The Reviewer's Table. Books, Reprints, and Instruments for this department, should be sent to the Editors, St. Louis THIS volume consists of an illustrated indexed series of thirty-six lectures and an appendix. It treats only of the LECTURES UPON THE PRINCIPLES OF SURGERY. principles of surgery, and this in a clear, concise manner. There is no recounting of obsolete views or voluminous reports of experiments, such as works of this character frequently contain. The author takes it for granted that the student possesses the requisite knowledge of pathology and bacteriology. He considers first hyperemia, regeneration of tissue, then inflammation. Following these lectures on changes in the blood and in the vessels, pyemia, septicemia, etc.; auto-intoxication, then suppuration, gangrene, ulceration are treated of, after which are given chapters on tetanus, hydrophobia, tuberculosis, and other surgical microbic diseases. The concluding chapters are on sterilization, dressing, anesthetics, etc. In the appendix Spitzley, Dr. Nancrede's assistant, has ably presented the various views, past and present, concerning the cause and nature of inflammation. THE author follows Gray rather closely, giving only the essentials of the SAUNDERS' QUESTION COMPENDS No. 3. ESSENTIALS OF ANATOMY, including the Anatomy of the Viscera, arranged in the form of Questions and Answers. Prepared Especially for Students of Medicine. By CHAS. B. NANCREDE, Professor of Surgery and Clinical Surgery, University of Michigan, etc. Sixth edition, thoroughly re vised by FRED. J. BROCKWAY, Assistant Demonstrator of Anatomy at Columbia University, New York. $1.00, net. Philadelphia: W. B. SAUNDERS. 1899. subject. It is not intended that this work shall replace larger works of anatomy. In the present edition the chief changes have been made in the illustrations and in correction of descriptions; some new matter has been added. THIS volume is intended to afford a condensed, yet comprehensive, text LEA'S SERIES OF POCKET TEXT-BOOKS. Edited by BEN B. GALLAUDET, M.D. MATERIA MEDICA, THERAPEUTICS, MEDICAL PHARMACY, PRESCRIPTION WRITING AND MEDICAL LATIN. A Manual for Students and Practitioners. By WILLIAM SCHLEIF, Ph.G., M.D., Instructor in Pharmacy, University of Tennessee. Philadelphia and New York: LEA BROTHERS & CO. book and work of reference on materia medica, therapeutics and allied subjects. It contains in a concise form the essential knowledge required in the most complete college course. The ar rangement of the paragraphs is such that the subject-matter may be easily memorized. LEA'S SERIES of PockeT TEXT-BOOKS.-The volumes of this series will hereafter be bound in red cloth, heavy beveled edge boards and also in flexible red leather with round corners and with margins trimmed to facilitate carrying in the pocket. The leather bound books will cost 50 cents more than the cloth bound. 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Prophylaxis of Typhoid Fever. BY J. H. MILLER, M. D., PANA, ILL. Read before the Twenty-fifth Semi-annual Meeting of the District Medical Society of Central Illinois, Pana, III., October 31, 1899. "For of all sad words of tongue or pen, The saddest are these: it might have been.'" HAT typhoid fever is to a great extent a preventable disease is a wellestablished fact. That in a multitude of cases, little or nothing is done. to prevent its spread, is a lamentable one. The bacillus typhosis will prove himself a very active member in any community in which he casts his lot, and will prove a foe worthy the steel of the most watchful sanitarian. You may freeze him, yet he will live. Neglect him and he will thrive. He will disappear this year only to reappear next, possibly at some distant point. To cmphasize the fact that a little lack of care may lead to disastrous results. I need only mention a few instances on record. In 1885, a man living up in the mountains above Plymouth, Pa., was taken sick with typhoid fever. The nurses in attendance carefully deposited the alvine discharges in the snow on the hillside. When the snow melted in the spring, the water, loaded with these discharges was carried into the stream that supplied the town with drinking wator. An epidemic of typhoid fever resulted, 1200 persons out of a population of 8000 being prostrated with it. In the town of Over Darwen, near Manchester, Eng., the discharges from a single case were deposited at a point from which they could contam inate the water supply of the city. One thousand five hundred cases resulted from this oversight. Hutchinson relates the circumstance of a man with typhoid fever who returned to a village hitherto free from this disease. The discharges from this patient were, for convenience, buried in a dunghill. Some time after, five men were employed in removing this heap. and all contracted typhoid fever. Their discharges were in turn deposited at the same point. Nine months after, one of two men sent to remove this heap, was stricken with the same fever and died. I was called to a family two years ago and found one member suffering from this disease. I looked about for the probable source of infection, and learned that a family living about a half block away had had a number of cases the year before, and that the discharges from these patients had been carried down and deposited in the garden towards the residence of my patient. No effort at disinfection had been made. The winter following had been a very wet one, just such a one as would favor the migration of germs by way of the subsoil water. Concluding that the well at the home of my patient was furnishing the infection, I ordered it abandoned at once and for good, and to get water from a distant point. My patient recovered after a reasonable length of time, and as I had caused the family to observe all necessary precautions, I supposed my labors in this family were done, but not so. Two weeks after the first case was dismissed, I was called to attend two others who were coming down with this disease. I ascertained that after the first case was safely through the family had concluded there was no further danger and had begun the use of the water from the well referred to above. Orders were given to fill the well, and no more cases appeared in this family. I might go on and enumerate like instances here all afternoon, but the above demonstrate the value of care, and the sad and costly results that may come from a lack of it. If we are to prevent typhoid fever we must first carefully study the best mode of thoroughly disposing of the germs that produce this disease. The bacillus typhosis is always present in the stools of the patient having this fever, but when we have disinfected these, our work is not yet complete. Dr. Richardson, of Boston, has found typhoid germs present in the urine of about twenty-five per cent of cases examined. The bacilli usually disappear from the alvine discharges when the fever subsides, or very soon after, but may remain indefinitely in the bladder, and in this way scatter the infection broadcast. Dr. Cushing, of Baltimore, found typhoid bacilli in the urine of a patient five years after an attack of this fever. Cystitis may result from the presence of these bacilli, and such cases following typhoid fever should be looked upon with suspicion. Then, again. the bacilli may appear in the sweat and in the bronchial mucus, and cloths used to receive these should be burned. The most careful physician cannot always prevent the spread of this disease, but he should at all times be found doing heroic work along this line. His patient may have had typhoid fever some days before he was called. The discharges, loaded with germs, may have been carelessly deposited about the premises, and in time may infect other members of the family, or being carried by subsoil water, may infect others at some distant point. If they have been deposited in a vault he may attack them there with quick lime, carbolic acid, or some other disinfectant. He should see that the discharges from the bowels and bladder are thoroughly disinfected as soon as passed. A good way to do this is to have a saturated solution of sulphate of iron (copperas) convenient and add a liberal quantity of this to the discharge, cover the vessel, remove it from the room and allow it to stand for some time, then dispose of it by burial in quick lime. A solution of carbolic acid, one to twenty, may be used instead of the sulphate of iron, if preferred. Bed and body linen should be changed at least once a day, or more frequently if soiled, and either boiled or immersed in a solution of carbolic acid, one to forty. Feeding utensils should be washed in boiling water after use. Plenty of fresh air should be admitted to the sick room, as well as sunlight. The fact that contagious and infectious diseases are more readily contracted when one is suffering from hunger or a depressed physical condition, should be remembered by the nurses for their own personal benefit. Since water is the medium through which this germ is most often con veyed, it is well to order all drinking water on the premises boiled. Milk is often the source of infection, contaminated either by washing the pans with or by the addition of water containing these germs. Milk is also a medium in which these germs develop rapidly, therefore great precaution should be exercised in the care of it. The urine should be examined from time to time during and after convalescence. A macroscopical examination may be sufficient, as the bacilli will render the urine cloudy if present in great numbers, yet the urine may be fairly well charged with these without showing any evidence of their presence to the unaided eye. If the physician in charge has no means of making a microscopical examination it might be well to err on the safe side, and give the patient at least a week's treatment for the purpose of heading off future infection from this source. Dr. Richardson found irrigation of the bladder with a 1:7000 solution of bichloride of mercury effective. As an internal remedy he found urotropin the best. This is one of the formaldehyde compounds, and was given in 10-grain doses three times a day. The humanitarian as well as sanitary principles, involved in the prophylaxis of typhoid fever, should merit the physician's best endeavors at all times, and with each and every case, and when this rule is conscientiously followed, many, many Rachels will be spared the necessity of weeping for their children. 41 South Locust St. Some Interesting Cases of Acquired Syphilis of the Nose and Throat. IN BY WM. D. H. BROWN, M. D., CHICAGO, ILL. Late Physician and Surgeon, Dansville Sanitarium, N. Y.; Physician of Vernon Hospital. 'N THE present state of science of medicine, treatment of the nose as in other diseases, a certain amount of experimentation seem necessary, and we must patiently gather our facts and systematize them before our frame-work of science is complete, and hence this paper will deal with enumeration of observations as found. In the secondary stage of acquired syphilis of the nose and nasopharynx the symptoms are not so pronounced and often overlooked by the patient, although in most cases there is the somewhat characteristic discoloration of the mucous membrane, together with erythematous patches of swelled mucous membrane, which is suggestive of the disease. In the tertiary stage, however, we have a more formidable condition of things to cope with, as it often involves the entire frame-work of the nose and face. In the pharynx are diffuse infiltration and ulceration, as well as gumata, with a marked change in the structure of the parts. The upper and lower pharynx are so often attacked by ulceration, as also the hard and soft palate (I presume the reason is the vascularity of the parts), as well as being so easily irritated, the ulcers are usually deep, red and inflammatory, with ragged edges, and secretions increased with bloody and purulent exudations with the hyperemic condition, the resonance of the voice is lost, usually it is deep and sonorous. In addition to the above we find extensive ulceration of the tonsils sometimes affecting an artery or nerve of the parts, and producing very serious results. One case in particular, I have seen of late, where there was extensive consecutive ulceration of the nose pharnyx and palate involving the nerves of the soft palate. CASE I. Mr. H., high liver and quite a smoker; business man; 45 years of age; traveler; had contracted syphilis, he was pretty well over it and stopped treatment; for some time it was quiescent, only to break out in simultaneous and deep ulceration of the soft palate, nose and tonsils when he consulted me. The ulceration of the nose on the right had perforated through the nasal septum greatly exaggerated hypertrophic condition of both nares, almost completely closed on the left side through which he had not breathed for some time. The voice had lost its ring, becoming dull and sonorous, the ulcer of the nose was ragged, purulent and bleeding continuously. There was also one large ulcer on the soft palate, which had perforated through, surrounded by an inflamed and livid red area. The patient was full-blooded and a high liver, the swallowing of hot liquids and rough food increased the pain. Right tonsils largely ulcerated and painful, surrounded by a swollen hypertrophic area. Patient complained |