Five hundred patients in the hospital wards were thus examined week by week besides a large number of others which were subjected to a less rigid examination.

:

The results, to say the least, are very interesting. We have only space to refer to those obtained from 13 cases of typhoid. In these, during the second week previous to convalescence* the amount of sulphocyanide was + 34 (as the saliva was at this time in very small quantity the total amount of the test present must have been very small)—in the succeeding week it rose to 2 in the first week after convalescence to +234; in the second week to +34; in the third to +234; in the fourth to +3, and remained high till after the seventh week of convalescence, in some instances rising to +7. Another point of interest lies in the fact that where the duration of the febrile stage was short the increase of the salivary salt was less abrupt, but the duration of the convalescence-as shown by the increase of salt-was longer. Hence the amount of the salt secreted during the first week of convalescence should help us greatly in our attempts to foretell the length of this, and prove therefore a fact of high value. But we cannot help remarking that the statement that typhoid with a febrile stage of less than twentyonę days has a longer convalescence than the same disease when the fever exceeds twenty-one days is a very hard saying in the ears of any practical physician.

On the other hand, in ten cases of progressing phthisis the average amount of the salivary salt was only 127: there is also a similar deficiency in the later stages of malignant disease. But space forbids. The work throughout is most ingenious and indicative of patient persevering labour: a work well worth perusal and rich in suggestiveness: a thoughtful contrast to the too-frequent literary advertisement through which we have to wade with a dull and dreary pain.

*i.e. the date at which the normal temperature was first permanently resumed.

OUTLINES OF PRACTICAL PHYSIOLOGY.*

THIS is an exceedingly convenient handbook of experimental physiology. The chemical and physical portions are both very complete, and are illustrated with abundant and well-chosen diagrams. The collection of diagrams for experiments on vision will be found particularly useful.

The book is designed specially for medical students; but, like all text books of the kind, it makes hardly enough distinction between the methods which are useful in medical practice, and those which are only of scientific interest.

It would be possible with a little ingenuity to considerably simplify the portions relating to quantitative analysis. Too often the student receives in the physiological laboratory his initiation into the mysteries of quantitative analysis; and for want of really simple and practical teaching, his one opportunity of acquiring skill in this art is sometimes lost.

There is an evident oversight on page 96, where we read,"To a solution of sodic chloride (normal saline), add mercuric nitrate=precipitate.”

TRANSACTIONS OF THE ACADEMY OF MEDICINE IN IRELAND.†

WE call attention with pleasure to the fifth volume of the Transactions of the Academy of Medicine in Ireland. The union of the various medical societies of Dublin, constituting a joint "Academy," has been productive of excellent results. The association seems to be in a flourishing condition, and the communications contributed by the Fellows and members are of the usual high standard. The volume is neatly printed and admirably illustrated. The lithographs of Mr. E. H. Bennett's case of Fracture of the Ischium have been especially well executed.

Outlines of Practical Physiology: being a Manual for the Physiological Laboratory, including Chemical and Experimental Physiology, with reference to Practical Medicine. By William Stirling, M.D., Sc.D., Professor in the Victoria University, &c., &c. London: Chas. Griffin & Co. 1888.

†Transactions of the Academy of Medicine in Ireland, vol. v., 1887. Dublin Fannin and Co.

NOTES ON DISEASES OF WOMEN.*

THIS little work consists of thirteen short essays on gynæcological subjects. They are very unequal; some of them—those on sterility and fibroid tumours, for example-possessing very considerable merit; while others are altogether inadequate to the subject of which they are supposed to treat. There is a philosophic tone or flavour-an appreciation of the value of comparative and developmental research-and an absence of therapeutic enthusiasm in the author's style which, in their way, are admirable qualities, especially as a basis on which to ground a more extended work. Sometimes, however, there are signs of a straining after effect in one of these directions which it would have been better to avoid. The following paragraphs, in the present writer's opinion, may fairly be considered as examples of this tendency :—

"The development of the uterus from the fallopian tubes is a fact worthy of being borne in mind, for patients who suffer from pyosalpinx invariably complain at some time or other in the progress of the disease, not only of disturbance during but of interference with the manifestations of the recurring physiological changes in the uterus."

Again: "The germ and sperm cell may meet and coalesce. In order, however, that an uninterrupted segmentation may be evolved, they must produce by their union not a state of equilibration, but a state of molecular disturbance. If the molecular waves of the two elements are too closely allied to each other, they induce a state of equilibrium with which all vital reaction ceases and no further evolutional change becomes possible. If two forces of equal intensity act upon each other in opposite directions, a state of rest will result. It is possible thus, by adding light to light to produce darkness; or by adding sound to sound to produce silence. The waves of the one force are spent in overcoming the waves of the other force." In almost every chapter of the book a paragraph appears on molecular disturbance and equilibration, which the author

*Notes on Diseases of Women. By James Oliver, M.D, Edin., F.R.S. Edin. London: Hirschfield Brothers.

1888.

introduces as of special significance. Whether an explanation capable of universal adaptation is of much value in the elucidation of vital phenomena is a question that many will consider doubtful.

As the first passage which was quoted was one on which the bearing of development appears to be somewhat strained and unnatural, it is only fair that another should be noticed, which, in our opinion, is of distinct value, and serves to mark and explain an important observation.

Dr. Oliver draws attention to the fact that the urinary and reproductive organs in the human frame are developed from a common structure (the temporary organs named the Wolffian bodies), and afterwards suggests that this may be explanatory of the symptom of menorrhagia which accompanies pyonephrosis. The present writer has often observed menorrhagia as a symptom accompanying tumour or enlargement of the kidney, and while this symptom is by no means uncommon in various small pelvic and abdominal tumours of other organs it is certainly very possible that development may have a special bearing upon its appearance in kidney disease.

Another paragraph containing a concise and forcible descriptive sentence may well be reproduced :—“It is more than probable, however, that as we may consider the epileptic patient as epileptic throughout, even to the finger-tips, the interruption of the periodically-recurring functional disturbance in the uterus is wholly independent of any defective structural state of the viscus itself."

The book is well got up-the type is excellent, and, with one exception (on page 26), no directly grammatical or typographical errors are to be met with. In his preface the author expresses a hope that his book "may lend in the establishment of gynecology on a more sure and scientific basis." This use of the verb is new in our experience, but perhaps the sentence may be framed on some old model of which we are ignorant.

An appreciative dedication to Sir James Sawyer draws attention to the fact that the writer is an old Birmingham student, who remembers gratefully his connection with the Queen's Hospital.

RETROSPECT.

NERVOUS DISEASES.

BY C. W. SUCKLING, M.D. LOND., M.R.C.P.

PHYSICIAN TO THE QUEEN'S HOSPITAL.

Alcoholic Neuritis -The Lancet of May 19, 1888, mentions a new contribution to the histology of peripheral neuritis by Professor Eichorst, of Zurich. At the autopsy of a case of well marked alcoholic paralysis no gross lesions could be seen in the nerve centres. The spinal nerve roots were normal but the tibial and radial nerves were profoundly diseased, osmic acid preparations showing very extensive degeneration and atrophy with absence of axis cylinders in a large proportion of the nerve fibres. Tracing the nerves to their peripheral terminations in the muscles Professor Eichorst found the lesions to be more advanced and complete there than in the nerve trunks. Within a muscle there was not a single normal nerve fibre. Each degenerated nerve fibre was surrounded by numerous laminæ of connective tissue produced from the endoneurium and perineurium. Professor Eichorst proposes to term the condition "neuritis fascians," as denoting what he considers to be the essential feature of the change, viz: the inflammation of the nerve sheath and the extension therefrom to the interstitial tissue of the muscles.

An Epidemic of Infantile Palsy (reported in the Lancet, January 28, 1888).—M. Cordier has observed an epidemic of this disease, of thirteen cases occurring in a period of two months, in a population of fifteen hundred. The age varied from one to thirty months, and nearly all the children were in perfect health. Four cases died on the third day of the disease. Fever, convulsions, profuse sweating, and paralysis of variable extent, observed on the second or third day, were the chief symptoms. The amelioration and repression of the paralysis, and the subsequent localisation with deformities leave