interesting in such a work to have had Erb's views on the subject, and any new facts at his command as to the treatment of plumbism.

In the lectures on pain and neuralgia-amongst the best in the book—it is disappointing to learn that he cannot confirm the statements of Frommhold regarding the good effects of electricity in migraine, from which so many suffer, and he, therefore, states that in this respect migraine is distinguished from other neuralgias, The manner in which diseases of the ear are dealt with is excellent, and the small but interesting collection of cases remarkably instructive, and well worthy the serious consideration of aural surgeons.

There are many other points in Prof. Erb's work upon which we should like to have remarked, but in the space at our disposal it is impossible to do more than touch upon some which appear more important. In such a book it would have been useful to have tables for reference-as, for instance, the diseases in which irritability of nerve is increased, those in which it is diminished, &c. A fuller index would also be an advantage. Whilst enthusiastic in some respects, the author is never carried beyond scientific accuracy, as his remarks in numerous places prove. The spirit in which he writes may be gathered from the following: "It is evident we have to deal in the main with empirical methods. I cannot warn you too strongly against illusions based upon theoretical views or against therapeutical illusions founded upon uncontrolled observation. Electro-therapeutic literature swarms with such instances, and the defective criticism of observations has led to immense unsuspected deceptions." After carefully reading through this work, it is refreshing to close it with the belief that the author is conscious of the fact that, much as electricity can do, it is not a panacea for all the diseases to which flesh is heir.

If we have had to allude to the paucity of illustrations in Professor Erb's work, we are certainly spared the necessity of making the same comment in the case of Dr. de Watteville's. The number of woodcuts relating to electrical instruments and appliances contained in the latter, is exactly double the total number of all the illustrations in the former; we are, however, not disposed to find fault with Dr. de Watteville on this account, more especially as he tells us in his preface that he has taken especial care to keep the number of illustrations within reasonable limits. As regards the measurement of electricity, Dr. de Watteville is able to speak of the adoption of the milliampere as the electrical unit as an accomplished fact, and its more general recognition is now only a matter of time. The ampere, we may mention, represents a current conveying the unit quantity of electricity, i.e., one weber during one second. This unit has this to recommend it, viz., that a current of one milliampere is that given by three Daniell's cells through the human body. We have then in this unit a convenient and simple method of measuring and recording the strength of the current used in any given case. Under the head of electro-diagnosis our author enters a vigorous protest against the notion that electrical investigations do not call for special training on the part of those who conduct them. He considers that the fallacies besetting it are far more

numerous and subtle than those attending the other methods of physical examination of the living organism. Now, admitting that there is a great deal of truth in what he says, yet it will be well not to push this view too far. Diseases in which the battery is called in, either to aid in diagnosis or for purposes of treatment, do not constitute a very large or important part of the work which the general practitioner will be called upon to perform, and in the education of the student this fact should not be lost sight of. Some excellent advice is given on the use of the galvanometer, and the means by which fallacies in diagnosis may be avoided, and the sections on galvanisation and faradisation furnish admirable and clear descriptions of their respective subjects. In an Appendix, the use of electrolysis in the treatment of nævi, port-wine stains, cancerous and fibrous tumours, cystic growths, and enlarged glands, is spoken of with much favour, one of its chief recommendations being that there is no cicatrisation after the removal of any such diseased condition by this method. In conclusion, we would say that the volume before us is an evidence that its author has had a large experience, and has used that experience well. With these valuable works, as well as the translations of Duchenne's book, and Dr. Hughes Bennett's less pretentious, but, nevertheless, useful volume to choose from, the student of the present day has every opportunity of mastering the principles and practice of this branch of the healing art.

A Manual of Psychological Medicine and Allied Nervous Diseases; by EDWARD C. MANN, M.D. Demy 8vo., pp. 691. Illustrated. J. & A. Churchill, 1883.-The modesty, fairness, and gentlemanly spirit with which Dr. Mann writes, are so pleasing and are in such striking contrast with the tone of other books on psychological subjects that we have recently had to review in these columns, as to produce a very favourable predisposition towards him and his book. The latter is a work of considerable interest and considerable

Dr.

value. It is a most useful book of reference, and one that every student of nervous diseases may consult with advantage. Its merits are due to its mode of construction, which is very peculiar, and indeed altogether unique. Every general nature-general in the sense not of generalisations chapter introduced by a few statements of an extremely but of generalities. They are descriptions in general terms of the empty shell of some individual case, which has been eviscerated of all its concrete contents. The remainder of the chapter is for the most part composed of quotations from different authors. It is in the length and number of these quotations that the peculiarity of the book consists. Mann has evidently read very extensively, but instead of following the prevailing practice of reproducing his predecessors' ideas in his own words, he follows the far better and fairer practice of allowing them to speak for themselves. He collects the writings of the best authorities on each subject, and reproduces them in extenso in their own words, and of course with due acknowledgment. The result is that each chapter is a symposium on the subject of its title. generosity with which he yields up his space to others is quite surprising. In his chapter on the Treatment of Insanity, Dr. Pliny Earle is quoted to the extent of six pages of small type. Dr. Gray, of Utica, occupies eighteen pages and a half, eleven of which are devoted to a reproduction of evidence taken before the English Parliamentary Committee of 1877. Dr. McDonald, of New York, follows with four pages, Dr. Kirkbride with eleven, Dr. Cowles with seven, Dr. Maudsley with two, Dr. Ray with four and a half, and a quotation from the Pall Mall Gazette occupies two more. reprints, while great part of the remainder is made up of More than half the chapter is taken up by these lengthy shorter reproductions. The chapter on Epilepsy is made up of seven pages and a half of original matter, and sixteen of

The

quotations. These reprints, as we may term them, are nearly all valuable, selected with care and judgment, and many of them are taken from sources that are now accessible with difficulty, or not at all. Herein lies the value of the book. Dr. Mann has put himself at a great disadvantage in compelling a comparison between himself and the many eminent men whom he quotes at such length; but even after making great allowances on this score, the part of the book that is written by himself is still open to a good deal of unfavourable criticism, which we would fain have been spared from making: and all the more so since most of the defects that we have to point out might have been avoided by the exercise of a little ordinary care. There is a lack of due proportion in the space and attention devoted to the various subjects. The histology and functions of the entire brain are disposed of in seven pages of a book of seven hundred, devoted to insanity and nervous diseases. On p. 326, the physiology of the corpus striatum is disposed of in three lines, and that of the optic thalamus in two. An entire chapter-not too much-is devoted to General Paralysis, but the etiology of the disease is referred to only in a footnote of three lines and a half. The literary style is bad, often very bad. On p. 88, we read "Her testamentary capacity, although an incurable case of insanity, was perfectly good, and her will perfectly valid. " Again, p. 128," The case just referred to had complained of pains in the head and sleeplessness, which had displayed marked periodicity, and which had been accompanied by great irritability of temper, excited by trifles, &c." Dr. Mann seems unable to make up his mind whether to speak of himself in the singular or the plural; in the event he compromises matters, and speaks as "I" in the text, and as "we" in the footnotes. The numbers of the figures in Plate II, which represent microscopical sections, have got mixed: figures 3 and 5, which are described as sections of brain, being sections of spinal cord. The titles of the figures in the frontispiece, which are photographs of people exemplifying the chief varieties of insanity, appear to have been similarly shuffled. The facial expressions of most of them are not, it is true, in the least characteristic of any form of insanity. The only one which is at all instructive is that labelled "general paralysis," and that is not at all like the face of a general paralytic, but is a tolerably accurate delineation of the expression seen in cases in which chronic melancholia is merging into dementia. Miliary sclerosis is described as a pathological change, no mention being made of the doctrine, now generally accepted, that it is a post-mortem change due to the immersion of the tissue in spirit. Regarded as a compendious work of reference, in which the views of many workers can be consulted in convenient proximity, the book is a success; to judge it as an original work would be unfair, since to originality it makes no pretensions.

Insanity considered in its Medico-Legal Relations; by T. R. BUCKHAM, A.M., M.D. 8vo, pp. 264. Lippincott and Co., Philadelphia, 1883.-The author of this book has brought together the dicta of a large number of judges, both English and American, upon the subject of insanity; and the symposium so constituted contains, perhaps, a greater diversity of opinion and more positive contradictions than could be adduced regarding any other topic whatever. The remainder of the volume consists mainly of a plea for the employment, in trials where the question of insanity is raised, of experts who have a knowledge of the subject; and especially for their employment, not by the prosecution nor the defence, but as amici curia. The argument is somewhat tedious, and much of the reasoning does not apply to the state of things existing in this country. If the author would omit the remainder of the book and republish the collection of judicial dicta in a pamphlet form, he would deserve well of the public.

Poisons: their Effects and Detection. By A. WYNTER BLYTH. London: Chas. Griffin and Co., 1883.-Mr. Wynter Blyth's somewhat bulky treatise on the effects of poisons and their detection is, as might be expected, addressed rather to chemists and analysts than to practitioners or students of medicine. In his classification of poisons, Mr. Blyth has struck out a new line, and after dismissing the

acids and alkalies, discusses poisonous substances capable of being separated by distillation from neutral or acid liquids; he next takes the alkaloids, then poisons derived from living or dead animal substances, then the oxalic acid group, and lastly, inorganic poisons. In his opening chapter, he describes this arrangement as partly chemical and partly symptomatic, and he adopts it on account of its representing, as far as possible, the order in which the chemical expert would search for an unknown poison. Each subject is dealt with in a methodical manner, especial attention being paid to the chemical character and physiological properties of the various substances. One of the most valuable sections of the book is that on the vegetable alkaloids, the methods of separation being expressed in an unusually clear form; and a table of the behaviour of some thirtysix alkaloids, as regards colour, under the influence of certain reagents will doubtless prove useful. The volume concludes with two appendices-one on the examination of blood stains, the other on the immediate steps to be taken in a case of poisoning; and the author winds up with the following aphorism-if any one is known to have taken poison, and yet the precise nature is not known, give a sulphate of zinc or ipecacuanha emetic, and follow it up by the multiple antidote, a mixture containing a saturated solution of sulphate of iron, magnesia, and animal charcoal.

Legal Medicine, Part II.; by CHARLES MEYMOTT TIDY, M.B., F.C.S. London: Smith, Elder and Co., 1883.—The chief subjects dealt with in this volume are pregnancy, abortion, live birth, infanticide, drowning, hanging, strangu lation, and suffocation. The great importance of this group, from a forensic point of view, will be conceded by all; indeed there are, probably, no questions in the whole range of medical practice which raise such difficult points as those respecting live birth. The general plan of the former volume is closely followed out in this one, and the manner in which Dr. Tidy has collected facts from all parts of the world, and extending over a considerable range of time, is worthy of the highest praise. As we noticed the first part at some length, we need only say now that this second part fully justifies the high opinion of the work at which we then arrived.

ABSTRACTS AND EXTRACTS.

PHARMACOLOGY AND THERAPEUTICS.

TRANSFUSION OF BLOOD IN ALBUMINURIA.-The Gazette Hebdomadaire for January 18th publishes what it regards as a very important paper, bearing this title, read by Dr. Dieulafoy, of the St. Antoine Hospital, at the Hospital Medical Society. He first draws attention to the remarkable fact that the lives of persons dying from hemorrhage have often been saved by the injection of so trifling an amount of blood as 100 or 150 grammes; and he relates a case in point, in which a person dying of an epistaxis which resisted every measure resorted to during 20 days, was at once rescued from danger by the transfusion of 120 grammes of healthy blood. Such a case as this, however, differs from those cases of traumatic hemorrhage (consecutive to operations or to delivery) in which the cause is purely accidental, for it is brought about and maintained by an altered condition of the blood, of an ill-defined nature, termed for want of a better name haemophilia-a dyscrasic condition in which perhaps the structure of the small vessels is at fault, but in which the blood certainly is no longer possessed of its normal properties. Life has been saved by transfusion in several cases of this kind, not merely because the blood supplies an additional amount of fuel to an expiring lamp, but because it plays the part of an agent which is to some extent hæmostatic. The addition of so small a quantity of healthy blood serves to modify advantageously the com position and fabrication of the blood that seems to have lost its principal qualities. "In such a case," Dr. Dieulafo, y observes, "the infused blood acts, I repeat, as a hæmostat ic agent. It is a powerful modifier, rapidly transferring a

dyscrasic condition of long date by a special action, the mechanism of which is as yet but ill-known, but with a result well calculated to attract attention. All the importance of these facts, which seem to me to dominate the history of transfusion, has not yet been sufficiently brought out. A closer investigation of them has led me to ask, like many others for that matter, whether there is not reason for the applications of transfusion to some dyscrasic conditions in which alterations in the blood seem to play an important part. May not dyscrasic hæmorrhages, uræmia, and Bright's disease, diabetes, and acetonæmia, the paroxysm of gout and rheumatism, derive benefit from this modifying agent, the effects of which we are as yet ignorant of, because they have not been sufficiently investigated? In order to render an extended theraputic application of transfusion possible, Dr. Dieulafoy has contrived an apparatus, which he believes wiil much simplify and facilitate its application. An illustrated description of it, as laid before the Académie de Médecine, is contained in the same number of the Gazette Hebdomadaire. In the present paper he relates three cases of Bright's disease in which transfusion was performed; but he admits that nothing conclusive can be decided from them. They however establish the innocuity with which injections of 120 grammes of blood may be performed, even in the later stages of Bright's disease; and also the temporary amelioration that may be obtained, even when the lesions are of the most

formidable character.

QUEBRACHO IN ASTHMA.-Professor Da Costa has had some very satisfactory results from the treatment of dyspnoea by quebracho. In a recent lecture he said that in his experience it had been especially serviceable in two classes of cases. 1. In purely nervous asthma he had found it to be invaluable. 2. In cases which have been rather loosely called cardiac asthma, cases in which a heart lesion has produced failure of cardiac contraction and consequent congestion of the lungs, he had also known it to be very useful. It may serve as a cardiac tonic, or may do good solely by its action on the respiratory centre in the medulla. Whatever be the explanation, however, quebracho gives relief in appropriate cases. Dr. Da Costa gives it in the form of the fluid extract in doses of twenty minims every hour, gradually increasing the amount, some patients requiring as much as a drachm before relief is obtained. The good effects are usually observed after two or three doses have been taken. The taste is well covered by using equal quantities of French syrup of red oranges and water as the vehicle, and in this form it usually agrees with the stomach. As the symptoms are relieved, the remedy maybe given at longer intervals.-Boston Medical Journal, December 27th.

ALUM IN HEMATURIA.-A case of severe hemorrhage from the kidney successfully treated by an unusual remedy, is recorded by Dr. J. S. Radcliffe, in the Philadelphia Medical News for January 12, 1884. The cause of the hæmaturia is left an open question. It is stated that the patient, a lady aged twenty-five, had suffered from malarial disorders, and that there was a family history of heart disease and rheumatic fever. At the time of the attack, however, the temperature was but slightly raised, and the heart sounds were normal. Although the hæmaturia came on suddenly, with paroxysmal pain in the right lumbar region and with nausea, it is curious to note that the urine remained bloody for nearly three weeks. During this time, almost all the astringents were tried with no beneficial effect. The patient was first given gallic acid alone, then in various combinations, the acid with quinine, with ergot, with sulphuric acid, with opium. She also took tannic acid, sugar of lead and opium, fluid extract of ergot, infusion of buchu and matico, muriated tincture of iron, and with this quinine; extract of logwood, and extract of hamamelis. employed internally and externally, and counter irritation, by sinapisms and blisters, was used. The hamamelis appeared to lessen the hæmorrhage slightly, but for the rest, Dr. Radcliffe says "it appeared as if I might as well have given her so much cold water. Rockbridge water was then used on theoretical grounds, champagne-glassful

Ice was

draughts being taken every three hours. Beneficial effects were manifested with the third dose, and on the fourth day the urine was free from blood corpuscles, and on the sixth day it was normal in colour, quantity and quality. It merely remains to add that the Rockbridge alum water appears, from an analysis appended to this paper, to be remarkably rich in aluminium sulphate, and to contain very appreciable quantities of calcium and magnesium sulphates, free sulphuric acid and cilicic acid. It is said to have been employed with benefit in chronic discharges, such as diarrhoea and bronchorrhoea.

ADMINISTRATION OF SALICYLIC ACID. The apyretic effect of salicylic acid is one of the most remarkable and important therapeutical discoveries of our age, and its control over all such conditions as are generally met with in acute and subacute rheumatism is almost complete. Its applications, therefore, in medicine are very numerous and very important. In its internal use, the points necessary to be borne in mind are the disturbing effects of very large doses, and the rapidity with which it is eliminated. It should, therefore, be given in full doses at first until the impression is made, and then in moderate or small doses, frequently repeated. It is best given in wafers or cachets, and it should not be packed in capsules. Two or three doses of fifteen to twenty grains, with two or three hours intervals, will usually produce its characteristic beneficial effects. Then ten grains every two hours, with intervals, gradually increasing to three and four hours, will serve to keep up the effects with the smallest risk of such disturbance as will require it to be suspended when most needed. Of late it has been more rarely used, the salicylate of sodium having taken its place with the same effect, and with some advantages. It is a curious and very important circumstance, that full doses of the acid or salicylate do not interfere with the digestive functions of the stomach, and yet a very small quantity will prevent the action of pepsin. At least this statement is made on what appears to be very good authority. An ordinary cold saturated solution contains somewhat about one part in 300; and such a solution is very convenient as a vehicle of solutions of alkaloids for hypodermic use. If a dram of the acid be added to a pint of water and the mixture well shaken, such a solution, with some undissolved acid at the bottom of the bottle, will be the result. Then, if this be used entire, or diluted with an equal portion of water, for making hypodermic injections, such a solution will remain free from growths of all kinds for an indefinite length of time, and will not be more irritant than when made from water alone.--Squibbs' Ephemeris.

RESORCIN IN PERTUSSIS.—Another remedy has to be added to the hundreds already known for pertussis. Dr. Moncorvo, of Rio Janeiro, in a communication to the Paris Socitété de Médecine, fully believing in the parasitic origin of pertussis, recommends the employment of an aqueous solution of resorcin (one per cent.) carried by means of a soft pencil with a long handle to the superior orifice of the glottis. Resorcin is more soluble, less irritating, and much less odorous than carbolic acid. He has applied the remedy in 30 cases every two hours during the day-time, and in all of these recovery was rapid.—Turin Méd., February 5th.

DISGUISING THE SMELL OF IODOFORM. Dr. Leidy, writing in the Philadelphia Medical Times, December 15th, observes that the best substance that he has met with for disguising the odour of iodoform is oil of citronella, which, unlike many substances employed for this purpose, has the further advantage of being very cheap. Two drops to a drachm are sufficient. It may also be added to cod-liver oil for the same purpose, when this is used externally. The citronella oil itself, when used externally, is a rubefacient and anodyne, and may be employed either alone or in combination.

SALICYLIC ACID PASTE IN ECZEMA.-Dr. Van Harlingen recommends the following:--Acid. Salicyl. gr. xv., Petroleol. 3iv., Pulv. Zinci Oxidi, Pulv. amyli, aa 3ii. Rub up into a smooth paste.-Philadelphia Med. Times, December 15th.