indeed, scarcely gives them a living. A few who have had means from other sources, or who may have had exceptionally good locations, may smile and be inclined to attribute want of financial to want of professional success.

Not so. Many men throughout the country who are eking out a miserable, beggarly exist ence on a small practice, for which they secure only about one-half of what is due them, are the superiors of many who are in better circumstances. But the points which I have been endeavoring to urge are well understood.

I may have a few readers unwilling to believe what I say, but more who read these lines will be able to practically appreciate their truthfulness. This, then, is whither we are drifting, viz.: into dragging the profession down below the level of a trade, making it unable to afford a physician an ordinary, decent, quiet living for himself and family, let alone securing a competency which to enjoy when through age or infirmity his hand "has lost its cunning."

What is to be done? The remedy seems plain enough. Close up the gates tighter through which entrance to the profession is obtained. Let there be union among members of the profession. Let the price of professional services be raised. In short, elevate the profession mentally, financially, morally, and socially.

First, then, the entrance must be more difficult. In a letter a year ago to the PRACTITIONER I urged the desirability of making graduation

I am

in arts the standard for matriculation. glad Dr. Bergin takes that stand also. Our Council should take action upon the question. If they do not we should elect men who will.

The profession is crowded; hundreds are taking advantage of the low standard of matriculation to register and enter upon the study of medicine, and the result is that annually the prospects of the medical profession are being made worse because its numbers are being increased out of all proportion to the demand.

Brethren, move in this matter! We will be doing but justice to ourselves and kindness to those whom we may deter from entering a profession already more than doubly filled.

Not only is matriculation too low but the time of study should be lengthened too. Let a

medical degree be made a prize which will bring honor and pecuniary benefit, instead of a doubtful position and still more doubtful living. Where will opposition to such changes come from where, but from the medical schools. With all due respect to the many estimable men who are engaged in the schools, it cannot be denied that they are endeavoring, first and foremost, to make money. This being the case, they would be glad to see a thousand or more students in training continually. But should the interests of a few school men be allowed to injure the whole profession of the Province ? I trow not. Much as we value our schools, if it comes to schools or profession existing, we must, in justice to ourselves, decide for the profession.

Need I say anything about union? Tradesmen unite, and fight to the bitter end to help one another. How is it with us, brethren? Do we labor for one another's interests, or are we in our hearts glad at the failures and shortcomings and poverty of our fellow practitioners? Do we put in a kind word for a fellow each day before we lie down to slumber, or do we by some unkindly thrust or dubious look stab him to the heart?

We are supposed to be men-and intelligent, gentlemanly men at that--but well may we use Miller's words and say,—

"God pity us all in our pitiful strife." I have done.

sentiments upon a question which must be dealt I have spoken plainly my with shortly. I may have spoken too plainly to please all; at least I have spoken no untruth, and if any fault can be found with my utterances it can only be on the plea that "Truth is sometimes best not spoken"-a plea with which I have no sympathy, so far as this question is concerned.

The PRACTITIONER is a valuable monthly, which I always heartily greet upon its coming. Yours, M.D.

HICCOUGH.-Dr. Gibson, in the Edinburgh Medical Journal, recommends the production of sneezing by tickling the nostrils in cases of hiccough. He has been very successful in several cases. Gentle irritation by any means is sufficient, even if sneezing be not produced.

Book Notices.

The Archives of Gynaecology, Obstetrics and Pediatries. Published bi-monthly by Leonard & Co., 141 Broadway, New York.

The numbers for February and April of this new journal contain a useful resumé of articles from different periodicals home and foreign. The first numbers present a good appearance, but we would prefer to have the leaves cut. There is no original matter. The selections are good and numerous.

The Field and Limitation of the Operation of the Surgery of the Human Brain. By JOHN B. ROBERTS, A.M., M.D., Professor of Ana tomy and Surgery in the Philadelphia Polyclinic; Surgeon to St. Mary's Hospital; etc. Philadelphia: P. Blakiston, Son & Co. Price: $1.25.

This interesting and instructive little work on the important subject of the surgery of the brain is divided into three chapters. The first treats of the general principles of cerebral surgery; the second treats of cerebral localization, while the third treats of operative treatment of cerebral lesions.

We have received the second volume of this very valuable work, which, as we before intimated, promises to embrace the entire range of scientific and practical medicine and allied science. The subjects are arranged in alphabetical order, and in volume II. include from C to E. We have much pleasure in testifying to the general excellence of the work, which appears likely to surpass our expectations. When complete in the eight volumes it will form a respectable medical library in itself, and will in

our opinion prove extremely valuable to every practitioner, whether general or special, who is fortunate enough to possess it.

Lectures on the Diseases of the Nose and Throat. By CHARLES E. SAJOUS, M.D. Philadelphia: F. A. Davis, Att'y, 1885.

This work, which originally consisted of Lectures delivered at the Jefferson Medical College, has just been presented to the Profession and ought to be extremely useful to the Student and

Practitioner of Diseases of the Nose, Pharynx and Larynx. There is nothing to speak of which is new in the text, no etiological or pathological discussions, save only those on Hay Fever, but the subjective symptoms and the objective signs and appearances are placed very plainly and concisely before the student and in a way that is easily followed, and the treatment is as comprehensive as possible within the limits, including everything that is modern and nothing that is obsolete. Most of the instruments now in use are shown by plates or described. The subject of Hay Fever is treated at considerable length: the history, causes, pathology and treatment being dealt with very fully indeed. The great feature about the work, however, is the colored engravings. These have been taken from nature by the author himself, and although it must be admitted they are as accurate and life-like as it is possible to make them, yet it seems to us, that the best colored plates can convey only a mere approximate idea of the affection. Perspective is not very well shown in the plates, but then, as in ordinary examinations, one makes use of only one eye at a time, one does not get perspective so well marked. There is also an excellent appendix of useful prescriptions attached and the whole is comprised in 439 pages.

The International Encyclopædia of Surgery. A Systematic Treatise on the Theory and Practice of Surgery by Authors of various Nations. Edited by JOHN ASHHURST, Jr., M.D., Professor of Clinical Surgery in the University of Pennsylvania. Illustrated with chromo-lithographs and woodcuts. In six volumes. Vol. VI. New York: William Wood & Company, 1886.

This last volume is well calculated to enhance

the reputation of the encyclopædia. The subjects treated of embrace the injuries and diseases of the alimentary canal below the pharynx, the genito-urinary system of both sexes, certain affections of the bones, and orthopedic surgery, while an appendix contains articles upon Hospitals, Field Surgery, and the History of Surgery, the last named being ably treated by George Jackson Fisher, of Sing Sing, than whom no one is more competent to discharge the task with accuracy and elegance.

The articles to our mind most worthy of commendation are those upon the Rectum, by William Allingham; Urinary Calculus, by G. L. Keyes; Bladder and Prostate, by Reginald Harrison; and Cæsarean Section and its Sub. stitutes, by Robert P. Harris. These, and especially the last named, are models of excellence. Parvin's contribution relating to the Female Genitals, is likewise deserving of mention as a clear and concise compilation of modern views. Simon Duplay, on the Urethra, and Ollier Vincent and Parest, on the Bones, are essentially French, and admirable according to their standard; but Fisher, on Or thopedic Surgery, is too restricted in his space and hence necessarily incomplete, which is the more to be regretted in view of his ability and the frequency and importance of the lesions to be treated. The only Canadian contributor (Dr. Hingston), has done his duty well, but why he should have been selected to write upon "Lithotrity," which Keyes had already ably handled, is not, superficially, apparent.

The articles of this last volume are throughout of more equal merit than those of its predecessors, and in cordially commending it to our readers we may justly say, Finis coronat

opus.

Illustrations of Unconscious Memory in Disease, including a Theory of Alteratives. By CHAS. CREIGHTON, M.D., New York: J. H. Vail & Co., 1886. Pp. 213.

Dr. Creighton's book on the Physiology and Pathology of the Breast bore the stamp of originality, and this small treatise on Memory, which we have read with much pleasure, proves that the author has evidently the courage of his opinions, and is not afraid to come out boldly in support of them, even when, in doing so, he has to run counter to the accepted views of many able pathologists. His theory is that many diseases, especially those of a chronic nature, are due to a morbid habit or unconscious memory of organs and tissues, keeping up the desire long after the exciting cause has ceased to operate, and that many remedies and drugs are alterative in their curative action by breaking up this habit or memory of morbid action, and allowing the tissues and organs

Dr. Creighton's

affected to return to their normal mode of action. The author finds it easy by his theory to dispose of the doctrine of germs and parasites, though we fancy many will hesitate to either accept his premises or coincide with his deductions. Of ague he says: "To refer it to a bacillus, or to any kind of poison at all, is not only a delusion of reasoning but a ludicrous error in the elementary sense of proportion." It is originally due to "primary and direct disorder of the heat-regulating mechanism," by "some concurrence of circumstances, predisposing in the individual and present in his external surroundings." The paroxysmal onset is repeated because the memory of it was retained, and is quotidian, tertian, quartan or remittant, according to the severity of the upsetting stroke, the individual's power of resistance and the external circumstances, ability is acknowledged and his reputation as a pathologist stands high, but we hardly think the latter will be increased by such sweeping assertions as the following, which, coming from a young man, and referring to the views of some of the foremost scientists of the present day, is, to put it mildly, scarcely polite: "Nothing more plainly marks the parasitic hypothesis of disease as an asylum ignorantiæ than the desire to extend the benefit of it to climatic fever." Of the bacillary origin of tubercle he speaks in terms equally positive and dogmatic. As to syphilis, he believes that any common sores on the genitals may, apart from all specific poison, under varying circumstances, heal up, become chancroids, or indurated infecting chancres. Gummatous tissue is due to the "memory of granulations gone wrong," or a "tradition of bad healing," and mercury acts by breaking the morbid habit in the tissues or effacing the evil memory in them, "leaving the system to the influence of its ordinary and healthy functions." The book is well worth reading—the theories it treats of are intelligibly advocated by a level-headed Scotch metaphysician; are ingeniously and logically applied to practical therapeutics, and thereby commend themselves to the attention of every practitioner of medicine who will find in them food for thought, and a new encouragement for the intelligent use of drugs-theories founded on

Newton's maxim that "no more causes are to be admitted than such as suffice to explain the phenomena," and Sir William Hamilton's Law of Parsimony, that "a plurality of principles is not to be assumed when the phenomena can possibly be explained by one." We advise our readers to study the book and decide for them selves whether the author has succeded in explaining the phenomena of disease by the principle of unconscious memory. The book is another evidence of the wide spreading influence over modern thought the doctrine of evolution has obtained.

Lersonal.

Dr. James Stewart is now in Berlin.

NOVEL LIVER SURGERY.-In a case of acute hepatitis with enlarged liver, ascites and other symptoms pointing to a fatal termination, Dr. George Harley introduced a trocar and canula into the liver and drew off twenty ounces of blood. The patient made a good recovery. Dr. Harley thinks hepatic phlebotomy is destined to rank in therapeutics as a safe and effective measure.

STATISTICS OF M. PASTEUR'S HYDROPHOBIA PRACTICE.-At a recent meeting of the Academy of Sciences, Paris, M. Pasteur announced that he had treated the following number of people from different countries for bites from mad dogs: France 505, Algeria 40, Russia 75, England 25, Italy 24, Austro-Hungary 13, Belgium

Portugal 5, Spain 4, Greece 3, Switzerland 1, Brazil 1. This makes a total of 726.

A CHICAGO paper tells the following of Dr. J. Adams Allen :-When he was commencing practice on a winter's day all muffled, he was riding in a street car, when he overheard two persons talking about him. One asked the other what sort of a doctor was this Allen ? "All I know of him is that he snatched my aunt from the grave last summer." "Did he, indeed?" said the other; "well then he must be a pretty good doctor. What was the matter with your aunt ?" "Oh, she was dead and buried, you know."-Amer. Lancet.

FOTHERGILL'S ADVICE. Let the student strive to see what are the indications for treatment, what in this case calls most imperiously for attention. He is taught too exclusively, at present, to look at disease from a deadhouse point of view. To make a diagnosis which would be corroborated in the deadhouse is great matter. In practice for yourself, remember that a living, grateful patient, recovered under your care, is worth more to you than any amount of accurate diagnosis which, so far as other persons and their opinions are concerned, is as voiceless to further your interests as the tombstones in the churchyard which mark your failures.

Original Communications.

THE INFLUENCE OF MALARIA AND QUININE UPON PREGNANCY AND PARTURITION.

BY GEORGE T. M'KEOUGH, M.B., CHATHAM, ONT. In the western peninsula of Ontario, notwithstanding extensive drainage, the erection of dikes, and other sanitary improvements, the various forms of morbid phenomena induced by malaria are still largely prevalent, and constitute probably the largest class of disease that medical practitioners have to contend with in that district, in consequence of which quinine is freely prescribed. To a medical man prac tising in such a locality there constantly arises some very important and unfortunately moot questions concerning the effect of both malaria and quinine upon the pregnant and parturient state. Of the few published observations on these points no two reporters apparently agree. In the hope of being able to come to some definite conclusions concerning these disputed questions, I have endeavoured, for some time past, to interrogate with reference to this particular subject all cases of pregnancy coming under my notice. Although my experience has necessarily been limited, I have thought it sufficient to arrive at certain deductions.

In the first place, are pregnant women liable to suffer from intermittent fever, or other manifestation of malarial toxæmia, or does the state of pregnancy confer upon them a condition of immunity from the action of this poison?

Credé (Monatsch. fur Geburtsh., Band xv, S. 1, 1886)* states that in Leipsic during the years 1856 to 1859 there was almost absolutely no case of ague in a pregnant woman. Griesinger (Virchow's Handb. der Spec. Path. and Ther. Infectious Krankh, 1856)† found that during the prevalence of a quartan fever in Prague only two out of 8,639 pregnant and parturient women were attacked. On the other hand, Loovt states that it is very common for pregnant women to have intermittent fever. Playfair § says that the occurrence of hypertrophied spleens in infants has been often observed in malarious districts, and consequently believes that the disease must frequently occur in intrauterine life. Goth, of Klanisburgh (Zeitsch fur Geb. und Gyn. Band vj. s. 17, 1881)* asserts that in a severe outbreak of malarial fever, 46 out of 881 pregnant women were affected. My own notes agree more nearly with the latter observers referred to. Of two hundred and twenty-eight (228) cases of pregnancy investigated by me, thirty-six, or 15.8 per cent., exhibited some form of malarial poisoning.

These investigations were made among women chiefly in the lower walks of life, who consequently were exposed to the various vicissitudes of the laboring classes, together with unsanitary surroundings-conditions that probably would render them more or less predisposed to those pathogenic organisms which there is much evi* Quoted in Brit. Med. Jour., July 18th, 1885. + Ibid.

‡Quoted in Am. Jour. Med. Sc., Jan., 1886 § System of Midwifery, p. 224.