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bibliographies are very complete, that dealing with puerperalfever taking up some 75 pages, although it contains refer-ences only to the publications which have appeared sincethe year 1889. The sections dealing with puerperal feverdwarf all else in this volume. The disease is discussedin all its aspects with the most complete thoroughness,Dr. Walthard describes the general bacteriology and a specialaccount of the gonococcus is given by Dr. Wildbolz. Themain part of the description of the disease, including thepathological anatomy and the treatment, is from the pen ofDr. 0. von Herff. The author (from the study of a largenumber of statistics) arrives at the conclusion which has beenreached by practically all writers on this subject-namely,that the death-rate from puerperal fever, in spite of all theadvances made in the prevention of the various forms ofseptic diseases in surgery, is at the present time practicallystationary. He shows that the lying-in woman is safest whenconfined in a lying-in hospital and he further proves that theobservance of strict antiseptic or aseptic precautions is asufficient and certain preventive of the disease. We are gladto see the stress which is laid on the use of alcohol in dis-infection of the hands, since the adoption of this substancefor the purpose is still far from common even in well-conducted lying-in hospitals in this country, and we areconvinced that it is of the utmost importance. No less

important is the wearing of sterilised rubber gloves, but atthe same time if such a practice is to lead to less

care being taken in the proper sterilisation of the handsit can only result in disaster and disappointment.Indeed, it is a moot point which are the most dangerous-imperfectly cleansed hands or imperfectly cleansed rubbergloves. It must always be remembered that whilst the

general surroundings and the atmosphere, so to speak, ofa surgical theatre or of the lying-in ward of a well-con-ducted hospital are directly conducive to the strict carry-ing out of antiseptic precautions the surroundings in the

majority of confinement cases in private practice are farfrom encouraging such observances. The treatment of casesof septic infection is very fully considered, although we mustconfess to some disappointment on reading this portion ofthe article. It is impossible to come to any other conclusionthan that treatment is of little avail, and if prevention failsthen the medical attendant is often only too helpless to averta fatal issue to the case. When we consider the mortalityrate of the disease the question as to whether any one of thevarious methods of treatment advocated really has mucheffect in diminishing the danger becomes a very difficultone to answer s3,tisfactorily. The teaching laid downas to the uselessness of the administration of alcohol in thesecases is directly opposed to that of most writers but is inaccordance with the opinion of some medical men as to theharmfulness of alcohol to the body in any conditions,whether it be those of health or disease. Curetting, we areglad to see, is strongly condemned and Dr. von Herff con-cludes that hysterectomy in these cases is usually of no88’Ð.il. The question as to whether any good is to be

expected from the excision of the pelvic veins in puerperalpyaemia receives the full consideration which it deserves.The opinion expressed, with which we are in accord, is thatthis operation is as a rule not indicated on account of thedifficulties experienced in deciding in what particular caseit should be performed and the further difficulty there oftenis in determining on which side the veins are affected. The

removal of the uterus is required only in cases where itcontains a sloughing fibroid or where there is definite, ievidence of an abscess in its walls. ’

These two volumes are amongst the best of the wholeseries and are in every respect most complete and helpful.The work constitutes a series of monographs written byeminent authorities and, we imagine, will long remain with-out any possible rival in this sphere of medicine. It is

indispensable for the teacher and should be in every largemedical library.

Oall-stones and Diseases of the Bile-d-ucts. By J. BLAND-SUTTON, F.R.C.S. Eng., Surgeon and Lecturer on

Surgery to the Middlesex Hospital. With 47 illustra-tions. London : James Nisbet and Co., Limited. 1907.Pp. 233. Price 3s. 6d. net.

THIS book commences with a short anatomical and

physiological account of the bile-ducts and the bile andall of this chapter is interesting and most of it is important.Then come sections on infections of the bile-ducts and gall-bladder. A good account is given of gall-stones and of theirresults. A chapter on cancer of the gall-bladder follows,and then comes a chapter on the effects of some forms ofpancreatic disease on the excretory apparatus of the liver.The signs and treatment of cholelithiasis are given atsome length and a chapter on the mortality of operations forthe relief of gall-stones closes the book. We have describedthe contents of the volume to show the reader that, thoughthe book is small, it contains a good deal. The style issimple and the addition to each chapter of references toworks dealing with the subject enables the reader to look upthe matter more fully if he wishes. We are pleased with thebook and though there are many controversial points dealtwith, about which we are not fully in accord with theauthor, it should prove of value to senior students and tothose in practice. This volume is the first of a new series ofbooks called Modern Clinics. If the later volumes are as

good as this the series will have justified its existence.

LIBRARY TABLE.

The Practical Medicine Benes. Under the general editorialcharge of GUSTAVUS P. HEAD, M.D. Vol. VIII., MateriaMedica and Therapeutics, Preventive Medicine, Climatology,Forensic Medicine. Edited by G. F. BUTLER, M.D., H. B.FAVILL, M.D., NORMAN BRIDGE, M.D., D. R. BROWER,! M.D., and H. N. MOYER, M.D. Series 1906. Chicago:The Year Book Publishers. Glasgow: G. Gillies and Co.-In this work the collaborators in the department ofMateria Medica and Therapeutics state that there has beena widespread demand for more simplification and precisionin the armamentarium and that the use of crude galenicalpreparations is giving way to active principles and remediesof known and unvarying strength. They regret that thecontributions on the subject of psycho-therapy, or suggestivetherapeutics, have been meagre during the year. Theywrite, ’’ Physicians should inculcate hope in the degree ofoptimism; their lives should radiate love, hope, cheerfulness,and optimism." In the section on Preventive Medicine the

suggestions on the protection of children from contagion arevaluable, as are indeed the directions for the conduct of thetuberculous as given by Rochester. The following isa brief summary : 1. The consumptive should kiss no

one and no one should kiss the consumptive on the

mouth. 2. The consumptive should never lend hishandker-chief to anyone or borrow a handkerchief from anyone.3. The eating and drinking utensils of a consumptiveshould be thoroughly boiled after he has used them.4. During.the act of coughing he should hold before hismouth a piece of cheese cloth or gauze or other material,which may be burned or boiled. 5. The sputum should bedischarged into a piece of cheese cloth or gauze, so foldedthat the sputum may be turned in and completely covered.Such piece of gauze should be put into a proper receptacleuntil it is time to take it out and to burn it. 6. The sheets,pillow cases, night-clothes, and underclothing of consump-tives should be boiled for half an hour before being washed.Under the heading of Climatology the question as to whetherthe sanatorium treatment of pulmonary tuberculosis is worthwhile is answered strongly in the affirmative. 14 Among the

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questions considered in the section on Forensic Medicine are:The Bases for Expert Testimony; Insane Heredity and Suicidein Relation to Testamentary Capacity; the Feeble-mindedCriminal; the Legal Aspects of Epilepsy; and the IllinoisProcedure in Annulment of Marriage for Prior Insanity.

The Seaside and Island Abc Holiday Guide for theUnited -Kingdom. London : The Wentworth PublishingCompany. 1907 Edition. Price 6d. net.-This is a usefullittle book of reference. It contains concise accounts inter-

spersed with photoprints of the chief British holiday resorts,inland and seaside, arranged in alphabetical order. At the

end is an index of the golf courses of the United Kingdomand of the angling stations. We note that it is claimed for

Hastings that it heads the list for all England as regards itsrecord of sunshine. We may remind our readers of the listswhich appeared in THE LANCET on Jan. 26th, 1907 (p. 243),and March 9th, 1907 (p. 676), and we may be excused fordoing so as we are sure that many people contemplating theirholidays will be glad to study the sunshine records after thegloomy weather which we have experienced lately. It maynot be necessary then to take too seriously the announce-ments of a certain radiant heat and light treatment to whichover-frequent attention is called throughout the book.

JOURNALS AND MAGAZINES.

The Asylum News.-The June number of this journal con-tains a full account of the annual meeting of the AsylumWorkers’ Association under the presidency of Sir WilliamCollins. In his interesting presidential address he brieflyreviewed the ethics of asylum work and the reform whichhad taken place in the treatment of the insane since the daysof Hogarth. Although dealing chiefly with the ethical sideof asylum nursing Sir William Collins also gave somesound advice in respect of the intellectual aspect of this

special work. The address was excellent both in diction andmatter and was in every way eminently suited to the

audience. The annual report for 1906 of the AsylumWorkers’ Association is also published in this number of theAsylum News and it shows what active work is being doneby this body for the welfare of its members. The Billsbefore Parliament concerning the registration of nurses havebeen carefully watched in the interest of asylum nurses,both male and female. During the year 1906 the questionsof housing accommodation for married attendants and

pensions for asylum workers have been under the considera-tion of the executive committee and the report indicatesthat everything is being done to bring these matters to thenotice of the Government.

Caledonian Medical Journal.-The first of the originalarticles in the July number is entitled The Role of theGeneral Practitioner in the Advancement of Medical Science."The author is Dr. James Mackenzie of Burnley who says thatthere are great questions which are not likely to be solveduntil the general practitioner takes his share in systematicresearch. Examples of this kind are to be found in the obser-vation of the progressive development of chronic ailments andin the recognition of that stage of disease when the prospectof successful treatment has passed. Dr. Keith NormanMacdonald relates many reminiscences of the medical cur-riculum at the University of Edinburgh in the early" fifties."Colonel Kenneth Macleod, I.M.S., contributes a sketch ofthe Indian medical administration through many stages ofdevelopment from the year 1600 to the present day. In the

editorial paragraphs it is announced that the annual meetingof the Caledonian Medical Society will be held at Bradford

,

on July 25th.The American Journal of Insanity (April).-Among

the several interesting papers in this number of the AmericanJournal of Insanity, the following call for special attention.

Dr. Solomon C. Fuller’s paper on a Study of the Neuro-fibrils in Dementia Paralytica, Dementia Senilis, ChronicAlcoholism, Cerebral Lues, and Microcephalic Idiocy is an

instructive digest on this subject and is accompanied by13 excellent plates. Dr. C. Lee Carlisle’s article on ManiacalConditions in Young Adults deals with the differential

diagnosis between the non-deteriorative and the deteriorativepsychoses. He clearly shows the clinical distinctions be-tween the symptom complex known as manic-depressiveinsanity and the katatonic excitement in dementia prsecox.Dr. William Macdonald contributes a paper entitled,"General Paresis or Cerebral Syphilis?

" It is written towarn the student not to accept too readily the statementcommonly found in text-books that cerebral syphilis andparetic dementia are diseases which can be readily differ-entiated from each other." Dr. G. A. Smith supplies anexcellent paper on the Application of the Cottage System tothe New Hospital. Dr. Smith states that he has had20 years’ experience of the colony system as appliedto the care of the insane, and he evidently stronglycommends it as giving the most satisfactory resultsalike with regard to treatment, occupation, and properclassification of the patients. The journal also containsa most interesting letter from a French correspondent onmedico-legal expert testimony. He writes that in France

experts in criminal matters are named according to thefollowing rules : At the beginning of each judicial year theCourts of Appeal name from the lists proposed by the tribunesof first instance within their jurisdiction doctors of medicineon whom they confer the title of "court experts." In orderto be named a candidate must have practised medicine atleast five years or hold a diploma for medico-legal studies.Expert physicians named on these conditions by the courtsare, in principle, the only ones to whom an expert report canbe intrusted. The expert is not allowed to receive anyfee for his services if he appears in court as a witness. He is

, paid from the public Treasury and the payments are accordingto a scale which is by no means a liberal one. The French

i expert is never invited to take the part of either the prosecu-i tion or the defence, as his fundamental quality is to be; impartial. It is evidently recognised in France that thei occupation of expert is an important and difficult one and

, recently the Universities of Paris and Lyons have taken up; the special instruction of the medico-legal physician.L _______________

New Inventions.ARTERY FORCEPS AND LIGATURE COMBINED.

THIS forceps, suggested by Dr. Schoemaker of the HagueHospital, has for its principal feature an ingenious device bywhich the application of a ligature to a severed artery isgreatly facilitated. As shown in the accompanying illustra-tion, the middle of the ligature, which must be more than

twice as long as the forceps, rests in a notch at the

extremity of one of the blades, whilst the free endsafter being tied loosely into the first half of an ordinary