last longer than two or three days, but if the X-rays are continued the disease, formerly advancing slowly, now develops rapidly. Two cases out of a much larger number are cited in detail in proof of the foregoing results. The writer is of the opinion that X-rays exercise a particularly debilitating effect in cases of phthisis, and that their application is absolutely contraindicated in thoracic affections not only as a therapeutic agent, but also as a means of diagnosis. LOUIS SAVATARD. DOCK (GEORGE). Roentgen Rays in the Treatment of Leukemia: A Under treatment with Roentgen rays some cases of leukemia undergo marked change for the better-the leukocytes become normal in number, the red blood corpuscles improve, the enlarged spleen and lymphatic glands resume normal proportions, and the general health seems restored. In other cases the effects are imperfect. In no case has observation been carried out long enough to speak of cure. In several cases death has resulted, while the symptoms seemed to indicate improvement. The mode of action of the rays is not known. At present the improvement must be considered functional and not affecting the original cause, nor in a permanent way the morbid histology of the disease. The improvement of the red blood cells may be due to general stimulation of nutrition, in which suggestion may have a part, or by diminution of lymphoid or myeloid tissue, and thus permitting development of red cells, as suggested by Ahrens. Roentgen ray treatment of leukemia is dangerous on account of the usual risk of dermatitis and burns, but probably also on account of toxic processes as yet impossible to explain. No stronger claims can be made for it. than can be made for arsenic and certain serums, but it may prove more certain in its action than arsenic and can be more readily applied in practice than the injection methods. No special rules can be laid down at present for treatment with Roentgen rays. Great care should be taken to avoid burns. The blood should be carefully examined as fully and as frequently as possible, and, if possible, urine examination should. be made, to throw additional light upon the metabolic changes. 66 LOUIS SAVATARD. HARTIGAN (T. J. P.). The Treatment of Port-Wine " Nævus by Radium Bromide. Brit. Journ. Dermatology, December, 1904. THE patient, a woman, aged 26 years, was born with a large "portwine" nævus covering the left cheek and side of the nose. The disfigurement was great. From observations of the effect of radium on the healthy skin and on lupus and rodent ulcer the writer was led to the conclusion that, by setting up a somewhat prolonged reaction, it would produce obliteration of the vessels, and "thus remove what has hitherto been regarded as an irremediable infirmity." The result is considered distinctly encouraging," for, with the exception of a few small untreated areas, the nævus has entirely disappeared. Two specimens of radium, weighing 10 mgr. each, and of the highest known radioactivity, were used. Thirty-nine exposures, varying from half to one hour, were given and the treatment extended over nine months. LITTLE (E. GRAHAM). A Case of Lupus Vulgaris Treated with Tuberculin. British Journal of Dermatology, 1904, p. 325. A DIAGNOSIS of lupus vulgaris verrucosus of the nose was made at the end of May, 1903. The surface was cleaned and thyroid extract administered (3 grs. three times a day). X-ray treatment was given daily with satisfactory results until August, 1903, when, unfortunately, the patient received a blow on the nose which seriously delayed the healing process. X-rays and thyroid extract were continued, however, up to December, 1903, but with so little encouragement that at this time he was placed under treatment with inoculation of tuberculin (T.R. of Koch) by Dr. A. E. Wright. Three inoculations in all were given, but the condition of the nose became worse and the area of invasion seemed larger. Dr. Wright pointed out that the case had been unsatisfactory because it had not been possible to time the inoculations so as to avoid accentuating the negative phase' which normally occurs in these inoculations in the present state of the experiences with them." Since then, however, Dr. Wright has perfected a means of estimating the phagocytic reaction before giving the inoculations which will probably result in the greater certainty and success of their administration. LOUIS SAVATARD. Short Notes on Selected Papers. Experimental Aortitis. By I. WALKER HALL, M.D. Pic and Bonnamour. Soc. Biol., Bd. 58, p. 219. Small quantities of adrenalin injected into the veins of rabbits produced atheromatous changes in the aorta. The results were most marked in animals during the lactation period, and in tuberculous animals. Young animals were not affected. Watery extracts of the suprarenal gland acted similarly, but renal extracts were without effect. Test for Excess of Hydrochloric Acid in the Gastric Contents. Add four drops of a solution of sodium hypochloride to 0·5 c.m. of aniline water and 2 c.m. of the filtered stomach contents. If a light violet colour appears and persists after dilution with water 2:1, then more than 0.2 per 1000 HCl is present. Renal Decapsulation. Boyd and Beattie. Edinburgh Med. Journal, 1905, p. 337. Report of a case in which the kidney was examined four months after operation. The capsule was much thickened, strands of cellular tissue proceeded therefrom into the kidney, and the vascular conditions had not been improved by the operation. The general conclusions are against decapsulation, but in favour of simple incisions. Reabsorption of Urine in the Kidney. Lindemann (W.). Ziegler's Beiträge, Bd. 37, Heft 1. The theory which supposes that the dilute urine emerging from the glomeruli is concentrated by reabsorption during its passage through the tubules, has gained a fair amount of support. It has been used to explain the localised action of certain toxins. Lindemann concludes that the cells of the renal tubules do not reabsorb the urine. Amongst other experiments, he filled the pelvis. of the kidney with olive oil, in order to raise the pressure of the of the urine in the tubules. The results were negative. No reabsorption of urine occurred. Human and Bovine Tubercle Bacilli. E De Jong. Centrlb. f. Bakt., 1905, p. 264. From an exhaustive investigation, in which goats, calves and guinea-pigs were injected with tubercle bacilli obtained from human beings, De Jong concludes that there are no valid differences between human and bovine tubercle bacilli, and that a weakly virulent human bacillus during its passage through animals has its virulence increased to a degree which makes it comparable to that of the bovine organism. Experimental Streptococcus Arthritis in Relation to the Etiology of Acute Articular Rheumatism. Cole (J. F.). Journal of Infectious Diseases, Vol. i., p. 714-737. Cole, in the Johns Hopkins Hospital, has for three years carefully worked out a large number of cases, and cannot confirm the findings of previous writers as to the etiological significance of the "micrococcus rheumaticus." He has intravenously injected streptococci obtained from cases of peritonitis following carcinoma, of puerperal fever, of septicemia, of empyema, of purulent glands following scarlet fever and of endocarditis of probable rheumatic origin. All alike caused arthritis and endocarditis, and the results of the injections were practically the same as when the "micrococcus rheumaticus" was injected. The Tumours of Mice. Haaland (M.). Annales de L'Institut Pasteur, 1905, T. 19, p. 165. The venue of cancer ætiology is ever changing. If the parasitic theory must be abandoned, can support be found for a toxin, or rather "virus?" Haaland, working in Borrel's laboratory, has investigated the tumours which occur in mice. Some of them present appearances similar to those of human tumours. Many of them can be transmitted to other mice by placing the animals in the same cage as the animals with tumours. Progressive growth of the tumour, cachexia and death are the general rule. Apparent secondary growths occur in the lung. These are not true secondaries, but nodules of epithelial tissues due to irritation. Inoculation of the tumours does not always lead to growth, nor to secondary nodules. Do the secondary nodules result from a virus which is destroyed or altered by its passage through an intermediate host? The paper will repay careful perusal. Reviews. Equanimitas, with other Addresses to Medical Students, Nurses and Practitioners of Medicine." By WILLIAM OSLER, M.D., F.R.S. London: H. K. Lewis, 1904. Demy 8vo. Pp. 389. Price 7s. 6d. In this book are printed various addresses which have been delivered by the author from time to time. They are charmingly written and are marked throughout by a marked degree of scholarship. The book is one which could be read with advantage by every student and practitioner of medicine. "A Treatise on Applied Anatomy." F.R.C.S.I. London: Charles By EDWARD H. TAYLOR, M.D., Pp. 738, 178 figures and plates. Price 30s. net. THIS book contains an account of regional anatomy in its more important applications to medicine and surgery. The author considers that the subject of anatomy might with advantage be taught more from the applied standpoint and less as an abstract science, and thus the wide gap which separates the dissecting room from the surgical theatre might be bridged over. He therefore treats the anatomical facts chiefly from a surgical standpoint. The book has evidently been compiled with great care. The text is well written and the illustrations, some of which are coloured, are excellent. We have every confidence in giving the book our strongest recommendation. It cannot fail to be of the greatest service to both students and practitioners. "Medical Monograph, Series No. 8: Insanity in Every-day Practice." By E. G. YOUNGER, M.D. (Brux.), M.R.C.P., D.P.H. THIS book is a small one containing simply the essentials of clinical insanity and is intended to place shortly before the general practitioner all that is necessary for his guidance in the certification of the insane. At the beginning the author gives an abstract from the Lunacy Acts at present in operation with a description of the procedure necessary for the removal of a pauper or private lunatic. The description of the clinical varieties of insanity is short, but their more important symptoms are given concisely with illustrative cases. The classification is a convenient one for a book of this size. "Guy's Hospital Reports." Edited by J. H. BRYANT, M.D., and F. J. STEWARD, M.S. Vol. lix. London: J. and A. Churchill, 1905. THIS Volume contains besides the usual lists of interest chiefly to Guy's men, seven valuable original papers based on the large amount of clinical and pathological material of the Hospital. Among the subjects |