that the author has not also given the treatment of THE PRINCIPLES AND PRACTICE OF GYNECOLOGY. those affections of the eye which are so faithfully portrayed. This would, in our opinion, have very much enhanced the value of the work and rendered By Thomas Addis Emmet, M.D., New York. Second edition, thoroughly revised. Philadelphia: H. C. Lea. Toronto: Hart & Rawlinson. it more useful as a text-book for students attending this work, and we have little to add to what we It is but a very short time since we reviewed a course of lectures on this subject. It is, however, a most admirable work, as far as it goes, and we cordially recommend a perusal of it to our readers. THE ESSENTIALS OF ANATOMY. By Wm. Darling, M.D., F.R.C.S. Eng., Prof. of Anatomy in the University of New York, and Ambrose L. Ranney, A.M., M.D, Adjunct Prof. of Anatomy. New York: G. P. Putnam's Sons. Toronto: Hart & Rawlinson. This work is designed, as the authors state, as a text-book for students and as a book of easy reference for the practitioner. It is well printed on good paper, and in general well arranged for convenient reference. The absence of plates, however, in a work of such pretensions is a serious drawback, and one which will militate greatly against the success of the work. At present it may be looked upon as a large note book of dry anatomical facts, put together with the particular object of aiding students in cramming as much knowledge of book anatomy into their heads as may be necessary to pass an examination on this subject. Prof. Darling's reputation as an anatomist, however, leads us to regard anything coming from his pen with respect, and although we cannot highly recommend the work as a text-book on this very important subject, we still think it a very useful work, and infinitely superior to any work we have seen on the Essentials of Anatomy. PHOTOGRAPHIC ILLUSTRATIONS OF SKIN DISEASES. then said in favor of the work. The author has have been re-written, some new matter added, and most carefully revised every page, several portions the work has thus been rendered still more worthy of the favor accorded it by the profession. We cordially recommend this edition to the readers of the LANCET. BRAIN WORK AND OVER-WORK. By Dr. H. C. Wood, of Philadelphia. Philadelphia: Lindsay & Blakiston. Toronto Willing & Williamson. This little brochure is one of the series of Health Primers recently issued under the editorship of W. W. Keen, M.D., of Philadelphia, and published by Messrs. Lindsay & Blakiston. It is a most excellent number of the series, intelligently and well written, and contains valuable information for the people. It deals with such subjects as "General causes of nervous trouble"; Work; Rest in labor; Kest in recreation; Rest in sleep," etc. By PRACTICAL EXAMINATION OF THE URINE. Births, Marriages and Deaths, At St. Jean, Isle d'Orleans, Que., on the 7th December, 1879, Dr. Joseph Demers, in the 46th year of his age. At Warkworth, Ont, on the 25th March, Nicholas chophytosis, (2 plates); lichen, (3 plates); kerion, D. Richards, M.B., Warkworth, to Maggie, daughlepra, molluscum, (2 plates); erythema, phthei-ter and only child of James N. McCrea, Esq., M.D. riasis, (2 plates); scabies, (2 plates), and porrigo. There are two parts yet to be published, making in all twelve parts to complete the work. The present numbers are quite equal to those that have preceded them. The work is a most valuable one, and has been well received by the profession, and particularly so by those who make a specialty of diseases of the skin. In Toronto, on the 1st ult., Dr. C. B. Hall, in the 65th year of his age. In Kentville, N. S., Dr. John Struthers, in the 45th year of his age. Lecturer on the Eye, Ear and Throat, in Trinity Medical Inflammation of the iris due to the poison of syphilis, is of frequent occurrence, and owing to its often painless and even insidious onset, it sometimes happens that it is overlooked until extensive adhesions have taken place between the iris and the lens capsule, and irreparable damage has been done. Hence, in all cases of syphilis, great attention should be paid to any eye symptoms which may arise, as an early recognition and prompt treatment of this affection are of the highest im portance. Iritis may occur as a symptom of congenital or acquired syphilis, and in all the stages of the dis ease. In the congenital form, it is most common in early infantile life, although it may occur at or after the seventh year, in connection with interstitial keratitis. Occasionally one sees tags of adhesion as evidences of intra-uterine iritis, but more commonly it occurs after birth. Like the iritis of acquired syphilis, there is often an absence of pain and dread of light. Mr. Hutchinson1 has given us a number of aphorisms bearing on this subject, which are so pertinent that I cannot forbear quoting them here in full: "1. The subjects of infantile iritis are more "frequently of the female than of the male sex. “2. The age of five months is the period of life "at or about which syphilitic infants are most "liable to suffer from iritis. "3. Syphilitic iritis in infants is often symmetri"cal, but quite as frequently not so. "4. Syphilitic iritis, as it occurs in infants, is "seldom complicated, and is attended by but few "of the more severe symptoms which characterize "the disease in the adult. "5. Notwithstanding the ill-characterized phenomena of acute inflammation, the effusion of "lymph is usually very free, and the danger of "of occlusion of the pupil great. "6. Mercurial treatment is most signally effica"cious in curing the disease, and, if recent, in "procuring the complete absorption of the effused "lymph. "7. Mercurial treatment previously adopted "does not prevent the occurrence of this form of "iritis. "8. The subjects of infantile iritis, though often "puny and cachectic. are also often apparently in "good condition. "9. Infants suffering from iritis almost always "show one or other of the well recognized symp"toms of hereditary taint. It Iritis occurs in acquired syphilis rarely in the primary, more commonly in the tertiary, and most frequently in the secondary stage of the disease, in connection with skin and mucous eruptions. may be the earliest secondary symptom, and then is usually mild; but more often it occurs between the third and sixth months after infection. It is also occasionally observed as a tertiary symptom, having been recorded as having occurred in the sixth year. Fifty to sixty per cent. of infected persons suffer from it. Its onset is commonly painless and even insidious, aptly called by 'Fournier, "début froid.” There is little dread of light; such a patient faces the light with eyes wide open, and hardly any flinching. Pain, if present, is worse at night, and is felt in the eye and around the orbit. A fine vascular zone of bright red vessels surround the cornea. That they are in the sclerotic and not in the conjunctiva, may be proved by the ability to move the conjunctival vessels by rubbing the lid without affecting the zone. It is said that a brownish tint of the vascular zone, as well as displacement up 1. Syphilitic Diseases of the Eye and Ear, London, 1863. wards and inwards of the pupil, are characteristics of this form of iritic inflammation. Wells, however, states that this is not the case, and that they are met with in persons free from syphilis. The cornea is generally clear, though sometimes keratitis is present. The aqueous humor is generally cloudy and has a peculiar dirty look; shreds of lymph may sometimes be seen floating in it. More commonly the lymph will be seen adhering to the iris, which is swollen or discolored, or the anterior chamber may be more or less filled by brownish, red or gray tumors. These are, according to Colbert, the gummata of Virchow; they spring from the fibrous groundwork of the iris, (parenchymatous iritis), and pushing the loose fibres aside, enter the anterior chamber. There may be two or more, and they may vary in size from that of a pin's head to that of a growth sufficient to completely fill the anterior chamber, and consider ably raise the tension of the eye. I saw such a case at Galezowski's clinic in Paris in 1876. It was mistaken at first for diffuse corncitis, so perfectly was it applied to the inner surface of the cornea, and so uniformly grey was it. The oblique light, however, revealed its true nature. These tumors consist of fusiform cells, of newly formed cells and free nuclei. They do not differ in structure from ordinary gummy tumors. These tumors are considered characteristic of syphilis, but Wells reports having seen a case of Mr. Critchett's, in which there were "well-marked tubercles, (ie. gummata), without the slightest evidence of syphilis." May it not have been a collection of fluid in the parenchyma of the iris, which did not go on to suppuration? The existence of other affections of the eye at the same time, as retinitis, neuritis, corneitis, etc., tends to confirm the diag. nosis. To resume, the diagnosis depends on the insidious and painless onset; if there be pain, it is principally at night; a muddy aqueous humor, the existence of gummy tumors, the presence of other eye affections, and a history of chancre, skin eruptions, etc. The pupil is contracted as in other forms of iritis. The treatment consists in the early and persistent use of a solution of atropine (gs. iv., ad. 3i). This gives rest to the iris, and by dilating it, prevents central adhesions Of mercurials, I prefer, as 2. Soelberg Wells' Treatise on Diseases of the Eye, 1873. 3. Op. cit., p. 167. taught by Mr. Hutchinson, hydrarg. cum crêta, in grain doses, three times a day, until slight tenderness of the gums is produced. The pain should be combated by hypodermic injections of morphia, if very severe, or in ordinary cases, by an ointment to the brow, containing Ext. bellad. zi., ung. simp. 3i. When atropine cannot be obtained, or is unreliable, these drops may be used, (Ext. bellad. 3ss. aq, dest. 3i.) If the atropine does not seem to act well, two to four leeches should be applied to the temple. It will then be found to dilate the pupil rapidly. If the atropine, however, should still cause much irritation and swelling of the lids, it should be stopped at once, and sod. bibor. grs. x. aq. dest. 3i. used instead, and when the irritation has subsided, atrop. sulph. zinci sulph. aa, gr. i., aq. dest. 3i., should be used. When not contraindicated by the irritation produced, atropine must be used frequently, every three hours, and in strong solution, grains iv-vi. to the ounce. symptoms of poisoning should arise through idiosyncrasy, or from swallowing atropine by mistake, the best and most rapid antidote will be found to be subcutaneous injections of morphia (gr. },−1), to be repeated, if necessary, several times in the course of a few hours. If Occlusion of the pupil, or iritic adhesions, may necessitate an iridectomy subsequently, and breaking down of a gumma, excision of the globe. The prognosis depends on the diagnosis being made early, and energetic treatment being adopted. Under atropine and mercurials, the recovery is often complete. Should, however, in spite of treatment, occlusion of the pupil take place, or the gummata break down, then the prognosis is very grave as regards the eye. A mild case of iritis may only last three or four days, whereas a more severe one will exist for weeks. There is much less liability to relapse in specific iritis than in the rheumatic and gouty forms. IMPERFORATE RECTUM-OPERATION. BY D. H. DOWSLEY, M.D., M.R.C.S., ENG., Mrs. C― gave birth to a male child November 15th, 1878. After the birth the child was examined, and all the apertures found apparently normal. On the following day, 16th, I received a The length of the occluded portion of the rectum was about three quarters of an inch, and was composed of two tightly constricting portions, the first about an inch from the anus, the second an inch and three quarters, while between these two constrictions was areolar tissue, moderately loose, and requiring a knife for its division. Correspondence. To the Editor of the CANADA LANCET. SIR, I understand that some of the candidates message stating the child was unable to urinate or | vals, until their use was no longer required. This evacuate the bowels, and that the nurse had given treatment was continued for about four months, a dose of castor oil, but without effect, except to the bougies being introduced latterly at intervals of increase its sufferings. At my next visit I found from two to four weeks. To-day the child is in the abdomen much distended, face livid, child in excellent health, and has had no obstruction since great pain, with considerable scrotal oedema. A March, 1879. very small sized silver catheter was carefully intro duced into the bladder which contained but a small quantity of urine. The anus was then examined, and found, as before mentioned, apparently normal. A probe was then introduced into the anal aperture, but passed only about one inch. A large bougie was next passed and met with the same ob struction. Upon dilating the anus with a small bivalve speculum, no opening whatever was found, but an apparently perfect mucous membrane covered its blind extremity. Upon partially removing the lateral pressure which the speculum exerted, a slight longitudinal groove was observed, and upon for re-election in the Medical Council have recentdistension again, a small whitish line, apparently | ly endeavoured to throw the blame of all the disnon-vascular, appeared in the site of the slight credit into which a most foolish policy has brought groove just mentioned. Through this part of the the Medical Council, upon the schoolmen, or the membrane, I concluded to cut in search of the representatives of the medical schools in that body. upper portion of the rectum, and after doing so As a matter of simple justice, allow me to give an to the extent of about an eighth of an inch, I emphatic denial to such a statement as affecting encountered nothing but loose areolar tissue which myself and the institution I have the honor to reI continued to separate through the speculum, by present. What has contributed largely and most the aid of a tenotome. A few drops of blood here unfortunately to making the council odious everyflowed, which was removed by a sponge dipped in where, to students and to medical men as well, is a solution of chloride of zinc, when the bleeding the most unwise adoption of a considerable numat once ceased. After cutting through this loose ber of utterly useless, and very arbitrary regulatissue, a second somewhat tense membrane was tions, which have been, one by one, sometimes met with, which appeared to bulge slightly, pre- several at once, pressed with singular persistency senting a ridge instead of a groove, as at the first until adopted. The one which audaciously robs constricting point. This was at first simply students by retaining their entire examination fees scratched with the side of the tenotome until it is one of the worst of these, and the others have yielded somewhat, when a distinct bulging was been already pretty fully discussed in your columns. observed. A trocar and canula was then thrust The faculty of Trinity Medical School have no through at the centre of the bulging portion, and sympathy whatever with any of these unwise and upon removing the trocar, considerable gas es- arbitrary regulations, simply because they hope caped, followed by the contents of the rectum. that the council may not only last, but become About an hour after, the child urinated without popular with the entire profession. They would difficulty. Patient was left till next morning, when like to see an increase in the number of the territoa small bougie was passed. A bougie was passed rial representatives, and an early re arrangement of through the constricting part daily until about the the most awkward and unwieldy districts now exsixth day, when it admitted a No. 19 French. The isting. They would like to see the term of office scrotal œdema passed away in a few days. Each shortened, so as to enable the profession to prointroduction caused a few drops of blood to flow nounce in say three, instead of five years, upon the for the first four or five days. Larger bougies course pursued by the gentlemen elected. They were then introduced at gradually increasing inter-advocate the publication of the proceedings of the Executive Committee in the medical journals; the submitting to the entire profession of every detail of the expenses of the council year by year, and the examinations being public, so far as to admit any professional man who wishes to be present. As the representative of Trinity Faculty I have always advocated these views, and shall if again honoured with that position continue to do so. We have no selfish, or school policy of any kind to carry out, but we do most sincerely wish to make the council so evidently a benefit to the entire profession as not only to secure its permanence, but to rally medical men and students equally around it. excellent facilities for carrying on the special line of practice peculiar to his class. His peculiar treatment brought about such unexpected results (to his patients), that he had to migrate suddenly. Collingwood, I think, is his base of operations at present. The pole of his battery (so he said) would "snuff out any disease in a twinkling of an eye." His patients were principally confined to a certain class. He rubbed some, soaked some, stewed some, and applied artificial and animal magnetism to a good many. The latter, in some instances, had a wonderful effect, especially with innocent and unsuspecting females. However sceptical this electrifier may have been in Divine law, like the rival of Sarah Bernhart, he carefully complied with one of its injunctions, namely, “increase and multiply." The Oshawa institution, like most of its kind, had a long scientific sort of title, and served at times as a sort of sanitarium for certain special jobs in the hands of his preceptor practising then in the vicinity of Markham, but now under exile. The public are not competent to judge who should, or should not practice the profession of medicine, and are not, therefore, the proper parties to advise, or instruct the Legislature in such matters. It is to be hoped the profession throughout the Province will adopt active measures, if necessary, against any attempt to abolish, or modify, in any way, the protection to life afforded by the penal clauses of the Ontario Medical Act. Trust I am, very truly, PRACTITIONER. To the Editor of the CANADA LANCET. Can it be possible, Mr. Editor, that anyone outside of a lunatic asylum could be found to write such trash? I am not a betting man, but I would not be afraid to risk a small amount that the fore-ing the Medical Council will look sharply after the going preamble and its context is the production circulating petition, and also the class of imposters of some half-witted dupe of the Clairvoio-Electro- above referred to, Thero-Cura-Pathic stripe,-a sort of hybrid no doubt, a half free-love moralist and half abortionist. There are any number of the kind, spread not only over the city of Toronto, but scattered throughout different parts of the Province. The public cannot be too strictly protected against these would-be gifted scientists. They ply their trade by bluster and pretence, and attract the weak and credulous by their glittering pretentious signs, and wonderful stock of parchmenis, bought by the yard, from swindling institutions operating in some of the cities of the United States. One of these disease slayers and wholesale diploma possessors located himself in the town of Oshawa, for a time, under the patronage and fostering care of some free-love dentists. This connection afforded him SIR, How much longer are our medical students to endure the annoyance of having the President of one of our medical schools continued as Treasurer of the Ontario Medical Council? It is manifestly unjust to have any teacher in such a place, and very galling to the great majority of medical students to be compelled to pay their fees to a Treasurer who belongs to a school they do not attend. And it is passing strange that the Council should be so foolishly blind as to continue this annoyance year after year. Having had |