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80 cents. Philadelphia: P. Blakiston's Son & Co. 1898.

The call for a sixth edition of Landis* Compend enabled the reviser
and editor, Dr. Well^, to make certain needed additions and to leave out
certain matters that it was thought might be dispensed with.

The result is that this old favorite comes out much improved and still
more deserving of the high esteem in which it has so long been held.

D. T. s.

A Manual of Otology. By Gorham Bacon, A. B., M. D., Professor of Otology in
Cornell University Medical College, New York ; Aural Surgeon, New York Eye and
Ear Infirmary. With an introductory Chapter by Ci^arbncb John Bi^ake, M.
D., Professor of Otology in Harvard University. With no illustrations and a
colored plate. 398 pp. Philadelphia : Lea Brothers & Co. 1898.

This is a short, compact treatise on otology, affording a book of easy
reference, and for the use of the general practitioner sufficient for all prac-
tical purposes. It is pre-eminently a practical volume.

The author, in an injunction that should reach the laity, urges and
emphasizes the importance of treating all diseases of the ear in their
earliest stages, as insuring the best chance of preventing the more serious
lesions.

The book is well illustrated and the type large and clear ; altogether it is
a useful book and pleasant to read. d. t. s.

Illustrated Skin Diseases. An Atlas and Text-Book, vrith Special Reference to
Modem Diagnosis and the Most Approved Methods of Treatment By Wili«iam
S. Gathei.1,, M. D.. Professor of Skin and Venereal Diseases at the New York
School of Clinical Medicine, etc. Portfolios i, 11, and iii. New York : E. B. Treat
&Co.

This work is to be issued in quarto portfolios, each comprising
twenty-four pages of text, with numerous formulae and four plates of cases
from life reproduced in colors with life-like effect, by a new photographic
process. The text is profusely illustrated with numerous black and



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The American Practitioner and News. 67

white illustrations from photographs from life selected from the author's
extensive collection taken in hospital, dispensary, and private practice. The
author hopes to complete the work in twelve portfolios. Price, per part,
$1.00. Six portfolios are now ready. The portfolios received bear out in
every respect the highest expectations to be drawn from the author's
promises. The plates are truly life-like and the descriptions vivid. We
predict for it a flattering success. d. t. s.

A Manual of the Practice of Medicine. By Frederick Taylor, M. D., F. R. C. P.,

Physician to and Lecturer on Medicine at Guy*s Hospital ; Examiner in Medicine
at the University of London, etc. Fifth edition. 1002 pp. Price, $4.00. London :
J.A.Churchill; P. Blakiston's Son & Co. 1898.

A work that has reached its fifth edition in England is one that can
hardly stand in need of the help of a review more than to say each edition,
and notably this, has been kept fully abreast with the latest progress in
medicine.

As must needs be in a work of its scope, it is eminently practical.
Attention has been mostly devoted to the description of symptoms, to
diagnosis, to prognosis, and to treatment. Etiology and pathology have
received consideration, but of course not to the extent given them in sys-
tematic works. It is altogether a work worthy to take its place among
the first order of manuals, and among the more than two hundred thousand
physicians in America must find many readers. d. t. s.

Tlie Pfaonendoscope and its i>ractical Application. By Aurei^io Bianchi, M. D.,
Professor of Preparatory Clinical Medicine and Pathology, Parma, Italy. With
37 illustrations. With Translations of Special Articles by Feux Regnaui^t, M.
D., France, and M. Anastasiades, M. D., Greece. Translated by GEORGE Barker,
A. M., M. D., Physician-in^chief of the Chinese Medical Dispensary, Philadelphia,
etc. 77 pp. Price, 50 cents. Philadelphia : George P. Pilling & Son. 1898.

This is really a superb advertisement of the modification or improve-
ment of the stethoscope made by Prof. Aurelio Bianchi, of Parma, and called
by him the phonendoscope.

It is a highly interesting work on phonendoscopy, being beautifully
illustrated on imported plates. The improvement certainly oflFers claims
to investigation. d. t. s.

Ooide to tlie Clinical Examination and Treatment of Children. By John Thom-
son, M. D., F. R. C. P. (Ed.), Extra Physician to the Royal Hospital for Sick Chil-
dren, and Lecturer on the Diseases of Children in the School of Medicine of the
Royal College, Edinburgh. With 52 illustrations. 336 pp. Price, $3.00. Phila-
delphia and New York : Lea Brothers & Co. 1898.

The author assures us that the scope of this work is essentially supple-
mentary. It is intended to supply to practitioners and senior students
practical and useful information, which, taken along with that contained in
a text-book on the practice of medicine, will be a help to them in the
study and treatment of sick children.



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68 The American Practitioner and News.

The subject has been approached from a purely clinical standpoint. In
his preface the author pays a high compliment to some American text-
books, especially those of Dr. L. E. Holt and Dr. T. M. Rotch. Under
the limitations and restrictions which the author himself imposes, the
work is a highly useful one, and especially helpful to one who needs hastily
to freshen his knowledge of children's diseases. Above all is the assur-
ance that what one reads here has tlie stamp of authority. d. t. s.



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LONDON LETTER.

[FROM OUR SPBCIAI, CORRESPONDENT.]

Military Surgery in the Future ; A Generous Gift; The Inspection of Food
Supplies ; Diphtheria and Elementary Schools; Cases oj Rabies; Vac-
cination Statistics ; Phthisis ; A Proposed Epileptic Colony ; Christmas
and the Hospitals.

Professor Esmarch has published an open letter, suggesting to the
Peace Conference which is to assemble at St. Petersburg certain measures
for the mitigation of the horrors of war. The professor says that in future
wars the number of wounded will be extremely large, and surgical aid will
be extremely taxed, consequently it is desirable that all soldiers be
instructed in first aid and furnished with the most necessary bandaging
materials. It is also most necessary that every soldier should be made to
understand fully the significance of the Geneva Convention in order to
prevent ill-treatment of medical oflScers and wounded men. Furthermore,
Professor Esmarch says that an agreement ought to be arrived at that no
small caliber bullets should be employed which are not cased either entirely
or at least at the point in hard metal, in order that the destructive action of
the Dum-Dum bullets used recently may be avoided.

The Council of the Jenner Institute have been -oflFered ;^250,ooo for the
purpose of endowing research in bacteriology and biology as bearing upon
the causes, nature, and prevention of disease, on condition that its manage-
ment and control should be vested in seven trustees.

For the supervision of the food imports into the port of London, four
inspectors are engaged on the river and three others in the various docks,
and their duty is, in addition to the sanitary inspection of the vessels, to
overhaul and sample all consignments of food which come under their
notice. In addition there are two highly trained special food inspectors
who devote their whole time, under the supervision of the medical oflScer
of health, to the examination of meat and other foods. The medical report



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The American Practitioner and News. 69

for the month of November shows that 104 carcasses of mutton, 459 sides
of bacon, 121 crates of rabbits and hares, 900 cases of tinned meat and fruit,
1,205 crates of bananas, 716 barrels of grapes, 9 cases of pineapples, 11
cases of frozen lobsters, and 267 cases of condensed milk were destroyed,
besides a large quantity of other goods in smaller quantities.

The Public Health Department of the London County Council has
issued a report upon diphtheria and elementary schools. Dr. Murphy in
the report says that the schools contribute largely to the prevalence of this
disease, and that it is absolutely necessary that the medical oflScer of health
should have free access to schools, where school children can be most
readily examined for the prosecution of his inquiries. Dr. Murphy has laid
special stress upon this point because the medical officer of health of a
London district has reported that the London School Board has addressed
to his authority a letter *' severely censuring him for examining in school
certain children during scarlet fever prevalence among pupils of the school,**
where, in fact, he found children he had grounds for regarding as possibly
infective. The board stated that they would not allow him " or any other
medical officer of health to examine children in their schools.** Dr.
Murphy considers that this subject urgently needs the attention of the
Local Government Board and the Education Department.

The Board of Agriculture are not without hopes that before long they
will be able to entirely withdraw the muzzling order. During this year
" there have been but sixteen cases of rabies in the whole of Great Britain,
as compared with six hundred and sixty-two in 1895.

Sir Richard Thome Thome, in his report to the Local Government
Board for 1897-98, is emphatic on the question of vaccination. He points
out that the last year for which final observation concerning every child is
procurable is the year 1895. That year shows a proportion unaccounted
for and necessarily unvaccinated of 24.9 per cent in the Metropolitan area
and 19.8 in the rest of England. The percentages reveal a failure to com-
ply with the provisions of the vaccination acts which has been steadily
growing for fifteen years, and the probability is that there are now in Eng-
land and Wales a full third of the children unvaccinated. Thus Sir
Richard considers the country is being prepared for widespread epidemics
of smallpox such as have been unknown to the present generation. The
figures which constitute the Digest of the Vaccination Officers* Returns
for the year 1895 show that Leicestershire is the most unvaccinated county
in England, showing 76.5 per cent of children " unaccounted for,** and the
counties of Bedford and Northampton are not far behind. Barrow-on-
Soar, a small town in Leicestershire, shows a percentage of 87.3, which is
the highest in any town or union of England and Wales. But Northampton,
Keighley in Yorkshire^ and some eight or ten industrial towns, all run Bar-
row very close. There are also some ** health resorts** which give a per-
centage of 70 or more of unvaccinated. These are the figures of three
years ago, since when things have been rapidly growing worse.



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70 The American Practitioner and News.

Dr. Crichton Browne, in a discussion on the subject of providing sana-
toria for consumptive patients, gave it as his opinion that if the present
rate of decrease in phthisis cases continued, the disease would have dis-
appeared in thirty years* time. To maintain the present rate, however,
fresh measures would have to be introduced, and of these agencies, the
provision of fresh air and healthy sanatoria are among the prime requisites.

It appears that there are between 600 and 700 insane male epileptics in
the London asylums, suflFering more or less acute forms of epilepsy ; to this
number may be added about one hundred London patients at present
boarded out in other asylums. It is now proposed that those epileptics
whose insanity is not continuous should be located in a separate building
to be erected on land at Horton; they will here form a working colony.

The annual dinner has just been held of the Medical, Surgical, and
Hygienic Exhibitors* Association. The Society was founded in 1895 with
the object of bringing together the professional men and the manufacturers
of the appliances in constant use in the healing art. In this way highly
skilled instrument-makers learn the views of the most experienced physi-
cians and surgeons, and show what they can do in meeting their suggestions.
The Association has held two exhibitions, the first attracting 4,500 people ;
at the second there were between 6,000 and 7,000 visitors, and of the 5,000
registered doctors in London, 3,000 attended. The next show will be in
May next, and already most of the space has been let.

The usual Christmas festivities have been held in the London hospitals.
At one institution, after breakfast on Christmas morning, one of the house
surgeons went round as Father Christmas, accompanied by a student as a
Pierrot, who drew a huge trolley filled with presents for each patient. In
most wards the men were allowed to smoke, pipes and tobacco being pro-
vided. Various troops of singers also gave entertainments.

London, December, 1898.



Ctbstracts anb Selections*



Some Minor Causes and Conditions Relative to the Spread
OF Typhoid Fever. — Recognizing the fact that the definite and exciting
cause of typhoid fever exists in the excreta of those who are ill with this
disease, there are yet many variable conditions and circumstances under
which the specific poison of the disease spreads from the sick to the well.
The most common medium of transmission of the typhoid germ is unques-
tionably the water-supply, either public or private, and the natural ten-
dency of water to run down hill, carrying these excreta with it from the
houses of the sick into wells» ponds, and streams, used as water-sources,
explains the frequency of this mode of infection. The serious epidemics



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The American Practitioner and News. 71

at Lawrence, Lowell, Newburyport, at Plymouth, Pa.. Chicago, and Phila-
delphia were all traceable to this cause and mode of infection. Dr. Ernest
Hart rendered a useful service in collecting a very large number of such
epidemics and publishing them under the name of "Water-borne Typhoid.''

Probably at least three quarters of the extensive epidemics of typhoid
fever have been of this character.

Closely allied to the water epidemics are those which are commonly
ascribed to the milk-supply, and in these the primary medium of trans-
mission is undoubtedly the polluted water which in some way or other
gains access to the milk, either as an adulterant or in its use for the wash-
ing of the receptacles in which the milk is stored, or transmitted from
producer to consumer, since no evidence has ever been produced to show
that typhoid-fever infection could be transmitted to the milk by means of
polluted water which the cows had swallowed.

The foregoing methods of transmission having been eliminated, there
yet remain other modes which recent observations have shown to be pos-
sible. At Lawrence, Mass., after the introduction of a filter for purifying
the entire water-supply of the city, and reducing the death-rate from
typhoid fever to less than one tenth of its former proportions, and elim-
inating certain cases among persons who were known to have drunk the
water of the canals in the city, there still remained unexplained other cases,
some of which appeared to be due to the return of persons from certain
summer resorts where the sanitary conditions were seriously at fault and
where these persons had contracted the disease. From a statement in the
last report of the State Board of Health it appears that an inspection of
these resorts, picnic grounds, etc., has been made, which showed that many
of these places aflForded conditions unusually favorable for the spread of
disease, but in many instances the proprietors had shown themselves will-
ing to comply with suggestions as to much-needed improvements. The
number of these places in the neighborhood of cities and large towns has
greatly increased since the introduction of electric railways running in
every direction.

Another source of infection, which has become manifest in recent
years, is the ice-supply. Well authenticated cases of t3rphoid fever have in
recent years been traced to the use of ice from ponds and streams polluted
with sewage. The need of protection in this direction has shown itself in
the trend of public legislation in the past twenty years, and at least three
different laws have been enacted in Massachusetts for the protection of the
community against the sale of polluted ice.

It is remarkable that thus far the cities and towns of Massachusetts
which have taken action under these statutes have been chiefly those of the
western part of the State (North Adams, Holyoke, and Worcester), in which
the actual degree of pollution has been much less than that of Eastern Mas-
sachusetts. The extent of water pollution depends very largely upon den-
sity of population, and the greater density is that of the Metropolitan



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7? The American Practitioner and News.

District. There are ponds still in use as sources of ice-supply in Brighton,
Arlington, Lynn, Wakefield, Melrose, and Woburn, upon whose water-sheds
the population is from i,ooo to 1,500 per square mile, and into which sew*
age is constantly running without let or hindrance. The authorities of
these places, as well as those of western towns, have power to prohibit the
sale of this ice.

Another source of typhoid infection is to be found in those shell-fish
which are eaten raw. Many diflFerent kinds of shell-fish are eaten raw in
England and upon the continent of Europe, but in America the oyster is
almost the only kind which is thus used.

The report of Dr. Bulstrode to the Local Government Board of England
in 1895 showed conclusively that epidemics of typhoid had been due to the
use of oysters from places upon the coast of England which were polluted
by sewage. Similar epidemics have also been reported from Connecticut
and from Amherst College, due to the same causes. It is not unreason-
able, therefore, to suppose that some of the unexplained cases which
occur in our cities in the autumn may be due to the eating of raw oysters
gathered from sewage-polluted waters. The season of greatest typhoid
prevalence coincides with the beginning of the oyster season. The actual
intensity of sewage-pollution in the Providence River, noted for its oyster-
beds, is far greater than that of any of the sea-coast oyster-beds mentioned
in the report of Dr. Bulstrode. The Providence River and Narragansett
Bay receive the sewage of about 300,000 inhabitants, living in Providence,
Pawtucket, Worcester, and other places contributing to the water-shed of
the bay, and this sewage-polluted stream floats to and fro over the oyster-
beds at each turn of the tide. — Boston Medical and Surgical Journal.

LocAi. Anesthesia and Artificial Ischemia.— Braun {CentralbL f.
Chirurgie, No. 43, 1898) holds that the arrest of the supply of blood to a
limb by Esmarch's method is both a useless and a dangerous adjunct to
any plan of producing local anesthesia. In discussing the practice recently
advocated by Kofmann of rendering bloodless the seat of a proposed opera-
tion and then injecting a solution of cocaine, he asserts that an artificially-
produced anemia does not, by itself, affect the organs of painful sensation.
The action of cocaine or any other local anesthetic injected into the tissues
may, however, be intensified by the condition of anemia in consequence of
the arrested absorption of the anesthetic solution. If local anesthesia be
absorbed after the simple production of local ischemia, such a result is due
not to the cutting off of the blood supply to the benumbed parts, but to a
dangerous compression of the sensory nerves. — British Medical Journal,

Typhoid Fever at Honolulu. — Typhoid fever prevails extensively
and unnecessarily among the United States troops at Honolulu, dispatches
dated November 23d stating that there were over three hundred cases there
at that time.



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The American Practitioner and News.

"nec TENUI PENNA,"

Vol. 27. JANUARY 18, 1899. No. 2.

H. A. COTTELL, M. D., Editor.

A Jonmal of Medicine and Surgery, published on the first and fifteenth of each
month. Price, $3 per year, postas^e paid.

This journal is devoted solely to the advancement of medical science and the promotion of the
interests of the whole profession. Essays, reports of cases, and correspondence upon subjects of pro-
fessional interest are solicited. The editor is not responsible for the views of contributors.

Books for re vi ew, and all communications relating to the columns of the journal, should be
sddressed to the Editor of Thb American Practitxonbr and Nbws, I<ouisville, Ky.

Subscriptions and advertisements received, specimen copies and bound yolumes for sale by the
undersigned, to whom remittances may be sent by postal money order, bank check, or registered
letter. Address jOHN P. MORTON & COMPANY, Louisville. Ky.

FIRST PRIZE COMES TO A LOUISVILLE PHYSICIAN.



Beginning early last year the Philadelphia Medical Journal, recently
established by some fifty or more of the leading physicians of the
United States and put under the editorial management of Dr. George
M. Gould, announced an oflfer of twelve hundred and fifty dollars in
prizes for the best ten essays in five different departments of medicine
and surgery.

Five of these prizes were of two hundred dollars each for the best
essays, and five of fifty dollars each for the next best. Two of these
prizes were to be awarded to the authors of the best essays in Obstet-
rics and Gynecology.-

After a painstaking examination by judges selected from among the
foremost physicians of Philadelphia, the first prize for this department,
|200, was awarded to Dr. D. T. Smith, of Louisville, formerly one of
the editors of the American Practitioner and News and now its prin-
cipal book reviewer. The pecuniary recompense the award carries,
while evidencing the liberality of the Philadelphia Medical Journal,
counts for nothing in the worth of such a recognition.

The subject chosen by Dr. Smith for his essay was Moot Points in
Obstetrics, in which he developed exhaustively several principles of
his own discovery for which he has been contending for several years.

These principles relate to the mechanism of labor, and embrace

6



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74 ^ ^^ American Practitioner and News.

" The Uses of the Amnion/' " The Cause of Head Presentation," and
** The Causes of Rotation.''

These are subjects that have been more or less matters of discussion
and fcontroversy since the days of Hippocrates and Aristotle, and about
the only thing in regard to the explanation of the related phenomena
about which obstetricians have been generally agreed is that no
explanation hitherto oflFered has been clearly intelligible or at all satis-
factory. That explanations for all these questions, entirely new and
doing away altogether with the old, could be oflfered at this late day
and meet with the approval of the leading physicians in one of the
foremost medical centers of the world is of itself a triumph of
ingenuity and originality, whatever may be the merits of the contribu-
tion otherwise. Presenting their claims from the vantage ground
attained by this' flattering recognition, the principles contended for in
the essay can not fail of attention on the part of obstetricians every-
where, -and they will no doubt be accorded such consideration and
discussion as will settle the question of their merit.

This recognition comes to Dr. Smith quite opportunely. He has
now in the press of John P. Morton & Company a book consisting of
essays on the same order as that submitted in the Journal prize contest,
only that they relate to certain subjects in physics and philosophy that
have likewise been ** moot points '' for centuries, and that have enlisted
the first minds of modern history in attempts at their elucidation.

Those who have had the opportunity of becoming acquainted with
Dr. Smith's views on these matters through his various brochures and
lectures will be greatly disappointed if they do not awaken a lively
interest throughout the scientific world.

Original and absolutely independent as a thinker, the Doctor pos-
sesses the scientific imagination and attractive style calculated to
inspire interest in a production of far less worth than that he is soon to
offer the reading public.



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The American Practitioner and News. 75



Hotes anb Ciueries-



First Aid on Railways. — A recent accident on a French railway



Online LibraryUniversidad de Buenos Aires. Facultad de Derecho yThe American practitioner → online text (page 9 of 109)