degree of concentration is almost equal to that of the finely powdered drug. Both the solution and powder should be applied on plugs of cotton-wool. Antipyrin, in short, if placed in contact with blood at its normal BOOK REVIEWS temperature, thickens and condenses it, and, without Medical Consultation Book, a Pharmaco causing coagulation prevents it from escaping from the vessels. It stops secondary hemorrhages, and is, altogether, according to Cesari, a most valuable hemos. tatic." logical and Clinical Book of Reference. By G. P. HACHENBERG, M.D. 1893. [Austin, Texas: Eugene von Beckmann. St. Louis: J. H. Chambers & Co., 914 Locust Street. medical student who abhors the more difficult task im. For more than a year I have depended entirely on antipyrin as a local hemostatic, and have never in a This volume is evidently intended as a contribution single case, had cause to regret the choice. Effects are to the "ever busy" practitioner who cannot find any prompt and lasting. There is no clot to interfere with time for reading his journals, and would not if he could. primary union, and it is in every respect the ideal To him it may prove just what the compend it to the styptic. I have used it in epistaxis, bleeding after extracting teeth, after operation for hemorrhoids, simple cuts, bleeding from lacerated urethra and many other cases. My method of application depends upon loca. tion of the hemorrhage-where possible I prefer the powder sprinkled over the bleeding surfaces and covered with borated cotton. Where this method cannot be persued, as in hemorrhage from urethra, epistaxis, etc., posed upon his analytical powers by the perusal of standard text books. The therapeutist that has man. aged to escape the taint of the fin de siecle skepticism, will find a veritable sesame in the 500 pages, closely covered with double columns of prescriptions designed to cure all ills and ailings that human flesh is heir to. Those who hanker after "nutshell" information will, no reach. E. C. R. By WALTER VOUGHT, PH B, MD. 1893. [Philadelphia: F. A. Davis Company. St. Louis: J. H. Chambers & Co., 914 Locust Street. a fifty per cent solution is injected. In hemorrhage doubt, benefit by keeping this work within their fir gers' following excision of the tonsil, used as a spray or gar. gle, or the powder applied directly by means of a tube, I believe it would prove a most effectual hemostatic. IA Chapter on Cholera for Lay Readers. would also prescribe it in small doses, frequently re peated in hematemesis. I have prescribed it with good results in one case of hematuria in which the course of hemorrhage could not be definitely determined, but which was evidently renal in origin. It was given in twenty grain doses, three times daily, and the urine was clear of blood after the seventh dose. As the drug is excreted principally by the kidneys, I believe it will be found to be our best remedy in all forms of hematuria. Antipyrin is also a most reliable antigalactagogue. This fact was first discovered by Dr. Ryon Tennyson, and his observations were verified later by M. H. Geibert (Semaine Medicale, 1890). Given in 30 grm. daily doses -grs. iv, every two hours, the lactive secretion will dis appear in from two to six days. To obtain this effect it is not necessary to make any change in the woman's diet. In my own practice I have never found it necessary to continue the treatment longer than four days. JEFF. S. DAVIS, M.D. Montevallo, Alabama, November 22, 1893. Toxicity of the Blood of the Common Toad.-MM. Phisalix and Bertand (Archiv. de Phy siol. Norm. et Patholog.) have found in the blood of toads certain active principles having the same poisonous effect upon frogs and mammals as the venom secreted by the cutaneous and parotid glands of toads. When injected into frogs they produce paralysis, beginning in the hind limbs, slowing and arrest of the heart, and contraction of the pupil. They are produced by an internal secretion of the cutaneous glands, and to this internal secretion must be attributed the immunity of toads, as venomous reptiles, for their own poison. This neatly gotten up little volume marks a step in the right direction. From the serious complaints made against the New York State medical officers during the last year's scare, one could readily judge that many of our enlightened citizens had not fathomed the far-reaching importance of quarantine and other hygienic meas ures. A widespread understanding of epidemic dis eases and their causes will prove an invaluable factor in establishing national and State prophylaxis. Dr. Vought succeeded in steering clear of all technicalities, and it is to be hoped that his voice, raised in such a good cause will reach the ears it was was directed to. E. C. R. Books and Pamphlets Received. A Practical Treatise on Diseases of the Skin. Third Edition. By James Nevins Hyde, A.M., M.D. Lea Clinical Gynecology-Being a Hand Book of Dis With Now is the time to subscribe for the MEDICAL REVIEW. used as a guide for the knife. After incision the cavity is packed with iodoform gauze. The first afternoon was devoted to a prepared dis cussion on LESIONS OF THe Pleura, which was opened by Dr. John Shrady, of New York County. Referring to pleurisy with serous effusion, he said that the indications for treatment were to limit the exudation in the early stage, to allay pain, to keep the bowels relaxed, to reduce the fever, and to adopt such measures as were best calculated to promote absorption. When there is enough fluid in the chest to cause intermittent orthopnea, or when the fluid half fills the pleural cavity, or when after a month it shows no tendency to absorption, it is time to aspirate. The effusion may become purulent and yet give rise to no characteristic constitutional disturbance unless some of the pus is absorbed; hence one should be on one's guard. Dr. William McCollom, of Kings County, who Dr. James G. Porteous, of Dutchess County, spoke parti- continued the discussion, was inclined to attribute concularly of the methods by which tuberculosis is dissemi-siderable importance to the streptococcus, the staphylonated, and read the printed directions that he gives his coccus, and the pneumonia coccus as etiologic factors, patients. They were cautioned against spitting on the and he thought some of the discrepancies in the observafloor or in the cars, and were directed to use a cup or tions in this direction might be explained by the fact wide mouthed bottle for a cuspidor, and to frequently that these different observations were made at different wash this out with hot water. They were also advised stages of the disease. Dr. J. Blake White, of New to use individual table utensils and table-linen, and to York County, has noted an interesting clinical fact, sleep alone in airy apartments, and not to kiss others. namely, that the tendency to clear the throat when Well persons were reminded that tuberculosis is princi- there is no local lesion is characteristic of pleurisy with pally communicated by swallowing the germs or receiv adhesion, and that a dry, short cough points to adheing them into wounds, and they were warned not to kiss sions high up in the chest, whereas if these adhesions on the lips anyone who has a cough. are lower down, the cough will be more prolonged. In a discussion that followed the reading of the paper Dr. Charles A. Leale cited several cases that showed by Dr. E. D. Ferguson on NEPHROTOMY AND NEPHRECTOMY, Dr. John Cronyn, of Erie County, cited a case in which for many years a lady had symptoms of stone only in the right kidney, yet the post-mortem examination showed that both kidneys contained large calculi. This illustrates some of the common difficulties in mak ing the diagnosis in this class of cases. Dr. Ferguson and Dr. Gouley both expressed the opinion that cystoscopic examination and catheterization of the ureters were more hazardous than an exploratory incision, and at the same time were less satisfactory. how much can be accomplished in empyema without FERMENTATIVE DYSPEPSIA. Dr. N. P. Dandrige, of Cincinnati, in a paper on THE SURGICAL TREATMENT OF PULMONARY CAVITIES, He is firmly convinced that fermentation in the alimen said that this method could be employed with advan-tary canal is due to micro-organisms, and consequently tage in cases of abscess of the lungs, pulmonary gan- he favors the use of anti fermentatives. An experience grene, hydatid cyst, and of tuberculous and bronchiec- of nearly a year with bismuth subgallate had led him to tatic cavities. The operation is often performed by look upon it as far superior to all other remedies of this mistake, under the supposition that the operator is class that be has employod. It may be given in doses of dealing with a localized empyema. When there are five grains, in capsules or in tablets. He had followed adhesions between the pleura and the chest wall, and his father's well-known practice of giving salicin in the cavity is superficial, the operation is simple and in- these cases, and although the results in many cases volves but little risk. The position of the cavity is were very satisfactory, they were not comparable to determined by means of an aspirating needle, which is those obtained with bismuth subgallate. Those who study the various methods advanced from into the bichlorid, so that its antiseptic action was time to time for amputatation at the hip joint will be called forth gradually but continuously. In order to interested in certain statistics presented to the Associa secure this gradual action, calomel should be given dry tion by Dr. John A. Wyeth, of New York, regarding on the tongue, so that it may be quickly converted in his well-known "bloodless method." He has collected the stomach into the albuminate. thirty-nine cases in which the method had been pursued, Dr. Donald McLean in presenting some surgical and the reports are the more valuable, as they represent memoranda remarked that a large experience with unthe work of a large number of operators of all degrees united fractures of the long bones had taught him that of skill. In thirty five of the cases, the amputation was the most common cause of non union was excessive performed for disease, and in four for injury. Five of violence at the time of the fracture. In cases of ampu those operated upon for disease died, giving a mortality tation at the hip joint he uses the aortic compressor, of 14 per cent; and all of those in which the operation and greatly prefers it to Wyeth's method of controlling was performed for injury succumbed, giving a mortality the hemorrhage. of 100 per cent. It should be said, however, that the latter were chiefly cases of severe railroad, crushing in juries, and hence the mortality after any operation must necessarily be very high. The operation had been before the profession since 1890, and it spoke for itself. The question of the voluntary commitment of the insane to asylums was brought up by a paper presented by Dr. W. D. Granger, of Westchester County. He said that at the present time the tendency is toward making asylums hospitals, and, as far as possible, individualizing the treatment. Certain insane patients will gladly seek the advantages of asylums if they can do so voluntarily. This has been the subject of legislation in several States, but the trouble has been that after the patients' admission to the asylum they have generally been deprived of their liberty, and treated in almost the same way as those committed involuntarily. The laws of New York State now permit insane persons who are in a condition to fully appreciate what they are doing to voluntarily commit themselves to family asylums, but no time is specified, the patient being allowed to leave whenever he pleases. Another interesting prepared discussion took place on the second afternoon, and was on the treatment of appendicitis. Dr. Frederic S. Dennis, of New York, who opened this discussion, stated that about 50 per cent of the cases of inflammation in the region of the appendix go on to resolution, and only about 11 per cent relapse. He did not approve of operation unless urgent symptoms had existed without abatement for forty eight hours. Errors in diagnosis are very frequent even among experienced and eminent practitioners, and the operation cannot be considered in itself as free from danger, although some would have us believe it a very trifling affair. The fact that one instrument-maker in New York has sold within the past year six doxen special trusses for ventral hernia occurring after this particular operation is in itself very significant. Dr. John W. S. Gouley, of New York, took the same conservative position with reference to the treatment of appendicitis, but admitted that, while in at least half of the cases an operation is not required, there are times when a life might be saved by very prompt resort to operation. Dr. Joseph D. Bryant, of New York, as a result of numerous observations carried on in the deadhouse of Bellevue Hospital, had found that a foreign body was present in the vermiform appendix in about 70 per cent of all male subjects and 40 per cent of females. The "McBurney point" can no longer be con Dr. Gustavius Eliot, of New Haven, Conn., contributed an interesting paper on the treatment of enteric fever. He said that as the safety of the patient depends so much upon absolute rest of both body and mind, the physician should make it a rule in every case of fever to be sure that the disease is not enteric fever before sidered characteristic of appendicitis, for it has been giving the patient permission to get out of bed. This condition of perfect rest should be maintained for at least a week after the temperature, morning and evening, has reached the normal. He advised begin ning the treatment by administering from seven to ten grains of calomel on alternate days for four days, and then following this by the administration of iodin and carbolic acid, well diluted. He was sure that the calomel treatment not only brings about immediate ame lioration in symptoms, but it also really shortens the duration of the disease. Dr. George Douglas, of Che nango County, and Dr. John H. Martin, of Otsego County, also advocated the calomel treatment, and expressed their disapproval of giving alcoholic stimulants in enteric fever. Dr. E. R. Squibb said that the bene- In speaking of the proper mode of introducing the ficial action of calomel in enteric fever was probably male catheter into the bladder, Dr. Douglas Ayres, of due to the fact that when it is ingested it is first con- Montgomery county, pointed out that by pressin down verted into an albuminate, and then slowly decomposed on the soft parts over the pubes, the suspensory liga found in other conditions, and besides this, examina. tions have shown that the position of the caput coli is very variable, and in a large percentage of cases is not in the immediate vicinity of this "point." If acute symptoms are present, he would not postpone operation longer than three days. Rigidity of the rectus muscle is, in his opinion, more reliable as a guide than the presence of a tumor in the ileo cecal region. Of course, if the symptoms apparently indicated perforation, immediate operation was demanded. Dr. J. A. Wyeth favored an early resort to exploratory operation, for, not only did he consider this the safer course, but there also is less likelihood of ventral hernia following the early operation. ment will be relaxed, and the introduction of the in- there being present Dr. A. L. Loomis, President of the strument in some cases greatly facilitated. Dr. Gouley Congress; Dr. H.P. Bowditch, representing the Physioexhibited an exact model in bronze of the catheter logical Association, Dr. D. B. St. John Roosa, of the found in the ruins of Pompeii. It is of the sigmoid Ophthalmological Association; Dr. Abram Jacobi of form, and is distinctly conical, and has a single eye near the Pediatric Association; Dr. P. A. Morrow, of the the vesical extremity. Dr. Gouley is of the opinion Dermatological Association; Dr. Jas. B. Walker of the that the catheters at present made in this country are far superior to those of foreign manufacture. A rather novel idea was brought forward by Dr. William Finder, of Rensselaer County, in a paper entitled RESEARCHES ON THE EFFICIENCY OF VACCINA Climatological Association; Dr. R. W. Taylor of the Genito Urinary Association; Dr. W. T. Lusk of the Gynecological Association; Dr. F. J. Shepherd of the Association of American Anatomists; Dr. L. McLane Tiffany of the American Surgical Association; Dr. Wm. H. Welch of the Association of American Physicians, and Dr. Landon Carter Gray of the American Neuro. He had found that a number of persons who had been logical Association. A local Committee of Arrangerecently ill with enteric fever were especially suscepti- ments in Washington was appointed as follows: ble to vaccination, and, after verifying these results by Dr. S. S. Adams, (Chairman) representing the Pedinumerous observations extending over a number of atric Association; Dr. John S. Billings, the Surgical years, he ventured to present these views to the Association; Dr. H. C. Beyer, the Physiological Asso. profession, so that further observations might confirm ciation; Dr. S. O. Ritchie, the Otological Association; or disprove the theory that enteric fever dissipates the Dr. S. C. Busey, the Gynecological Association; Dr. W. protection conferred by vaccination. It is his practice W. Johnson, the Climatological Association; Dr. J. Atnow to revaccinate the patients after an attack of en-kinson, (Baltimore) the Dermatologicat Association; Dr. teric fever. As a sort of offset to the general enthusiasm over pelvic surgery, Dr. T. J. McGillicuddy, of New York, presented a paper entitled A PLEA FOR THE NON OPERATIVE METHOD OF TREAT His plan is to stimulate the portal circulation by free In view of a circular-letter sent out by the American Medical Association asking for an expression of opinion as to the advisability of amending the Code of Ethics, the Association ordered the following communication to be sent: "In reply to the notice that the American Medical Association had requested the State medical organiza. tions in affiliation with that body to express their wishes in reference to any changes in the Code of Ethics, the New York State Medical Association has to state that it has made that Code one of its foundation stones, and that it is entirely opposed to any alteration therein. This is the result of a full reconsideration of the subject, and after an experience of ten years of organization under the Code." Wm. H. Welch, (Baltimore) the Association of Physicians; Dr. I. C. Rosse, the Neurological Association; Dr. Samuel Theobald, the Ophthalmological Associa tion; Dr. D. W. Prentiss, the Genito Urinary Association; Dr. Frank Baker the Anatomical Association. It was arranged that the following subjects should be discussed by the Congress at its next meeting in Washington in the latter part of May, 1894: The Climatological Association: "Sewer Gas;" Genito Urinary Association: "The Surgical Kidney in its Clinical Aspects;" Dermatological Association; "Leprosy in the United States;" Laryngological Association; "Intra Nasal Surgery;" Gynecological Association; "Conservative Treatment of the Female Pelvic Organs; Neurological Association; "The Effects of Infectious Processes on the Nervous System." One Association is yet to select a subject for discussion. Dr. W. II. Carmalt, of New Haven, Conn., resigned from the sub committee deputed to take charge of the organization of the Congress, and Dr. Wm. H. Welch of Baltimore, was appointed in his place, so that the committee now consists of Dr. A. L. Loomis, President of the Congress; Dr. Landon Carter Gray, Chairman of the Executive Committee; Dr. Newton M. Shaffer, Secretary of the Executive Committee, and Dr. Wm. H. Welch. Northwestern Ohio Medical Association. Dr. Thomas D. Strong, of Chautauqua County, was-The forty-seventh semi-annual meeting of this assoelected President for the ensuing year. Executive Committee of the Congress of American Physicians and Surgeons. - A meeting of the Executive Committee of the Congress of American Physicians and Surgeons was recently held at the house of the Chairman, Dr. Landon Carter Gray, | ciation was held at Toledo, Ohio, Thursday and Friday, Dec. 14 and 15, 1893. The following essays were read: Extra Uterine Pregnancy, W. N. Yost, Findlay. The Uric Acid Diathesis, Clem. D. McCoy, Kenton. Report of Two Cases of Operation for Movable Kidney, August Rhu, Marion. Disinfection and Sterilization, Charles Graefe, Sandusky. Prophylaxis, J. R. Clark, Bluffton. Esophagotomy for the Removal of a BuckeyeRecovery, W. D. Hamilton, Columbus, O. Experiences in Surgery of the Gall Bladder, Illus trating Important Points in Diagnosis, Chas. A. L Seed, Cincinnati, O. Report of Case with Treatment, D. H. Brinkerhoff, Fremont. Injury of the Cervical Vertebræ, G. W. McGavern Van Wert. When is Abdominal Section for the Relief of Peritonitis Demanded, T. M. Gehrett, Deshler. Report of a case of Amputation at the Hip Joint, N. P. Dandridge, Cincinnati, O. Physiological Action and Therapeutic uses of Ergot, A. S. Rudy, Lima. President's Annual Address, C. A. Kirkley, Toledo. Early Diagnosis and Operation in Cancer of the Uterus, C. N. Smith, Toledo, O. The Functions of the Brain, J. H. Calvin, Huron. Deafness-Its Effect upon the Voice and Intellect, Thos. Hubbard, Toledo. Electro-Therapeutis as Applied to Surgery, W. Herdman, Ann Arbor, Mich. J. The Physician and the Clinical Thermometer, F. H. Schlink, Delphos. American Public Health Association.-At the annual meeting of the American Public Health Association, held at Chicago, Oct 9-14, 1893, the following resolution offered by Dr. Henry P. Walcott of Massachusetts, was adopted: NOTES: AND ITEMS The Twenty-Fifth Quarterly Meeting of the Austin District Medical Society will be held in Austin, Texas, Thursday, December 21, 1893. The annual meeting of the Western Association of Obstetricians and Gynecologists will take place at Des Moines, Iowa, Dec. 28 and 29, 1893. The "Medical Review" Pocket Reference Book and Visiting List, Perpetual, price 75 cents, published by J. H. Chambers & Co., St. Louis, Mo., is a favorite with very many physicians. It is ar ranged especially with a view to furnishing what the practitioner needs at the bedside. Its emergency de partment is especially commendable.-Nashville Jour nal of Medicine and Surgery. To Quiet Pain. We have often wondered whether a substitute could be found for morphine. The temptation to use this drug is often so great, its effects are many times so charming, that the young physician especially is inclined to administer it too often. When we consider on the other hand, some of the dire effects of this powerful drug, we are all the better prepared to welcome any substitute that will be less deleterious in its effects. The more we become familiar with phena. cetine, so much the inore are we impressed with its great value. It certainly has a prominent place already in our list of valuable drugs. It acts promptly and ef fectively and quiets pain to a marvelous degree. We believe the more the drug is used so much the greater will it take the place of the preparations of opium.Food, August, 1893. Resolved, That the American Public Health Association again urge upon Congress the necessity of the ap- A New Medical Novelist.-Dr. Arabella Ke pointment of some officer with general sanitary author-nealy is the writer of a work of fiction, entitled "Dr. ity in connection with the National Government. That the functions of such an authority are of sufficient importance to demand the exclusive attention of the best instructed sanitarian. That such authority should be enabled, from time to time and under proper regulations, to secure the advice and cooperation of State Boards of Health. IRVING A. WATSON, Secretary. Janet of Harley Street" (N. Y. Med. Jour.), which has reached its fourth edition. She is said to have gone through a complete training in medicine with the express purpose of employing the knowledge thus gained in the construction of novels. Early in life she had displayed a good literary talent, and conceived the original notion that she was deficient in that knowl edge of human nature and human motives which mediConcord, N. H., Oct. 25, 1893. cal study would supply her with. She determined, therefore, to bury herself for the requisite number of Change of Date of Meeting.-Official No-years away from the literary world and obtain a meditice. In order to enable the State Medical Societies to send instruction as to their action upon the matter re ferred to them by the American Medical Association at its recent meeting at Milwaukee, and for other reasons, the time of meeting of the Association at San Francisco, has been changed from the first Tuesday in May to the first Tuesday in June, 1894. cal degree, although in the eyes of many of her friends these years of study seemed little better than a waste of time. But her self estimate appears to have been substantiated. Alfred Ludlow Carroll-In Memoriam.— The members of the Council of the New York State Medical Association deeply mourn the loss of their beloved, erudite, scholarly and gentle colleague, Alfred |