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constant, and we would have yellow fever recurring here every summer, under the influence of our solar heat, which varies very little from year to year." Such not being the case however, the author infers that some other cause must be looked for. Such cause he regards as miasmatic, due to a mild winter succeeded by long-continued oppressive heat, with much rainfall, and consequently a large area of stagnant water, wet soil, which would give rise to noxious emanations or miasms, called more recently contagium vivum. This paper throughout is most interesting, as in it the various destructive epidemics which occurred in 1817, 1820, 1854 and 1876 are compared. The author concludes this part of his essay with a clinical table which shows, as he observes, "as naught but figures can, the variations of the pulse, temperature, relapses, and influence of quinine treatment, all of which sustain me in classifying yellow fever as a malarial disease."

Dr. James B. Baird gives an excellent paper on neuralgia, and its modern therapeusis. The author's conclusions as to cause of these affections is that, while admitting the possibility of their being variable, that in this country at least, the most frequent cause is malaria. The malarial origin of some cases. of neuralgia would seem to be undeniable, but the most severe, constant, and unrelievable cases of neuralgia which we have ever witnessed, were due to pressure directly on the nerves by cancerous growths. The next paper is a report of one hundred and thirty operations for strabismus, from the pen of Dr. A. W. Calhoun.

Dr. V. H. Taliaferro, professor of obstetrics in the Atlanta Medical College, gives a paper on "the application of pressure in diseases of the uterus,"-this is followed by a paper on the use of uterine tents; the author, Dr. Goldsmith, proposes the pith of the dried corn stalk as a uterine tent. There are two reports on Surgery, the one by Dr. A. A. Smith, for the third congressional district-the other for the fifth congressional district, by Dr. J. T. Johnson. These are followed by a paper on the soft palate, from the pen of Dr. W. A. Love. Dr. Leitner suggests tar as a means of rendering solid bandages,

and as a substitute for starch, glue, dextrine, &c. The work is concluded with a report of an obstinate case of hiccough, a report on necrology, the constitution and by-laws of the association and the roll of members. Altogether, this is very creditable production, and the Secretary, Dr. Baird, to whom we presume we are indebted for its publication, is to be congratulated for its respectable appearance.

The Throat and its Diseases. With one hundred typical illustrations in colour and fifty wood engravings designed and executed by the author. By LENNOX BRowne, F. R. C. S., Edin.; Senior Surgeon to the Central London Throat and Ear Hospital. 8vo, pp. 351. London: BALLIERE, TINDELL & Cox, 1878.

The author in his preface states that this book, the result of eleven years of work devoted to diseases of the throat, is offered as a practical guide to the diagnosis and treatment of those affections. He does not enter into pathological questions, but confines his remarks to whatever can aid the busy practitioner in carrying through, with the hope of success, the treatment of affections of the throat. So that questions of "purely pathological interest" are not discussed in these pages.

The attention of the reader is in the main directed to diseases of the throat which have been brought out more prominently since the introduction of the use of the laryngeal mirror. By the use of the Laryngoscope the observer has the means of making out with accuracy many special conditions of the larynx and trachea, by actually seeing with his eye these parts, which otherwise would be invisible during life. Thus with this powerful auxiliary he has these cavities laid open to his view, and it alone requires careful observation, with an intelligence equal to knowing what is observed, to enable the physician to form an accurate diagnosis and to predict results, which will surely follow, although no indications of such events may be present. Thus, for instance, a man may be the subject of thoracic aneurism encroaching on

the trachea, or probably almost completely blocking up one of the bifurcations of the trachea; the symptoms may be obscure —not sufficient at least to enable the practitioner to positively pronounce the presence of such a fatal malady, but the laryngoscope would in all likelihood aid him in making out the pressure or obstruction, and its most probable cause.

The text of this work is divided into seventeen chapters; the first three are taken up with a description of the laryngoscope and how to use it; the anatomy of the larynx is next dealt with, after which the laryngoscopic and rhynoscopic images are described- these are accompanied by several excellent outline engravings on wood. Chapters four and five are devoted to the semeiology and therapeutics of throat diseases, after which the diseases of the pharynx and fauces, the uvula and tonsils are discussed in chapters six and seven. Catarrh, naso-pharyngeal and posterior nasal, has a chapter devoted to itself. Diphtheria is the next subject taken up in chapter nine. On the question of general treatment, the author is not very pronounced. He remarks that, "Many general remedies have been suggested, and some have been vaunted as specifics, but the most rational and satifactory method seems to be that of treating symptoms as they arise." The author believes that, "locally very much may be done"; as long as the disease is confined to the pharynx he believes that the spray or brush may be of great service. The author does not enter into the question of tracheotomy, although he remarks that if it does not save the life of the patient, it certainly lessens the agony of death. We certainly think, that in view of the marked success of the operation in this very fatal malady, where the larynx is implicated, that the neglect to perform the operation is to be condemned, and we are disappointed to find in a work ostensibly devoted to the practical consideration of this subject, that it is dismissed in a paragraph of some six lines. This work is offered as a practical guide to the diagnosis and treatment of diseases of the throat, but it would appear that the author has not fully made up his mind, at least on this most important point of treatment, and the sooner he does so the better. We

do not believe in half measures in surgery. In surgery, as in war, action to be successful must be prompt, decisive and energetic, with a full knowledge of the topography of the country, and a careful attention to the rules of strategy. It must not be supposed, however, that, because there is this want of decision in recommending the operation of tracheotomy in diphtheritic laryngitis, that there is the same lack of practical instruction throughout the volume. There are a few points in which a decided opinion might be advantageously given, but we presume the author has not acquired such an amount of experience as to give him that necessary self-reliance which alone is looked for in the practical man. We shall hope to see a decided improvement in this and many other respects in a second edition of this work. Meanwhile, we may remark that there is much instruction to be gained from these pages, and the coloured lithographs are very beautifully executed and very truthful.

Anatomy-Descriptive and Surgical. By HENRY GRAY, F. R. S., with five hundred and twenty-two engravings on wood, with an introduction on general anatomy and development. By T. HOLMES, M. A., Cantab. A new American from the eighth and enlarged English edition, to which is added Landmarks, Medical and Surgical. By LUTHER HOLDEN, F.R.C.S. Imp. 8vo, pp. 983. Philadelphia: HENRY C. LEA, 1878.

It is scarcely necessary to draw attention to this well-known work, except to announce a new American from the eighth and enlarged English edition. This edition has been passed through the press by Dr. Richard J. Dunglison, and from the fact that the work had received three revisions at the hands of the English editor, Mr. Timothy Holmes, since the issue of the previous American re-print, no further additions were deemed necessary. The publisher has enhanced the value of this book by adding to it at the end of the volume Holden's Landmarks, Medical and Surgical; this has been an addition of some 45

pages of reading matter. Gray's Anatomy has been a favourite with students and practitioners for many years, and this edition has lost none of its attractiveness. It is the same valuable and reliable guide brought down to the anatomical knowledge of the day.

Extracts from British and Foreign Journals.

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

The Treatment of Phagedænic Ulcers— By Dr. G. E. WEISFOLG, Virch. Archives, Vol. LXVI, page 311. Among the many therapeutical problems presented by the various manifestations of syphilis, the treatment of phagedænic ulcers is, perhaps, the most difficult.

No plan of treatment hitherto recommended by the best authorities suffices to alleviate, much less to arrest, the pain which these ulcers give rise to.

The desire to afford relief in this terrible disease, has led to the use of an infinite variety of local remedies. One author has even extolled the use of the actual cautery.* As an offset

to this truly barbarous surgical practice, I venture to publish the result of treatment in nine cases. The method to be described was so successful, that I think it deserves to take precedence of all others.

No matter how intense the pain occasioned by a phagedænic ulcer may be, it ceases immediately when the ulcer is exposed to the action of an electro-magnetic bath.

If the sore is not so situated that it can be immersed in the water, the faradization may be applied to the nerves supplying this part; the effect, though not so strikingly beneficial, still suffices to render the condition of the patient comparatively comfortable.

The faradaic bath may usually be applied as follows: The sore is to be immersed in a basin of warm water, to the bottom

Morrison. Fiset "On the local treatment of Venereal Ulcers," in the New York Recorder, Oct. 15, 1874.

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