sense of constriction was felt in the chest, the radial pulse was not perceptible on the right side, while on the left side it was very small and irregular. One day, when the patient had just passed out of an attack, an attempt was made to enlarge the pulse by nitrite of amyl.* In this I succeeded very promptly, and after the experiment had been repeated twice, both on palpation and auscultation a momentary arrest of the heart was observed, while a deep bronchial respiration was heard. After a few seconds the heart sounds became audible again, and after the lapse of ten minutes the cardiac impulse was very powerful. The radial pulse remained full for some time. (Still the attack continued for some hours, notwithstanding the experiment.) This experiment shows also what extent the vascular spasm can attain. A permanent enlargement of the pulse was only obtained by galvanization of the sympathetic; whether, however, a cure was effected, I could not learn.

A second instance was the case of an epileptic man, whose attack was always preceded by a premonitory vaso motor symptom in the shape of circumscribed redness of the left cheek. I saw the man one day at this period, and an examination showed the pulse filiform in the carotid as well as the subclavian and radial arteries and the lower extremities. By strong galvanization of the sympathetic I succeeded in rendering the pulse fuller, and the attack was prevented.

No less striking are the appearances in tic douloureux, where either the pulse of the carotid artery is full during the attack or on the hand very small. That the carotid artery can be dilated like an aneurism by the expansion of the places of origin of the smaller arteries, I have witnessed both in tic douloureux (vide case 87 of the "Nerven pathologie") and hydrophobia. In the former

* Riegel has lately used this remedy to dilate the arteries in lead poisoning.

I will here insist that an epileptic attack rarely occurs without vaso motor or psychical prodromata.

case the abnormal distension of the vessel disappeared with the affection, and in the latter case no anomaly was found in the cadaver.

Spasms of vessels or pareses in limited vascular districts are also a common symptom in hysteria.

I attach special importance to this method in diseases of the brain. Under normal circumstances a difference is often noted between the pulse of both carotids, and, as a rule, the radial pulse corresponding to the large carotid artery is in that case the smaller. In hemiplegia and cerebral disease, I have repeatedly observed, that on one side (in the former case the paralyzed side) both the pulse of the common carotid and of the arteries of the arm was small and filiform. Such a condition denotes a profound disturbance of circulation by dilatation in numerous vascular districts, and my idea to prognosticate from this condition the danger of apoplexy has in several instances been unhappily confirmed.

In Basedow's disease the pulse is usually large in both carotids and correspondingly small in both radial arteries. I am not at present enabled to perfect these observations on a larger scale; I can, therefore, merely recommend them most urgently to my colleagues. We can expect from this method not only the discovery of special facts, but even a further illumination of the causes of trophic processes and an increased accuracy of prognosis. Especially in local inflammations in the extremities can the observation of the local arterial tension be of interest.

FLEETWOOD CHURCHILL, author of "Churchill's Obstetrics," and kindred works, has lately retired from practice. His practice for many years of late has been confined wholly to obstetric and gynecologic consultations.

Book Reviews.

[NOTE. All works reviewed in the pages of the CHICAGO MEDICAL JOURNAL AND EXAMINER may be found in the extensive stock of W. B. KEEN, COOKE & Co., whose catalogue of Medical Books will be sent to any address upon request.]

1. PLAIN DIRECTIONS FOR ACCIDENTS, EMERGENCIES, AND POISONS. Keep this where you can readily find it. By a Fellow of the College of Physicians of Philadelphia, and Physician to several of the Charitable Institutions of the same city. Fiftieth thousand. All rights reserved by the Author. Distributed to its Policy-Holders by the Mutual Life Insurance Company of New York. F. S. Winston, President.

2. PLAIN DIRECTIONS FOR THE CARE OF THE SICK, AND RECIPES FOR SICK PEOPLE. Keep this where you can readily find it. By a Fellow of the College of Physicians of Philadelphia, and Physician to several of the Charitable Institutions of the same city. Eightieth thousand. All rights reserved by the Author. Distributed to its Policy-Holders by the Mutual Life Insurance Company of New York. F. S. Winston, President.

These two little volumes are unique. Their gailyilluminated covers suggest the dime novel and the ladies' magazine, while their contents treat of the accident in the street and the mishap in the family.

We are of those who advocate the widest possible dissemination of useful knowledge among the masses. But we are also of opinion that it is possible to give a little information, in certain cases, which may prove to be a dangerous thing. There are physicians who, in the sick room, discourse in such a manner as to produce the impression that they are the sole repositories of an incommunicable science. There are others yet who, on every possible occasion, deliver a species of medical lecture to all who chance to surround the sick bed. They who are truly wise do neither. The volumes before us, while they contain many excellent suggestions which a skilful

practitioner would endorse, yet share the error of the second class of men.

On page 48 of the first volume, for example, two unprofessional fingers are represented in the act of strapping an extensive incised wound of the thigh-such a wound as the veriest tyro in surgery would not attempt to close without the aid of sutures. If the artist intended to represent a temporary dressing merely, the procedure suggested is laughably inadequate. The strips of plaster are cut so short as to be entirely unfit for the purpose, and are as few and far between as the individuals who succeed in carrying the policy of an insurance company during the term of their natural lives. To speak more plainly, less than half of those who are insured are said to remain so; and there is a great deal less than half enough plaster on the aforesaid wound.

Still, a very little of the latter might go a long way, if the author can be believed; for he asserts, on the very next page, that "the edges of an incised wound of some length were successfully held together by a postage stamp, divided lengthwise into four strips"!

Here are also directions for removing foreign bodies from punctured wounds, by making incisions along the course of the wound; directions for splitting the nail with a penknife; directions regarding the treatment of sloughing wounds, with a description of the mode of repair by granulation. Here are also indications for using such remedies as aqua ammoniæ, tincture of opium, oil of turpentine, ipecac in powder and syrup, Glauber's salt, and compound cathartic pills.

We submit that if an author is disposed to write a book on Minor Surgery, it were well to indicate his purpose in its title. Show us one hundred policy-holders of the Mutual Life Insurance Company, who treat themselves for extensive incisions along the thigh, punctured wounds requiring interference, wounds that slough and wounds that granulate who move their bowels with Glauber's salt, and empty their stomachs with sulphate of zinc; and we will point out a certain proportion of the

entire number whose widows are likely to realize from the investments made for them in the Company!

These volumes of themselves would scarcely deserve attention, were it not for the fact that they are circulated by a wealthy corporation, commanding a capital of seventy-two millions of dollars, and having ninety thousand policy-holders. One of these monographs has reached an edition of eighty thousand copies—truly an enormous edition for any work!

The author says there is scarcely any excuse for the "effrontery" of ringing up an apothecary, of a cold night, to supply ten cents worth of paregoric. Will the Mutual Life Insurance Company of New York excuse the "effrontery" of our asking why, when it was concluded to publish such volumes for the benefit of their policy-holders, they felt constrained to step outside of the medical profession of their own city, in order to find an author in Philadelphia ?

LESSONS ON PRESCRIPTIONS AND THE ART OF PRESCRIBING. By W. Handel Griffiths, Ph.D., L.R C.P.E. London: Macmillan & Co. 1875. 12mo., pp. 150. Price, $1.25.

Its title indicates its design, which it well fulfills. By careful attention to its instructions, a novice can learn to write a prescription accurately, in a very short time. One point the author fails to emphasize, which should be insisted on with something akin to energy, viz., an avoidance of abbreviations in writing prescriptions. Chapter 6 is on "Incompatibility," and it is worth the price of the book. If it were in the reviewer's power, every graduate of medicine in this country would commit this chapter to memory. Nearly the first half of the book-65 pages-is didactic, and the remainder consists of "Examples and Exercises." The subject of prescription writing is so thoroughly written up, in works on Materia Medica, that nothing new remains to be culled by writers on this subject alone. This work embraces everything of profit to the senior student and practitioner, and will repay studying.

E.