of such tumors may be technically impossible, on account of the large extent of the intra-ligamentary wound surface and the impossibility of thoroughly checking hemorrhage. The unfavorable insertion of the tumor may usually be foretold with complete certainty by an anal examination."

Did space permit, we would give the author's very lucid account of the treatment of such cases-the best we have ever read.

No one treating diseases of women can afford to be without this work.

DISEASES OF THE BLADDER AND URETHRA IN WOMEN. By ALEXANDER SKENE, M. D., Professor of Diseases of Women in L. I. College Hospital; Fellow of American Gynecological Society; Corresponding Member of Gynecological Society of Boston; Member of Medical Society of the County of Kings and of the Obstetrical Society of N. Y. Illustrated. Second Edition, thoroughly revised. Pages 374. New York: William Wood & Co., 56 Lafayette Place. 1887.

Prof. Skene has presented us with the only systematic work on the subject in the English language, if we except that of Winkel, which has now been translated for Wood's Cyclopedia of Gynecology. The author, who is one of the most successful teachers in America, has written a full, lucid and thoroughly practical treatise about a class of diseases of which most of us possess but very vague knowledge.

Anatomy and malformations are carefully described. Then functional diseases are taken up. A distinction is made between women who will not urinate, because of their fondness for having their sexual organs handled by the interesting young physician, and those who cannot, because of the pressure of an erect clitoris upon the urethra. In neurosis of the bladder, rapid dilatation is the remedy, when all milder measures have failed; but even in skillful hands incurable incontinence has occasionally resulted. A greatly distended bladder should be emptied gradually: death has resulted from a neglect of this precaution. Here we would like to insist that the Jacques soft-rubber, "velvet-eyed" male catheter is the only one which should be ordinarily used in the female; and that in those difficult cases of distension of the bladder, produced by retroflexion of the grand uterus, the olive-pointed, flexible male catheter is invaluable.

Boiling in water for a few minutes is the only certain way of disinfecting catheters.

Just mentioning Lecture III, which contains an excellent account of urinary analysis and of the endoscope, we will pass on to some points in the treatment of chronic cystitis, given in Lecture IV. Irrigation holds the first rank; cautious injection of 5 or 10 drops of a solution of nitrate of silver (20 grs. to the oz.), and permanent drainage by Holt's catheter are highly praised. Where all other treatment fails, the formation of an artificial vesico-vaginal fistula is advised; but we are cautioned not to resort to this operation hastily, and are told that even in the Women's Hospital but four cases out of seventeen operated upon were cured. We would like to know the author's opinion of the utility of stitching the vaginal and bladder mucosa together in this operation, to prevent premature healing.

The sixth lecture treats, among other things, of foreign bodies in the bladder. We see no mention of air in this connection. In a unique case coming under our care, an ignorant nurse, in giving a vaginal injection, distended the bladder with air, causing great pain. The diagnosis was made from the presence of a tympanitic tumor above the pubes, reaching to the umbilicus, and by the use of the catheter.

The two last lectures are on diseases of the urethra, in the diagnosis of which the author finds the endoscope indispensable. It is interesting to note that the greatest success in treatment seems to have been obtained by mild measures, and that here, as indeed throughout the whole work, the use of heroic remedies is only advised where it is unavoidable.

In conclusion, we would ask our readers not only to buy this remarkable book, but also to patiently study it.

WE observe that an article on Duodeno-Cholecystostomy, contributed by Dr. J. McF. Gaston, of this city, to the Reference Handbook of the Medical Sciences, has been translated and republished, with the illustrations, in the Journal de Medicine of Paris. It may be noticed, in connection with this recognition of Professor Gaston abroad, that he has recently performed a nephrotomy and removed two urinary calculi from the opening of the ureter, and, on the 25th of November, he ligated the femoral artery below scarpa triangle in a case of popliteal aneurism.-Southern Medical Record.

MONTHLY METEOROLOGICAL SUMMARY OF THE U. S. SIGNAL SERVICE, LOS ANGELES STATION, FOR JUNE, 1887.

WAR DEPARTMENT, SIGNAL SERVICE, U. S. ARMY. Divisions of Telegrams and Reports for the Benefit of Commerce and Agriculture. Los Angeles, California. Month of June, 1887.

NOTES: Barometer reduced to sea level and standard gravity.