the subject is given, its causes and the various methods of relief are dwelt upon to some extent. After a description of his own mode of operation, which does not differ materially from the methods usually pursued, the history of eighteen cases are given, in which Dr. Agnew operated for fistula. They all contain points of more or less interest, and make a výluable addition to the statistics of the operation. The papers are well written and give a clear and concise statement of the methods to be pursued in the operation for lacerated perineum and vesico-vaginal fistula, and are a valuable contribution to practical surgery.

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Sex in Education; or a Fair Chance for the Girls. By Edward H. Clarke, M. D., etc. Boston: James R. Osgood & Co., 1873. Buffalo: Martin Taylor.

This little book is the outgrowth of an essay which the author read about a year since before the W men's Club of Boston. The ideas of the author at that time attracted considerable attention and so many were the inquiries addressed to him concerning his views, that he was induced to review the whole subject carefully, and the result has been, the book now before us. The topic under consideration is one of general interest and it is discussed in a manner which shows careful study and a desire to place the subject in its true light. Now that the subject of female education is and has been attracting so much attention, we are glad to see that Dr. Clarke has seen the necessity of looking at the matter from-a physiological point of view. It is from this stand point that the subject is in the future to be decided, and the author has opened the discussion in a manner which will carry conviction to many of his readers.

Those who have hitherto insisted that the girl was capable of going through with the same course of study as her brother in the same manner and space of time have overlooked the physiological differences which distinguish her from the male sex. It is against this viscious system that this book is directed. Dr. Clarke has had opportunities of observing the working of this system and its results and the arguments which he brings against it are supported by sound medical judgment. He speaks plainly, and does not endeavor to cover up the truth or obscure his meaning by the use of obscure and blind phr-ses. Written by a physician of experience, it will be read by his professional brethren with interest, but at the same time the general public will do well to read and profit by its teachings. The law which governs the education of the boy and the life of the man is continuous; it is not during any time divided into periods during which any different rules of living are found necessary.

With the girl on the contrary, after a certain age life is a sy-tem of periods. It is during the time that this change is about 10 take place that the young girl is most frequently made to undergo the most severe strain at school and

* *

seminary. Nor is any calculation made in the system of study which they are made to undergo that at regularly recurring monthly periods, there occurs a number of days when nature demands, and should have in order to the proper performance of a peculiar and important function, complete rest. As a statement showing the position the physician occupies in relation to this problem, we copy from page 61: "The sick chamber, not the school room; the physician's private consultation, not the committee's public examination; the hospital not the college, the work shop, or the parlor, disclose the sad result which modern social customs, modern education and modern ways of labor have entailed on women. Examples of them may be found in every walk of life. On the luxurious couches of Beacon Street; in the palaces of Fifth Avenue; among the classes of our private, common and normal schools; among the female graduates of our colleges; behind the counters of Washington Street and Broadway; in our factories, workshops and homes-may be found numberless pale weak neuralgic dyspeptic, hysterical monorrh gic, dysmenorrhoeic girls and women, that are living illustratious of the truth of this brief monograph. It is not asserted here that improper methods of study, and a disregard of the reproductive apparatus and its functions during the educational life of girls are the sole causes of female diseases; neither is it asserted that all female graduates of our schools and colleges are pathological specimines. But it is asserted that the number of these graduates who have been permanently disabled to a greater or less degree by these causes is so great, as to excite the gravest alarm, and to demand the serious attention of the community." We should be pleased to quote many other passages but can only say to our readers get the look study and read it for yourselves. The author has been sharply criticized by some who seem to think that in some passage they detect a thrust at some pet institution. If they do not come under the list of those who would pay no regard to the physical peculiarities of the female let them strive to bring others into a like manner of thinking rather than find fault with Dr. Clarke in the excellent work which he has undertaken.

The Mechanism of the Ossicles of the Ear and Membrana Tympani. By H. Helmholtz. Translated from the German by Albert H. Buck and Normand Smith. With Twelve Illustrations. New York: D. Appleton & Co., 1873. Buffalo: Martin Taylor. This essay attempts to place in a clearer light, and to demonstrate more perfectly than has hitherto been done, the problems concerning the action of the conducting apparatus of the ear in transmitting sound.

Prot. Helmholtz, is a thorough and careful investigator, and this work will be received by those interested in the department of otology with pleasure. The translation is well made, although from the terse style of the author such

a task is far from easy. The eight sections into which the work is divided, treat of the results due to the small dimensions of the auditory apparatus, the Anatomy of the Membrana Tympani, the attachments of the Hammer, and of the Anvil; the movements of the Stirrup, the concerted action of the bones of the ear, the Mechanism of the Membrana Tympani, and a mathamatical consideration of the mechani-m of curved membranes. As a scientific work this essay deserves a first position, and the greatest regret which we have, is that it will be read and appreciated by but few, except those who make the study of otology a special work.

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Books and Pamphlets Received.

History of the American Ambulance Established in Paris, during the Siege of 1870-71: together with the details of its Method and its Work. By Thomas W. Evans, M. D., D.D.S., Ph D., etc., London: 1873. New York: William Wood & Co. Buffalo: H H. Otis.

The Nature of Gun-Shot Wonds of the Abdomen, and their Treatment. By Eugene Peugnet, M. D. New York: Wm. Wood & Co., 1874. Buffalo: H. H. Otis.

Clinical Researches in Electro-Surgery. By A. D. Rockwell, A. M., M. D., and Geo. M. Beard, A. M., M. D. New York: Wm. Wood & Co., 1873. Buffalo: H. H. Otis.

A Hand-Book of Medical and Surgical Reference. By John A. Wyeth, M. D. New York: Wm. Wood & Co., 1873. Buffalo: H. H. Otis.

A Clinical History of the Medical and Robert Barnes. M. D., etc. Illustrated. Buffalo: Theo. Butler & Son.

Surgical Diseases of Won.en. By Philadelphia: Henry C. Lea, 1874.

The Students Guide to Surgical Anatomy. By Edward Bellamy, F. R. C. S., etc. Illustrated. Philadelphia. Henry C. Lea, 1874. Buffalo: Theo. Butler & Son.

A Practical Treatise on the Diseases of Children. By J. Forsyth Meigs, M. D., and William Pepper, M. D. Fifth Edition Revised and Enlarged. Philadelphia: Lindsay & Blakiston, 1874.

The Sphygmograph; Its Physiological and Pathological Indication. By Edgar E. Holden, A. M., M. D. Philadelphia: Lindsay & Blakiston, 1874.

Dictionary of Elevations and Climatic Register of the United States; containing in addition to Elevations, the Latitude, Mean Annual Temperature, etc. etc, with a brief Introduction. By J. M. Toner, M. D. New York: D. Van Nostrand, 1873.

ART. I.-On the Diffusion of Typhoid Fever by means of Drinking Water. By AUSTIN FLINT, M. D.*

Of the late acquisitions in medicine, one of the most interesting and important is the discovery that typhoid fever may be communicated through the medium of water used for drinking or for culinary purposes. It is now less than half a century since the researches of Bretonneau and Louis established the basis of the individuality of this disease. Its non-identity with typhus fever has only within the last quarter of a century been generally admitted, and even now there are some who deny this well-settled doctrine. The contagiousness of typhoid fever has been a mooted question since the date of Louis' researches. It is possible that the doctrine of its non-contagiousness has at the present time some adherents; but the proof of its communicability has been

*To the Editors of the Buffalo Medical and Surgical Journal.

DEAR SIRS. his paper was read at a meeting of the American Public Health Associa tion, held in the city of New York, in November last. One reason for sending it to you for publication is, that the epidemic which it describes occurred very near Buffalo, and there are certain points relating to the epidemic. which on account of their importance at the time not being appreciated failed to receive attention. These points are, the proximity of the privy of the tavern, and of the privies of the surrounding houses to the well in common use the nature of the soil, the depth of the well and other circumstances bearing on the question as to the pollution with excrementitious matter of the water used for drinking and culinary purposes. Facts with respect to these points may perhaps now be ascertained, and I shall be glad if the publication of the paper in your Journal excites interest in the Physicians living in or near North Boston, sufficiently to lead to enquires which will supply informa tion rendering the history of the epidemic more complete. With much esteem, Yours very truly, AUSTIN FLINT.

rendered so abundant and conclusive that the number of those who are not convinced of the fact must be exceedingly few. Heretofore, however, some of the ablest of observers and authors have advocated its non-contagiousness. A concise statement of fundamental facts relating to the contagiousness of typhoid fever will prepare for an appreciation of our knowledge touching the agency of water as a medium for the communication of this disease. For the sake of conciseness I shall embody these facts in a few propositions.

1. Typhoid fever is very rarely, if ever, communicated by means of emanations from the bodies of patients affected with the disease.

My own experience in this regard accords with that of numerous observers cited by Murchison, exclusive of an epidemic many years ago, within a circumscribed area, of which I shall presently give an account. I have know of very few instances in which personal intercourse could be suspected as the means of communicating the disease. In these few instances there was room for the supposition either that the disease was not communicated, or that contagion was received otherwise than through the atmosphere. The disease does not spread from cases in the hospitals to fellow patients, nurses, and medical attendants. This statement is based on large opportunities for observations for more than twenty years. The different members of a family are seldom affected successively in such a way as to show communication of the disease from one to another. Certainly, as a rule, whenever several persons in a family become affected, the most rational, if not an obvious explanation, is that they have been exposed to a cause alike common to all. As a rule, when persons contract the disease in one locality and pass through the disease in another locality they who are brought into contact with, or proximity to, the cases do not, contract it. There are exceptions to this rule, but in the exceptional instances there is now a more satisfactory explanation than that which refers the communication by means of an infectious miasm. These are the considerations which establish the first proposition.

2. Isolated cases of typhoid fever are numerous, occurring in