to do mainly with what is discovered between now and then.

D. T. S.

A Manual of Obstetrics. By A. F. A. KING, A. M., M. D, Professor of Obstetrics and Diseases of Women and Children in the Medical Department of the Columbian University, Washington, D. C., and in the University of Vermont. Seventh edition, with two hundred and twenty-three illustrations. 574 pp. Philadelphia and New York: Lea Brothers & Co. 1898.

In the preface to the first edition the author stated that the chief purpose of his book was to present in an easily intelligible form such an outline of the rudiments of Obstetric Science as may constitute a good ground-work for the student at the beginning of his obstetric studies, and

one by which it is hoped he will be better prepared to understand and assimilate the extensive knowledge and classical descriptions contained in larger and more elaborate text-books, and he also declares it confessedly in great part a compilation.

Seven editions are the conclusive proof that he has met the professional demand of the country. The work is sound as the adoption of the soundest views offered by the masters can make it, while the style is simple and clear. While it is a compilation it is truly a happy compilation and really one of the best and apparently easiest hits in bookmaking.

The author not only does not attempt theory, but seldom quotes theory, and when he does, the writer must say from the standpoint of one who has theories of his own not always happily. As to the cause of head presentations, that moot point of twenty-three centuries, where Prof. Parvin presents with approval the diving theory, the author is silent. Rotation he would explain by the old notion of the influence of the ischial spines, a contention that never has and never will have the approval of any one having the ability and the disposition to put the problem to the test of ultimate analysis based on definite physical principles. The inclined planes are the same on both sides of the pelvis, and if they alone were involved they would prevent rather than cause rotation in the most striking examples of these rotations, viz., those from occipito-posterior to occipito-anterior.

In explaining those few cases in which there is posterior rotation of the occiput, he says it is due to imperfect flexion of the head so that the forehead is too low; and that in reality it is anterior rotation of the forehead which causes posterior rotation of the occiput in obedience to a general rule that whichever pole of the head is the lowest in the pelvis will rotate to the pubic symphysis.

The simple physical fact is, however, that when the head is thrown back till the forehead rests on the pelvic floor, the forehead then becomes the fulcrum, the occiput constitutes the long arm of the lever and the chin the short arm; as the head glides forward toward the pubis both these arms of the lever meet with equal resistance. Therefore, according to a well-known principle of physics, the long arm, the occiput, is forced backward and the chin compelled to move forward to the symphysis.

D. T. S.

A Text-Book on Surgery: General, Operative, and Mechanical. By JOHN A. WYETH, M. D., Professor of Surgery in and President of the Faculty of the New York Polyclinic Medical School and Hospital, etc. Third edition, revised and enlarged. 997 pp. New York: D. Appleton & Co. 1898.

In reviewing the first edition of this work in these columns it was urged against, as detracting somewhat from its great scientific excellence, that there was a certain choppiness or lack of flow of style that prevented it from being easy reading, and that space was wasted and good taste disregarded in the largeness of the illustrations. Neither of these objections stands against this volume.

Of the scientific excellence of Wyeth's Surgery there has never been a question. The author, as a writer, a teacher, and an operator, stands easily in the front rank, and he has that wide acquaintance with the affairs of life that supplies him with a fertility of resources that is rarely met with in the ranks of surgery or medicine. The work has been rearranged and largely rewritten, and though much matter has been left out, that it was thought could be eliminated without serious disadvantage, in adding what was new and indispensable the volume has gained in bulk by about one hundred pages.

Instead of a detailed review of the various sections of the work it is enough to say that it embraces all that can be required in a text-book on surgery, that its methods have been approved by the test of experience at the hands of one of the most capable and zealous surgeons in any country, and that it is gotten out, as to illustration, binding, and letter-press, in the highest style of the bookmaker's art.

It must be a matter of pride for Louisville that both the author and one of his helpful assistants in the work bear diplomas from a Louisville medical school.

D. T. S.

Orthopedic Surgery. By JAMES E. MOORE, M. D., Professor of Orthopedia and of Clinical Surgery in the College of Medicine in the University of Minnesota, etc. With one hundred and seventy-seven illustrations. 354 pp. Price, $2.50. Philadelphia: W. B. Saunders. 1898.

To make a regulation good book on nearly any subject in medicine at the present time is about as easy as it is difficult to distance the field and produce something of surpassing excellence. The work before us is of the field. The best feature about it is the fullness and accuracy of illustration. Though not executed in any high style of art, the illustrations bring out every point so fully and distinctly that the tyro is led to wonder what there is in orthopedia that anybody could not do.

We will find fault of the author, however, in some of the credits he gives. His treatment of the late Dr. Lewis A. Sayre and Dr. Ap Morgan Vance in the matter of giving credit for invention too much illustrates the Scripture that "To him that hath shall be given, and from him that hath not shall be taken away even that he hath."

Dr. Sayre first applied the plaster jacket to the treatment of Potts' disease, and for it he gets ready credit; Dr. Vance made a more distinct discovery in making splints of leather taken from boiling water and molding while hot, and Dr. Moore, though recommending this form of splint in the treatment of several forms of disease in preference to all other means, does not even mention the inventor's name.

Indeed he speaks of making apparatus of loop leather or sole leather, merely wetting the material without mentioning heat, in such a way as that one might think heat was not to be employed in preparing the leather. Surely if Dr. Moore has found a way to make splints of leather and cold water, as one might judge from his writing, he ought to have credit for it.

The author favors cutting operations in the treatment of deformities more frequently than most of those who devote themselves to orthopedics. In this he is probably right, for no man can pursue one thing habitually without coming to magnify it, let it be law, medicine, politics or what not. While it can not be said that this work surpasses, it is profitable reading to those for whom it is intended, and on the whole can be commended.

D. T. S.

A System of Practical Medicine by American Authors. Edited by ALFRED LEE LOOMIS, M. D., LL. D., late Professor of Pathology and Practical Medicine in the New York University, etc., and WILLIAM GILMAN THOMPSON, M. D., Professor of Medicine in the New York University, etc. Volume III, Diseases of the Alimentary Canal, Diseases of the Peritoneum, Diseases of the Liver and Gall-Bladder, Diseases of the Spleen, Diseases of the Thyroid Gland, Chronic Metal Poisoning, Alcoholism, Morphinism, etc. Illustrated. 926 pp. Philadelphia and New York: Lea Brothers & Co

1898.

Like the previous volume, this numbers among its contributors many of the proudest names in medicine who have already won a world-wide reputation, together with some who follow with unequal steps.

The contributors are Drs. Richard C. Cabot, Warren Coleman, George Dock, Fred. G. Finley, J. E. Graham, H. A. Hare, Walter B. James, William W. Johnston, Allen A. Jones, Francis P. Kennicutt, Alexander Lambert, James Law, George Roe Lockwood, Henry M. Lyman, W. F. McWuth, M. Allen Starr, James Stewart, Charles G. Stockton, and Victor C. Vaughan.

As its title promises, the work is eminently practical, speculative matters being almost wholly discarded. To many this must prove a high recommendation, for while speculation and the search for ultimate causes is to many a matter of the greatest delight, to others it is burdensome and uninteresting. Nearly every line in the whole work leads up through diagnosis to treatment. The most interesting chapter, perhaps, in this volume is probably that of Victor C. Vaughan on poisonous foods, which may be in part due to the fact that he treats the subject with all the enthusiasm of a discoverer.

The book is bound most attractively, and the arrangement such as greatly to favor reference and a ready grasp of the subject-matter. It bears throughout the stamp of thorough editorial supervision, and the scope and style would seldom suggest a multiplicity of authors. It is a distinct credit to American medicine.

D. T. S.

A Practical Treatise on Diseases of the Skin. By JOHN V. SHOEMAKER, M. D., LL. D., Professor of Skin and Venereal Diseases in the Medico-Chirurgical College and Hospital of Philadelphia, etc. Third edition, revised and enlarged, with chromogravure plates and other illustrations. 894 pp.

For ten years the work of Professor Shoemaker has been before the profession, and with each of the three editions that the industrious and energetic editor has brought the work it has grown in public appreciation.

From the various contributions made to the knowledge of diseases of