mucous membrane and to the submucous tissues, the removal or destruction of which will be followed by permanent relief.

The treatment advised is removal of the diseased bone by surgical methods, or, if the disease has not extended so far, the mucoperiostium may be destroyed by the galvanocautery or caustics. The statement is made that the use of chromic acid for the purpose of destroying hypertrophies in the nose "would seem not yet to have been adopted by the profession in America." This is far from the fact. Its value has for a long time been here recognized. The reviewer was in the habit of using it long before he saw it applied in London. The book contains nothing of value, but will be read by many because of its novelty.

J. M. R.

Ophthalmic Surgery. By ROBERT BRUDENELL CARTER, F. R. C. S., and WILLIAM ADAMS FROST, F. R. C. S. Illustrated with a chromograph and ninety-one engravings. Price, $2.25. Philadelphia: Lea Brothers & Co.

This little book places before the profession a concise account of the present state of ophthalmic surgery. Like all the writings of Mr. Carter it is very interesting. In its pages may be found the description of the various older ophthalmic operations, but many new operations are not discussed. It would seem that in a work devoted exclusively to ophthalmic surgery all the operations so far proposed should be mentioned. In treating of the method of removing chalaza, no mention is made of the operation proposed by the late Dr. Agnew, namely, incision along the free edge of the lid and scraping out the contents. This will be found a most elegant method of removing these tumors without leaving a scar on either the conjunctival or skin surface. I can find no description of the most useful operation of canthoplasty, or, more appropriately, cantholysis (Noyes). A most excellent description of the different operations for cataract is given, this chapter alone being worth the price of the book. The work also takes up the consideration of color blindness and

Lesions of the Vagina and the Pelvic Floor, with Special Reference to Uterine and Vaginal Prolapse. By B. E. HADRA, M. D., Austin, Texas. With eighty-three illustrations. Pages, 329. Philadelphia: Records, McMullin & Co. 1888.

The aim of the author in this little work was to show in a comprehensive form the causes, progress, symptoms, and treatment of the various gynecological injuries of the vagina and pelvic floor.

The author has not entered upon an uncultivated field, as perhaps no department of medicine at present gives employment to better thinkers, closer students, and men of greater skill than that of gynecology. Under such circumstances it was not to be expected that Dr. Hadra could work any thing like a revolution in obstetric teaching. All things considered, however, he has given us a

In no department of medical diagnosis are greater powers required than in diseases of the heart, and in this department Dr. Clark stood in the very front rank. Indeed, it was impossible for him to impart to others. his powers by teaching. His power was that of a genius. Still his contributions to medical literature were all too few. No one who would reap the fruits of the clearest thought and the ripest experience, expressed in most attractive style, in the departments to which it relates, should fail to study these lectures.

D. T. S.

Contributions to the Study of the Heart and Lungs. By JAMES R. LEAMING, M. D. Pages, vi-300. Price, $2.75. New York: E. B. Treat. 1888.

In this work Dr. Leaming proposes new views on the following subjects: (1) The analysis of respiratory murmurs and sounds. (2) The existence and diagnostic value of true respiratory murmurs. (3) The constitution and resistance of residual air. (4) The site and mechanism of rales and rhonchi. (5) Recognition of the importance and special office of the nutrient artery, and the philosophy of its agency in producing and removing pathological results.

The author has in the premises undertaken a worthy task, and it is not to be gainsaid that laurels should justly crown success in his undertaking. But it is no more than fair to claim that when an author attempts to investigate physical subjects he should employ the methods of physics. In all cases he should perform his own mental digestion and not impose a task on the reader that will lead him into the notion that the ideas are his own by right of discovery.

In the establishment of physical truths we require either accurate experiments or plain analogies drawn from known facts, and of these we would also like a clear arrangement.

The suggestions of Dr. Leaming are worth looking into; his reasoning is to be reviewed with the severest scrutiny. Unsupported assumptions count for nothing in physics.

A Manual of the Minor Gynecological Operations. By J. HALLIDAY CROOM, M. D., F. R. C. P., F. R. S. E. First American from the second Edinburgh edition, revised and enlarged by LEWIS S. MCMURTRY, A. M., M. D. Pages, xii and 228. Philadelphia: Records, MeMullin & Co. 1888.

The great bulk to which special work in nearly every department of medicine has attained has rendered absolutely necessary the preparation of compends, where at a glance we may recall to memory all the important principles of each particular branch. This work has been exceeding well performed by Dr. Croom, the eminent and variously accomplished Edinburgh gynecologist.

The entire work of Dr. Croom is that of a logical, thoughtful, and judicious writer. Even such as have not the opportunity to give the subject thorough study will find here suggestions that will direct attention to the proper procedure in nearly every class of cases coming within the scope of this branch, and will thus enable practitioners to put patients in the way of proper care.

The editor has inserted notes into the text at such points as he believed the original was not sufficiently full or explicit. He has also appended at the end of the volume a chapter on laparotomy, giving the indications for the operation and the details for its performance.

Correspondence.

PARIS LETTER.

[FROM OUR SPECIAL CORRESPONDENT.]

D. T. 8.

At a recent meeting of the Academy of Medicine a discussion took place on the microbian nature of epidemic or tropical dysentery, some of the speakers being for, and others against the microbian theory of the disease. Dr. Le Roy de Méricourt, an old naval surgeon, ranged himself with the latter, and expressed himself in the following terms: "I imagine that there is a romance in this conception of bacteriologists which represents the human organism as a receptacle swarming with multitudes of enemies of life, watching for the occasion to enter

into action and to accomplish their murderous work. Doubtless there are figured elements in the humors, the tissues, the morbid products of the economy affected with an infectious malady. But are they the result of fermentations or the primary cause of the infection. Are they hosts or agents? It is this which does not appear to me to be well elucidated. These discoveries of innumerable microbes have not had, and do not appear to me destined to have any result whatever for clinical practice."

At the congress of the Société Française d'Ophthalmologie, held last month at Paris, Dr. Abadie read a very interesting paper on Ocular Asepsis and Antisepsis. In his preliminary remarks he stated that notwithstanding the numerous works written on the subject, the question of ocular asepsis and antisepsis is far from being exhausted. At the present time there seems to be an agreement at least on this point, that is, that asepsis is more important than antisepsis. It is therefore necessary, above all, to remove the microbes and not introduce them. For this it is sufficient to subject to boiling every thing that would serve for an operation, instruments, solution which should serve for washing, cotton-wool, etc. The instruments are not deteriorated by this temperature, which is sufficient to destroy all the pathogenic microbes. The washings should be effected simply with boiling water or a solution of boric acid which had been previously boiled. In operations involving the cornea, for instance, it is important that the knife should be disinfected. by boiling water, as it most frequently happens that it is with the knife that the corneal tissue is inoculated by introducing microbes into it, which would be with difficulty removed by washings, whereas those which come from without and which are on the surface of the wound will be easily removed by final washing. The same precautions should be taken in the case of traumatisms. Having read about the experiments of Maklakoff, Dr. Abadie tried oxygenated water as an antiseptic in operations on the eye, but he had to give it up as it was too irritating. If one would wish to use it as a caustic, it is not equal to the thermo-cautery, and it is to the latter that the preference should be given. As for boiling water, it produces a perfect asepsis,

as has been proved by numerous observations borrowed from the practice of gynecologists, who in their abdominal operations, do not use any thing but boiling water. As regards the washing of the anterior chamber after operation for cataract, Dr. Abadie has given it up, because he does not much believe in the infection of those operated on for cataract by means of germs of the air. The analysis of the air taken in the most diverse places, in the country, hospital wards, etc., has shown that, contrary to that which one would be inclined to believe, the air did not contain any pathogenic microbes. It is for this reason that the employment of the spray is being more and more abandoned by surgeons and by Sir Joseph Lister himself.

A writer in the Petit Journal de La Santé recommends the seeds of cacao in the treatment of infantile diarrhea. The seeds are pulverized after having been previously torrefied. This powder is to be boiled, mixed with sugar, in milk, 10 grams of cacao, 5 grams of sugar for a cup of milk. This mixture is administered to the young patient three times a day. The dose is diminished as soon as an improvement takes place in the child. The effect is rapid, and the improvement becomes manifest on the first day of treatment. It is adapted to adults also. The treatment had been tried on about a hundred patients, in whom the cure was effected in eight days. It applies principally to diarrhea in its chronic state.

Les Noveaux Remèdes reproduces a note from the Indian Medical Gazette, in which Dr. G. H. Young vaunts pepsine in the treatment of tropical diarrhea. The author cites three cases of chronic diarrhea which had resisted all the remedies ordinarily employed in such cases. He stopped all medication, and the patients were put on milk diet; they took half a pint of milk every three hours, and thirty centigrams of pepsine four times a day. The results being excellent, he administered pepsine to a great number of other cases, always with success. According to Dr. Young this medication is chiefly applicable to diarrhea characterized by copious and frothy stools, due to imperfect digestion and to the decomposition of aliments in the intestinal tube. In these conditions astringents are not only useless but dangerous. Pep

sine arrests diarrhea. The only aliment should be milk. The author thinks that in typhoid fever pepsine, in facilitating the digestion and the assimilation of food, should diminish the diarrhea and the irritation of the intestinal tube, and as a consequence render the malady less dangerous. Pepsine would be found equally very useful in the dysentery of enfeebled subjects.

One of the symptoms the most frequent and the most difficult to interpret, even by the most experienced laryngologist, is edematous infiltration of the vocal cords. This lesion may, according to Dr. Baumgarten, be due as well to a simple catarrh as to a tuberculous, scrofulous syphilitic or cancerous alteration. Moreover, it is not rare that the most minute examination of the general constitution and of the antecedents of the patient furnish no means whatever to clear up the difficulty and fix the diagnosis. Dr. Baumgarten states, in his note in the Union Médicale, that he finds in cocaine a sure criterium. It is known, he adds, that this agent produces a contraction of the capillaries of the regions on which it is placed; the result is a paleness, a local anemia more or less persistent. This is what occurs when a simple catarrh is concerned, but this same result is not obtained when a more serious etiological factor, syphilis for example, is in cause. Thus, when with the aid of a brush one can apply a few drops of a solution of cocaine to the vocal cords, if the mucous membrane does not turn pale, one may be assured that we are in the presence of a serious malady and not of an inflammation purely catarrhal. Dr. Baumgarten had tried this test in a great number of cases, and the solution which he employed was a ten-per-cent

one.

Dr. Baumann, Professor of Chemistry at the Faculty of Medicine of Fribourg has, according the Semaine Médicale, lately discovered a new product to which he has given the name of "Sulphonal." It belongs to the group of disulphonates, and is a product of the oxidation of a mixture of ethylmercaptan and acetone. Sulphonal possesses hypnotic properties; it is administered in wafers at a dose of from one to three grams. As it is insipid and without odor it is easily accepted by patients. Moreover, it

has the advantage of losing nothing of its efficacy in persons who have taken it for a certain time.

PARIS, June 22, 1888.

Translations.

UNDER THE CHARGE OF I. N. BLOOM, A. B., M. D., DERMATOLOGIST TO LOUISVILLE CITY HOSPITAL, ETC.

SURGICAL TREATMENT OF SUPPURATING VENEREAL BUBOES.-(Dr. Karl Szadek, in Kiew, 1888, Heft 2.) After a most comprehensive review of the literature of all languages on this subject, embracing one hundred and fifty citations, beginning with Astruc, Benjamin Bell, and Swediaur, through to Petersen, S. gives the method of treatment at the Kiew Military Hospital as the most modern and shortest. After expressing his distrust of any attempt to abort the bubo before suppuration commences, be it with tinct. iodinii, carbolic acid, or pressure, he advises: As long as there is no fluctuation or redness, rest alone is recommended. When hyperemia appears, a compress soaked in carbolic solution should be applied until suppuration takes place. The incision should be made parallel to Poupart's ligament, and should be sufficiently large. All affected glands, whether involved in the suppurating process or not, should be removed either with the fingers, the blunt knife-handle, or the curette. If the skin shows any signs of gangrene, those parts should be removed with the scissors. The wound should be thoroughly disinfected and filled with iodoform and iodoform gauze. S. does not believe in the suture, as union by first intention is a rarity, and even then the cure requires as long a time as with the open treatment. He generally changes the dressing but three times. The first dressing is kept in place from two to five days. When taken off the edges of the wound are cleansed with fiveper-cent carbolic solution, or one-per-cent bichloride of mercury, the cavity is filled with iodoform without irrigation or tampons, and a dry bandage replaced. The second and third bandages are applied in the same manner after from five to ten days.

ANOTHER PREVENTATIVE AGAINST SEA

ecze

DEATH FROM HEMORRHAGE.-(G. Hayem, Arch. de Physiol., xx, 1, 1888.) This article tries to solve, experimentally, the question as to what causes death from hemorrhage whether the brain or the heart is first paralyzed. In those experiments where the death of animals followed very quickly, and where transfusion of blood did not revive them, it was impossible to ascertain whether the heart ceased to beat from peripheral or central causes, on account of the rapidity with which the symptoms followed one another. In experiments where death did not occur so quickly, it was ascertained with certainty that paralysis of the heart and brain occurred entirely independent of one another. When all connection between the heart and nerve centers are paralyzed by the ligature of all the arteries going to the head, the heart can still functionate, provided oxygenated blood is furnished it. Death follows only when the heart itself is not sufficiently nourished, and is caused by heart paralysis, the result of anemia of the heart ganglia. These are more sensitive than the ganglia of the brain, and can. not endure the loss of their physiological nutriment, blood.

From this we see what clinical experience too has taught, the benefit which quick transfusion of blood confers on those in danger of death from hemorrhage. Further experiments must determine whether salt water can take the place of blood transfusions.

f. d. Med. Wessensh, xxv, 50, 1887.) Andeer is a ship physician, and has experimented upon himself and very many others to whom he has given this panacea, resorcin, in doses from 0.75 to 1.50 (eleven to twentytwo grains). It is valuable both as a prophylactic measure and also after the qualms have begun. The resorcin intoxication quiets the dizzy feeling and produces sleep of varied duration, from which the patients awake either completely restored or at least to become so after a short time without fresh exacerbations of the mal de mer.

A. prizes resorcin over other drugs because it does not spoil the stomach, but rather increases the appetite and allays bellyache and nausea.-Schmidt's Jahrbeucher, No. 5, 1888.

SOME INDICATIONS AND CONTRA-INDICATIONS FOR ANTIPYRINE; ITS EFFECT IN CERTAIN CASES OF POLYURIA.-(Prof. Huchard, Semaine Médicale, 1888.) The enthusiasm with which antipyrine was welcomed as an analgesic in so many painful affections has decidedly abated of late. It is true that its wonderful effects in subduing the pain of ticdouloureux have been maintained in most cases, but in sciatica, intercostal neuralgias, etc., the failures have been much more frequent than its successes.

The effect of the drug on tissue metamorphosis, especially as shown in the diminution of the amount of urine, has caused many to think that its use is contra-indicated in kidney affections and all diseases with kidney complications, as for instance the typhoid kidney. Antipyrine should only be used in angina pectoris when the nervous origin of the disease is certain.

It is contra-indicated in those cases of angina pectoris where stenosis of the coronary arteries exists as a cause; in such, even small doses often cause severe symptoms of weak heart, as Huchard has had occasion to observe several times. He has also seen symptoms of collapse follow its use in several cases of broncho-pneumonia.