the skin during recent years the author has gathered what has met with approval of experience; this especially relates to the conclusions reached by the latest investigators in relation to the symptomatology, diagnosis, etiology, and treatment of the maladies described. Notice has also been taken of such new remedies as have had their worth thoroughly tested and approved. Newly discovered diseases that are of most frequent occurrence and have been accurately made out have received such attention as seemed to be due them.

The work is practically without illustration, a feature that will not be objected to by the special student, since nothing less than such full portrayal as can be furnished by elaborate maps alone can give satisfactory assistance to the learner. This new edition can not fail to add to the reputation of its distinguished author, as it does to the elucidation of an important department of medical science.

D. T. S.

Pathological Technique. A Practical Manual for the Pathological Laboratory. By FRANK BURR MALLORY, A. M., M. D., Assistant Professor of Pathology, Harvard University Medical School, etc., and JAMES HOMER WRIGHT, A. M., M. D., Director of the Laboratory of the Massachusetts General Hospital, etc. With one hundred and five illustrations. 397 pp. Price, $2.50. Philadelphia: W. B. Saunders. 1897. This work is a comprehensive guide to all the tasks that devolve on the pathologist. It begins with an exhaustive description of the methods of postmortem examinations, then devotes about one hundred and thirty pages to bacteriological examinations, and closes with about one hundred and eighty pages given to a consideration of histological methods. The work is not limited to dry details, as so many of its general class are, but it is made attractive by the application of the facts gained by the various methods of investigation described.

It covers the field in a different way from any other work of its kind, and can not fail to prove eminently interesting as well as helpful to all practitioners who are in love with this class of work or who have the curiosity that makes it possible to be lured into the pursuit of it.

Of the many methods that have been devised for various steps of this character of study, the authors have selected only the best, and have therefore been able to set them forth more fully than would otherwise be the case. A generous reception may be predicted for the work.

D. T. S.

A Manual of Clinical Diagnosis by Means of Microscopic and Chemical Methods. For Students, Hospital Physicians, and Practitioners. By CHARLES E. Simon, M. D., late Assistant Resident Physician, Johns Hopkins Hospital, Baltimore, etc. Second edition, revised and enlarged. With one hundred and thirty-three illustrations on wood and fourteen colored plates. 563 pp. Price, $3.50. Philadelphia and New York: Lea Brothers & Co. 1897.

This work in the first edition met with a large success, which it fully merited. In the present edition it has received considerable revision, bringing it up to date. There is a considerable increase in the number of cuts,

and about fifty pages have been added. It is a complete, authentic, and useful manual of the microscopical and chemical methods which are now employed in diagnosis.

The work treats of the technique and the value in diagnosis of facts revealed in examining the blood, saliva, gastric contents, feces, nasal secretions, sputum, urine, transudates and exudates, cystic contents, cerebrospinal fluid, semen, vaginal discharges, and milk. Throughout the text numerous additions have been made, and care has been taken to substitute new methods of chemical examination, where such have appeared, for the older and more complicated ones. The excellent system of illustrations that characterized the first edition have even been improved upon. This especially appears in the beautiful illustration of Simon's improved application of Hiller's test, which shows how much better the test may be made with a conical glass than with the ordinary tube.

D. T. S.

A Text-Book of the Diseases of Women. By HENRY J. GARRIGUES, A. M., M. D., Professor of Gynecology and Obstetrics in the New York School of Clinical Medicine, etc. Containing three hundred and thirty-five engravings and colored plates. Second edition, thoroughly revised. 728 pp. Price, cloth, $4.00; half morocco, $5.00. Philadelphia: W. B. Saunders. 1897.

This work in its first edition has everywhere been regarded as one of the most faithful and full exponents of American gynecology. Dr. Garrigues is equally master of the knife and the pen. He has, moreover, the reputation of an eloquent speaker. It was only to be expected then that he should give us one of the best books for students and practitioners that has been published in the English language. Few men have had better opportunities, or been possessed of larger capacity and willingness to make use of them.

This edition has been brought fully up to date. The work is lucid and concise as well as comprehensive, and can be heartily recommended to students and practitioners.

D. T. S.

ROENTGEN SKIAGRAM IN PERSISTENCE OF DUCTUS BOTALLI.-In a case presented a short time ago at the Berlin Society for Internal Medicine, the diagnosis of a persistent ductus botalli was confirmed by the X-ray picture of the case. Gerhardt has pointed out that there is in such cases an area of dullness above the base of the heart to the left of the sternum. This is considered to be due to the dilated pulmonary artery. In this case a distinct shadow was found in this situation in the Roentgen skiagram. This, too, is typical of the zeitgeist in Germany, for, while scarcely a surgeon makes a diagnosis of a fracture without a skiagram, no internist concludes definitely as to the presence of an aneurism without the same aid, and even evokes it at times for tubercular infiltration of the lungs and other intrathoracic conditions.-Philadelphia Medical Journal.

Foreign Correspondence.

LONDON LETTER.

[FROM OUR SPECIAL CORRESPONDENT.]

Modern Bullet Wounds; Medical Aid in India; Lecture on Inebriety; A New Expedition; Case of Typewriter's Cramp; Glycerine and Calf Lymph; Oysters and Typhoid; "He War Dead."

Surgeon Captain Dutch recently gave a very interesting lecture on bullets and bullet wounds produced in modern warfare, and the means by which they are located and removed by the surgeon. In the course of his remarks Surgeon Captain Dutch contrasted the controlling influence which determined their flight as regards the size, weight, shape, and atmospheric density with those of the old form of ammunition. Specimens of fired and unfired bullets were also shown, and the lecturer argued that the nature of the wounds produced behooves the army surgeon of the present day to make a study of their "flattening-up" properties in order to render the prognosis of any case being of value. The latest fashion of locating bullets. in situ and injury to bones resulting therefrom by means of the X-rays was also demonstrated.

According to the report for the last year of the United Kingdom Branch of the Dufferin and Ava fund for supplying medical aid to women in India, the growth of the movement is phenomenal. In the twelve months under review no less than 1,327,000 women received attention, either in hospitals or their own homes, from lady doctors. There are now 103 hospitals and dispensaries under the charge of twenty-eight ladies, whose names are on the English Medical Register, seventy lady assistant surgeons, and seventy hospital assistants, most of whom are native women, educated at the Indian universities. At the present time there are two hundred and forty ladies studying in the medical colleges, among them being high class Hindus, Mohammedans, Parsees, Karens, and Burmese.

Guy's Hospital benefits to the extent of £20,000, the gift of Henry Lewis Raphael, who has given that sum to the Institution for the building and endowment of a Nurses' Home, to be known as the Henrietta Raphael Nurses' Home, in memory of his wife.

Dr. W. L. Brown contributed at a meeting of the London Society for the Study of Inebriety a paper on the subject of "Inebriety and Its Cures. among the Ancients." He said, among other things, that prohibition was first tried in Britain by the Saxon King Edgar (959-971), who reduced the number of ale-houses in the villages, and introduced the custom of pegging the huge drinking cups then in use. King Edgar made it a penal offense for any one to drink beyond the peg. St. Anselm, who died in 1079,

forbade priests to go to "drinking bouts" or to "drink to pegs." Early closing was first tried, it appears, in the reign of Edward the First, to prevent excessive drinking and its noxious effects." Laws were passed to secure good ale for the public and the punishment of those who sold adulterated liquors. Ale couriers were appointed by many corporations to see that the ale was good and the brewer had to swear on the Blessed Evangelists to "brew good ale and wholesome so far as ability and human frailty permits."

The first exploring expedition ever sent out by a university has just sailed to Torres Straits. The University of Cambridge has the honor of having provided the funds for this venture. The chief of the expedition is Dr. Hadden, Lecturer on Anthropology at the University, and there are with him Dr. McDougall, of St. Thomas' Hospital, Mr. C. S. Myers, of St. Bartholomew's Hospital, and Dr. Rivers, the Lecturer on Experimental Psychology at Cambridge. Dr. Hadden is especially charged to study the subject of folk lore. After Torres Straits Borneo and New Guinea will be visited, the expedition expecting to be away fifteen months. The party are taking a phonograph and a kinemalograph so as to be able to bring back records of songs and dances.

Dr. F. H. Simpson has recorded an interesting case of a patient suffering from typewriter's cramp; he says he is unacquainted with any authentic record of a similar case. The patient is a muscular man, thirty-three years of age. He began working as a clerk when eighteen years of age; after seven years of this employment the first symptoms of writer's cramp showed themselves. He then learned to use the typewriting machine. After a year of this he went to sea, and did not again take up typing for some six years, when he entered an office as typewriter, but was only engaged working the machine for two or three hours daily. After about two months' work, one day, while at work typing his right index finger became bent by cramp. Daily after this a repetition of the cramp occurred each evening, a slight involuntary flexion of the wrist being superadded. After a few weeks he had to substitute the middle for the index finger; in six days the middle finger became involved. He then, acting upon advice, used a small hammer to strike the keys. For some time he experienced much relief, but eventually cramp affected the whole right forearm, necessitating his abandoning his present occupation. The patient when piano-playing has no symptoms of any digital spasm.

The Maidstone Water Company's offer of £3.000 as compensation to sufferers by the late typhoid epidemic has been rejected, and it has been decided in numerous instances to commence actions against the company forthwith. No legal liability is at present admitted by the company.

It is considered that the researches by Dr. Copeman on the influence of the addition of glycerine to the calf lymph used in vaccination is a noteworthy contribution to the history of vaccination against smallpox. Dr. Copeman has shown that a single calf will yield from ten to fifteen grams' weight of vaccine material; to this may be added equal parts of water and glycerine, to an extent equal to fourteen times the original bulk of the

matter obtained from the calf. Thus the result, if properly and judiciously used, will suffice to vaccinate fifteen thousand persons. Dr. Copeman claims that the glycerine serves to destroy forms of microbe life which may cause accidents of untoward character.

Dr. G. S. Buchanan, of the Local Government Board, has just presented his report on certain cases of enteric fever which occurred in Essex during 1897, and were considered as being due to eating oysters which had become contaminated with sewage containing the bacillus of typhoid. Dr. Buchanan as a result of his exhaustive investigation considers that the oysters were at fault. It is expected that the remaining volumes of the System of Medicine edited by Professor Clifford Allbutt will be issued before the end of the year. A juror at Horsham in Hampshire, having been sworn, proceeded recently in company with the other "good men and true" to view the body. On returning to the coroner's court this juryman was missed. After the inquest the missing juryman was discovered, and when asked to account for his non-appearance he quite innocently replied, "Well, what more do 'ee want? I saw'd the poor fellow; he war dead. The cor'ner didn't tell I to come back."

LONDON, March, 1898.

Abstracts and Selections.

A CASE OF PUErperal SeptiCEMIA.-The following notes of a severe case of puerperal septicemia may be of interest from the fact that grave complications seem to have been modified by the use of antistreptococcic serum. I have reason to believe that some practitioners in such cases take no steps to remove from the uterus any putrescent offending matter or to render its cavity surgically clean, and such a case as the following amply demonstrates the necessity for such interference, otherwise the probability is that the patient slips through one's fingers.

The patient was a very thin, pale, and delicate woman, aged twenty-five years. At her confinement on December 10, 1897, she could render herself very little help, the pains were feeble and useless, consequently she was delivered by forceps, in regard to which operation there was no particular difficulty. For two days she did very well, but on December 13th the temperature in the morning was 102° F. and the pulse was 104. There was no abdominal tenderness but there was very slight fetor of the lochia. On the 14th the temperature was still 102° and the fetor was more marked. The uterus was washed out with a 1 in 60 solution of carbolic acid and then with hot water. On the 15th the temperature was 101°, but no local treatment was allowed as the patient felt so ill. On the 16th the temperature was 101.5° in the morning and 103° at night. On the 17th the temperature reached 103°, and during the night a severe rigor had occurred; the onlookers