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On Rest and Pain.A course of lectures on the influence

of mechanical and physiological rest in the treatment of accidents and surgical diseases. By John HILTON, F.R.S., F.R.C.S., &c., &c. Second edition, 8vo., pp. 299. New York: WILLIAM WOOD & Co., 27 Great Jones Street, 1879.

These lectures are too well known to demand an extended notice at our hands. They were first delivered by Mr. Hilton before the Royal College of Surgeons as early as the year 1860, and still they may be read with advantage and instruction, a lot which does not fall to every work after a lapse of eighteen years: This is a reprint of the second edition of these lectures, which appeared in London some two years ago under the editorial guidance of Mr. Jacobson, aided by the author. It was the intention of Mr. Hilton to have enlarged the work by the addition of material gathered from other surgical observations, but all having the same end in view, namely, that of illustrating by clinical records the advantages to be gained in a practical sense of the recuperative powers of Nature, “ aided by the suggestions of a thoughtful surgeon.” Throughout these lectures the author emphatically points to the therapeutic value of mechanical and physiological rest in the treatment of surgical disease. It is a work that has been regarded with general favour. Our object now in noticing it is to call attentiou to the republication of this work as forming the first of the series of Messrs. Wood's Library of Standard Medical Works. We alluded on a former occasion to this scheme, but it may have escaped the observation of our readers, and we conclude this notice with an extract from a circular received from the Messrs. Wood. It is understood that the intention is to publish each year twelve volumes of standard medical works. The publishers look for the support of the profession in this enterprise, and we can only remark that if the series are brought out with the same care and style as this, the first volume which is before us, that our medical friends will have in the course of a few years a handsome library of useful medical works at a nominal price. The circular concludes as follows:

“Will you kindly have this volume noticed at an early day that we may avail ourselves of the influence of your journal in obtaining subscriptions to the series?

“ To meet the views of all classes, we have concluded to take subscriptions :—1st. The $12.00, payable on delivery of the first volume, in which case the volumes are all delivered free, by mail, from New York. 2nd. Payable $6.00 semi-annually, in January and July, in which case the subscriber pays express charges on the January and on the July volumes, the other volumes being sent free, by mail ; and 3rd. Payable monthly at $1.25 per volume ; in this case the volumes are each delivered free, by express or carrier, C. O. D.”

Cyclopedia of the Practice of Medicine.—Edited by Dr. H.

ZIEMSSEN. Vol. XIII. Diseases of the Spinal Cord and
Medulla Oblongata —By Prof. W. H. ERB. Translated
by E. G. GEOGHEGAN, M.D., of London: E. W. SCHAUF-
FLER, M.D., of Kansas City ; D. F. LINCOLN, M.D., of
Boston; John A. McCREERY, M.D., of New York ;
ALBERT H. Buck, M.D., New York, Editor of American
edition. 8vo., pp. XII. 975. WILLIAM WOOD & Co., 27
Great Jones Street, New York, 1878.

This is the fourth volume on diseases of the nervous system and is devoted to affections of the medulla spinalis and spinal cord. In the arrangement the author deems it advisable to give, as an introduction to the history of these diseases, a brief statement of the macroscopic and microscopic anatomy of the cord and its membranes, together with its physiology, and in following this arrangement he remarks that he feels justified in so doing by the fact that a knowledge of these things is essential to the proper understanding of these diseases. The minutiæ of subjects of this nature are apt to escape the memory of the busy practitioner and would have to be searched for in text-books not always at hand, furthermore, when found the description is not always given with due regard to a knowledge of or connection with pathology.

Under the heading of general symptomatology we have the several sections of disturbance of sensibility, disturbance of mobility, disturbance of reflex activity, vaso motor disturbance, trophic disturbance, disturbance of urinary and sexual appar. atus, disturbance of digestion and defæcation, disturbance of respiration and circulation, disturbance of the pupillary fibres, cerebral nerves and of the brain itself.

Of the causes of disease of the spinal cord there are mentioned sexual excesses, influence of age and sex, disturbance of nutrition, propagation through morbid processes, existing in other parts extending to or propagating disease in the spinal column, exposure to cold, excessive exertion or physical influences, poisoning and the local development of infectious diseases, acute disease, and the irritation depending on disease of

the other organs.

The diseases of the membranes of the spinal cord forms the subject of the next article, in which we have discussed hyperæmia of the membranes of the cord itself, meningeal hæmorrhage, inflamation of the spinal dura mater, inflamation of the spinal pia mater the acute and chronic form, tumours of the spinal membranes, and as an addendum, the changes met with in the spinal membrane which are without clinical significance.

Diseases of the spinal cord itself is the next subject given, hyperæmia and anæmia of the cord, spinal apoplexy, wounds of the cord, slow compression of the cord, concussion of the spine, spinal irritation, Myelitis, Tabes Dorsalis, and various degrees of paralysis. In the last section is considered the diseases and injuries of the medulla oblongata, and tumours of the medulla. The work seems to be abreast of the times; it is full without being tedious, and the descriptions are clear and readable. The translators have performed their task well, and the volume is produced in the same excellent style as those that precede it.

Extracts from British and Foreign Journals.

Unless otherwise stated the translations are made specially for this Journal.

Caustic Alcohols.-On the remedial application of the Ethylates of Sodium and Potassium, or Caustic Alcohol. By BENJAMIN RICHARDSON, M D., F.R.S.—The great interest displayed at the last meeting of the Medical Society of London on the subject of the ethylates of sodium and potassium, which I introduced into medicine in the year 1870, leads me to think that a brief description of these substances and their medicina) application may be of interest to the wider circle of medical practitioners who are readers of The Lancet.

The ethylates first came into my hands for study when I was conducting a series of experimental inquiries on the action of the different alcohols. They are sometimes called alcohols because in them the atom of hydrogen which in alcohol is, with its radical, combined with oxygen, is replaced by an atom of sodium or potassium. Thus, taking ethylic alcohol, which is composed of the radical ethyl (C,H), hydrogen and oxygen, as the type, the sodium or potassium replaces the hydrogen :

Sodium Alcohol.

Ethylic Alcohol.


Potassium Alcohol.


The first object of research was to ascertain what would be the effect of introducing a new element, by substitution, into a substance,-alcohol, -the physiological action of which was understood ; and the subjoined description formed part of my report to the British Association for the Advancement of Science in 1870.

Sodium Alcohol, or Ethylate of Sodium, is prepared by treating absolute alcohol with pure metallic sodium. So soon as the sodium comes in contact with the alcohol there is


of hydrogen, and the addition of sodium has to be continued until action ceases.

I find it good to increase the temperature gradually as the action declines. At last there is obtained a thick, nearly white product, which is a saturated solution of sodium alcohol. From the solution the ethylate of sodium cryatallises out in beautiful crystals.

When the ethylate is brought into contact with water it is decomposed, the sodium becoming oxidised by the oxygen of the water to form sodium hydrate, and the hydrogen of the water going to reconstitute the ethylic alcohol.

The change of ethylic alcohol into sodium alcohol transforms it from an irritant to a caustic. Laid on dry parts of the body the sodium alcohol is comparatively inert, creating no more change than the redness and tingling caused by common alcohol; but so soon as the part to which the substance is applied gives up a little water, the transformation I have described above occurs ; caustic soda is produced in contact with the skin as water is eliminated by the skin, and there proceeds a gradual destruction of tissue, which may be so moderated as hardly to be perceptible, or may be so intensified as to act almost like a cutting instrument.

Potassium Alcohol, or Potassium Ethylate, is made in a similar manner as sodium ethylate-viz., by bringing pure potassium into contact with absolute alcohol. The action of the potassium is much more energetic than that of sodium fer to immerse the potassium under the alcohol in a small glass bell, from which there is a tube to allow of the escape of the liberated hydrogen. When saturation is complete, a thick and almost colourless fluid is formed, from which the ethylate may be obtained in a solid crystalline state. Exposed to water, the potassium ethylate is transformed, as is the sodium ethylate, into ethylic alcohol and potassium hydrate. The action of this compound on animal tissues, living and dead, is the same as that of the sodium compound, but is more energetic.

PRACTICAL USES OF SODIUM AND POTASSIUM ALCOHOLS. I do not as yet see the means of applying readily these two active alcohols for internal administration, but I can predict for them a very extensive application for external purposes. They are most potent caustics. In some cases they may be employed to destroy rapidly such morbid growths as are not favourable


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