Such is a hasty schedule of the principal physiological effects of jaborandi.

4. Gelsemia. Its Physiological Action.

Dr. J. Ott, Demonstrator of Physiology in the University of Pennsylvania, after a prolonged series of experiments enumerated in the Philadelphia Med. Times, July 31, 1875, which he made in the laboratory of Prof. F. G. Smith, gives the following summation of his observation on the action of this alkaloid of gelseminum.

1st. In cold blooded animals it paralyzes first the sensory ganglia, and then the motor ganglia in the central nervous system. This order is reversed in warm blooded animals.

2nd. It diminishes the pulse and pressure.

3rd. This decrease of pulse rate is due to lessened irritability of the excito-motor ganglia of the heart. 4th. The fall of pressure is due to the diminution of cardiac irritability and vaso-motor tonus.

5th. It decreases the respiration through a paralyzing action on the respiratory centres.

6th. It dilates the pupil.

7th. It reduces the temperature.

5. Chloral versus Strychnia Poisoning. Another Case.

Dr. J. W. Winslow, of East Hampton, Mass., adds another case of successful treatment of strychnia poisoning with chloral, to the many already recorded. He writes to the Philadelphia Med. and Surg. Reporter, Aug. 14, 1875, "On my arrival at the house about an hour and a half after the dose was taken (half a teaspoonful of strychnia in half a tumbler of water), I was met by the father, who told me that his daughter, a young woman, had had spasms for the past hour and that they were increasing in severity-that she was "just gone." Cupric sulphate produced speedy emesis. "Spasms were severe and continuous." Twenty grains chloral were given, when suddenly a frightful opisthotonic

convulsion occurred. "Soon as possible afterwards thirty grains more were given, when the spasms gradually diminished in frequency and force, entirely subsiding within the space of two hours." Recovery was complete.

6. Still Another.

The Philadelphia Med. Times, also bearing date Aug. 14, 1875, records another case of successful treatment of a case of strychnia poisoning by chloral, communicated by Dr. C. Bivine, of Tarrytown, Md. He gave 40 grs. of chloral when the patient-a girl of 16 years of age—had reached the stage of "general spasms, accompanied by opisthotonos and asphyxia ;" 30 minutes thereafter he gave 40 grs. chloral more, and "soon after, she fell asleep." Thence to recovering he gave her chloral and potassic bromide as the case demanded. When she awoke and convulsions appeared, more chloral was given. Gradually the toxic action passed off. At the end of 48 hours there were only "slight occasional renewal of spasms and some nervous spasms." Recovery, as in the preceding case, was complete.

7. Treatment of Neuralgia.

Prof. von Pitha having suffered from various kinds of neuralgia for the last two years, gives an interesting account of his observations on himself, and comes to the conclusion that the hypodermic use of morphia is the only rational treatment, and generally can be employed without injurious consequences for a long period. But very small doses must be given to begin with, and gradually increased as need be. To guard against the unpleasant action of the morphine on the stomach, P. recommends the addition to the morphine of sulphate of atropia (gr. Tʊ) or the internal administration of muriate of quinia in black coffee.- Wiener Med. Zeitung.

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.]

ON PARALYSIS FROM BRAIN DISEASE IN ITS COMMON FORMS. By H. Charlton Bastian, M.D., Etc. New York: D. Appleton & Co. 1875.

pp. 335. Price, $1.75.

It is as pleasurable as it is rare, among the multitude of books that appear to have been born because their authors and not the world were in need of them, to come to one that is valuable throughout and that has hardly a defect. Yet such is the volume before us. It comprises eight lectures delivered on this interesting subject by Dr. Bastian in University College Hospital in 1874. Previous to their publication in book form the lectures were revised and somewhat enlarged.

The author discusses the subject from a purely clinical stand-point, in marked contrast with the manner heretofore generally in vogue among writers on this subject, and of which he complains, of considering the topic almost solely from the aspect of pathological science.

There is no objection to pathological studies; these are valuable. But any one of several different kinds of lesion in a given part of the brain may cause the same group of symptoms; so that a most important study of the subject, for the active physician especially, must be that which considers, from the symptoms and history, the location in the brain of the lesion, the extent and nature of the damage, and, as far as possible from such information, the pathological nature of the lesion in each case, the prognosis and treatment. Such a study the author attempts to supply, while at the same time a tolerably systematic consideration of the whole subject is presented. As he truly says of his subject, "No

department of medicine stands more in need of being represented in a text book of moderate compass.

In the first lecture the causes of hemiplegia are briefly considered, "with the view of obtaining data available for purposes of diagnosis." The only causes thoroughly discussed, however, with their more immediate consequences, are rupture, occlusion and spasm of the cerebral arteries. Meningeal, cerebral and cerebellar hæmorrhage, thrombosis and embolism, and the softening often so rapidly following these, are considered at considerable length, while induration, tumors, abscesses, injuries and congenital atrophies are barely mentioned, as they relate to the more slowly arising and more irregular forms of hemiplegia. About spasm of vessels as a cause, it is very safely said, "there is a great deal of uncertainty." There is probably an altered molecular state in the brain tissue which accounts for the spasms which come and go so quietly that they leave no organic change by which we may be sure they ever existed, and yet the author has no doubt many cases of hemiplegia are to be placed in this category. Here he groups many cases of Epileptic Hemiplegia," "Emotional Hemiplegia," and a few " 'cases of an hysterical character." Patients with various symptoms that class them under these respective heads are attacked, fall down, become hemiplegic and after a variable time and possibly many vicissitudes recover, and no discoverable lesion tells us positively of the condition that existed. Spasm of vessels is the expla nation offered; but sparseness of facts that can be presented bearing on this point make it one of great interest in clinical study.

66

Speaking of hemichorea as being followed by hemiplegia of the same side, the author believes in a certain number of such cases "minute vessels become blocked in the corpus striatum and adjacent parts of the brain," he himself having found this on three or four occasions.

In the second lecture hereditary influences as favoring

hemiplegia are considered; then follows an admirably concise statement of the important knowledge-that from both early and recent investigations concerning the distribution and relations of the cerebral blood vessels, the lecture closing with a discussion in part of the symtomatology of hemiplegia, which is continued through succeeding lectures.

A lecture is devoted to alteration of nutrition, degeneration of the cord, and the symptoms due to the functional differences between the two cerebral hemispheres ; another to regional diagnosis in brain disease-the most valuable chapter in the book, in our estimation; the seventh considers the cerebellum, its functions and symptomatology, and closes with half a dozen pages on

pathological diagnosis," while in the closing lecture the subjects of prognosis and treatment are briefly considered.

With Broadbent, the author denies for the optici thalami the seat of the 'sense centre' for common sensation, but locates it on the upper and posterior part of the pons Varolii, thereby agreeing with "many eminent physiologists."

Of the author's recorded cases of hemiplegia about three and one-half per cent. were of the irregular and exceptional form in which the upper extremity recovers more rapidly than the lower-the reverse being the rule. He does not think these causes are necessarily attended with dementia or an earlier fatality than the more common forms herein differing with the opinion of Trousseau.

After referring at considerable length to aphasia and other conditions and symptoms due to a lesion in the left hemisphere, we are told that lesions of the right hemisphere are more often fatal than those of the left; that, too, disorders of nutrition on the paralyzed side and convulsion and spasms of these parts, as well as the "conjugated deviation of the eyes," "hysterical paralysis," and paralysis and convulsions of muscles on the same side of the body with the lesion, occur most with