abscesses form in the cancellous tissue in consequence of the irritation of the pent-up discharges. "By the repetition of this process, the bone gradually becomes the seat of an inflammatory hypertrophy, and is left perforated in all directions by sinuses generally communicating with one another with a central chamber." The disease is unaccompanied by caries or necrosis, and, if left to itself, shows no disposition to recovery.

As

The treatment adopted is simply to lay open all the sinuses by means of the trephine, chisel, and bone forceps, when granulations spring healthily from the bottom, and a rapid cure results. In illustration of this disease he gives some very interesting cases. rickets seems almost unknown in New York, Dr. Markoe has relied mainly on Sir William Jenner's admirable lectures for an account of the disease.

In the chapter on caries the description of the microscopic appearances is borrowed from Mr. Barwell's work on joints, and contains a detailed account of changes commencing in the lacunæ. This account also is illustrated by a figure borrowed from Billroth, which is specially designed to demonstrate that author's view, that the bonecorpuscles remain totally unaltered until swallowed up in the cellgrowth advancing from the Haversian canals. It is well to give both sides of a question; but it is only fair to let an author explain his own drawings.

Necrosis seems to be the subject to which Dr. Markoe has devoted the greatest attention, as, while tubercle of bone and caries only occupy thirty-four pages, necrosis extends over nearly one hundred. The author seems to have seen a remarkable number of cases of severe hæmorrhage caused by a wound of one of the larger vessels by a loose sequestrum. In the majority of these the bleeding was at first intermittent, and easily arrested in some cases, deceiving the surgeon and tempting him to the fatal mistake, against which the author warns his readers, of delaying operation under the supposition that only a small vessel was concerned. Dr. Markoe recommends immediate removal of the sequestrum, and that then an attempt be made to ligature the bleeding vessel in the wound, failing in which amputation is the only resource.

The internal tubular sequestra, so common after amputation of the thigh, the author believes to be due to division of the nutritious artery, so that the supply of blood is cut off from a portion of the medulla and wall of the medullary canal. He gives statistics regarding the position of the artery, but none as to the relative frequency of necrosis when the bone is sawn above or below the foramen, so that at present his theory requires proof.

Among the constitutional effects of bone diseases with prolonged suppuration, he makes no mention of albuminoid degeneration of the liver, kidney, &c.

100-L.

30

Tumours of bone occupy nearly half the volume, and for their pathology the author is chiefly indebted to Sir James Paget; and for the chapter on tumours of the jaw to Mr. Christopher Heath. With the exception of myeloid sarcoma (which following Paget; he puts in a class by itself), he entirely ignores all modern observations with regard to the various sarcomata of bone, classing them all with soft cancers under the name "malignant tumours of bone." fact, he even borrows from Billroth three drawings of sarcomata of bone, and uses them to illustrate soft cancer. He seems to have done this deliberately, and we cannot but think this confusion to be a retrograde step hardly justifiable in the present day.

In

The information in the whole book is to a very large extent compiled; the chief authors quoted being Stanley, Brodie, Paget, Billroth, Nélaton and Heath, and Barwell, and the greater part of the illustrations are copied from the works of Billroth, Erichsen, Paget, and Heath. The author in his preface says of the work, that "It does not claim to be a complete compendium of all that is known on the subjects of which it treats," and apologises on the ground of extensive practice and want of leisure. We can only accept his apology and thank him for so much as he has given us.

Galvano Therapeutics. By W. B. Neftel, M.D. New York. 1871.-Books on electro-therapeutics require very careful sifting, for it depends much on the vigour of contemporary criticism whether this branch of therapeutics shall make a real and useful progress or whether it shall remain as it has been until our own generation, a very valuable and potent means rendered almost useless by the want of anything like accurate investigation and temperate handling.

Electro-therapeutics, being a very complicated and difficult study, are a snare to all men who have not accustomed themselves by early training to both accuracy and security of mental habits, and much rubbish is written and published upon the subject. It is impossible to class Dr. Neftel's little book under this latter head, for rubbish it certainly is not. The author, indeed, is one of the very few men we have met with who have really understood the force and bearings of Brenner's polar method and have endeavoured fruitfully to apply it. Brenner's great forte lies in the treatment of diseases of the ear, and this is at once a drawback and an advantage. The minute accuracy it requires is the advantage, but the drawback is that the field of his experience is confined to a department of which medical men generally know absolutely nothing, and the valuable results which he has won cannot, therefore, be appreciated beyond a very small circle of readers. Dr. Neftel has had the great advantage of studying Brenner's work at the fountain-head, namely in St. Petersburg itself; he has carried away a very intelligent and complete

Galvano-Therapeutics. By W. B. NEFTEL, M.D. New York, 1871.

notion of it, and seems himself to continue it with skill and discrimination. But it is rather in its application to general therapeutics that our readers will wish to hear what Dr. Neftel has to say, and we are the more sorry as Dr. Neftel has given us in the present little treatise a mere fragment of a larger one which he has in preparation. It seems unfair and a waste of time to criticise the conclusions at which an author arrives when we have none or but few of the grounds before us on which those conclusions are founded. Still, in spite of this hesitation, we must say that when we leave ear medicine we do not find that style of handling which would give us confidence in the writer. For instance, the power of galvanizing the sympathetic in any direct and exclusive way during life has been gravely questioned by many observers, namely by Ziemssen in Germany, and by Dr. Clifford Allbutt in this journal; yet Dr. Neftel relies to a great extent upon this supposed possibility without adding anything important in the way of further proof. The one experiment he adduces seems to us so inadequate that it rather decreases than increases our faith in the writer. On this slender foundation, however, Dr. Neftel builds up a fabric of practice which unfortunately gives us, as is the case with so many treatises on electro-therapeutics, the same impression as the perusal of a pamphlet of Mr. Holloway, and we half unconsciously looked to find at the end of the several case-histories the patient's signature with a permission "to make any use of this you please." When will medical electricians learn that they must give us all their cases, good and bad together, if they intend to carry any conviction to the mind of the instructed physician?

Medical Thermometry.-Wunderlich's classical work has now been done twice into English-once by Dr. Séguin in America and once by our own Sydenham Society. In appearance, at least, the latter is by far the preferable volume, for the book now under review does not reflect much credit upon the printer, whatever we may grant to the editor. Concerning the first and chief part of the volume, which consists of the translation of Wunderlich's work, somewhat abridged by the translator, we need say little, the merits of that classical treatise being sufficiently known. The translation seems to be satisfactory enough. In a second part of the volume, however, Dr. Séguin appends some original matter of his own, which claims an especial notice at our hands. This we welcome as the evidence of useful activity in a new field, for there is so much to be done in medical thermometry that we have need of many workers. Dr. Séguin also, as a member of the active and intelligent brotherhood of American physicians, must be regarded by us with respect and 'Medical Thermometry. By C. A. WUNDERLICH. Translated, with additions, by Dr. SÉGUIN. New York, 1871.

courtesy. At the same time we cannot see that his original contributions are likely to do much for the branch of science now under consideration. A great part of his appendix is occupied with the complaint that the thermometers used in medicine are not medical thermometers, but the tools of the physicist. By a medical thermometer Dr. Séguin would understand an instrument, the zero of which is placed at the normal bloodheat, all degrees above that being units of fever, all below units of algidity. Such an instrument, marked some dozen or so of centigrade degrees above and below a zero point corresponding to 98.6° of the Fahrenheit scale, he has constructed and calls it truly medical. Surely this is not only fanciful, but a mischievous whim. The great interest many of our best observers find in the study of medical thermometry is, that we are thereby enabled to bring many of the phenomena of life into direct comparison with physical phenomena, and to prove the common nature of the two. To set up an artificial barrier between them, to divide the physiological from the physical facts, even in appearance, seems to us a very retrograde step. Dr. Séguin, moreover, in imitation of the old-fashioned barometers marked "rain," "change," "set fair," &c., gives us his medical thermometer with storied margins thus :-5° to 6° (c), death; 3.5° high fever; 2° collapse, and so on, which, in our humble judgment, is very far from science. Another chapter of Dr. Séguin's appendix consists in a series of remarks upon surface thermometers; he admits that all observers hitherto have been disappointed in their endeavours to make such instruments of a trustworthy kind, but believes he has himself overcome the difficulties of the problem. When we come to learn in what way he has obtained so marked a success, we find it is by the use of the well-known button bulb, which, probably, every inventor in this department has tried and discarded. We have not found much pleasure or profit, then, we must confess, in the original chapters of this little book; but we would conclude with a word more of thanks to Dr. Séguin for his labours in endeavouring to popularise the results of the investigations of others.

The Fallacies of Teetotalism.—It is very difficult to review this book, because the reviewer may look at it from two rather different points of view. He may look at its value either as a permanent contribution to the study of the question with which it deals, or as a temporary help in fighting a battle in which hard knocks are given and taken. As a permanent contribution to the study of teetotalism as a medical or social question Mr. Ward's volume can take no rank. Both facts and arguments are of that rough and ready kind which do almost better than the best for purposes of agitation and protest,

1

The Fallacies of Teetotalism. By ROBERT WARD. London, 1872.

but which could not stand any degree of careful sifting or discussion.

Regarded as it is, as a vigorous piece of polemics, it is very effective, and will serve a good purpose. We as advocates of temperance, and therefore opponents of teetotalism, have a kindness for the book as a bold and honest attempt to stem a vast rush of ignorance and fanaticism, and we think it will do a great deal of good as a popular rally. Too many of us are ashamed to resist the narrow and mischievous policy of abstainers, and to argue against their essentially ascetic, and, therefore, dark and retrograde theories, lest we should be accused of sympathy with drunkards and indifference to the miseries which will come of intemperance. Let it be distinctly understood, as Mr. Ward boldly proclaims, that a man of temperance is as out-and-out an enemy of the drunkard as he is of the teetotal man, and thus the cause of the golden mean will prosper.

Reports of the Rudolph Hospital, Vienna.1-We have received these reports with pleasure, as they seem to us eminently useful and more to the point than the ambitious volumes which issue from the English hospitals. They are small books, and are occupied entirely by actual accounts of hospital work, pointed here and there by brief annotations by the physicians and surgeons of the institutions. In short, they more resemble a published collection of the hospital reports of our journals than the collection of essays initiated by the staff at Guy's Hospital. We have no reason to complain that such handsome volumes issue from our press, and that the heads of the profession deliver themselves annually of such excellent discourses; still the great multiplication of archives is a nuisance to the student, who would lose less time could he count on finding these essays in the recognised journals and reviews, whose pages are always ready to receive them. The hospital reports, meanwhile, would contain their own special contributions, which the student would seek in their right place.

The volumes before us contain the usual tables, professional and economical; a detailed list of the cases which have been under treatment, with brief remarks upon each class of them, and a very readable and valuable collection of special case-histories, with notes on individual cases by the medical officers of the charity. These annotations seldom occupy a page, sometimes only three lines, but they are pithy, and often contain matter of great interest. We take the following at random from annotations on "Neubildungen," which scarcely fill two pages, and which come partly from the hand of Dr. Drasche, and partly from Dr. Mader. Dr. Drasche says briefly as to case-history (No. 16) of cancer of the mediastinum:-"I believe that we were able to recognise its probable cause as traumatic.

1 Bericht d. k. k. Kranken-Anstalt Rudolph-Stiftung, in Wien, von Jahren, 1869 and 1870.