GEORGE GILLETT THOMAS, M.D.,

HENRY T. BAHNSON, M.D.,

CORNELIUS KOLLOCK, A.M., M.D.,

S. WESTRAY BATTLE, M.D., U.S.N. ROBERT S. YOUNG, M.D.,

HUNTER MCGUIRE, M.D., LL.D.

THE STATE HOSPITAL AT MOR

GANTON.

We have before us the Report of the Superintendent of the State Hospital for the years 1893-4. During this time the daily average of patients was a fraction over 556. There were discharged recovered 132; improved 32; unimproved 11; not insane 3; died 67. The cost of maintaining the patients was, after deducting the cost of new buildings and permanent improve ments, about $150 per capita. The Superintendent estimates the increase in the number of inmates for the next two years, made possible by the building of new quarters, to be 140, and for the support of these he asks for an increase on the appropriation for the past two years, which will be a per capita of only $70. Think of it and

compare it with the cost of maintaining paupers in the County Homes New Hanover county lets out the keeping of her indigent poor to the lowest bidder, and yet she is now pay. ing for their maintainance $78.32 per capita per annum.

The efficient Superintendent, Dr. P. L. Murphy, is to be congratulated upon the marked success with which he has managed the affairs of the Hospital, and, while increasing year by year the comforts of the patients and bringing about a constant betterment of their condition, having constantly reduced their per capita cost until it has reached the low figure of $142, which is his estimate for the next two years.

Our Legislators may well study these figures and note the vast improvement that has been made in this Institution

under its present Superintendent. They should take a hint, too, from the fact that 140 additional patients can be maintained at a cost less than that in

the average poor house. Would it not be wise, then, to so enlarge the present institutions so that all of the State's insane may have the advantage of the greater comforts and prospects of recovery which they would find at these hospitals? The counties have to bear the expense of their maintenance at the poor-houses. Would it not be economy to remove them to the State Hospitals, if they can be maintained at less expense? The people pay for it whether these unfortunates are cared for by the county or the State. Therefore if the State can provide for them at a lower rate than the individual counties, it will save the people money if the State takes them.

We see it would be wise from a pecuniary stand-point-how is it from a humanitarian point of view? Any one who knows anything about the average poor house in North Carolina, will not hesitate to answer that these places are by no means fit for these

afflicted people. The keepers are generally ignorant persons, often cruel, and there are numerous cases where the insane inmates have been cruelly and inhumanly treated. They are looked upon rather as criminals than sick persons, they have only the commonest and coarsest of food, there is nothing to cheer and encourage them, and, in short, there is no hope and but little possibility of their improvement as long as they have to remain under such adverse conditions. Let them go to the State Hospitals and they are constantly under skilled medical supervision, they have kind and attentive nurses, they are neatly and cleanly clad, they receive such food as will best nourish them, they are givon such outdoor exercise as is best suited to the condition of each, and we see from Dr. Murphy's report that, for 264 admissions, one hundred and thirty-two were discharged recovered.

What more convincing argument could be advanced in favor of adding to, rather than taking from, the work the State Asylums are doing?

A Dictionary of Medicine. Including General Pathology, General Therapeutics, Hygiene and the Diseases of Women and Children. By Various Writers. Edited by Richard Quain, Bart., M.D., Lond., LL.D., Ed., F. R.S., Assisted by Frederick Thomas Roberts, M.D., Lond., B. Sc. and J. Mitchell Bruce, M.A., Abdn., M.D., Lond., with an American Appendix by Samuel Treat Armstrong, M.D., Ph.D., New Edition, Revised Throughout and Enlarged. In two royal octavo volumes comprising 2,518 pages. Appleton & Co., New York, 1894.

D.

The conditions which prompted the

editor to produce this work in 1882 are greatly emphasized at this time. "With progress so rapid and information so diffused, it is extremely difficult. alike for the practitioner, the teacher and the student to keep pace”—much more so in 1894 than it was in 1882. As an evidence of this rapid progress, note the following quotation from the remarks. concerning Behring's work. with antitoxin : "Recently experiments have been made by Behring and

even before the book containing this statement has left the hands of its publishers, the wonderful success that is attending the use of Behring's discovery is attracting the attention and arousing the enthusiasm of the whole. world, so rapidly does science progress in this age when once the right track is struck. We might safely assert that no work, which would require much time in passing through the hands of the printers and binders, would be free from the omission of some important advance.

The title of the work, "A Dictionary of Medicine," is rather misleading, as one would suppose it to contain all the terms used in medicine, while such is not the case. It is rather a dictionary of diseases, in which the several diseases are taken up in alphabetical order and their etiology, pathology, symptoms, diagnosis, prognosis and treatment discussed by various wellknown authorities, each of whom is peculiarly fitted to write upon the subject allotted him. Each article has its author's name attached. The former edition had no less than 162 contributors and this edition has 50 additional, who have been selected to write upon new subjects or to supply the place of former contributors who have died. The high standing of these gentlemen and their recognized positions as authorities add immensely to the reliability of the work and ensures

the reader that it is up to date, and that the opinions expressed represent the most accepted teaching of the day.

The publishers have left nothing to be desired in the typography and general mechanism of the volumes, and the work is destined to retain its position as a most valuable reference book-a resumé of medical practice, condensed sufficiently for quick reference, but not so brief as to take from its value as a guide.

Sexual Neurasthenia-[Nervous Exhaustion]. Its Hygiene, Causes, Symptoms and Treatment. With a Chapter on Diet for the Nervous. By George M. Beard, A.M., M.D., Formerly Lecturer on Nervous Diseases University City of New York, etc., Edited, with Notes and Additions, by A. D. Rockwell, A. M., M.D., Formerly Professor in the New York Post-Graduate School, etc. Fourth Edition-with Formulas. E. B. Treat, New York, 1895. Price $2.75.

etc.

It will be remembered that this work was first edited by Dr. Rockwell from the posthumous manuscript of Dr. Beard, and but little more was done than to arrange the papers and fill up a gap or two where the continuity was broken. In the present revision Dr. Rockwell has added a chapter on Sexual Erethism. The chapters on Symptomatology and Treatment are full and clear and will prove helpful in a large degree to any who may be called upon to treat this most distressing affliction.

The Johns Hopkins Reports. Report in Surgery. II. The Johns Hopkins Press. Baltimore, Md., 1894.

This report is the result of operations for the cure of cancer of the breast performed at the Johns Hopkins Hospital, from June, 1889, to January, 1894, by Dr. William S. Halsted. In a series of fifty operations there have been recurrence in only 6 per cent., with, however, regionary recurrence in about 15 per cent, more.