1141

Wounds. In one the wound had been caused by the excisionof a large part of the skin c. f the thigh on account of numeroussmall sarcomatous growths and the other was due to anaccident. In each case it had been found that whilst

epithelial grafts give rapidly a covering layer to the granula-tions this covering is thin and nothing like so permanentlyvaluable as that provided by whole-skin grafts. Photographsrepresenting the various stages of the healing process wereexhibited.

Dr. NEWMAN showed specimens from a case of MalignantDisease of the (Esophagus which had terminated fatallyin consequence of the ulcerative process extending intothe aorta. The stricture had been recognised during’life, the growth not only producing dysphagia, but also

paralysis of the left vocal cord. Gastrostomy was success-fully performed and for fourteen days progress was quitesatisfactory. Then blood began to pass from the opening inthe stomach and in the end death occurred suddenly from asevere haemorrhage. The opening into the aorta was

situated in the descending arch.-Dr. HAWTHORNE, in dis-cussing the case, referred to the rarity of the mode of deathin malignant disease of the oesophagus, and directed atten-tion to a very similar case under the care of Dr. Frederick

Taylor, reported in THE LANCET of April llth 1896, p. 991.

ROYAL ACADEMY OF MEDICINE INIRELAND.

t

SECTION OF SURGERY. V

The Radical Cure of Inguinal Hernia.-Restoration of a

the Nose. ]A MEETING of this section was held on March 20th, Sir W. (

THORNLEY STOKER, President. being in the chair. Mr. HEUSTON read a paper on the Radical Cure of Inguinal

Hernia, in the course of which he said that as hernia gave (rise to a general weakening of the fascia transversalis in the (inguinal region it was necessary in any operation aiming atradical cure to support and strengthen this fascia, and themost frequent cause of recurrence after some of the recentoperations was neglect of this point. He then mentioned someof the operations now generally recommended, dividing theminto those where the inguinal canal is not opened and thosewhere the inguinal canal is opened; the results of thesecond variety were very good as it was possible to see whichstructure required most attention, but he feared that after atime recurrerce’would be likely to occur through absorptionof cicatricial tissue. He then described an operation whichhe had himself performed on thirty-two occasions, thepatients varying in age between eighteen months and fifty-two year’!; all of the patients recovered, and, as far as hecould ascertain, the hernia had not recurred in any. This

operation consisted in exposing the inguinal canal, separatingthe sac from the cord to its full extent twisting the neck ofthe sac and ligaturing it by a Stafforclshir knot with stronggut at its exit from the external abdominal ring, thEn

suturing the twisted neck of the sac to the postejior andsuperior walls of the canal in such a manner as to approxi-mate those walls and cause the twisted sac to bacome unitedto the posterior wall and fascia transversalis, thus hinderinga recurrence through any portion of the posterior wall of theinguinal canal. He uses catgut sutures throughout theoperation, and depends on inflammatory adhesions to hinderrecurrence.

Mr. ROBERT H. WOODS read a paper on a Modification of the Indian Operation for Restoration of the Nose. The Ipatient, a female aged twenty-nine years, had had the cartilaginous nose destroyed by lupus. The forehead flapwas cut according to Dieffenbach’s pattern. The skin fromthe bridge of the nose was detached and reflected downwardsso that the raw surface looked forwards and the skin back-wards towards the na-al cavity, the raw surfa .ce of thistriangle was adapted to that of the forehead fl :), and soformed a portion of the skin lining the new nose The liningwas completed by the flaps inverted to form the alas, so thatthe whola new nose was lined with skin, and the tendency tocontraction which is always present where a surface is left togranalate and cicatrise was obviated. The forehead surfacewas not sutured but wa covered by a flap 0" skin, transplantedfrom the arm as in Wolfe’s method. This iiap perfectlycovered the deficiency ; it was absolutely wanting in sensi-bility. There was no secretion from the nose.

Reviews and Notices of Books.Dictionary of National Biography. Vol. XLVI. Pocock-

Puckering. Edited by SIDNEY LEE. London: Smith,Elder, and Co. 1896. Price 15s.

THIS volume contains upwards of 450 articles, the mostnoteworthy of which are probably those on Alexander Popeand Joseph Priestley. Mr. Leslie Stephen, to whom we areindebted for the biography of Pope, says of him that "hehad qualities which would have enabled him to give anadequate embodiment in verse of the spirit of any generationinto which he had been born. He might have rivalledChaucer in one century and Wordsworth in another." The

poet was a remarkable example of the association of greatmental endowments with bodily infirmity, being of weaklyconstitution, greatly deformed, and only about four anda half feet in stature. He was born in Lombard-street in the City of London in 1688, died in 1744,

and was buried in Twickenham Church. The versa-

tility of Priestley’s genius is sufficiently attested by

the fact that the writing of his biography has beendivided between two authors-Mr. Hartog undertaking thescientific and the Rev. Alexander Gordon the theological andpolitical survey of his work. His discovery of oxygen gaswas made on Aug. lst, 1774, and was first publiclyannounced in a letter to Sir John Pringle dated March 15th,1775. Scheele made the same discovery independently, butdid not publish his results until a later date. Priestley alsowas the first to prepare seven other gases-namely, hydro-chloric acid gas, nitric oxide, nitrous oxide, ammonia gas,carbonic oxide, sulphur dioxide, and silicon tetrafluoride.He and Professor Rutherford of Edinburgh simultaneouslyand independently discovered nitrogen in 1772. Priestleywas born in Yorkshire in 1733, went to America in 1794, anddied in 1804 at Northumberland in Pennsylvania.The medical biographies are about twenty-four in number.

Sir Francis Prujean was born at Bury St. Edmunds in 1593and graduated as M.D. at Cambridge University in 1625.He was elected a Fellow of the Royal College of Physiciansof London in 1626, was censor for several years, registrarfrom 1641 to 1647, president from 1650 to 1654. and treasurerfrom 1655 to 1663. He was knighted in 1661 and died in.1666. Prujean-square, a small passage leading off the Old’Bailey, is named after him. Richard Powell was bon in<

1767, and graduated as M.D. at Oxford University in 1795.He was elected a Fellow of the Royal College of Physicians ofLondon in 1796, was censor for several years, Gulstonian-Lecturer in 1799, Harveian Orator in 1808, and LumleianLecturer from 1811 to 1822. In his Gulstonian lectures hementioned the fact, up to that time unrecorded in this

country, that impaction of biliary calculi in the gall-bladderdoes not necessarily cause serious symptoms. Dr. Powellwas physician to St. Bartholomew’s Hospital from

1801 to 1824 and was the first to print the whole text of theancient charter granted to the hospital in the year 1137.He died in 1834. Sir John Pringle was the youngest.son of a Roxburghshire baronet and was born in 1707.He studied medicine at Leyden, where he graduated)as M.D. in 1730, and after some years of practice in

Edinburgh he received in 1742 a hospital appointmentwith the British forces in Flanders. In 1744 he was made

physician-general to the forces there, and in 1745 was present.with the Duke of Cumberland at the battle of Culloden in

Scotland, subsequently returning for two years to the armyserving on the Continent. About 1748 he settled in London,still holding his appointment of physician to the forces, and-rapidly attained professional distinction, being made phy-.sician to the Duke of Cumberland in 1749, to the Queen in -1761, and to the King in 1774. In 1763 he was elected a.,

1142

Fellow of the Royal College of Physicians of London, in 1766he was created a baronet, and in 1772 he becamePresident of the Royal Society. He died in Londonin 1782. Pringle’s writings and practical work did muchfor the advancement of military hygiene ; his biographer(Dr. J. F. Payne) says that "he may fairly be regarded asthe founder of modern military medicine in distinction fromsurgery." Percivall Pott was born in Threadneedle-streetin 1714, and was admitted into the freedom of the Barber-Surgeons’ Company in 1736. The union of the Surgeons andBarbers came to an end in 1745, and in 1753 Pott and JohnHunter were elected the first Lecturers on Anatomy to thenewly-formed Corporation of Surgeons. He became AssistantSurgeon to St. Bartholomew’s Hospital in 1744, and was fullSurgeon from 1749 to 1787, during which long period of activeservice he made many improvements in practical surgery.He was also the author of many celebrated treatises, thechief of which are those on Ruptures, on Fistula in Ano, onInjuries of the Head, on Fractures and Dislocations, on Cur-vature of the Spine with Palsy of the Lower Limbs, and his"Chirurgical Observations." The term Pott’s fracture"

originated in his having himself sustained that injury in

1756 through being thrown from his horse. His practicewas very large and the lectures delivered by him to thestudents of St. Bartholomew’s Hospital were the most cele-brated in London. He died in 1788. Sir George HornidgePorter was born in Dublin in 1822, being the only son ofMr. William Porter, a distinguished Dublin surgeon, who wasProfessor of Surgery in the Irish College of Surgeons Schoolof Medicine and filled the office of President of the Collegein 1838. Having studied medicine in his native city andbecome a Fellow of the Royal College of Surgeons in Irelandin 1844, he graduated as M.B. at Trinity College, Dublin, in1845 and in 1849 was elected surgeon to the Meath Hospital,in the duties of which appointment he continued to be

actively engaged for the remainder of his life. In 1865he received the degree of M.D. from Trinity College,Dublin; in 1863 he was elected President of the RoyalCollege of Surgeons in Ireland; in 1869 he was appointedsurgeon-in-ordinary to the Queen in Ireland ; in 1883 hewas knighted, and in 1889 he received a baronetcy in

recognition of his distinguished position as a surgeon.His literary work consists of numerous records of

surgical cases and operations published in the periodicalpress. He died in 1895. Sir James Prior was born atLisburn about 1790, entered the Navy in 1810, and becamesurgeon to three of the Royal yachts in 1815. In 1843 hewas created deputy-inspector of hospitals, received knight-hood in 1858, and died at Brighton in 1869. He had a con-siderable literary reputation, having published a memoir ofEdmund Burke, which appeared in 1824 and passed throughseveral editions, as well as some poetical pieces, a life ofOliver Goldsmith, and an edition of Goldsmith’s mis-

cellaneous works. John Postgate was born in Scarboroughin 1820, took the diploma of the Royal College of Surgeonsof England in 1844, settled in practice in Birmingham in1851, became a Fellow of the College of Surgeons in 1857,and acquired a well-deserved prominence by his labours forthe exposure and repression of the adulteration of food.Under his influence nine Bills were introduced into theHouse of Commons by the members for Birmingham.Postgate obtained no public recognition of any kind for hisservices. He was appointed professor of medical jurispru-dence in Queen’s College, Birmingham, in 1860, and died in1881.

____________

Servera.qe and Sewage Disposal. By HENRY ROlHNSO,N,M. Inst. C.E. London : E. and F. N. Spon. 1896. ,

PROFESSOR Roi3iNso-N-s book deals with a most importantsubject upon which he is an accepted authority. It is

disappointing, however, not to find in it any indication of a

promise of the solution of the problem of really utilisingsewage. It is, of course, an important thing to be ableto purify sewage or to dispose of it in a sanitary way,but it would be far more satisfactory if it could beturned to useful account rather than be left with the

chance of polluting watercourses, or in the form of sewagecake to go begging for want of a purchaser or even

of an individual to take it away gratis in any quantityhe pleases. Chemical treatment and precipitation haveaccomplished a good deal in effecting the purification of ourrivers and in having a marked favourable influence on thepublic health, for which we are thankful, but the process inits entirety is not scientific. Mainly through the admirableresearches of the Massachusetts Board of Health, and ofthe experiments of Mr. Scott Moncrieff, we are beginningto suspect that with a due study of the conditions weshall be enabled soon to "engineer" organisms so as

not only to dispose of sewage but to convert it into aninnocuous and a highly valuable agricultural product.Nature knows no waste, and we have only to patientlywrest her mystic plans of action from her to effectthe same end. Professor Robinson’s book is admittedly asummary of important data connected with water-supply,sewerage, and sewage disposal, and it places in the handsof the engineer many valuable facts that he should be inpossession of. The first chapter relates to house drainageand is followed by memoranda relating to sewage, and thenby a section on sewage generally, and the question of theformula of flow, &c. The chapter on river pollution is ex-cellent, as is also the section on precipitation dealing withthe more important methods in use. Included under this

heading are the electrical method of Webster, which dependslargely upon the formation of iron salt by electrolysis actingupon and precipitating the sewage matters, and the Hermiteprocess. We find no reference to THE LANCET reportl uponthe latter process, which we believe was more exhaustivethan any other report, giving as it did full details bearingon its chemical and bacteriological aspect. Filtration,in which the claims of the Scott Moncrieff method are

epitomised, but nct to any extent criticised, is then dealtwith. The volume concludes with a diagram giving at aglance the discharges and velocities of oval and circularsewers.

__ ________

LIBRARY TABLE.

Elementary Inorganic Cll81nist’l’Y. By A. HUMBOLDT

SEXTON, F.I.C., F.C.S. Fourth Edition, revised and con-

siderably enlarged. London : Blackie and Son. 1895.Price 2s. 6d. - Though we deprecate the publication ofbooks written almost exclusively for purposes of examina-tion we are pleased to find that the small work before ushas arrived at the stage of a fourth edition. Despitethe fact that it is adapted to the wants of students pre-paring for the Science and Art examination and the LondonMatriculation, it is a sound exposition of the factsand the general principles of chemical science. It is anexcellent chemical primer, due and equal emphasis beinggiven to theory and practice and a proper importance to thephysical aspect of the changes in matter. The treatmentof the subject is scientific although simple, and it is thisfeature which singles out this elementary work from a shoalof others which have no real raison d’etre,

7/MM6. By Professor J. LANE NOTTER, M.D. Dub, andSurgeon-Major R. H. FIRTH, F.R.C.S. Eug. Second Edition.

Longmans, Green, and Co. 1895.-The rapid exhaustion ofthe first edition of this work has necessitated the issue of asecond edition within only a few months of publication.

1 THE LANCET, May 26th, 1894.

1143

’Expansion and growth are the natural conditions of manualswhen re-issued, but we are glad to see that the authors havenot added much to the bulk of their new volume. The new

material which has been added is chiefly to be found in thechapter on the "Removal and Disposal of Refuse and

Excreta," which has been almost re-written and much im-proved on, and in the entirely new chapter on " SanitaryLaw." This new chapter we welcome as a great addition tothe work ; in it is clearly set forth all that should be knownor might be required by the head of a household ; in placeof analysing each Sanitary Act separately the general effectof legislation as a whole upon certain matters of sanitaryimportance is considered, the summary being limited to thelaw as applicable to England and Wales.

New Inventions.VEHICLES FOR THE USE OF MEDICAL

PRACTITIONERS.

CARRIAGE-BUILDING has of recent years undergone severalimprovements, and some novel features have been intro-

duced, designed chiefly either to reduce the weight of thevehicles or to render them more comfortable and com-modious in use. These various desiderata appear to have’been carefully and successfully studied by the Cortland

Wagon Company of Henrietta-street, Covent-garden, andnot may be useful to direct attention to a few styles of

vehicle which seem to possess qualities likely to be service--able to medical men. The Henrietta Gig or Car (Fig. 1)

"weighs about 24’ cwt., and is suitable for a horse standingfrom 14 hands to 152 hands. It has elliptic springs, hickorywheels 4 ft. high provided with steel tyres, and from its

lightness and strength is well adapted for long journeysover unfavourable roads. It is well finished and cushioned,and carries either one or two persons.

The Bombay Cart is 1ightly heavier than the fore-going. It carries two in ltonB and if required can befitted with a Syce’s seat in the rrar suitable for use inIndia, as well as with a pjle when a pair of horses are to bedriven.To those who desire increased protection in winter

weather, or against wind, t-un, and rain, the four-wheeledhooded carriages (Fig 2) offer many advantages. They are

. seated for two persons, may be <lmwn -by either one horse ora pair, and have ample space tor instrument bags and siml1alrequisites. The houds fold lip nnd can be opened or clos(-(3at will ; the spaces at the bajk and side are filled byleather curtains.The Cortland Stanhope Phaeton is a somewhat larger

style of four-wheeled carriage, carrying two in front and

two behind. This phaeton may be driven with either onehorse or a pair, in which latter case a pole is supplied. Itis very light in draught and turns in a small space.The Cortland Bellamy Trap is a four-wheeled carriage

constructed to carry a party of four, but the back seat may

be folded up when not in use. Either one horse or a, pairmay be driven in it.In all these vehicles the excellence of the materials is

guaranteed, and the execution of needful repairs is facilitatedby interchangeable parts being kept in stock. Whenrequired any carriage can be fitted with indiarubber

tyres, either solid, as commonly used for hansom cabs, orpneumatic. American harness is supplied to purchasers whoprefer it; it differs n some respects from the Englishpatterns, the bearing reins in particular being less irksometo the horses.

THE " ELLISON " BREAST BANDAGE..

WE have received from Messrs. W. H. Bailey and Son,38, Oxford-street, W., a little appliance which we can con-ceive might be of considerable practical use in many cir-cumstances. It is a form of breast bandage consisting ofa waistband of strong linen and braces of the same material

made to cross at the back justabove the lumbar region and infront at about the junction ofthe superior and middle por-tions of the sternum. Theaccompanying illustration showsthat the front of the braces areexpanded on either side intoshallow linen bags, which willreceive the respective breast andsupport it in any direction andwith any required amount oftightness, according as the strapsupon the collar-bone are adjusted.Pressure can of course be regu-lated and applied in this or that

direction by the insertion of pans within the bags. The

bandage may also be used for securing dressings or poultices,then it will obviate unnecesaty moving of the patient. Itis made in three sizes, small, medium, and large, and theprice is 5s. 6d. -

A LITMUS PENCIL.

LITMUS is an admirable indicator of acids and alkalies, butfor this purpose can only be relied upon when pure,. Its

preparation in a pure state is not easy and involves a series ofoperations which take an inconveniently long time., Thelitmus pencil provides us at onc(- with the pure colouring’natoial in a very c ’nvetiit-nt form for use. Thus by merelyra. ing n. piece of paper with the pencil a mark is obtainedwbi&uuml;h we unf) 3s extremely seni ive to minute quantities ofapd all;;:’11&Igrave;,"B, accorning, of eoarse, as to whether the- dlle or the ted end of the pencil hus been used. For the).))’nction<-’ in testir g, for exarr,r h., the reaction of urine itwill he invaluable t’ecaut.e rebable, and the indication it

give"B is <ii-tinct.. The specimen was sent to us by Messrs.’1. Christy and Co. of 25, Lime-street, E.C.