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may also be observed that unsuccessful cases as a rule are not reported, consequently statistics alone, unless properly compiled, are misleading; even the records of reputable hospitals may give an erroneous impression, as Gottstein has already pointed out, for many children suffering from lighter forms of throat complaints are now sent to the hospitals to be treated with serum. Let us now recall the so-called cures by Koch's tuberculin, and be thoroughly careful and scientific in the consideration and use of antitoxin serum.

Among the most valuable statistics yet published are those of Roux and Martin, and without now entering at length into the exact figures, these statistics may be said to be fairly convincing upon the question of the success of the new treatment. It is only natural that every medical man inclines to take a hopeful view of the treatment, for we have been prepared to expect some such scientific therapeutic measure, laboratory experiments lead us to look for success in dealing with the same disease in man, and statistics appear to confirm our hopes of success. Roux, in the Hôpital des Enfants Malades-has used as much as 125 c.cm. of his antitoxin serum, and the least amount used is 20 c.cm., which is given as an initial dose, so that it may be well to point out that it is practically trifling with the treatment and the disease to administer a series of small doses. Behring has, in his new directions, almost trebled the amount of antitoxin, which he advises should be used.

In the next issue of the Journal will be given a full account of the strength and dosage of the different "brands" of antitoxin serum, and the general mode of its preparation. Meanwhile, we must not let our anxiety for the success of the treatment carry us away into unscientific enthusiasm. Hansemann, one of Virchow's senior assistants, has recently made a vigorous attack upon antitoxin serum, in which he denies its therapeutic action, its harmlessness, and its immunizing power.

Reviews.

An American Text-book of the Diseases of Children, by American Teachers. Edited by LOUIS STARR, M.D., assisted by THOMPSON S. WESTCOTT, M.D. Philadelphia: W. B. Saunders, 1894.

For a modern text-book on diseases of children to be thoroughly up to date (in view of the rapid advances that are being daily made in bacteriology and treatment), a system of collaboration is. imperative, and Dr. Louis Starr is certainly to be congratulated on the success attained in the book at present under review. Although failing in his endeavour to secure all the field of pediatrics between the covers of one readily-handled volume (for the book weighs 6 lb. 10 oz.), he has certainly succeeded in producing a work that is thoroughly abreast of the times.

The book chiefly deals with the medical side of children's diseases, and is the result of contributions from no less than sixtythree different collaborators, from the most important medical centres of the United States. The wood-cuts, half-tone plates and coloured illustrations, are excellent reproductions, and greatly add to the value of the publication; the glazed paper, however, used by the printer, makes it a trying book to read by artificial light.

Want of space prevents a full consideration of all the articles contained in this work, but some call for special mention. Dr. Osler's article on tuberculosis is certainly the best that has been yet written in a text-book, and is a model of conciseness. The dangers arising from the consumption of tuberculous milk and butter, and the necessity for proper cattle inspection, are clearly pointed out.

Vaughan's article on diarrhœal diseases has a fresh honest ring about it, and is far in advance of the ordinary English text-books on diseases of children. The absolute necessity of recognising decomposing milk, with its accompanying ptomaine poisons, as the main factor in the causation of infantile diarrhoea in summer time, and the futility of the ordinary medicinal treatment of the same is most emphatically laid down. He compares the milk ptomaines to mineral poisons, and strongly recommends his readers to try and remove them with the utmost dispatch, strongly urging the use of stomach and bowel irrigation as the

most satisfactory means to attain that end. The only exception that can be taken to this article is, the meagre information it contains with regard to the dieting of children suffering from subacute milk infection. Dr. Vaughan admits that the question of feeding is one of the most perplexing with which the physician has to deal, and then joyfully refers the reader to Dr. Louis Starr's article on the feeding of infants, but the perplexed reader will fail to glean much practical knowledge of the necessary details from either article. The questions, what to give as a substitute for milk in these affections? how to make it? how often to give it? and how to administer it? are all of such vital importance, that it is a pity that greater attention has not been paid to this part of treatment.

The articles on infectious diseases are all excellent resumés of the recent work that has been done in connection with them, special attention being drawn to the details necessary for both prophylaxis and subsequent disinfection.

Dr. Dillon Brown, in his article on diphtheria, lays rather more stress on the value of local treatment than is usually done. He praises subcutaneous injections of morphia in cases of heart failure, and concludes a forcible article by a very hopeful paragraph on the benefit that will probably arise from the use of antitoxin.

In his article on pneumonia, Dr. William Pepper mentions the use of serum from the blood of convalescent patients, as being successful in some cases in producing a crisis, when sub-cutaneously injected in acute cases.

Dr. Allen Starr contributes the article on chorea, but after a review of the modern theories with regard to its pathology, confesses that the pathological anatomy of chorea is unknown. He recommends sea air as preferable to mountain air during convalescence. This is distinctly contrary to the experience of the authorities at the Children's Hospital, Melbourne, where relapses at the seaside are of almost constant occurence.

The article by Dr. Charles Mills on idiocy and imbecility deserves special mention. More detail with regard to treatment is given by this writer than is usually the case in medical textbooks. Medical practitioners will also find valuable advice on the subject of how to deal with these unfortunate cases when they occur in large families.

G

The diseases of eye, ear, nose, throat, and skin, receive special notice, the last 114 pages being devoted to their consideration by well recognised specialists in these branches. On the whole, pediatric literature has been considerably enriched by the publication of this book, and it is one that can be thoroughly recommended to all who take an interest in the modern treatment of diseases of children. A. J. W.

The Theory and Practice of Medicine. By FREDERICK T. ROBERTS, M.D. B. Sc., F.R.C.P. 9th edition. London :

H. K. Lewis, 1894.

We

The ninth edition of such a standard and widely used text-book as Roberts' Medicine calls for no detailed review. New sections on the general therapeutics of the principal systems and organs of the body have been added to this edition, and the advances in Bacteriology receive due attention. The Antitoxin treatment is mentioned in the case of tetanus, but not of diphtheria. note that in the treatment of Hydatids the author holds that the balance of evidence is in favour of the more simple methods. Appendicitus receives full attention, and it is observed "that a large proportion of the cases must come under the treatment of the surgeon, and "that modern surgical treatment has materially diminished the danger" from this class of lesions.

Annual of the Universal Medical Sciences. Edited by CHARLES

E. SAJOUS, M.D., and seventy Associate Editors. Philadelphia, New York, and Chicago: The F. A. Davis Co., 1894. The present issue of this Annual is kept up to the high standard of previous numbers, and the editors are to be congratulated on the successful results of their labours, which must have been very heavy.

Vital Statistics.

The births of 1024 children, viz., 525 boys and 499 girls, were registered in Greater Melbourne during the month of December. In the month of November, 1177 births were registered, or 153 more than in the month under review. The births were 165 below the average of the month during the previous ten years, and 235 below that average, if allowance be made for the increase of population.

The deaths registered in December numbered 669, viz., 371 of males and 298 of females; the births thus exceeded the deaths by 355, or 53 per cent. The deaths were more numerous than those in November by 162, but below the average of December during the previous ten years by 166. If, however, allowance be made for the increase of population, they will be found to have been less than that average by 215.

To every 1000 of the population of the district, the proportion of births registered was 2.30, and of deaths registered 1.50.

Zymotic diseases caused 90 deaths in December, as against 45 in the preceding month, the chief increase being due to diarrhoeal diseases, deaths from which rose from 10 to 42. Deaths from typhoid fever, moreover, rose from 6 to 16, and 5 deaths were set down to diphtheria, as against 1 in November. Deaths from local diseases rose from 249 to 315, the increase being due to diseases of the digestive system, which rose from 67 to 129.

The following is a statement of the deaths set down to typhoid fever and diphtheria in each month of the years 1889 to 1894 :

DEATHS FROM TYPHOID FEVER AND DIPHTHERIA, 1889 to 1894.

MONTH.

TYPHOID FEVER.

DIPHTHERIA.

1889 1890 1891 1892 1893 1894 1889 1890 1891 1892 1893 1894

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13 15 25 7
73 32 23 19 22 13 46
89 36 39 21 31 18
63 30
92 36 20 9
36 20 11 12

9

56

19

26

50

11

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22

35

39

23

11

6

30

45

16

15

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1534

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31 13 17

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559 403 192 154 120 155 329 400 145 88 33 48

1574 315

Local Subjects.

MEDICAL BOARD OF VICTORIA.—The following gentlemen have registered their qualifications:-Alexander Park, M.B., Ch.B. et B.A.O., R. Univ. Irel. 1894; Edward Yeates, L. 1886, F. 1893, R.C.S. Irel., L. et L.Mid. K.Q.C.P. Irel. 1886. Name of deceased practitioner erased from the register :-Albert Edward Sprod, M.B. Names erased from the register under the provisions of section 7 of the Act:-William Henry Coutie; Thomas Dealtry Atkins; Matthias Butler; Arthur Edwin Joscelyne. Names restored to the register under the provisions of section 7 of the Act:-Harry Sydenham Lyons, M.B. et Ch.B. Glas., L. et L. Mid. R.C.S. et R.C.P. Edin., 1879; John McInerny, L.S.A. Lond. 1889, M.D. C.P.S. City of New

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