considers the various diseases more from their etiologic and pathologic standpoint than from their occurrence in any particular location, thus gonorrhea is discussed as an entity and not described in several chapters under the headings of the different organs in which it may manifest itself. The author has devised a number of operative procedures and while these are carefully detailed due prominence has also been given to other methods of accomplishing the same ends. Non-operative and conservative cperative treatment has been given due consideration especially in the case of ovarian and tubal lesions. The tabular arrangement of the points in differential diagnosis will appeal to the student and tends to impress these facts upon the memory. The numerous and excellent illustrations, especially the plates showing the different steps of various operations, are of decided value. The work can be heartily recommended as one of the best textbooks upon the subject. Pulmonary Tuberculosis and all Complications, by Sherman G. Bonney, M. D., Professor of Medicine, Denver and Grosse College of Medicine, Denver. Octavo of 778 pages, with 189 original illustrations, including 20 in colors and 60 X-ray photographs. Philadelphia and London, W. B. Saunders Company, 1908. Cloth, $7.00 net; half-morocco, $8.50 net. The subject of pulmonary tuberculosis in the broadest sense is most thoroughly treated in this admirable work, which represents to a great extent the extensive personal experience of its author. It is considered mainly from the clinical viewpoint, and the practical side of the subject is especially emphasized, presenting a most satisfactory survey of the disease and its manifold complications. Etiology and pathologic anatomy comprise about 80 pages. The chapter upon racial influence presents not only the facts regarding the Negroes and Indians, but considers such within the confines of the white as well, noting the relative immunity of the Jewish people, the great susceptibility of the Irish, and the varying death rate of our other national factors in this regard. About 150 pages are devoted to treatment, stress being placed upon attention to infinite detail and while, of course, open air and hygiene are emphasized as essential factors, and the routine administration of drugs is deprecated, he enters a protest against the prevailing tendency to decry the value of all medication in this disease. His estimate of such therapy appears eminently judicious. He believes the intelligent use of a few well selected remedies to meet varying exciting needs to be by all means indicated. Drugs find a suitable place in managing special symptoms but the indications for general drug therapy are extremely few. As to creosote, he most emphatically condemns its general use, impressing its restriction to intractable cases of gastric and intestinal fermentation with impaired appetite, chronic bronchitis, etc., and having but little confidence in its practical value for inhalation. In hemoptysis, rest in a fixed position is insisted upon, while, as regards drugs, his experience with the chlorid and lactate of calcium has not been satisfactory. He believes, however, that the clinical value of the nitrites and nitroglycerin seems to be established and of these the amyl nitrite is the most prompt. Morphin, however, is in his opinion the most important agent in pulmonary hemorrhage, and atropin is of value especially in the most urgent cases, and in good sized doses as 1-50 of a grain. Normal salt solution cautiously employed he has found valuable after profuse hemorrhage. As to specific treatment, tuberculin is quite fully considered, and opsonins as well. Concerning the latter the statement is made that "the role of the opsonic index in vaccine therapy still remains an experimental study," and further, "this feature should remain for the present sub judice." The illustrations are excellent and the work is a splendid one throughout, complete and practical, and cannot be too highly commended. The Principles of Pathology. Volume 1. General Pathology, by J. George Adami, M. A., M. D., LL. D., F. R. S., Professor of Pathology in McGill University, Montreal. Octavo, 948 pages, with 322 engravings and 16 plates. Cloth, $6.00 net. Lea & Febiger, publishers, Philadelphia and New York, 1908. The volume under consideration is of especial interest in that it shows certain more or less wide departures from the accepted form of textbooks on pathology. Appreciation of the magnitude of the subject has driven the author to divide the work into two volumes, of which the first deals only with subjects coming under the head of general pathology, while the other is to deal with systematic pathology. Whether the increased size of the work and the consequent increase in price will prevent wide use of the book cannot be accurately foreseen. As against these disadvantages can be placed the compendious nature of the information. The first 130 pages are devoted to pure cytology, giving an excellent summary of the present status of knowledge, followed by an extensive outline of the theories concerning heredity and such proofs as we have. This information, unnecessary perhaps when good preliminary courses in biology and cytology precede the medical curriculum, leads up to heredity of pathologic conditions or tendencies, with its relation to the various monstrosities. As am example of the detail characteristics of the book, it may be noted here that the mode of formation of twins, etc., is carefully diagrammed so as to be clear to anyone, without necessary reference to books on embryology. General parasitology, followed by the various forms of intoxication, together with portals of entry and predisposing causes, precedes the study of inflammation. This begins the third main section of the book, that on morbid reactive processes. A full historic and critical summary of immunity follows upon inflammation. Contrary to the usual procedure, it is at this point rather than earlier that the progressive and regressive tissue changes are introduced. The author has his own ideas on classification and arrangements of tumors, and it is difficult to say without careful comparison whether the already complex subject is clouded or clarified by his method. He is, however, in this subject as well as in others in which he differs from the usual teaching, diffident in urging his own schemes, and careful to note for the student's benefit how and why the variations occur. A final appendix deals with recent work on finer cytology and brings the book to date in that line. The main impression given by the volume as a whole is one of extensive reading, with the information of the present day brought into moderate compass and expressed with great clarity. The allied subjects of physiology, chemistry, embryology, etc., are discussed with unusual fullness where they touch on pathology, with the view that these all are not individual lines, but part of one and the same great study. The book is perhaps too full for the ordinary student, though on the other hand it will reduce the required amount of side reading, always a difficult thing to induce students to do. The form and type are excellent, and the typographic errors are not numerous. The illustrations appear adequate in spite of the author's loss by fire. In fact, the book seems one of very unusual value, and the new method of presentation will stimulate inspection of the subject of pathology from a greater number of directions. Medical News George F. Thomas announces the removal of his office to 1016 Rose Building. R. G. Perkins has been appointed Associate Professor of Pathology and Hygiene and M. W. Blackman has been made Lecturer in Histology and Embryology at the W. R. U. Medical College. George N. Stewart, Professor of Experimental Medicine at W. R. U., has recently returned from abroad and takes charge of the new laboratory which is to be opened November 20. Prof. W. H. Welch, of Johns Hopkins, will deliver the opening address upon this occasion. The cornerstone of the new German Hospital at 3305 Franklin Avenue was laid on Sunday, September 27, by Rev. J. S. Kosower, Superintendent of the Hospital. A number of students desire an opportunity to earn money wherewith to defray the expenses of their collegiate training. They do not seek charity or gifts but a chance to give services for value received. Without work of this sort many of them will be unable to continue their college course. Anyone who can furnish employment of this sort, even if of a temporary character, should communicate with Dean C. Mathews of Adelbert College, Secretary F. C. Waite of the W. R. U. Medical College, or Dean R. E. Skeel of the Cleveland College of Physicians and Surgeons. St. Alexis Hospital Alumni Association met September 3. The program was as follows: Treatment of Rheumatism, A. J. Prudhomme; Report of Case of Diabetes, B. S. Frary. Stark County Medical Society met Tuesday, September 15, 1908, at one o'clock at the City Hall, Canton, Ohio. The program was as follows: Lectures, "Normal Mentation, " H. C. Eyman; "Gastro-Intestinal Diseases of Children," W. H. Becher; "A Plea for the Family Physician,' H. E. Corl. Case Reports, Abscess of the Thyroid and Diabetes, J. E. Shorb; Purulent Meningitis as a Sequel to Suppurative Appendicitis, P. F. King; Ileo-Colitis, D. F. Banker. Sixteenth International Medical Congress. The members of the medical profession are reminded that contributions to the Congress must be announced to the Secretary before January, 1909. It is desired by the Committee that the manuscripts should be in their possession by January 31, 1909. It should be known that the time for the reading of a paper does not exceed twenty minutes and that manuscripts should be clearly written, as the correction of the proofs is attended to at the office of the General Secretary. Copies of the manuscripts will be returned by July 31, 1909. The General Secretary is Professor Emil Grosz, M. D., the address, Budapest, VIII., Esterhazy-uteza 7. Blank forms of application for membership to the Congress and for the presentation of papers can be had of the Chairman of the Committee, J. H. Musser, M. D., 1927 Chestnut St., Philadelphia, Pa. Deaths M. F. Warner, this city, died August 29, aged 59. Medical Journal VOL VII NOVEMBER, 1908 No 11 Experiences with the Cutaneous Tuberculin Reaction. and the Findings in Two Hundred Postmortems on Children BY CLEMENS VON PIRQUET, M. D., Assistant to Professor Escherich, Director of the Pediatric Clinic, The findings in the first hundred autopsies which were made on children, who had undergone the cutaneous tuberculin test, have already been reported. Now the second hundred has been reached. The cutaneous test originated in the following manner: I had found that in vaccination against smallpox only those persons show local symptoms within 24 hours who have formerly been vaccinated. One may, therefore, conclude if any early local reaction is obtained that the person has been previously vaccinated. In applying the method of vaccination to tuberculosis, I found that, in the same way, an early reaction at the point of vaccination with Koch's tuberculin proves a previous infection with tuberculosis, and that this cutaneous reaction corresponds to Koch's fever reaction after injection with tuberculin. The first cases which I reported last year were nearly all tuberculinized by inoculating two of the abraded points with 25% tuberculin while the third was uninoculated and acted as a control. This year nearly all were vaccinated with undiluted old tuberculin. The test was generally made on the right arm, sometimes on other parts of the body, although the place of application is not important. In several cases besides the cutaneous test the conjunctival and the dermal applications were also tried. The conjunctival method of tuberculin application (Wolff-Eisner-Calmette test) I Read before the Academy of Medicine of Cleveland, October 9, 1908 |