35

stress on the enormous infantile mortality, which was

greater than it was 60 years ago. He mentioned threesocieties which in different ways tried to remedy this con-dition of affairs-(l) the National League for PhysicalEducation and Improvement ; (2) the National ServiceLeague; and (3) the Society for Housing of the WorkingClasses.-Owing to the lateness of the hour the discussiononDr. Thomas’s paper was deferred to the next meeting.

Reviews and Notices of Books.Sa;nitall’1f Laws of Scotland and Principles of Public Health.

By W. J. BROCK, D.Sc., M.B. Edin., F.R.S.Edin., &c.,Medical Officer of Health of Midlothian, &c. Londonand Edinburgh : Oliver and Boyd. Small 8vo, pp. 480.Price 7s. 6d.

THIS little volume is handsomely bound in flexible red

leather, gilt-edged, and well printed, though the type of allbut 120 pages is so small as rather to strain the reader’s eyes,in gas light especially, the paper being, in order to keep thevolume in small bulk, so thin as to be a little too transparent-which means, after all, that we cannot have large type andthick paper combined with small bulk and full contents.The work includes, verbatim or in abstract, all the statutesrelating to public health which apply to Scotland, even

though they are not confined to that country-such as theRivers Pollution Prevention Acts, the Factory Acts, the Saleof Food and Drugs Acts, and the Housing of the WorkingClasses Acts. Most are given only in abstract, the mainexception naturally being Scotland’s Magna Charta of

public health, the Act of 1897. Following the Acts them-selves there is in an appendix a reprint of official circulars andOrders relating to them, on the same lines as those of a littlevolume issued by the Scottish Local Government Board. In

other appendices vital statistics, food, water, air, and venti-lation are dealt with ; in another a synopsis is given of therequirements of the Scottish Conjoint Colleges ExaminingBoard for the diploma in public health and a syllabus ofrequirements for sanitary inspectors’ certificates ; and stillanother appendix gives a digest of decisions on the sanitarylaws. The scheme of the book is therefore good and mostof it has been well carried out.

In some respects, however, the work is open to criticism.Concerning preventive measures in infectious diseases, atten-tion is quite properly given to the value of hospital isolationof scarlet fever and the author states that he will quoteextracts from writers who have recently given their viewson the subject. All the writers quoted, however, are thoseRho can be ranked as doubting or denying the value of suchisolation and not a word is quoted on the’ other side.Statistics for Edinburgh are given which are interestingand, so far as they go, support the view that hospital isolationis useful, which is evidently not what the author himselftbinks, but he is quite right to doubt deductions from thefigures of only a limited period. Regarding the Edinburghfigures, it would have been convenient had explanation beengiven of such facts as that in the year 1896 there were 2185notified cases, of which 1703 were removed to hospital,while in 1897 the cases were 2597 and only 748 went tohospital, and of the still more remarkable fact that in

1904 the number of cases treated in hospital considerablyexceeded the total number notified. Regarding disinfection,it is stated at p. 323 that corrosive sublimate solution (1 partto 1000 parts of water) should have added to it 10 percent. of chloride of sodium, but on the next page it is morereasonably stated as 10 parts, not 10 per cent. In usingthe same solution for a disinfecting spray it is recommendedthat 10 per cent. of alcohol should be added. As to vaccina-

tion, the author does not appear to know that we in Englandhave since 1897 had the compulsory age fixed at six months

as in his own country. Wakley, not Wakely, was a coronerfor Middlesex, and Russell, not Russel, was member of theLocal Government Board in Scotland. Virchow’s researches

relating to typhoid fever in Hamburg are spoken of but itis not said where a record of these researches is to be found.Here and there, indeed, the writing is a little careless. The

book contains a great deal of useful information regardingvital statistics, air and ventilation, food, drinking water,and so on, and the digest of decisions on the sanitary lawswill be found valuable. Also there is an excellent index.

Hygiene. By J. LANE NOTTER, M.A., M.D. Dub., Chairmanof Council and Examiner to the Royal Sanitary Institute ;Examiner in Public Health to the Universities of Cam-bridge, Manchester, and Liverpool ; Honorary Memberof the Hungarian Society of Public Health, &c. ; andR. H. FIRTH, Lieutenant-Colonel, Royal Army MedicalCorps ; Professor of Hygiene in the Royal Army MedicalCollege ; Member of the Council and Examiner tothe Royal Sanitary Institute. Sixth edition. London,New York, and Bombay : Longmans, Green, and Co.1905. Pp. 491. Price 4s. 6d.

So to write a work of this nature as to adapt it to therequirements of both professional and non-professionalreaders is a more serious undertaking than appears at firstsight or is generally believed. Setting aside the number andvariety of scientific subjects which fall within its scope, itis no easy task to determine what to omit and what to

include in order to give the general but appreciative readersound, intelligent, and untechnical knowledge of the factsand principles underlying the many-sided subject of hygieneon the one hand, while maintaining its scientific character

sufficiently to fit it to take its proper place in a series ofscientific manuals intended for more advanced students,on the other hand. It is but natural in such circum-stances for the reader to turn to the scientific acquire-ments and reputation of those undertaking it as evidenceof their competence to do so and to the measure of successwhich has followed their attempt. In these respects thereis no room for misgiving in the present case. The namesand recognised position of the authors are a sufficient

guarantee of their competence and the fact that this isthe sixth edition of their work (the first was published in1894) sufficiently proves the success of it. It is mainly withthe general laws and principles of hygiene and with thereasons which have led up to the establishment of theserather than with the enumeration of a number of detailsthat the authors have very properly concerned themselves.But such facts and details as have any direct bearing or areillustrative of any point under discussion have not by anymeans been ignored or neglected. It is surprising, indeed,what an amount of relevant and readable information is

comprised in some 490 pages of which the volume consists.We have gone through these and in doing so had markedmany of them for reference and comment but it is not easy,nor is there any need, to do this in the space at our disposal.We have already said enough to indicate our opinion of

the nature and the value of the book. The present editionhas been partly re-written and otherwise added to and

revised. We may especially direct the reader’s attentionto the sections devoted to air, water and its chemical

analysis and bacteriological examination, the ultimate dis-

posal of refuse and excreta (remarks on land treatmentand biological methods), and to Chapter VII., on infectionand disinfection. In this chapter the subject of infectiousdiseases and infection in connexion with the micro-organismsof modern bacteriological researches and the existing viewsregarding immunity to disease are well and succinctly setforth. It would be hopeless to attempt to keep pace alto-gether with the almost daily developments and advances inpractical science, nor is it the object of a book of this kindto do so. But it is only right to add that the authors of

36

this manual, which contains many useful formulas and

diagrams, seem to have spared no pains to bring it up todate and to make it a trustworthy and valuable guide forall and an excellent introduction in particular for those whointend to enter on a more extended course of study andwork in this direction.

Handboo7z of Physiology for Students and Practitioners ofMedicine. By AUSTIN FLINT, M.D., LL.D., Professor ofPhysiology in Cornell University Medical College. With247 illustrations and 16 coloured plates on Histology.New York: The Macmillan Company. 1905. Pp. 877.Price 21s. net.

Dr. Flint’s name is well known as the author of severalbooks on physiology. He has taught the subject since 1858and this work represents his teaching as given at present inthe Cornell University Medical Collfge. Candidly, we donot think that it will "hold the field" in this countryagainst other better and well-known text-books. There isa kind of feeling on reading it that reminds us of the oldpractice-condemned on high authority as unsatisfactory-viz., putting new cloth on old garments. It contains a gooddeal of what used to be called " physiological anatomy," alarge number of the illustrations being from Sappey andHirschfeld. This the author regards as a necessity for hisstudents. Descriptions and " illustrations of instruments andapparatus are omitted." Of the physiology of nerve andmuscle there is but little. The Atlas of Histology consists of16 plates in colour, some of which are taken from Sobotta’sAtlas ; the others have been reproduced by the three-colourphotographic process from actual specimens, and to theseare added a few from Wilson’s " Atlas."To the account of the blood about 14 pages are given.

There are no diagrams of its spectroscopic characters,while in the composition of blood plasma the carbonic

dioxide is given as in solution. Moreover, peptones are

said to exist in it to the amount of 4 per 1000. In dealingwith the cause of cardiac rhythm one ganglion of the frog’sheart is described as placed between the left auricle andthe right ventricle" (p. 45). We are told that reflex arrestof the heart can be produced by stimulation of the cervicalsympathetic. There are no tracings of blood pressure, of

respiratory movements, or muscle curves ; indeed, the directresults of the graphic method have practically no representa-tion. There are but two or three " curves " of any kind in

the book and these are pulse tracings, including an obsoleteone by Vierordt. At the present time it seems odd to producea text-book on physiology and one illustrated by such a largenumber of figures, and yet that no space is found for blood-pressure tracings and other graphic records.The salivary glands are described as of the racemose

variety. We do not find an account of the fundamental

experiments of Ludwig on the secretion of saliva. The

products of gastric digestion are described in very generalterms. Enterokinase can hardly be called a true proteidferment." As to the recent work on intestinal movements,it finds no place. Each chapter is introduced by a discourseon the physiological anatomy of the organ with which it

deals, and this subject, it seems to us, is far too prominent,though it is possibly necessary for the students of CornellCollege. No doubt it is helpful, but much space is

taken up that might be devoted to physiology proper.The cranial nerves are fully illustrated and their functionsdescribed, about 50 pages being devoted to this subject,while their functions are also illustrated by references toclinical cases. About 20 pages suffice for the spinal cord.The diagrams given to show the motor and other corticalareas hardly correspond with our most recent knowledge onthis subject. As to the sympathetic system, its treatment ismore anatomical than physiological and we failed to

find an accoui.t of the use of nicotine in connexion with

" cell stations." Here is a curious statement : When the

f-ympathetic filaments distributed to a gland are divided thesupply of blood is much increased and an abundant flow ofthe secretion follows (Bernard)," (p. 613).A rather long chapter is devoted to embryology and it is

illustrated by a number of figures, anatomical and histo-logical. As a whole the work seems to us to deal with

physiology more on anatomical than true physiological lines.No doubt here and there reference is made to certain modern

advances but other advances of equal importance are con-spicuous by their absence.As to the " Atlas," there is a note on the technique of

photomicrography in colours by Dr. Leaming, stating howthe results are obtained. The author states that he is

"particularly fortunate in certain objects for reproduction."The section of the stomach showing peptic cells and acidcells he believes to be unique. We do not share his opinionif he means by unique-unique in its excellence.

A Text-book of Clinical Diagnosis by Laboratory Methods.By L. NAPOLEON BOSTON, M.D., Director of ’he ClinicalLaboratories, Medico-Chirurgical College, Philadelphia.Second edition, with 330 illustrations. London and

Philadelphia : W. B. Saunders and Co. 1905. Pp. 563.Price 18s. net.

IN February last we reviewed the first edition of thiswork and our forecast as to its merits and usefulnes hasbeen fully justified, for the author was called upon to preparea revision of his book tight months after its publication.Slight changes have been made aLd 17 pages of new matterhave been added at the end covering the more imp-rtantadvances, or at least what are claimed as advances, such asBiff’s new basmoglobinometer, Ficker’s reaction on the

clumping of dead typhoid baci li, Ravold’s combined heatand contact test for albumin, Cammidge’s test for glycerinein the urine, and Cipollino’s test (December, 1904) fcr

hydrochloric acid in the gastric contents. Where there is a

multitude of tests it rather points to the supposed unsatis-factory nature of the old standards. Most of the new

advances require careful control. This, of course, can be

done by the wide publicity given to them by such a workas the present. We have got reconciled to the use of theword "centrifuge," but now we are presented with "tor-fugation," a centrifugal method depending upon the revolu-tion of a tube-containing bar upon a twisted cord, withwhich a speed of 5000 revolutions a minute may be obtained,and it is, of course, an easy stage to a "torkrit."

" In other

respects the work is substantially unchanged. The printand illustrations are excellent. The work will prove a mineof reference for the busy practitioner and at the same timeit will give him a broad view of the great strides which are

being made almost daily in clinical diagnostic methods.

A .i1Iantwl of Surgery for Students and Praetit’ioners. ByWILLIAM ROSE, M.B., B.S.Lond., ]’.R.C.S. Eng.,Emeritus Professor of Surgery in King’s College,London, and formerly Senior Surgeon to King’s CollegeHospital ; and ALBERT CARLESS, M.S. Lond., F.R.C.S.Eng., Professor of Surgery in King’s College, andSurgeon to King’s College Hospital, London ; Exa-miner in Surgery to the Victoria University of Man-chester, and to the Universities of Liverpool and Leeds.Sixth edition. London: Bailliere, Tindall, and Cox.1905. Pp. 1350. Price, cloth, 21s. ; flexible leather,25s. net.

WE have on many previous occasions spoken highly of thiswork and the appearance of this the sixth edition merelyrequires that we should mention the chief changes whichhave been made. Modern surgical technique has had achapter devoted to it, several chapters have been rearranged,and a new chapter has been written on the surgical aspectsof gyna3cology. The value of the x rays in diagnosis

37

and treatment has received due recognition. Much of the

pathological portion of the book has been rewritten by Dr.W. D’Este Emery, clinical pathologist to King’s CollegeHospital. The book now contains 200 more pages thanwere inTthe previous edition, though the adoption of anexcellent, thin, but opaque pJge has made the volume lessbulky than’it was. We hope the authors will guard againstthe very natural tendency to enlarge a book at every edition.We ’commend this issue to the attention of the student as

heartily-as we commended previous editions.

LIBRARY TABLE.

A St1bdy in N1irsi’l1g. By Miss A. L. PRINGLE, formerlyMatron of St. Thomas’s Hospital. London : Macmillan and

Company. 1905. Pp. 98. Price 1s. net.-This little book

isnot intended to teach nursing in detail. It is a retrospectof a nurse’s work which will be a useful study for her

juniors. Miss Pringle says that the lessons of manymasters are so mingled in these pages with the teachings ofexperience] that she cannot always distinguish the source ofwhat she has written. At any rate the book containsmuch sound advice. The headings of the chapters indi-

cate the scope of the little work; they are : 1. What is

Nursing? And who should be Nurses. 2. A Glance at the

Beginning of the Present System of Nursing. 3 Fields

of Nursing. 4. Organisation of the Nursing Staff in a

Large Hospital: The Matron’s Duties. 5. The HospitalStaff: Ward Sisters and Nurses. 6. The Night Service.7. The Domestic Staff. 8. The Probationer’s Training.9. The Patient’s Bed: The Linen Store. 10. A Study of aNursing Staff in a Poor-Law Infirmary. Miss Pringle quotesDr. Worcester’s definition of nursing; it is one worthyof remembrance. He says: "The profession of nurbinglike that of medicine is an art dependent on science;

’

but in nursing, important as is the underlying science,the art must always predominate." The tone through-out the book is excellent. The ideal person to make a

good nurse is shadowed forth in the following paragraph:"The ministering angel must have her wings tied under abig apron! The least reflection shows that there must belabour and drudgery in the task of nursing ; that it involves

some offices that are strongly disagreeable and some of adelicate nature ; and that there will be exercises for a fine

intelligence and deft hands. We must start with the

-sincere desire to serve and the resolution to bear what is

trying so quietly and cheerfully that our sick shall not knowwhat it costs us. We shall need that true refinement which

treats delicate matters simply and delicately. Sympathyand good sense must go together in their observations andactions, and the cool, soft hand must be at once tender, firm,and skilful" No nurse can read this little book without

finding much to charm and to cheer her, or without

improving her knowledge.With the Abyssinians Ú/, Somalila’l1d. By Major J. WILLES

JENNINGS, D.S.O., R.A.M.C., P.M.O. of the Force, andCHRISTOPHER ADDISON, M.D. Lond., F.R C.S. Eng., Lectureron Anatomy, Charing Cross Hospital Medical School, whoarranged the matter for publication. With a Preface byColonel A. N. ROCHFORT, C.B., C.M.G., R.A. London :Hodder and Stoughton. 1905. Pp. 265.-This volume

embodies a diary kept by Major Jennings during the

expedition against the Mullah in which the EmperorMenelik undertook to assist by operations in AbyssinianSomaliland. Colonel Rochfort was associated with the

Emperor’s troops and on this occasion was providedwith a small staff. The Emperor requested the servicesof two British medical officers. Major Jennings was

selected as the senior. The operations in the fieldare well described and the information which hehas collected concerning the customs, religions, charac-

teristics, and folk-lore of the Abyssinians will interest

the general reader. Major Jennings, who had served forsome years in the Egyptian Army, sailed from England inOctober, 1903, and returned to London on April 28th

following. In writing of medical matters among the

Abyssinians, he draws attention to the prevalence of

leprosy and to the enormous number of persons whosuffer from a cestode parasite which inhabits the in-

testinal tract and which, he says, is no doubt chiefly intro-duced in the half-cooked or raw beef that is so mucheaten. Rheumatism, minor intestinal disorders, inflam-mation of the eyes and of the outer ear passages,and hysteria in women are common disorders. Dysen-tery is extremely rare and malaria is scarcely known inthe highlands, though it prevails in the low countries.There are no general medical practitioners in Abyssinia.Each physician is a specialist but the list of his remedies isbut a small one. The book is very suitably illustrated with65 pictures from photographs taken by Major Jennings andby a map of the route which he traversed. The volume is

very good reading and the portions given up to reminiscencesof big game shooting and other forms of sport are attractive.The medical aspect of the book is a comparatively small onebut the whole work is of considerable interest.

Landmarks and surface lIIa1’kin.qs of the I11lrnan Body.By Louis BATHE PAWLING, M.B., B.C. Cantab., F.R C.S.

Eng., Assistant Surgeon, Senior Demonstrator of Anatomy,and Demonstrator of Practical Surgery at St. Bartholomew’s

Hospital ; late Assistant Surgeon to the German Hospital,Dalston ; late Hunterian Professor, Royal College of

Surgeons of England, &c. With 31 illustrations. Secondedition. London: H. K. Lewis. 1905. Pp. 96. Price 5s.net.-We congratulate the author on the appearance of asecond edition of this work within 12 months. Opportunityhas been taken of making numerous alterations and additionsin the text and the illustrations have been revised and somenew ones added. The surface markings of the cerebrum andlateral sinus, which we had occasion to criticise in the formeredition, are now given with greater accuracy, and we noticealso that Fig. 18 has been modified to show more clearlythe position of the colon. The book is certainly improved inmany ways and forms a concise and luc’d guide to the sub-ject of which it treats.

71 hitccker’s Alnianack for 1906. By JOSEPH WHITAKER,F.S.A. Pp. 792. Price 2s. 6d. net. Wltitaker’s Peerage for1906. Pp. 724. London: J. Whitaker and Sons.-The

thirty-eighth issue of that incomparable work, Whitaker’sAlmanack, reminds us of the remark which Cromwell wrotein his Bible: "Qui cessat esse melior, cessat esse bonus,"for we think that it is better than ever. Not but thatwe miss some of the articles which have been eliminatedin order to make room for others, still that is merely per-sonal predilection. There is hardly any subject uponwhich the average man can desire information which hewill not find treated of in the work under review, althoughthe recent changes in the Ministry are of course not

included for the very good reason that the Almanack waspublished in the month of November. But "Whitaker" "

continues to be a book which everyone must have at

hand. "Whitaker’s Peerage," which is also a Baronetage,Knightage, and " Companionage, is singularly compact andis full of useful information. In addition to the body of thebook the introductions deal with various points concerningthe Sovereign, the Regalia, the Peerage and its degrees,peers outside the House of Peers, and the vexed question asto whether or not a bishop is always to be called the LordBishop. The book is an admirable complement to the

Almanack.

Hcc:ll’s Annual for 1906. London : Hazell, Watson, andViney. Pp. 640. Price 3s. 6d. net.-"Hazell’s Annual" "

differs from other books of reference which appear at theclose of a year in that it is in great part retrospective, while