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space to analyze these sections, but regard them as deserving the
-closest scrutiny. Syphilis in relation to public health, by Samuel
Treat Armstrong should be read by every sanitarian and public



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PLATFAIB : SOIBNCS AND PBACTICS OP MIDWIFBBY. 497

health officer. In this section are discussed the relation of prosti-
tntion to syphilis and the methods of regulation of prostitution,
as well as other measures to limit the spread of syphilis.

We now come to the final and perhaps one of the most inter-
esting, if not important, sections of the hook, in which chancroid
is treated of by Edward Martin in a most masterly manner, and
chancroid of the anus and rectum is dealt with at the hands of
James P. Tuttle. Martin's definition of chancroid is so simple that
when once learned it cannot be forgotten. He says : <* It is a
contagious venereal ulcer, which, when uncomplicated, is not fol-
lowed by constitutional symptoms." There is no longer any dis-
pute as to the fact that chancroid cannot produce constitutional
syphilis. The pyogenic microbes of chancroid cannot be inocu-
lated upon an unbroken skin surface.

We regard this work, which is encyclopedic in character, as
the ablest exposition of syphilis extant. The authors have been
selected with special reference to their knowledge and experience
in the several branches of the subject upon which they have written,
and, conjointly with the editor, have produced the most scholarly,
exhaustive and satisfactory work on the subject in the English
language. We devote considerable ppace to its consideration on
account of the importance of the subject.



A Treatise on the Science and Practice op Midwifery. By W. S.
Playpair, M. D., F. R. C. p., Professor of Obstetric Medicine in
King's College, London ; Examiner in Midwifery to the Universities
of Cambridge and London, and to the Royal College of Physicians.
Sixth American, from the eighth English, edition. Edited, with
additions, by Robert P. Harris, M. D. In one octavo volume of 697
pages, with 217 engravings and five plates. Cloth, $4.00 ; leather,
$5.00. Philadelphia : Lea Brothers & Co. 1893.

Since 1676, Playfair has been accepted as authority in the
department of obstetrics. When his first edition was issued, it was
found to be such a clear exposition of the subject that Playfair's
treatise was readily adopted by our colleges as a text-book. Stu-
dents, therefore, became familiar with it at once, and obstetricians
have followed it through its several editions with interest and
satisfaction. At the time of which we speak, and during all the
years previous, it is an admitted fact that students generally left
the schools in greater ignorance of obstetrics than of any other
branch of medicine. This is not true at present, and it is the
special pride of American medicine that its graduates rarely leave



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498 BSYIEWS.

college — we mean such colleges as are worth attending — witboat
an experience of from two to six obstetrical cases. It cannot be
denied that this is a totally inadequate equipment with which to
enter the practice of medicine and at once assume the grave
responsibilities of the lying-in chamber ; but it is such a vast im-
provement over the old way that we cannot but feel satisfaction in
the progress made and that is making.

We have noticed the several editions of Playfair as they have
appeared, and are always glad to publish in our review columns
the results of our examination of such good books as this. It is
four years since the last American edition was issued, and during
that interval much of importance has happened in the medical
world in general and in the obstetrical world in particular. To
keep pace with these advances, Playfair has nearly, or quite,
rewritten some of the chapters in the present edition, notably those
on extra-uterine pregnancy, the Cesarean section, symphyseotomy
and puerperal septicemia. It is these chapters that will be most
likely to challenge criticism, for in all new studies in pathology
or treatment where preconceived ideas are overturned, divers
opinions obtain, and only after time has elapsed can solid ground
be reached.

Playfair leans to Tait's classification of extra-uterine pregnancy,
who, as is well known, considers all ectopic pregnancies to be
primarily tubal, and that the other varieties are developed after
rupture. Bland Sutton, as is also well known, accepts Tait's posi-
tion and maintains that all forms of extra-uterine gestation pass
their primary stage in the Fallopian tube. Playfair cautiously —
we might almost say overcautiously — says that this opinion,
although it is receiving an increasing number of supporters, can
not, as yet, be admitted as conclusively proved. He, therefore,
thinks it best to retain, provisionally at least, the ordinary classi-
fication.

In regard to treatment, Playfair is again conservative, affirming
that if diagnosis were quite certain, removal of tube and contents
by abdominal section would be quite justifiable. He then goes on
to enumerate the expedients that have been offered in substitution
for abdominal section, or to avoid what some are pleased to regard
as so formidable an operation. We think it would be better in a
text-booli^ of this kind, and in view of the present state of our
knowledge, to take a decided stand in favor of operation wherever
the symptoms are urgent and the diagnosis proftod^.



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playfaib: sgibncb and practicb of midwifery. 499

Symphyseotomy is a subjeot that is now attracting attention
in obstetric circles, and what Playfair has to say regarding it will
command audience. He affirms that if a woman is operated upon
in good season and by the sab-osseous section, she should run but
moderate risk of her life and her child likewise, but that, like
Cesarean section, much will depend upon the length of labor and
the condition of the patient when operated on for securing a suc-
cessful issue. Symphyseotomy ought to be less dangerous than
the Cesarean section, and nothing short of this should satisfy those
who propose to substitute it for craniotomic infanticide. He
affirms, moreover, that it is a less formidable operation and women
make less objection to it than they do to the abdominal operation.
It requires less skill in its execution, but take the whole delivery, in
many cases, and it will be found that no little skill is required to
secure a favorable result. We believe that the obstetrician of the
future, armed with the modified Cesarean section and symphyseo-
tomy, ought to wipe out craniotomy and make it a lost art.

In dealing with puerperal septicemia, Playfair, like all obstetric
authorities, is somewhat confusing in regard to the theories of its
true nature. It seems to us that the time has arrived to teach
students that this is essentially a surgical disease ; that it is a true
puerperal sepsis, caused by the absorption of poison through lesions
of the genital tract. Furthermore, we believe that they should be
taught to conduct a labor with the same precautions that would be
insisted upon in a formidable surgical operation like cranial,
thoracic, or abdominal section. If this were universally done, it
would reduce the number of cases of so-called puerperal fever to
an exiguity heretofore unheard of, and the prevention and cure of
puerperal sepsis WQuld be an accomplished fact, or as practically
so as any one in medicine.

The editor of this edition has substituted the term celiotomy
and the prefix celio — for the term laparatomy and the prefix laparo
— as applied to abdominal surgery. We should be very glad to
resort to any reasonable means to get rid of the term laparatomy
and its compounds, which we regard as a mongrel in derivation and
meaning ; but we cannot accept the term celiotomy as preferable
to the other. It is not technically correct, because celia means
something besides belly and is already used to denote other cavities
of the body. Until some word can be devised which shall mean
the same, let us use, as far as practicable, the term abdominal
section.



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500 REVIEWS.

This work of Playfair must ever occupy a foremost place in
obstetric medicine as a safe guide to both student and obstetrician.
It holds a place among the ablest English-speaking authorities on
the obstetric art.



Intebkatiomal Clinics. A Quarterly of Clinical Lectures on Medi-
cine, Neurology, Pediatrics, Surgery, Genito-Urinary Surgery,
Gynecology, Ophthalmology, Laryngology, Otology and Dermatol-
ogy. By professors and lecturers in the leading medical colleges
of the United States, Great Britain and Canada. Edited by John
M. Keating, M. D., LL.D., Colorado Springs, Col.; Fellow of Col-
lege of Physicians, Philadelphia ; formerly Consulting Physician
for Diseases of Women to St. Agnes^ Hospital ; Gynecologist to St
Joseph^ 8 Hospital ; Visiting Obstetrician to the Philadelphia Hos-
pital, and Lecturer on Diseases of Women and Children. Philadel-
phia ; Editor Cyclopedia of the Diseases of Children. Judson
Daland, M. D., Philadelphia, Instructor in Clinical Medicine, and
Lecturer on Physical Diagnosis and Symptomatology, in the Uni-
versity of Pennsylvania ; Assistant Physician to the University
Hospital ; Physician to the Philadelphia Hospital and to the Rush
Hospital for Consumption. J. Mitchell Bruce, M. D., F. R. C. P.,
London, England. Physician and Lecturer on Therapeutics at the
Charing Cross Hospital. David W. Finlay, M. D., F. R. C. P.,
Aberdeen, Scotland, Professor of Practice of Medicine in the Uni-
versity of Aberdeen ; Physician to, and Lecturer on, Olinical Medi-
cine in the Aberdeen Royal Infirmary ; Consulting Physician to the
Royal Hospital for Diseases of the Chest, London. Volume III.
Third series. Royal octavo, pp. xii. — 366. Philadelphia : J. B.
Lippincott Co. 1893. •

This volume of the third series of International Clinics follows
the same general plan as its predecessors with reference to variety
of subjects and careful selection of the authors. Dr. George W.
Gay, of Boston, speaks most interestingly and instructively on the
management of patients during critical operations; Dr. John B.
Hamilton, of Chicago, has an interesting lecture in this number on
tuberculosis of the sacro-iliac joint and several other surgical ques-
tions, including popliteal aneurism. Dr. Alexander Haig, of Lon-
don, speaks interestingly in regard to the pathology and treatment
of asthma. This teacher is fast becoming recognized as an author-
ity on internal medicine. Gastric ulcer is another subject of great
importance, and Dr. James Tyson handles it with intelligence in
the lecture that he devotes to its consideration. It is important
for those who have obtained the previous numbers of these clinics
to secure this one promptly, that the series may be completed in
their libraries as fast as issued.



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THE PHABMAOOPEIA OF THE. UNITED STATES. 501

The Phabmacopeia of the United States of America. Seventh
decennial revision (1890). By authority of the National Conven-
tion for Revising the Pharmacopeia, held at Washingfton, A. D.
1890. Official for January 1, 1894. Published by the Committee
on Revision. Octavo, pp. 1.— 602. Philadelphia : J. B. Lippin-
cott Company, Printers and Binders. P. Blakiston, Son & Co.,
Agents. 1898.

The enormous labor required to revise the Pharmacopeia of the
United States makes it impracticable to do so oftener than once in
ten years. The seventh revision, made by tbe convention of 1890,
is before as and we feel sore that it will meet the critical expecta-
tions of professional experts. A number of articles have been
added to the pharmacopeia, and almost an equal number have been
dismissed from its pages. A considerable list of changes of
official Latin titles is announced, and about treble the number of
English titles have been changed. The metric system has been
adhered to with reference to weights and measures throughout the
volume. This action of the committee will do much to hasten the
adoption of the metric system by physicians and druggists, though
it will occasion some perplexity among those unfamiliar with its
uses and equivalents. A table of equivalents of weights and meas-
ures — customary and metric — is given on page 554, et, seq.y for
reference by those who may need it.

The general make-up of the volume is such as to commend
it to those who may have occasion to consult it. The titles are
in large, heavy type and the descriptions are printed in heavy small
pica, while further allusion to each article appears in strong-faced
long primer type. The book has been somewhat delayed in its
appearance, but this could hardly be avoided when the extraordi-
nary labors of the committee are taken into consideration. The
changes are more radical in this revision than in any of its prede-
cessors, consequently greater care has been necessary in its publica-
tion, and hence, more time was required to do the work satisfactorily.



Transactions OF THE American 'Surgical Association. Volume
XI. Edited by DeForest Willard, M. D., Recorder of the Asso-
ciation. Philadelphia : Printed for the Association, and for sale by
William J. Dornan. 1898.

This volume records the work of this celebrated association
done at its meeting in Buffalo last May. While it is not as large
as some of its predecessors, it is yet replete with articles of great
interest. The president. Dr. Nicholas Senn, chose for the subject



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502 BBVIBW8.

of his address, A New Method of Direct Fixation of the Frag-
ments in Compound and Ununited Fractures, in which he discusses
the history of direct immobilization of fragments, and brings to
the notice of the profession his own plan of the retention of com-
pound ununited fractures by direct fixation with bone ferrule.
This consists of preparing from the bones of animals a ferrule,
varying from a quarter of an inch to an inch in width, and about
one-sixth of an inch in thickness, or, in some instances, a much
thinner ring may furnish the necessary lateral support. Steriliza-
tion is effected by boiling for an hour or more, after which the
rings are kept immersed in sublimate alcohol 1-1000. Under
strict antiseptic precautions the seal of fracture is to be expoE>ed
in such a way that both fragments are readily accessible. The
most convenient fragment is isolated, the ferrule slipped over it
and pushed away from the line of fracture far enough to clear the
other fragment. After reduction is accomplished, the second frag-
ment is engaged in the ring, which is then pushed back sufficiently
far to grasp both fragments securely. Bending at the seat of
fracture is prevented by the application of a plaster of Paris
splint, fenestrated at a point opposite the wound. Dr. Senn
reported a number of cases in which he had employed this method
with success. This unique address is illustrated with twenty-
three wood-cuts, and is one of the most valuable contributions to
the literature of surgery of the year. The volume is full of inter-
est, and should be in the hands of every practical surgeon.



A Practical Treatise on the Diseases of the Skin. For the use of
students and practitioners. By J. Nevins Hyde, A. M., M. D..
Professor of Dermatology and Veuereal Diseases in Rush Medical
College, Chicago. New (third) edition. In one octavo volume of
802 pages, with nine plates, of which three are colored, and 108
engravings. Cloth, $5.00; leather, $6.00. Philadelphia: Lea
Bros. & Co. 1893.

The science of dermatology has advanced so rapidly that a
work written ten years ago, like the present one under considera-
tion, even with a new edition five years thereafter, finds it neces-
sary after five years more to rewrite a large part of the original
treatise as well as to add many new and important chapters. Dr.
Hyde is an experienced teacher as well as a competent author, and
his former editions were received with approval by dermatologists
as well as by those general practitioners who are interested in the
study and treatment of diseases of the skin.



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▲shhubst: thb principles and pbactice of subgebt. 603

To illastrate, Hyde states in bis preface that thirty-five new
diseases are considered in the present edition ; that the chapter on
tuberculosis has been entirely rewritten and enlarged to meet the
most modem views of this subject, and that several other import-
ant changes have been made for like reasons. There are two
chapters that will prove of especial interest to dermatologists and
general practitioners alike, namely — one on general therapeutics,
in which the nature and application of various drugs used in treat-
ment of diseases of the skin are described, and another entitled
Dermatitis Medicamentosa, in which a large number of drugs are
catalogued that cause cutaneous eruptions with greater or less
frequency. This list is constantly being added to, as experience
demonstrates the tendency among drugs to cause eruptions, and it
is probable that in another edition Hyde will be called upon to
considerably increase the category, as he himself intimates.

A large number of new and original illustrations — five plates
and twenty-two wood-cuts — have been designed especially for this
^ition. The mechanical execution of the work is all that could
be desired, and the treatise is one that affords much satisfaction, in
that it is a safe guide for both students and practitioners, either
general or special, and particularly does it adapt itself to the use
of dermatologists.



The Pbinciples and Practice of Scrgery. By John Ashhurst, Jr. ,
M. D., Barton ProfeBsor of Surgery and Clinical Surgery in the
UDlversity of Pennsylvania ; Surgeon to the Pennsylvania Hospital,
Philadelphia. New (sixth) edition, enlarged and thoroughly
revised. In one octavo volume of 1.161 pages, with 656 engrav-
ings and a* colored plate. Cloth, $6.00; leather, $7.00. Philadel-
phia : Lea Bros. & Co. 1893.

This author has been before the surgical world so long and is
so versatile and resourceful, that his several editions are rapidly
taken up and others follow in equally prompt measures of time.
Ashhurst has taken great pains to render this sixth edition fully
^qual to the demands of the present, and has constructed it on
lines which merit a continuance of the confidence of the profes-
sion. In this edition he has incorporated an account of the more
important recent observations in surgical science, as well as such
novelties in surgical practice as merit the classification of improve-
ments. Dr. Charles B. Nancrede, of Ann Arbor, has contributed
a new chapter on surgical bacteriology ; Dr. Barton C. Hirst has
revised the sections on gynecolegical subjects; and Drs. George



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504 BXYIBWS.

E. de Schweinitz and Alexander Randall have revised the chap-
ters on diseases of the eye and ear. The volume preserves the
same general arrangement as in former editions, bat by the exclu-
sion of matter that has ceased to be of importance, much space has
been gained, permitting the introduction of a large amount of new
material, with only a slight increase in the total number of pages.

The illustrations, too, have been greatly improved by the intro-
duction of original cuts from photographs, and a colored plate
containing seven figures pertaining to bacteriolbgical subjects.
We think it important in the present age that surgical treatises
should be more completely illustrated by photographs from actual
cases than is generally practised. Some of the cuts in this book
are old-timers, that might well be replaced by a further use of the
photograph.

We desire to especially compliment the author on his index,
which increases the value of the work for reference by its com-
pleteness. There is nothing new or of special interest in the
gynecological part of the work, and we think that it would be
quite as well for surgeons to omit this department in their trear
tises and so be enabled to devote more space to the consideration
of surgical conditions that are often too condensed to be of great
value to surgeons or students of surgery.

Those surgeons who possess earlier editions of Ashhurst's Trea-
tise will make haste to obtain this new one, and those who are not
familiar with the work will necessarily add it to their libraries.
The surgical science is so varied and extensive in its application,
that one must needs have at hand all the contemporary authors
extant in order to intelligently keep pace with its progress.



A Text-Book of Physiological Chemistrt. By Olof Hammarstbn,
Professor of Medical and Physiological Chemistry in the University
of Upsala. Authorized translation from the second Swedish edition
^nd from the author^s enlarged and revised German edition. By
John A. Mandel, Assistant to the Chair of Chemistry, etc., in the
Bellevue Hospital Medical College and in the College of the City of
New York. First edition ; first thousand. Octavo, cloth, pp. x. —
511. Price, $4.00, New York : John Wiley & Sons, 53 East Tenth
street. 1893.

The medical profession is to be congratulated upon having
received another addition to the meager literature on physiological
chemistry. It indicates an advance and a demand for a more thor-
ough study of chemistry in its relations to physiological processes.

This volume, from the pen of a man of international reputa-



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stills: the national dispbnsatoby. 606-

tioD, gives an excellent exposition of the subject of physiological
chemistry. We believe, however, that the book would have been
very much enhanced in value if the subject of pathological chem-
istry had been treated in more thorough detail. It is to be
regretted that the author did not see fit to allow Mr. Mandel to*
make such additions as would bring this branch of the subject up
to date. While the physician should be familiar with the normal
conditions from a chemical standpoint, it is also of vital import-
ance that he should be familiar with any morbid declensions from
the normal performance of the functions of any of the organs of
the animal economy.

The typography of the book is excellent, it is very neatly
bound, and quite free from errors. It is a decided credit to the
publishers. J. A. M.



The National Dispensatory. Containing the Natural History, Chem-
istry, Pharmacy, Actions aud Uses of Medicines, including those
recognized in the Pharmacopeias of the United States, Great
Britaki and Grermany, with numerous references to the French
Codex. By Alfred Stille, M. D., LL. D., Professor Emeritus
of the Theory and Practice of Medicine and of Clinical Medicine in
the University of Pennsylvania ; John M. Maisch, Ph. M.. Phar. D.,
Late Professor of Materia Medica and Botany in Philadelphia College
of Pharmacy; Secretary to the American Pharmaceutical Association;.
Charles Caspari, Jr., Ph. 6., Professor of Pharmacy in the Marland
College of Pharmacy, Baltimore ; and Henry C. C. Maisch, Ph. G.,
Ph. D. New (fifth) edition, thoroughly revised, according to the
new United States Pharmacopeia (seventh decennial revision, 1894).
In one magnificent imperial octavo volume of 1910 pages, with 320
elaborate engravings. Cloth, $7.15 ; leather, $8.00. With ready
reference thumb-letter index— cloth, $7.85 ; leather, $8.60. Phila-
delphia : Lea Brothers & Co. 1894.

^hat this great work should present itself to the profession
within five months after the publication of the new United States-
Pharmacopeia, and but a single month after it went into effect, must
afford great satisfaction to the editors and publishers. But it is^
also of equal satisfaction to the professions of medicine and phar-
macy, whose interests are so intimately blended in the National
Dispensatory. The vast fund of information which it contains
should be placed at the disposal of all concerned with the least
possible delay. It is the oflScial guide for the medical and phar-
maceutical professions, and is to them of like importance as the-
rudder to the great ocean steamship in buffeting the storms and
high seas of practical medicine and pharmacy.



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506 BBVIBWS.

The changes in the new Pharmacopeia, to which we have
alluded elsewhere, were of such a sweeping character that it neces-
sarily entailed greater work upon the part of authors and editors
to prepare this edition than upon those that had preceded it. New
tables of value have been inserted, weights and measures are given



Online LibraryJ. A. (Joel Asaph) AllenBuffalo medical journal → online text (page 50 of 78)