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spinal meningitis is however discussed, although many authorities regard it as not belonging, strictly speaking, to nervous disorders. Von Ziemmsen in his cyclopædia classifies it among the acute infectious diseases, and many other authors place it among the fevers. It can, however, in a work of this nature, be very properly considered. The work commences by an introduction in which will be found in the first part hints as to the method of examination and study of cases, and also the proper method of conducting an autopsy, and microscopical examina tions.

In the second part is mentioned instruments used as aids to the diagnosis and treatment of nervous diseases ; such as the thermometer, the æsthesiometer, the dynamometer, and the ophthalmoscope. These are all essential aids to the diagnosis of these affections ; and in the treatment we have electrical apparatus, the hypodermic syringe, ice bags of various designs, and cauteries. The rest of the book is divided into eighteen chapters; the opening chapter being devoted to disease of the cerebral meninges. Chapters ii. to vi. inclusive are given to the discussion of diseases of the cerebrum and cerebellum. In chapter vii. diseases of the spinal meninges are considered, then the ensuing four chapters are devoted to diseases of the spinal cord. There is a chapter on bulbar paralysis, then follow two chapters on what the author classifies under the heading of cerebro spinal diseases, these consisting of cerebro spinal menengitis, cerebro spinal sclerosis, alcoholism, hydrophobia, hysteria, hystero-epilepsy, catalepsy, chorea paralysis agitans and exophthalmic goitre. The remaining four chapters are on diseases of the peripheral nerves.

At the end of the volume there are formulæ for various mixtures, pills, powders, hypodermic injections, inhalations, lotions and unguents. This book contains a large amount of material which is not to be found elsewhere ; the style is very clear and readable, and the teaching sound. No physician ought to be without a copy of this work. The author has had ample opportunity in connection with the epileptic hospital on Blackwell's Island, as also with the out-door department of the New York

Hospital, and has apparently fully utilised the material at his disposal. The work appears to be a very important and useful addition to the literature of this subject, which was prior to the appearance of this volume rather meagre.

Transactions of the American Gynaecological Society. Vol. 2.

For the year 1877. 8vo., pp. 672, with index of Gynce-
cological and Obstetrical Literature of all countries, from
July 1st 1876, to January 1st 1877, pp. 25. Boston:
Houghton, Osgood & Co., Cambridge. The Riverside
Press, 1878.

This is the second volume of Transactions of the American Gynecological Society, and consists of a series of papers submitted to the Society at its second Annual Meeting, held in May, 1877. It has taken a little over a year to bring out this volume-perhaps a little tardy, but what has been done is well done. The volume is got up in the same style as its predecessor, in good readable type, on fully toned paper, and illustrated throughout with chromolithographs and heliotypes of excellent finish. From an introductory note by Dr. Chadwick, the secretary of the Society, we learn that it is the intention to publish in each succeeding volume, an index for the year to the Gyneecological and Obstetric Literature of all Countries. This volume contains such an index, extending from the 1st July 1876, to the 1st January 1877. It has been prepared with the coöperation of Dr. J. S. Billings, of the National Medical Library at Washington ; this will add greatly to the value of the work, and if kept up from year to year will render the work indispensable in the library of the scientific student. After lists of honorary fellows and ordinary fellows, and minutes of the proceedings of the second annual meeting, the real interest in the volume opens with the annual address on medical Gynæcology by the president, Dr. Fordyce Barker. In a few introductory remarks, he points to the advisability of the careful distribution of foreign honorary fellowships, observing that the society should adopt “the wise policy of selecting a very small number from those only who have done so much for the literature and science of our branch of the profession, as to make their election an expression of the highest respect which this society can evince"; and as regards honorary fellowships from amongst his own countrymen he suggests the expediency of selection only from amongst those who “have won the honour by good service in the society.”. Certainly if these suggestions are fully carried out they will do much to elevate the character and standing of the society, for, as he truly observes, “ honours cheapened by being made common, are but lightly esteemed."

This excellent address is followed by one from the pen of Dr. James R. Chadwick, of Boston, on the functions of the anal sphincters, so called, and the art of defecation; in this we have described the physiological action of the sphincters, the author recognising after Hyrtl the sphincter ani tertius. This paper is very interesting and leads to practical deductions, of which the following are a summary: That in the introduction of a bougie into the rectum it is an error to imagine that a straight bougie ought not to meet with any natural obstruction. 2nd. “ As the anterior half of the inferior detrusor is just below the level of the bottom of Douglas’s pouch, it seems probable that the point at which inter-peritoneal abscesses are most likely to perforate the rectum is just above this constricting fold,” and 3rd. “ As the superior detrusor is shown to be forced down into the canal during defecation by the action of the abdominal muscles, the suggestion presents itself that this part of the rectum is the one that first emerges in cases of prolapsus of the rectum.” This article is illustrated by two heliotype plates.

Dr. John Byrne, of Brooklyn, N. Y., gives a practical paper on amputation and excision of the cervix uteri, their indications and methods. The term excision he restricts to the removal of comparatively small portions of the cervix in contradistinction to the term amputation, by which he would imply the entire removal of an hypertrophied or diseased cervix. In speaking of the means used for the amputation or excision of the cervix, the author shows a decided preference to the use of the galvanic cautery ; seven cases are reported with encouraging success;


an interesting discussion on this paper follows, and we have the opinion of Dr. Scott, of the Women's Hospital, San Francisco, Dr. Byford, of Chicago, Dr. Goodell, of Philadelphia, and Dr. Noeggerath, of New York.

We next have a report on the corpus luteum, from the pen of Dr. John C. Dalton, of New York. . It appears that at the meeting of the society, held in 1876, Dr. Dalton was invited to prepare a report on this subject, and through the coöperation of a number of medical friends he obtained in good condition thirty-two pairs of ovaries, at various periods after menstruation, and after delivery the first ten cases reported, illustrated the growth and retrogression of the corpus luteum as connected with the menstrual period. Then we have the record of six cases in which the condition of the ovaries is described after menstruation had been suspended for several months or years. These cases, the author informs us, serve to illustrate the negative history of the corpus luteum in its relations with menstruation. The ensuing five cases illustrate certain irregularities and marked deviations in the corpus luteum of menstruation, and the remaining cases illustrate the appearance of the corpus luteum of pregnancy and after delivery; this paper is illustrated with twelve coloured lithographs.

Dr. G. H. Bixby, of Boston, gives a translation of a paper by Dr. Otto Spiegelberg, on the pathology and treatment of puerperal eclampsia. This is followed by a paper on dilatation of the cervix uteri for the arrest of hæmorrhage, by Dr. G. H. Lyman, of Boston. There are three short papers, one by Dr. Skene, on the principles of gynoecological surgery applied in obstetric operations, another, researches on the mucous membrane of the uterus, by Dr. Engelmann, and a third on the necessity of caution in the use of chloroform during labour, by Dr. W. T. Lusk. In this paper the author assigns five reasons why chloroform is objectionable. 1st. If carried to complete loss of consciousness, it sometimes weakens uterine action, or may suspend it altogether. This may possibly follow, but we should think it exceptional. Uterine action may, as a first effect, be weakened, but we cannot call to mind any case where

it has been totally suspended during the parturient act. In the third proposition the author denies that patients in labour enjoy any absolute immunity from the pernicious effects of chloroform. Fourthly, the author holds that the anæsthetic ought not to be given in the third stage, as he remarks, the relative safety of chloroform in parturition ceases with the birth of the child. In this we fully agree. The chief objection to our mind to the use of chloroform, is a decided tendency to post partum hæmorrhage as following its employment. It appears to influence injuriously the contractile power or tone of the muscle of the uterus, and in our experience post partum hæmorrhage is very apt to follow

its use.

This fact was long since pointed out, and in all cases in which chloroform has been freely administered, the accoucheur should always use more than ordinary precautions against this result which is so apt to follow, as undoubtedly the anæsthetic tends to produce uterine relaxation.

The next paper is by Dr. Van de Warker, on the present status of the intra uterine stem in the treatment of flexions of the uterus. This paper is fully discussed, the discussion being participated in by all the leading gynoccologists present. A case of vaginal ovariotomy is reported by Dr. Goodell. This is followed by a paper from Dr. Robert Battey, entitled, “ Is there a proper field for Battey's operation ?As our readers are aware, Dr. Battey proposes the removal of the ovaries while still functionally active, as a means of relieving certain conditions, and he offers the following propositions: He would practice removal of the ovaries—1st. “ In those cases of absence of the uterus, in which life is endangered or health destroyed by reason of the deficiency.” 2nd. “In cases when the uterine cavity or vaginal canal has been obliterated and cannot be restored by surgical means. If grave symptoms are present, the removal of the ovaries becomes a last and only resort, and may be hopefully invoked in the case.” 3rd. “ In cases of insanity or confirmed epilepsy, dependent on uterine or ovarian disease.” 4th. “In cases of long protracted physical and mental suffering, dependent on monthly nervous and vascular

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