pared Especially for the Students. By A. A.
Stevens. A.M., M. D. Professor of Pathology
in the Woman's Medical College of Pennsyl-
vania, &c. Fifth Edition, Revised and En-
larged. Illustrated. Philadelphia. W. B.
Saunders.

Steven's Manual on the Practice of Medi-
cine occupies a very high position among
the list of manuals from its points of ex-
cellence and usefulness. This book is par-
ticularly popular among students and ex-
tensively admired and used by practition-
ers. The one prime reason for the great
popularity of this work is that there is
nothing useless about it. You find the dis-
ease you look for and the etiology, symp-
toms, pathology, diagnosis, prognosis and
treatment are given in a very few words,
brief but complete. This is the fifth edi-
tion and it has been thoroughly revised and
contains many important modifications and
considerable additions. The chapter on
Diseases of the Pancreas, the introductory
chapter on Diseases of the Blood, and of
the Ductless Glands, and the articles on
Appendicitis, Angina Pectoris, Aphasia,
Myxoedema, and Syringo-Myelia, have
been entirely re-written. New articles



treating of acute cholecystitis. Tuberculosis
of the Kidney, Gastroptosis and Enterop-
tosis, and Chronic Cerebral Leptomeningi-
tis have been introduced. We highly
recommend the book to our readers.

The International Text-Book of Surgery. By
American and British authors. Edited by J.
Collins Warren, M. D., LL.D., Professor of
Surgery in Harvard Medical School; Surgeon
to the Massachusetts General Hospital, and
A. Pearce Gould, M. S. F. R. C.S., Surgeon to
Middlesex Hospital; Lecturer on Practical
Surgery and Teacher of Operative Surgery,
Middlesex Medical School, etc. Vol. I. Gen-
eral and Operative ^Surgery. Philadelphia :
W. B. Saunders, 925 Walnut St. 1900.
While we have many new works recently
published on surgery, the authors of this
volume, however, need offer no apology for
its appearance. Modern surgery is still in
the transition stage of its development, and
physicians gladly welcome all new and use-
ful matter in this progressive science. The
authors have produced a reliable text-book
of surgery embodying a clear but succinct
statement of our present knowledge of sur-
gical pathology, symptomotology, and diag-
nosis, and such a detailed account of treat-
ment as to form a safe and reliable guide to
modern practice. The work has been so
arranged that Vol. I. is devoted chiefly to
General Surgery, and Vol. II. to the vari-
ous branches. The ever-widening field of
surgery has been developed largely by spe-
cial work, and by such means it has been
made practically impossible for one man to
write authoritatively on the vast range of
subjects embraced in a modern text-book of
surgery. In order, therefore, to make this
work up to date in everv sense, the authors
have sought the aid of men of wide expe-
rience and established reputation in the
various departments of surgery. Among
the list of contributors will be found the
names of Bird, Bradford, Burns, Bunell,
Cobat, Cameron, Cheyne, DaCosta, Ernest,
Fowler, Gay, Hamilton, Makins, McBur-
ney. Monks, Parker, Pitcher, Pfaaf, Rich-
ardson, Smith, Spencer, Sulton, Tiffany,
Hook, Warbasse, Warren, and Willard.
These men are all writers of eminence in
their various departments, and their ideas
and opinions in reference to the different
subjects herein treated will be read by phy-
sicians profitably and pleasantly.

The first forty-two pages of this work is
devoted to Surgical Bacteriology, giving
the structure and classification, the methods
of Cultivation, methods of Examination,
&c., &c.

The next chapters considered are Hyper-
emia, Inflammation, Local Infection and its



126



THE CHARLOTTE MEDICAL JOURNAL.



Terminations. Suppuration : Abscess, Ul-
cers, Sinus and Fistula are next considered.
Surgical Pathology of the Blood is treated
very ably in chapter IV, Following these
we have the many diseases following in the
course of surgery very clearly and forcibly
discussed. The section on Fractures is one
of the best in the volume. The chapter on
Bandaging is very prettily illustrated. The
volume taken from any standpoint cannot
be excelled.

The chapters upon the diflferent subjects
have been carefully prepared, are short,
concise and to the point. It is with a great
deal of pleasure we recommend the work to
all our readers.

A Manual of Surgical Treatment. By W. Wat-
son Cheyne, M.B., F.R.C.S., F.R.S., and F.F.
Burghard, M.D.^andM.S., (Lond) F.R.C.S.
In Six Volumes. Vol. 4. Lea Brothers &
Co., Philadelphia and New York. 1900.
This volume is devoted to the treatment
of the surgical affections of the tissues, in-
cluding the skin and subcutaneous tissues,
the nails, the lymphatic vessels and glands,
the fascia, bursae, muscles, tendons and
sheaths, nerves, veins and arteries, de-
formities. The first one hundred and forty
pages is taken up with the subject of de-
formities, such as hammer toe, hollux
valgus and bunions, flat-foot, club-foot,
&c. The treatment given for these serious
deformities is very complete and successful
and is clearly illustrated. The second di-
vision, as stated above, is devoted to sur-
gical affections of the tissues. The main
plan of treatment for each of these diseases
is based upon experience and the author
has given the best methods of treatment
from the commencement to the termination
of the illness. The author does not worry
or confuse you with a summary of many
methods of treatment from time to time
proposed, but gives exactly and in detail
the best method, judging from his own ex-
perience. The work at once commends
itself to progressive physicians.

Lea's Series of Pocket Text- Books. Histology
and Pathology. A Manual for Students and
Practitioners. By John Benjamin Nichols,
M.D. Demonstrator of Histology, Medical
Department Columbian University, Washing-
tou, D. C, and Frank Palmer Vale, M.D.
Series Edited by Bern B. Gallaudet, M.D. Lea
Bros.-, & Co., Philadelphia and New York.
This work of four hundred and fifty-eight
pages is divided into three separate and dis-
tinct sections — Normal History, Pathology
and Special Pathology. The three sections
are very thoroughly and comprehensively
treated and the excellencies of the book



stand out very prominently to all those who
fortunately come into its possession. It
presents all the essential facts relating to
the normal histology and the pathological
anatomy and histology of man in a syste-
matic and concise manner. It presents the
subject up to the most recent discoveries
and developments, avoiding points unset-
tled and in doubt. The book is neatly
printed, nicely bound and can be highly
recommended to students and practitioners
of medicine.

Christian Science, An Exposition of Mrs.
Eddy's Wonderful Discovery, Including Its
Legal Aspects. A Plea for Children and
other Helpless Sick. By William A. Pen-
nington. New York. E. B. Treat & Co.,
241-243 West 23rd St. 1900. Price $1.00.
This work expounds the dangerous teach-
ings of our latter-day delusion. Christian
Science, and the theory and limitations of
medical legislation. The little book is di-
vided into six chapters with an appendix.
The following subjects are considered :
Christian Science and Its Legal Aspects,
The Case Against Christian Science, Man-
slaughter, Christian Science and the Law,
Christian Science Before the Law, How
Far Can Legislation Aid in Maintaining
a Proper Standard of Medical Education,
The Evolution of the Apothecary,
The book is well written.

Children, Acid and Alkaline. By Thomas C.
Duncan, M.D., Ph. D.,L.L.D. Author of
Text-Book on Diseases of Children. Phila-
delphia. Boericke & Tafel. 1900.
This work contains 148 pages and is di-
vided into three classes, the Normal, the
Acid and the Alkaline. In this work will
be found the Methods of How to Manage
Acid and Alkaline Babies, leading Acid
and Alkaline Remedies, a Study of Peoples,
Differences, &c.



LITERARY NOTES.



The topics editorially treated in the Amer-
ican Monthly Review of Reviews for Feb-
ruary are the Nicaragua Canal proposition
now before Congress, the Canadian and
Erie Canal projects, underground transit in
New York and elsewhere, the currency and
business situation, the Treasury and the
banks, the popular election of Senators,
Mr. Beveridge's speech in the Senate on the
Philippine question, our tariff policy in
Puerto Rico and Cuba, the meaning of
"neutrality" in the Boer war, and the
strength and weakness of the Boer position.



THE CHARLOTTE MEDICAL JOURNAL.



127



The January Coming Age. — The Jan-
uary issue of The Coming Age opens the
second year of this sterling review of
twentieth century thought. The opening
paper, which is sumptuously illustrated by
finely executed photo-gravures, is a critical
study of Mr. James A. Heme's new dra-
matic success, "Sag Harbor," which has
been playing a hundred nights's engage-
ment in Boston. Mrs. Reifsnider has
given an entertaining sketch of the play,
pointing out its ethical aspects in some well-
chosen and timely observations. Mr.
Horace Lewis, the popular actor, given a
charming conversation on his Twenty-five
Years Before the Footlights. The eight
original essays are all of special interest and
excellence. "The Gate Beautiful," by Prof.
John Ward Stimson, is one of the most
helpful discussions on the vital uses of art
that has recently appeared. Dr. Henrik
G. Peterson, the eminent Boston physician,
contributes the first of four papers of rare
value on "Applied Psychology : or, Hypno-
Suggestive Therapeutics." The Coming
Hygine of Dietetics and Development,"
by the late Prof. Joseph Rodes Buchanan,
is a very strong feature of this issue. Rev.
Charles R. Brown's social study, entitled
"The Cities of the World to Come," justly
merits wide reading. "The George Junior
Republic" is the first of a series of papers
on helpful social experiments which are
promised for the ensuing year. "A New
Prophet in the Choir of Progress" is a
helpful study of Ernest Crosby's latest
work. A poem of unusual excellence, by
Miss Coletta Ryan, is also an interesting
feature of this issue.



Among the notable contributions in The
Coming Age for February are "Educational
and Therapeutic Value of Hypnotism," by
the eminent New York physician and au-
thor. Dr. R. Osgood Mason, M.D., A.M. ;
"The Ideal Philosophy of Leibnitz," by
Prof. E. M. Chesley, A.M.; "Happy
Hours in Mirthless Childhood," by Alma
Calder Johnston ; "Personal Atmosphere,"
by Annie Pillsbury Young; "Fra Elbertus
and the Roycrofters," by B. O. Flower;
"Shakespeare and the Development of
General Culture," by Rev. H. C. Meserve ;
"The Referendum in Boston," by Prof.
Frank Parsons ; "Peace, Interior and Eco-
nomic," by Bolton Hall; An Unobjec-
tionable Expansion," by I. L. Albert;
"The Poems of Emerson" critically con-
sidered by Charles Malloy, president of the
Boston Emerson Society; and "Poe and
Emerson," compared by Leigh H. Irvine.
There are several other articles worthy of
mention, besides the regular departments;



but the above are papers which challenge
the attention of all thoughtful men and wo-
men. The success of The Coming Age is
well merited. It reflects the best thought
of the t-ime, and appeals to the moral no
less than the intellectual side of man's life.



The Forum for February contains many
articles of great merit, nearly all written by
well-known authorities, Lieut. -Gen, Den
Beer Poortugael, of the Holland Privy
Council, contributes the leading article on
"The Relation of England to the Trans-
vaal;" an able paper is furnished on "The
People's Party," by vSenator Marion But-
let, Chairman of the People's Party Na-
tional Executive Committee. President
Charles Dabney, of the University of Ten-
nessee, writes a timely article on "Wash-
ington's University." Two papers on the
Old- Age Pension Problem in England are
contributed by two eminent men, the first
by Michael Davitt, M. P., on "A Plea for
Old- Age Pensions," and the second by Rt.
Hon. W. H. Lecky, the brilliant English
historian, on "Why I Oppose Old- Age
Pensions." David Willcox throws new
light on "The Futility of the Anti-Trust
Issue," and William R. Thayer writes an
unusually convincing paper on "Longevity
and Degeneration."



The Living Age promises a paper on
Robert Louis Stevenson's Letters, by Au-
gustine Birrell, in its issue for February lo.
There could scarcely be a more delightful
combination of author and subject.



ABSTRACTS of the One Hundred
Leading Articles of the Month.

Osteosarcoma.

A very interesting case of osteosarcoma,
in which the superior maxilla, turbinate,
palate, vomer and parts of the ethmoid and
malar bones were removed with good re-
covery, is reported by Lanphear in the
American Journal of Surgery and Gyneco-
logy for January.

The huge cavity was packed with iodo-
form gauze and the soft parts carefully su-
tured into place.

When the surfaces were entirely healed,
an obturator was worn, made with an up-
right plate to fit snugly bet>veen the rem-
nants of the facial bones and with a hori-
zontal plate carrying teeth, so that the pa-
tient can eat and articulate fairly well.

The growth was found upon examination
to be a giant-celled sarcoma, and after eight
years there is no sign of recurrence.



128



THE CHARLOTTE MEDICAL JOURNAL.



Hemoglobinuria.

Hicks reports a case in the Virginia Med-
ical Semi-Monthly for December 2 2d, fol-
lowing two months after an attack of quo-
tidian malaria, lasting for ten weeks, but
finally broken up with large doses of quin-
ine. He had taken no quinine since and
gave no history of syphilis.

Examination of the blood showed small,
dark, irregular granules in the red cells,
which were taken to be the granular forms
of the malarial organism.

No "crescents" or other younger forms
could be found.

He considered it a case of parasitic he-
moglobinuria of malarial origin.

The treatment was rest in bed and saline
purgatives.

The patient returned to duty on the fifth
day, the parasite having disappeared from
the blood and the blood from the urine.
He suggests that this case may throw some
light on the so-called -'paroxysmal" type
of hemoglobinuria.



Cystic Distension of tlie Appendix.

Wood, in the American Journal of Ob-
stetrics for January, describes a case which
was operated on for a large myofibromatous
tumor in which cystic distension of the ap-
pendix was found and the organ removed.

As a matter of routine he examined the
appendix after completing his work in the
pelvis and was surprised to find attached to
the extremity of the cecum a mass as large
as a kidnev or the link of a large bologna
sausage.

This was tied off and the stump inverted
by means of a purse string suture supple-
mented by two Lembert sutures.

The appendix measured 20 centimetres in
length and 7 in diameter, and its walls were
thin, tense and injected, containing a clear,
transparent fluid, which was absolutely
sterile.

The patient had not had any symptoms
calling attention to the appendix and no
evidences of appendicitis, either acute or
chronic.

He concludes that in nearly every case of
cystic distension of the vermiform appendix
recorded there were no subjective phenom-
ena arising from the condition, and that in
the majority of cases it was discovered ac-
cidentally.

That when the cyst finds its way into the
inguinal canal there is danger of causing its
rupture by taxis, as actually happened in
Van Hook's case.

The possibility of mistaking a large cyst
of the appendix for a floating kidney must
be borne in mind. In a thinner patient



such a mistake might easily have been
made in the case passing under his obser-
vation.



Tlie Hospital Treatment of Melaucliolia.

Babcock, in the International Medical
Magazine for January, discusses the treat-
ment of acute and curable forms of melan-
cholia.

He divides the curable forms into acute,
agitated and stuporous.

The first indication is to combat sleep-
lessness and this is done by the scientific
use of massage, static electricity, cold baths
and sponges and well regulated out-door
exercise, leaving a very limited field for the
use of hypnotics.

The second indication is to keep the pa-
tient well nourished. Salines and intes-
tinal antiseptics should be administered
with the first food given artificially. For
forced feeding give three egge, four ounces
of expressed meat juice and one quart of
milk twice. daily.

Lavage, careful attention to the bowels,
constant nursing, alteratives and excito-
motors as quinine, strychnine, or nuxvomi-
ca, iron, arsenic, coca, hypophosphites and
bitter tonic are indicated.

Opium should not be used except cau-
tiously in the agitated form.

Melancholia with stupor should be treated
as above with special attention to the elimi-
native functions. Weir Mitchell's rest cure
is applicable in this form. The cold pack
for sleeplessness.

The thyroid extract should be tried, re-
membering that in many cases no mental
improvement occurs until the thyroid has
been discontinued, when a mental and phy-
sical reaction takes place which does not
cease until convalesence is well established.



Gall Stones in the Common Duct.

Samuel, in the American Practitioner
and News for December 15th, recommends
an incision from opposite the 8th or 9th
costal cartilage to 2-^ inches above the um-
bilicus, making an angle that is extended
along a line parallel to the free border of
the costal cartilages.

When the stone is found do not waste
time trying to push it back into the gall
bladder or into the bowel.

The opening into the duct is better left
open.

The gall bladder should be opened for
drainage of a diseased organ.

A choledochotomy call for a cholecysto-
tomy at the same time, the only exception
is in absence of gall bladder or contraction
making drainage impossible.



THE CHARLOTTE MEDICAL JOURNAL.



129



Food and Drug Inspection.

The State Board of Health of Massa-
chusetts has been looking after the food and
drugs of the State for the past 17 years and
their work has been of immense value to
the people.

The articles most liable to adulteration
are milk, butter, spices, coffee, syrups and
molasses, cream of tartar, honey, vinegar,
jellies and jams, olive oil and certain kinds
of canned goods, says Abbott, the Secretary
ot the Board, in the Boston Medical and
Surgical Journal for January 25th.

Eleven thousand five hundred dollars an-
nually has been appropriated for the past
four years.

The essentials necessary for carrying on
the work are, a sufficient annual appropri-
ation, a well equipped laboratory, a general
director, an experienced food chemist or
anylist, and the collector of samples.

That those States that have no such sys-
tem of inspection have an inferior food sup-
ply (so far as relates to articles liable to
adulteration) is susceptible of proof, since
occasional inspections made in those States
have shown this to be the case.

There can, therefore, be no reasonable
doubt that the system is well worthy of
adoption in all communities. It is now in
force in almost every large city on the con-
tinent of Europe as well as Great Brittain,
and commends itself for general adoption
everywhere, until the day shall come when
man will no longer line his own pockets by
defrauding his neighbor.



Laryngeal Stenosis.

In catarrhal laryngitis, if counter irrita-
*tion, simple purgatives, antipyretics and
antiphlogistics fail to relieve we should re-
sort to intubation, says Merriman, in the
Kansas City Medical Index-Lancet.

Paralysis of the abductors of the vocal
cords requires an intubation or tracheo-
tomy.

Enlarged glands should be removed with
the knife.

Laryngeal stenosis due to a false mem-
brane is always diphtheritic and should be
treated with antitoxin.

In the majority of cases he prefers intu-
bation to tracheotomy, but in cases'of diph-
theria when preparing for intubation, pre-
pare also for tracheotomy.

Intubation should not consume more than
30 seconds, as every effort that is a failure
is detrimental to the child.

He concludes that we have not used every
available means in laryngeal stenosis until
intubation or tracheotomy has been tried.



Excision of High Rectal Carcinoma.

Senn, in Galliard's Medical Journal for
January, reprinted from the Philadelphia
Medical Journal of September 30th, says
that Krase's operation is unjustifiable and
should not be done. He says that resection
of the coccyx will give plenty of room and
that the additional room gained by resect-
ing part of the sacrum is so little that it is
not worth the risk to patients' life.

He reports two cases in detail which
plainly show the objection to the sacral
route has a clinical basis.

In the first case the excision necessarily
included the sphincters and during the
operation it was found impossible to bring
the proximal end down to a level with the
anus, so a sacral anus was made from ne-
cessity.

In the second case the lower portion of
the rectum was left intact, as the disease
had a high orign. The sphincters were
preserved and the two ends were sutured
together for its anterior two-thirds.

Radical operation for carcinoma is con-
traindicated when the proximal limits of
the tumor are beyond the reach of the in-
dex finger; when there is extensive involve-,
ment of the retro-peritoneal glands and
marked extension of the disease beyond the
rectal wall.

In the first case mentioned above 5^ in-
ches of lower rectum was resected, re-
covered with permanent coccygral anus
and partial control.

In the second case there was a circular
resection, temporary coccygeal anus, re-
covery with full use of sphincter muscles.



Nasal Obstruction.

Many of the immediate and remote effects
of nasal obstruction are brought out by
Reynolds in the Medical Age for January
25th.

The warming and moistening of the in-
spired air are very important.

Diseases such as anemia, marasmus, hay
fever, [asthma and larynglsimus stridulus,
may be cured by relieving the nasal steno-
sis. Reflex cough, pharyngitis, deafness,
etc., may have their origin in nasal sten-
osis.

For hypertrophy of the turbinates he re-
commends chemical caustics as chromic or
glacial acetic acid, nitrate of silver or nitric
acid, and the electric or galvano-cautery.

The saw and gouge or trephine run by
the electric motor he has found most con-
venient and useful for removing promi-
nent portions of the septum.

He reports three cases, all improved un-
der appropriate treatment.



130



THE CHARLOTTE MEDICAL JOURNAL.



Gonorrhea; Its Dangers to Society.

In the Medical News for January 20th,
Neisser concludes his article on this subject.

We all know that it is often responsible
for articular rheumatism. Its infection is
persistent and a man supposedly well may
infect his wife months after con-
tracting the disease. The indication is
to cure a gonorrhea at once before the seri-
ous and intractable complications and se-
quloB have come on.

While the general mortality is perhaps
influenced by this disease, he says the mor-
bidity of the population is influenced in a
very striking way. There is an enormous
loss of working strength and wages.

Sickness of the wife of the working man
means disaster. Ten to twenty per cent,
of all blindness is due to gonorrheal infec-
tion. Crede's i.iethod has diminished the
number of cases greatly in the past few
years.

Many sterile marriages are caused by a
gonorrhael epididymitis in the male.

Out of 327 women, 221 were sterile be-
cause of gonorrhea, and in 43 of these cases
the women had been infected by their hus-
• bands.

Gonorrhea is a social danger for the peo-
ple and requires the most careful attention
from the authorities who are responsible for
the public health.

The Death Rate from Nephritis.

Wilkinson, in the Texas Medical Jour-
nal for January, gives the death rate from
nephritis in 140 cities of the United States
for 1898.

Charleston, S. C, has the high rate, i in
386 of population. New York City i in
1,765, Washington i in 955, St. Louis i in
1,681, New Orleans i in 753, Mobile i in
558, Lowell, I in 963, Springfield i in 663,
Albany i in 631.

The author is incliaed to the bacilliary
origin of the disease and notices that wher-
ever consumption prevails there Bright's
disease is common.

The table is very useful and will repay
careful study.

Vaccination after Denudation of the Sl<in with