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Reviews and Notices of Books.A illanual of Physiology, for the use of Junior Students ofJfedicinoi By GERALD F. YEO, M.D. Dub., F.R.C.S.

Pp. 632. With 301 Illustrations. London : J. and A.Churchill. 1884.

THIS work belongs both in size and scope to the well-known series of manuals published by Meesra. Churchill,and is the legitimate successor of the similar treatise hyDr. Carpenter, which, excellent as that was at the time it waswritten, has, we suppose, been found so defective as to requiremore time and trouble to renovate than would be demandedto write a new work. We think Messrs. Churchill havedone well in selecting Dr. Gerald Yeo for the author üftheir new manual. This gentleman occupies the physiological chair at King’s College, has a good reputation as ateacher, and is known as having ably assisted Dr. Ferrierin the interesting researches made by that physician on thelocalisation of function in the brain. The plan followed inthe work is to give in the first place a general view of theanimal structures, then to describe the chemical basis of thebody and the vital characteristics of animal organisms, andnext to consider in succession, and in the following order,the functions of digestion, absorption, circulation, iespira-’tion, secretion, animal heat, muscle, voice and speech, thenervous system, special senses, reproduction, and develop-ment.In dealing with his subject, Dr. Yeo has introduced in

many places a brief account of the histological features ofthe parts of which he is about to show the physiological use.This plan has its advantages and its disadvantages. Itserves to instruct the student upon the more importantstructural points which bear upon the function of each

organ; but, on the other hand, it is apt to lead him to thinkthat nothing further need be known, and consequently toneglect other and equally fundamental facts. In some cases,as, for example, in the description of the heart, Dr. Yeo hasoccupied four or five pages with illustrations, and withanatomical details with which the student might reason-ably be expected to have familiarised himself in the

dissecting-room. Allowance must be made in a bookof this kind for the space at the author’s disposal, butwe think some points have been omitted that the studentshould know. Thus, whilst there is a brief description ofthe development of bone, with a good woodcut, no word issaid of the growth of bone, of the distinction between

epiphysis and diaphysis, of the conclusions to be drawn fromthe insertion of pegs into these parts, and of the effects of

feeding animals with madder. An account of the periods oferuption of the teeth, which is of considerable practicalvalue, might have been given.A curious error has slipped into the account of the relative

s’zes of the red corpuscles of different animals, that of manbeing given at rhth of an inch-which, we presume, meansof a millimetre-and the same mistake occurs with the oth. rmammals. Dr. Yeo gives a classification of the nitrogenousbodies which form part of the system. The first groupincludes complex bodies forming the active portions of all

tissues, such as protoplasm ;the second group includes bodieswhich enter into the constitution of the first group-viz.,albumen, serum-albumen; the third group includes bodiesthe outcome of differentiation, manufactured in the tissues-the albuminoids, such as gelatin ; the last group are theintermediate, bye, or effete products of tissue manufacture,as lecithin and urea. We should rather take exception tothe third of the above groups, or at least to the examplegiven-gelatin. Is gelatin a constituent of the body ?The mode in which Dr. Yeo deals with disputed points

has in every instance we have met with been remarkablysensible and straightforward. Taking, for example, the

cause of the first sound of the heart, in regard to which somuch difference of opinion exists, he observes that possiblythere are several factors in its production, and he proceedsto give the principal events that are occurring at the momentof its production-viz., the heart’s impulse, the contractionof the heart muscle, the rush of blood into the arteries, and thesudden tension of theventricularchambers and of theauriculo-ventrictilar valves. That the heart’s impulse is not the cause ofthe first sound is rendered evident by the fact that it can bereadily heard when the chest wall is removed. Then again,although the sound resembles the tetanic contraction of theskeletal muscles, and although it corresponds in time to thecontraction of the cardiac muscle and varies in loudness withthe strength of that muscle, and may still be heard when theheart is empty, yet there is the great impediment to the re-ception of this view that the cardiac contraction is not aseries of vibrations by which a sound is invariably produced,but a single contraction, and is therefore incompetent toproduce a sound. Finally, Dr. Yeo points out that the closureof the auriculo.ventricular valves is synchronous with thebeginning of the sound, and that lesions of these valvesweaken or modify the first sound. Yet the tension of thevalves would not account for presystolic sounds, and thefirst sound can be heard in an empty heart removed from theanimal, in which the valves could not become tense.

Analysis of the sound by suitable resonators has demon-strated the existence of two distinct tones : one high andshort, corresponding to the closure of the valves ; the otherlong and low, corresponding in duration with the musclecontraction. " So that, after all, it would appear that boththe tension of the valves and the muscle tone have somethingto do with the production of the sound." Dr. Yeo enter-tains no doubt that the second sound is due to the suddentension of the semilunar valves. The best chapters arethose which treat of the urinary secretion and of nerve andmuscle. These are particularly well worked up, and givemost of the results of recent research. Upon the whole,although we have taken exception to one or two points, weconsider Dr. Yeo’s book to be a very good one. It is trust.

worthy, and clearly and intelligently written.We cannot conclude our notice of this work without

referring to the excellence of the woodcuts. These are not

only very numerous and generally well executed, but to alarge extent novel. Many are taken from Cadiat’s recentwork, and as a rule the source is acknowledged.

OUR LIBRARY TABLE.

Some Practical Observations on Vaccination (and Revac-cination). By W. H. WHITEWAYWILKINSON, L.R.C.P.Ed.,&c., one of the Public Vaccinators for the Parish of St. Mary,Islington. London : J. and A. Churchill. -At a time like the

present all observations of experienced vaccinators have theirvalue; therefore Mr. Wilkinson’s book is opportune. He iisometimes crude in his theories-as where he traces po"t-vaccinal erysipelas to stomach derangements, &c. There is

room, too, for much more literary care and accuracy in state -ment, and out of his large mass of caes—20,000 vaccinations-he might have given a larger number of precise data than hedoes, but after all these qualifications have been madethe little book will be found useful to those interested

practically in vaccination. Mr. W’ilkinsoa recommends, asmost authorities do now, revaccination to be practiced earlierthan puberty-about the time of the second dentition. He

very properly insists on care being tiken to shield vaccinevesicles from harm. Half the soreness attending vaccinationsand revaccinations comes from neglecting this precaution. Forinflamed arms he recommends cold water, or painting witha mixture of linseed oil, glycerine, and Goulard’s extract.

TVhat to do first in Accidents and Emergencies. AManual explaining the Treatment of Surgical and other

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Injuries in the absence of the Physician. By CHARLESW. DULLES, M.D., Fellow of the College of Physicians ofPhiladelphia, &c. Second edition, revised and enlargedwith new illustrations. Philadelphia : P. Blakiston, Son,and Co. 1883.-This is much like other small manuals ofthe same description, and appears to possess no merits

superior to some already familiar to us. We are alarmed tofind that Dr. Dulles states that in the case of foreign bodiesin the ear "very gentle efforts may even be made toremove" them "with a crotchet needle, or a bodkin, or anear spoon," which to our thinking is an extraordinarilydangerous piece of advice to give to laymen. We also findthat amateur surgeons are recommended to attempt to

reduce dislocations of the shoulder by the heel in the axilla.These two faults in the book are alone sufficient to condemnit in the eyes of those who understand the perils of amateursurgery unless very carefully restricted.An TMCa? q/’<S’Mr</6ry. Being a Concise Classification of the

Main Facts and Theories of Surgery, for the use of SeniorStudents and others. By C. B. KEETLEY, F.R.C.S., SeniorSurgeon to the West London Hospital. Second Edition.London: Smith, Elder, and Co. 1884.-We sufficientlyindicated the general character and scope of this work whenthe first edition appeared. The fact that another edition isso soon called for shows that it supplies a felt want. Wehave looked through the volume, and confess to beingpleased with it. It is full of sound practical information,and will be very useful to senior students.The Anatomy of the Incquinal and Femoral Regions. By

EDWARD L’E. LEDWICH, Lecturer on Anatomy in theLedwich School of Medicine, Dublin. Dublin : Fannin andCo. 1884.&mdash;The descriptive and surgical anatomy of theparts in relation with hernia is so important as to fullyjustify the appearance of a small monograph dealing withthese regions, and we can strongly recommend Mr.Ledwich’s work. The descriptions are very clear and accu-rate, and the illustrations are well chosen and most carefullydone. We have great pleasure in advising its careful perusalby the student and the surgeon, for we know no better

guide to an adequate knowledge of the anatomy of theinguinal and femoral regions. The introductory chaptershould be read by every beginner before he commences todissect the parts described in this snall volume.Sanitary Principles, more especially as applied to India.

By Surgeon S. J. THOMSON, Bengal Medical Service.Pp. 147. Calcutta: Brown and Co. 1883.-This is a laud-able attempt on the part of an officer of the Indian MedicalService to diffuse knowledge on the subject of public healthand the means necessary for its promotion, among theeducated members of the Indian community. It is, in fact,an extension to India of the movement which has been

going on for some time at home in the form of health lecturesand sanitary handbok. We are disposed to think that the Iwork would have been improved by a judicious curtailment Iof the introductory chapter and the omission of the moretechnical portions of the chapters on air, water, and food, asthey may have the effect of deterring many readers fromstudying the book. But even with this drawback the workcontains much that ought to prove very useful in promotingsanitary reforms and improving the health and social con.dition of the natives. We trust the author’s efforts may bethus rewarded, and that his example may be followed bymany others who have the opportunity of diffusing soundknowledge on this important subject.

Hygienisc7ber Fuhrer dllrch Berlin. Herauqgegeben vonDr. PAUL B6RNER. Berlin: Max Pasch. 1S83.-Amongstthe numerous works upon sanitation which may be con-

sidered as the literary gains of the recent Berlin Exhibition,few can show such painstaking labour as the compilationwhich Dr. Boraer issues under the above title. To the

author, also well-known as the editor of the Deutsche.31-edizinisclte Wochenschrift, Berlin owes a debt of gratitudefor the production of the book. It is one which barelyadmits of critical analysis. Suffice it to say here that itdeals in turn with the health statistic3 of Berlin, withthe authorities who have the care of public health, with themanagement of streets and open spaces, the water-supplyand drainage, the food-supply, schools, orphanages, work.houses, the hospitals, asylums, and prisons, and that it isillustrated by numerous plans and some excellent maps.

THE LATE MR. MIDDLETON AND THEINFLUENCE OF DAMP SOIL ON

PHTHISIS.1’0 tlte Editor of THE LANCET.

SiR,-In Dr. Andrew’srecent lectures on Phthisis occurs thefollowing. Alltiding to Dr. B achaii an’s report for the year 1866,he states, "In this he establishes this fact, at that time anunexpected one, that the drying of the soil effected by sewer.age works is generally followed by a great reduction in themortality from phthisis." This fact was not by any meansan unexpected one, for it had been previously discovered andgiven to the world by the late Mr. A. B. Middleton, of

Salisbury. In a paper read at Bath, on September 16th,1864, before the British Association for the Advancement ofScience, entitled " The Benefits of Sanitary Reform a9

"

shown at Salisbury," he states: "There was one diseasevery fatal in Salisbury, as some figures will presently show- consumption. The causes may have been various, but Iam inclined to think that humidity and nastiness of atmo-sphere produced by the canals and cesspools .... weremainly the causes." Again, " The evils then were wet sub.soil, bad sewerage, bad water. The indications of treatmentwere to dry the subsoil." Again, "Since drainage a greatchange has taken place in the number of deaths from theallied tubercular diseases, phthisis, tabes mesenterica, andhydrocephalus, as the annexed table will show." (Here thetable was given.) "This diminution in a class of diseasesadmitted to be intimately connected with dirty and moistatmosphere is remarkable." Again, "At Salisbury for theseven years, about one-tenth of the deaths have been fromphthisis; for the last three years only one-thirteenth, andfor the year 1863 only eleven deaths occurred from phthisis,or 1 in 818 of the population, the proportion for Londonhaving been 1 in 363, and for all England 1 in 374." At

page 26, in assigning a cause for the diminished generalmortality, he adds :&mdash;’’ The diminution of consumptioncertainly appears to be a demonstrated effect from an evidentcause." The year following the publication of this paperDr. Bdchanan visited Salisbury as Government inspector,and the late Mr. Middleton then gave him a copy of it, andinformed him of his theory as to the causation of phthisis.The Blue Book already alluded to appeared a year after thismeeting, but from some unassigned cause Mr. Middleton’smame is not mentioned in it. As these facts do not appearto be generally known, I ask you to insert this in your journalas due to the memory of one who was ceitainly amongst theforemost sanitarians of his day, and to whom Salisoury isindebted for her position amongst the healthiest of Englishtowns. I am, Sir, yours obediently,! FREDERICK STOCKWELL, M.D. Lond., Bruton, Somerset, May 6th, 1884.

FREDERICK STOCKWELL, M.D. Lond.

NORTH-WESTERN AND YORKSHIRE ASSOCIATIONSOF MEDICAL OFFICERS OF HEALTH.&mdash;A. meeting of theseAssociations was held at Halifax on tl1e 8th inst. Dr. Britton,who occupied the chair, read a paper on the Working of theFactory and Workshops Act (Retail Bakehouses), 1883, inrural and semi-rural districts ; Dr. T. W. Hime gave anaddress on Poisoning by Coal Gas; Mr. Francis Vacher reada paper on the Dress of Women and Children; andDr. G. A. Kenyon spoke on the subject of Water Analysis.An animated discussion followed the reading of each paper,and in the course of some remarks at the close ofMr. Vacher’s paper Dr. Deville spoke of the ill-effects of tight-lacing, and stated that the abolition of stays would neverdetract from the form of women.