progressed normally. Ten hours after delivery the patient had a convulsion. Consciousness returned in less than half an hour. It was learned that she had been subject to epileptic fits. for fifteen years. Convalescence from labour was quite normal, the albuminuria and oedema gradually disappearing. On the eleventh day the patient again had a convulsion. It was preceded by a shrill cry. Consciousness returned in twenty minutes. The further convalescence was uneventful. ALAN MCDOUGALL. WHERRY (J. W.). Results of an Experimental Treatment of Epileptic Insanity. American Medicine, 1904, p. 62. THIS treatment consisted in giving a combination of vaso-dilating drugs with a saline cathartic and an alterative. The seven patients specially referred to in this paper were the most disorderly and intractible of all in the ward, and at the same time their epilepsy was of the longest standing and their attacks the most frequent and severe. There are no real or assumed recoveries to be reported-none were expected; but the object sought was accomplished, the improvement in conduct and in the patients' general, physical, and mental condition was all that could be desired, and more than was hoped for. The ward, formerly the most unpleasant of any in the asylum, is now less in evidence than others containing no epileptics. The quarrelsome and irritable disposition has been practically eliminated, and with its exclusion the violent, vicious and disorderly tendencies have disappeared. While this treatment was not directed toward the convulsion, the improvement in the frequency and severity of this symptom was so marked as to attract attention. The treatment was based on the theory that epilepsy is a condition of auto-intoxication, producing a vaso-motor spasm. ALAN MCDOUGALL. TARNOWSKI (R.). Recent Work on the Etiology, Prophylaxis, Treatment and Prognosis of Pulmonary Tuberculosis. Prager med Wochenschr., 1904, No. 10. In spite of the title of this article there is not much that is new; rather the author insists upon the old methods of examination, and their more stringent application. The main thesis is that the earliest seat of tuberculosis of the lungs is in most cases the pleura at the apices of the lungs, and that the attention of the clinician is too much devoted to the detection of signs in the lungs, and not sufficiently awake to those of disease of the pleural membrane. Auscultation is therefore his sheetanchor, and in our opinion the author is inclined to attribute too great importance to slight deviations from the standard which he has set up as normal; and as a consequence is too ready to diagnose tuberculosis. D As regard prophylaxis and therapeutics, the chief reliance is placed upon breathing exercises, and sanatoria and sanatorial treatment came in for some shrewd criticism. It is an interesting paper, but in our opinion shows too much prejudice. H. THURSField. PETRUSCHKY. Koch's Tuberculin and its Use in Human Beings. THIS is the review of Petruschky's analysis of his results of treatment by the injection of Koch's tuberculin. The results are undoubtedly good, but the cases seem to have been rather elaborately selected, and on Petruschky's own showing the injections are attended by a very considerable amount of discomfort, not to say danger. On the whole, the perusal of the paper does not tend to make us feel anxious to use the remedy. H. THURSFIELD. VON BEHRING. The Origin of Tuberculosis, with Special Reference to von Behring's Theory. Münchener med. Wochenschr., March 18, 1904. THIS paper is a part of a very pretty controversy which apparently is raging between Professor Cornet and von Behring. The latter, from the quotations given in the present article, appears to have thrown doubt on the doctrine that inhalation of the tubercle bacilli is the chief source of lung disease, and believes that tuberculosis is acquired early in life, generally from milk, and manifests itself later in tissues of the body remote from the original site of infection. Cornet writes an extremely interesting paper filled with statistics, figures and records. of experiments too lengthy to quote, seeking to show that von Behring's position is wholly untenable. Von Behring's papers are not available, so that one is judging his position from the account of his opponent; but it would appear that Cornet's arguments and reasoning are quite unanswerable, at least on the main thesis, and we imagine that very few English physicians would be tempted to support the new ideas. Apart from the controversy, Cornet's paper is well worth reading for the mass of facts relating to experimental tuberculosis which it contains. H. THURSFIeld. RULLMAN. On the Killing of Tubercle Bacillus in Heated Milk. Münchener med. Wochenschr., 1904, No. 12. DR. RULLMAN, of Münich, the author of this paper, has carried out a series of elaborate experiments to determine the exact temperature and the length of time of exposure, which will determine the death of the tubercle bacillus in milk. He finds that some authors have been inclined, as a result of this work, to place both figures too low, and after repeating many of their experiments, and adding many more of his own, comes to the conclusion that in order to be perfectly safe the milk must be heated to 68°C, and maintained at that temperature for an hour. The paper is elaborate, and the experiments, which are fully reported, are of great interest. H. THURSField. RIEBOLD (G.). On Delirium in Phthisical Patients. Münchener med. Wochenschr., 1904, No. 12. A CAREFUL and painstaking description of the delirium which not infrequently attacks patients in the later stages of phthisis. Dr. Riebold does not pretend that there is any very special feature which would serve to distinguish the delirium of phthisis from other forms. He concludes that in the course of phthisis it is not infrequent to observe attacks of delirium, which belong to the class of asthenic dementia or acute amentia, but have certain special characteristics, such as temporary hallucinations, and a periodic type, always more pronounced at night, and improving in the morning. The cause he believes to be a poison produced by the diseased lung tissue and acting on the cerebral cortex. As to treatment, chloral is the only drug that produces any amelioration; morphia is to be avoided. H. THURSFIELD. FREZE. On the Relations Between Tuberculosis of the Lungs and Larynx. Münchener med. Wochenschr., 1904, No. 12. THIS paper contains an excellent account of the present state of our knowledge regarding laryngeal tuberculosis. The author holds firmly to the belief that primary laryngeal tuberculosis is one of the rarest phenomena, and that in the vast majority of cases it is associated with tuberculosis of the lungs. He has carried out experiments on dogs, intended to show that the infection in the larynx is due to the contact of infected sputum, and not to lymphogenous infection. The experiments do not appear to us conclusive, but certainly support the author's opinion. H. THURSFIeld. BERNARD (L.). The Permeability of the Kidneys in Bright's Disease. Rev. de Méd., 1903, p. 906. Vol. xxiii. In this paper are given the results of a large number of observations in cases of kidney affection, obtained by kryoscopy, by the method of Claude and Balthazard and by the methylene blue test. The results are summarised as follows:-In Bright's disease the functional activity of the kidneys does not show an unequivocal alteration; the cases of chronic nephritis associated with great oedema and abundant albuminuria (chronic epithelial nephritis) have functionally active kidneys, so far as the cases which progress rapidly towards a fatal termination are concerned; whilst in other cases the organs show diminished permeability in the second period of the development of the disease. (that of cardio-vascular changes). In chronic interstitial nephritis. there is early and constant impermeability, compensated for a time by polyuria, in the absence of which renal insufficiency supervenes. Kryoscopy shows in the former event a meiocrasia, and in the latter a pleiocrasia. In acute nephritis the renal permeability varies according to the severity of the disease; normal in slight cases, it is much diminished as the case becomes more grave. Thus the idea of the co-existence of nephritis with functionally active kidneys, suggested by the results of chemical analysis, densimetry, toxicity and of the methylene blue test, is strengthened by those obtained from kryoscopy. From the theoretical point of view this idea is of interest; it should lead to a systematic research into the degree of renal permeability in the various kidney disorders which are not Bright's disease (urinary, cardiac, diabetes, etc.) into the revision of the theories of uræmia, and into the possibility of grouping symptoms of renal origin, according to the functional fault which begets them. From the practical point of view the doctrine should modify to some extent the elements of diagnosis and prognosis in all kidney affections, especially in Bright's disease. The application of these methods to diseases recognised clinically as " cardio-renal" enables us to separate this morbid type into its two constituent elements-cardiac or nephritic, the type being recognised during the evolution of the malady by the degree of permeability met with in these two categories of disease. T. A. GOODFELLOW. AARON (CHARLES D.). Treatment in Four Hundred and Twenty-two Cases of Movable Kidney Without Surgical Intervention. American Medicine, Dec. 5, 1903, p. 893. THE author believes that 90 per cent. of patients who suffer from movable kidney and associated ptoses can be relieved without operation. He advises support of the dislocated organ and such other organs as are displaced, along with maintenance in their normal position. He uses special bands for each patient, constructed out of stiff material, and fitted after the position of both kidneys, stomach, transverse colon, liver and spleen has been carefully mapped out. The band is worn for one year. Revision of diet, tonics, electricity and massage all tend to hasten the result of the treatment. The histories of a few selected cases are given. T. A. GOODfellow. TURNER (W. A.). The Mental Condition in Epilepsy in Relation to Prognosis. Lancet, April 9, 1904, p. 982. THE writer has investigated 161 cases of epilepsy at the Colony for Epileptics, Chalfont St. Peter, an institution that refuses to accept patients who are demented, dangerous or unfit for some kind of active work. The paper deals with the mental features during the interparoxysmal state. The patients are divided into four classes-(a) without mental impairment; (b) with some loss of memory; (c) with defective power of initiation and capacity for work; (d) with dementia. The influences of sex, hereditary disposition, duration of the disease, age at onset, character of the fits, frequency of the seizures, and the facies epileptica are in turn discussed. Sex has little influence; there is a larger percentage of women than men in class a, but on the other hand, the higher degree of dementia is somewhat more common in women than in men. A family predisposition to epilepsy and insanity, although not necessarily militating against the retention of normal mental faculties, favours the supervention of some degree of mental impairment. Mental impairment is less frequent when the fits have lasted for under five years, just as mental integrity is less commonly seen when attacks have persisted for ten or more years. The earlier the onset of the disease the less the probability of an unimpaired mental state. The profoundest degree of dementia is most commonly seen when major and minor attacks co-exist. With grand mal alone mental health is as common as mental efficiency, with petit mal are found the lower grades of mental impairment. The more frequent the seizures the greater the degree of mental impairment, and vice versâ. Fits recurring in groups are accompanied by a high grade of dementia. Though more commonly found with the higher grades of dementia, the "facies epileptica" is seen sometimes in patients who show no mental failure. The writer upholds the view that the inter-paroxysmal mental condition seen in most cases of epilepsy is one expression of the neurosis of which the fits are another; that the former is therefore not directly dependant upon the seizures and that the frequency and character combination of the paroxysms in association with the degree of mental failure indicate the severity and intensity of the disease. Of the 161 cases class a contained 13.6 per cent. ; class b, 31.6 per cent. ; class c, 254 per cent. ; and class d, 29.1 per cent. ALAN MCDOUGALL. ADAM (G. ROTHWELL). Movable Kidney. HINDER (H. CRITCHLEY). Surgical Aspect of Floating Kidney. Inter-Colonial Medical Journal of Australasia, 1903. Vol. xviii., No. 10. Hinder comments on the rareness of those cases in which mobility |