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occurring in a primipara at the eighth month when the usualmethods of treatment had no effect on the severity of theconvulsions, and where recovery was much delayed on

account of the rigid condition of the cervix. The variousmethods of treatment were discussed, and reference made tothe treatment of such severe cases by deep incisions into thecervix or by Cassarean section as advocated and successfullycarried out by Halbertsma of Utrecht.

Dr. MACKIE WHYTE showed a specimen of Thrombosis ofthe Basilar Artery taken from a woman of seventy-three whodied in the Dundee Royal Infirmary. The upper half of the

artery contained clot, the outer part of which was pale andfibrinous, the inner dark red and evidently recent. Therewas well-marked white softening of the lower two-thirds ofthe pons, of the anterior pyramids (superficial) and of thecerebellum in the region supplied by the right anteriorinferior cerebellar artery. The duration of the illness, eightweeks, was unusual, Gowers stating that it is rare for life tobe prolonged beyond a fortnight. Among the symptomsnoted as characteristic were: (1) Repeated seizures affectingopposite sides of the body, the first and second with aninterval of a fortnight, paralysing the right side slightly, thethird and fourth on the third day before death involving theleft arm and leg ; (2) crossed paralysis, the right side of theface being affected along with the left side of the body ;(3) conjucat6 deviation of the eyes to the left, while the leftlimbs were paralysed; (4) hyperpyrexia, temperature 1080fifty minutes before death.

TORQUAY MEDICAL SOCIETY.

A MEETING was held at the Torbay Hospital on July 8th,Mr. Karkeek, President, in the chair.

Several cases of interest were shown, amongst which werePrimary Epithelioma of the Tonsil in a man aged sixty-three,with Secondary Enlargement of the Glands of the Neck, and aPerforating Wound of the Knee-joint treated by incision anddrainage, with good recovery, by Mr. Watson, senior housesurgeon, Torbay Hospital.

Dr. Wilking Stabb read notes of a case of Pernicious Anasmiawhich ran an unusually rapid course. The patient was a widowof fifty years of age, who had passed the menopause a year pre-viously and had never had any serious illness. Three weeksbefore seeking advice she had a fall and struck her headagainst the kerbstone, to which she attributed her illness.She complained of debility and shortness of breath on the leastexertion. She was a stout, anasmic woman. The only physicalsigns were a soft systolic murmur at the apex, well conductedinto the axilla, and a rough systolic murmur at the base. Theanasmia rapidly increased, the skin becoming waxy and themucous membranes almost white. Slight cedema of the legsand ankles developed ; also anorexia, furred tongue and muchnausea, which seemed to contraindicate the administrationof arsenic. Blood pale and watery ; no apparent alterationin size or number of leucocytes ; red corpuscles varied incolour and formed bad rouleaux. Nine days before deaththere was slight epistaxis, which recurred once. The diseaseterminated in the usual way-viz., by a severe attack ofdyspnosa with shallow sighing respiration and with no signof pulmonary affection. The attack lasted eight hours,during which time the patient lay low in bed on her left side.From the date of the fall to her decease the patient was onlyill nine weeks and two days, during the first three weeks ofwhich she was not so unwell as to seek advice. Treatmentwas at first by iron and digitalis ; towards the close it wasdirected simply to relieving the digestive disturbance.

Reviews and Notices of Books.report on tlw Etiology and Prevention of Yellow Fever. By

GEORGE M. STERNBERG, Lieutenant-Colonel and Surgeon,U. S. Army. Washington : Government Printing Office.

l 1890.IN his report to the United States Government on the above

subject, Dr. Sternberg has prepared a monograph on theetiology and pathology of yellow fever that should prove ofvery great value to those who have to deal with this fataldisease. Having carried on his investigations in Brazil,Mexico and Havana, he has had an experience that makes

the controversial part of the work much more important tha,nit could possibly have been on any other grounds. He goes

very fully into the claims put forward by Dr. Freire that he hasproduced a protective inoculation against yellow fever, andhe maintains that Dr. Freire has not a tittle of evidence to

bring forward in support of his contention that inoculatedpersons are less liable to the disease and that they take it ina milder form than do those uninoculated; in fact, it would

appear from the statistics cited that the mortality amongstthe former is even greater than amongst the latter.

In the first place Dr. Sternberg finds that the micro-

organism produced as a pure culture by Dr. Freire and putforward by him a,s the etiological factor in yellow fever can be-obtained from the skin of persons who have no trace of thedisease about them; it may, in fact, be looked upon ratheras a saprophytic organism than as one having anything to dôwith the disease. He goes very thoroughly into Dr. Freire’sclaims that his cryptococcus xanthogenicus is present in greatnumbers in the blood and tissues of yellow fever patients; aftermaking a very large number of careful microscopic examina-tions he feels compelled to state that such organism does netoccur in the body, but that it does occur with very greatfrequency in the skin; he believes, indeed, "that the specieinfective agent in yellow fever has not yet been demon-strated, " although he describes no fewer than twenty-eightforms of bacilli, eight forms of micrococci, and a torulawhich he has been able to separate from the blood or organstaken from cases of yellow fever ; some obtained duringvarious stages of the disease, others from the organs afterthey had been removed from the body and kept in antisepticwrappings for forty-eight hours. Most of these organismshave been carefully photographed under the microscope, andin some cases photographs.of colonies and drawings of theappearances of the growths in test-tubes are given, so thatthey may be the more readily recognised ; but he failed

absolutely to demonstrate the presence of any particularpathogenic micro-organism in the blood and tissues from

these cases.The organism most constantly and abundantly found wa

bacterium coli commune, an organism presentin the intestine 01healthy individuals; he considers, therefore, that its presence iathe blood and tissues can have little or no etiological import.Another organism, the bacillus cadaveris, was also frequently fmet with. Then, too, the blood, urine and crushed liver tissueobtained from bodies recently dead were not pathogenic inthe case of either rabbits or guinea-pigs, unless they wereadministered in considerable quantities. Dr. Sternberg found,however, that such materials preserved under antisepticprecautions for forty-eight hours were very fatal to guinea-pigs when injected subcutaneously. He looked upon theresults obtained as being due to the presence of micro-

organisms which continue to produce their toxines after

the death of the patient. As a result of these observations;,he argues that, as in the case of cholera, any specific germif present must be in the alimentary canal, but after anextended research he has been unable to find any varietyof bacillus present in any such proportion as happens in thecase of cholera, for in every case he obtained a number ofdifferent species, no single one appearing to preponderate,.and very few of those present liquefied the gelatine.Some of the bacilli are anaerobic, others are facultativeanaerobes. One of these, which he calls his bacillus "X,"he has been able to isolate from the contents of theintestine in a number of cases of yellow fever, and heholds that it may have been present in all; he has nevermet with it in any other conditions, and he finds that it ispathogenic in the case of rabbits when injected into theabdomen. He is, however, far from satisfied that this canbe the cause of the disease, though it is the only one of allthose that he has examined about which he is doubtful.

From the manner in which a yellow fever epidemic extends

885

and from the fact that it has certain features in which itresembles cholera, he is led to believe that fsecal matter is thevehicle in which the pathogenic agent passes from individualto individual, but he holds that there is no evidence that

yellow fever is propagated by the contamination of drinkingwater, as frequently and usually occurs in the case of typhoidfever and cholera ; he considers, moreover, that the organismmust be a strict anaerobe.

The author lays great stress on the fact that a temporarydepression of vitality is one of the most important predis-posing causes in this disease, especially where the alimentarycanal is affected, and, as in the case of cholera, a recent- debauch is a recognised predisposing cause. " Sailors who

go on shore at an infected port for a little spree very com-monly turn up in the hospital, or are taken sick after they.come on board ship, and serve as the starting-point of an.epidemic amongst their comrades, and subsequently perhapsat the port of destination of the vessel. " Finally, he

.says: "The experimental evidence recorded and the facts

just stated seem to justify the recommendation that.the dejecta of yellow fever patients should be re-

.garded as infectious material, and such material should neverbe thrown into privy vaults or upon the soil until it hasbeen completely disinfected. "The pathological part of the report, as well as the clinical and

<etiological, has been reprinted from the article contributed to"Wood’s Handbook of the Medical Sciences." The patho-logical changes are evidently those associated with the

excretion of poisonous products, and take the form of.acute hepatitis and nephritis, characterised first of all bymarked cloudy swelling, sometimes of the acute vacuolatedform described by Greenfield and others, this ultimatelyleading in some rare cases to necrosis in patches, but usuallytaking the more common course of fatty degeneration. Acute

interstitial changes in the above organs are also fairly wellmarked in certain cases. For these changes, however, wemust refer our readers to the original work. Although weare naturally disappointed that no more definite results haveso far been obtained, it must be confessed that Dr. Stern-

berg has certainly placed in a very fair light the evidenceon which he has based his conclusions, and he has also

given very sufficient reason for coming to the conclusionthat Dr. Freire’s observations and experiments are scarcelyto be relied on.

Materia Mediea, Pharmaey, Pharmacology and Therapeutics.By W. HALE WHITE, M.D., F.R.C.P. Lond. London:J. & A. Churchill. 1892.THIS book contains a great deal of useful information con-

cerning drugs, and it may at once be said that the dry detailsof the Pharmacopoeia are reduced to insignificant proportions,- while greater space has been allotted to the more interestingsubjects of the action of drugs and therapeutics.The arrangement of material does not present any novel

features. After briefly defining the terms upon the title-page,the subject of pharmacy is approached and the ground iscleared by setting forth the general characteristics of

alkaloids, glucosides, neutral principles and the like. Verybrief notices of various pharmacopceial processes are followedby tables of weights and measures. These inevitable detailslead up to a more satisfactory section, in which an accountis given of the pharmacopoeial preparations, which are use-fully grouped according to their doses. A small oversight Ioccurs under the heading Glycerines, " which are describedas being "all liquid preparations," except glycerinumtragacanth2e, omitting reference to the glycerinum amyli,described in the Pharmacopoeia as "a translucent jelly." To

counterbalance this a list is inserted of non-pharmacopceialpreparations, explanatory of such terms as cerata, cremora,gargarisma, nebulse &c., which are often to be found inmedical literature and are rarely defined in text-books. Somebrief considerations connected with the prescrip+io7 and with

abbreviations dispose of minor matters, and then comes

an important section upon pharmacological and thera-

peutical actions. The author’s indebtedness to those

who have worked in the same branch of study is here

very apparent, but his selection of material and skilful

compression as a rule leave little to desire. Occasion-

ally, as in most first editions, slight inconsistencies

creep in ; thus it is difficult to harmonise the statementsmade (p. 39 and p. 133) concerning the action of rectal

injections of salt water in cases of threadworm. The

greater portion of the book is made up of the pharmacopceialmateria medica, only a few pages at the end being devotedto unttfficial remedies which have found more or less favour.When dealing with sharply defined physiological and thera-peutic actions the author has brought his material well upto date, and he writes in convincing terms devoid of enthu-siastic exaggerations. It may be doubted whether much is

gained from remarks like the following (p. 214) : "As itsaction is unknown it has been given in numbers of diseaseswhose pathology is unknown, but without benefit." For theuse of the student the value of the book is enhanced byjudicious alterations of type for the more important state-ments.

The Food 3fanagement of Infants and Young Children. ByG. R. SAUNDERS, B.A., M.B., B.C. Wanganui, NewZealand : A. D. Willis. 1892.

IT is a pleasure to welcome this unpretentious little book,which has reached us from so far. As might be gatheredfrom the title, it is essentially intended for the use ofmothers and nurses rather than for students or members ofthe medical profession ; hence its value lies in its lucidityand simplicity. The directions given are clear and sensible,and, although addressed to a popular audience, the authorhas not disdained to avail himself of the writings of manyrecent workers who have approached the subject from apurely scientific standpoint. The result is that in short

space the author has set forth views which are fully abreastof modern teaching. He is clearly in favour of simplicity,though he gives practical rules for guidance where simplicityfails. Careful perusal of this book, which is easy to readand not overweighted with scientific detail, should go fartowards helping young mothers to avoid the pitfalls inci-dental to inexperience and to the reckless advice of well-meaning but ignorant friends. It will also supply manyuseful hints for the management of the nursery and the sickroom.

_______

On Changes in the Red Blood Corpuscles in the PerniciousAnaemia of Texas Cczttle Fever. By THEOBALD .Pe?’KMMM’ Ph.D., M.D., of Washington.I As a result of his researches, Dr. Smith has come tothe conclusion that in the anaemia that accompanies Texascattle fever there is an exceedingly rapid diminution in thenumber of the red corpuscles in the blood, but it is

only when the low figure of 2,000,01)0 is reached thatwhat he calls embryonic or transitory forms appear. These

transitory forms (macrocytes, corpuscles with granulesand diffusely stained, and hasmatoblasts), however, appearvery rapidly in mild cases of Texas fever and also after

haemorrhage, rising as the corpuscles diminish in number,but disappearing very rapidly after the corpuscles again beginto increase in number. In Texas fever so characteristic isthis rise and fall that the presence of these transition forms"when there is suspicion of infection and no history of anyvery severe haemorrhage is almost as certain a diagnostic signas the parasite itself," and he concludes that " it is possibleto estimate approximately, from the number and kinds oftransition forms, the number of corpuscles still in the bloodand the time which has elapsed since their destruction began.The presence of these forms is a favourable sign and mayserve, when taken into consideration with the parasite, 3j1 a

886

fairly good basis for a prognosis." It is open to some doubtwhether the forms above described are really transition forms,for recent observations on anaemia and leucocythaxmia wouldlead us to argue that some of these corpuscles at anyrate have a perfectly distinct source from that of others. It

may be, however, that Dr. Smith’s observations may renderit necessary for us to revise our notions as to the nature of

some of the peculiar corpuscular bodies met with in theseconditions.

LIBRARY TABLE.

IN the August number of the Annales de l’Institut PastenrM. J. Soudakewitch continues his account of his observationson Intra-cellular Parasitism in Cancerous New Growths. He

strongly combats the idea brought forward by ProfessorVirchow, that the parasites described by recent observers havelittle to do with the etiology of cancer. He still maintains thatthe structures he describes in the cancer cells are true para-sites ; that by certain features they may be distinguished fromvarious degenerated products and altered cells ; he has nowbeen able to see falciform bodies within these parasitic cysts.He has noted the division of the body into a larger number ofsmaller bodies, and he has found these smaller bodies in-creasing in size, ultimately forming groups of the largerorganisms contained in a large mass of protoplasm. In the110 cases he has now examined he has always obtained thesame results. He thinks that the young parasite passesinto the substance of the cell ; that there it grows slowly ;that the capsule that surrounds it becomes more and more

marked ; that the nucleus is gradually compressed until ittakes the form of a flattened layer around the capsule, towhich it is closely applied; the protoplasm of the cell is alsogradually distended, becomes more homogeneous, is not so

brilliantly stained and ultimately may form only a thin mem-brane around the parasite. The parasite is then set free, itscontents become divided into what may be termed "spores," Iand these make their way into the neighbouring cells, whenthe process recommences, so that a single cancer cell maygive rise to the contamination of a considerable numberof those cells around it. He also holds, however, that thecell containing the cancer parasite may divide and that theparasite may divide along with it, both of the resulting cellsbeing thus infested. He does not, however, seem to takeinto account that these parasites as they grow must give offeffete matter, which probably may have a most important I

influence in determining the proliferation of the epithelialcells in the immediate neighbourhood, and that therefore itis not to be expected that one of these parasites would befound in every cancer cell. These and other recent observa-tions on cancer open up a new line of research, and one that

promises to give us some new light on the etiology of thisfell disease.THE Yeterinarian for September opens with the first part of

an interesting paper by Mr. Fred. Smith, M. R. C. V. S., I’. I. C.,on Veterinary Hygiene, which was read in Section III. of theInternational Congress of Hygiene and Demography. Thereis a report of the Government Veterinary Surgeon of Queens-land on experiments made with a view to test the variousspecifics in use for expelling parasitic worms from sheep;solutions of arsenic, turpentine mixture, Hayward’s mixture,cocoa-nut oil, powder supplied by Dr. Thos. L. Bancroft,and salt and lime, were used, and as the outcome of twosets of experiments, it is considered that the preparation ofarsenic has given the best results. Sheep take it readily."It is recommended that three doses should be given at in-tervals of nine days between each dose, the sheep to bekept without food for at least twelve hours before a dose andfor two hours after ; they may be allowed water half an hourafter receiving the medicine." The remainder of the journalis taken up with accounts of the meetings of the Royal Agri-cultural Society of England, the Royal College of Veterinary

Surgeons, Royal Veterinary College, Central VeterinaryMedical Society (at which there was a discussion on intes-tinal obstruction in the horse), and the Scottish MetropolitanVeterinary Medical Society.

2%s JOllrnal of Anatoiny and Physiology. Conduded bySir GEORGE M. HUMPHRY, Sir WILLIAM TURNER, and J.M’KENDRICK, F. R. S. Vol. XXVI. Part 3. April, 1892.London : Williams and Norgate. -This part contains no lescthan eighteen separate papers, with an account of the pro-ceedings of the Anatomical Society of Great Britain andIreland. The more important of the papers are: 1. The

Myology of the Larynx, by A. A. Kanthack, with two plates,a paper of much importance to laryngologists. 2. A Note,with a good bibliography, on Identical Malformation in Twins,.by Bertram Windle, D. Sc. 3. On the Cause of the Twisting-of the Umbilical Cord, illustrated by mechanical models, byF. J. Allen, M.A. 4. The Nutritive Importance of the YelkSac, by Arthtir Robinson, M.D. ; the Comparative Anatomyof the Muscles and Nerves of the Limbs of Anthropoid Apes,’by David Hepburn, part 2, with a plate. 5. The CerebraD

Hemispheres of the Ornithorhynchus, by Sir William Turner.6. A Few Applications of a Physical Theorem to Membranesin the Human Body in a State of Tension. 7. On the Effectof certain Drugs on the Reflex Excitability of the SpinalCord, by William Stirling, M.D. 8. On the Pedal Skeletonof the Dorking Fowl, by G. B. Howes. 9. On the Enzymesproduced by Bacteria, by F. Allan MacFadyen, M.D.

-Eisenba7in 1%erletwtcngen in Jare7isischer ttnd Klinische

Bergic7wng. Von HERBERT W. PAGE, M.A., M.C. Cantab,,F.R.C.S. Eng. ; Chirurg am St. Mary’s Hospital &c.

Autorisirte Deutsche Uebersetzung von Dr. S. PLACZEK,Arzt in Berlin. Berlin, 1892.-We congratulate Mr. Pageon the appearance of this German translation of his excellentlittle monograph on the subject to which he is known to

have given great attention and on which his opinions are ofgreat value.

News Inventions.URINE CHARTS.

WE have before us two useful additions to the clinica]

armamentarium, for the purpose of accurately and fullyrecording the details of the qualitative and quantitative-estimation of the urine. To Mr. Manley Sims we owe -avolume of these charts drawn upon a simple plan, but containingample space for the record of the chemical and microscopicalcharacters of the sample of urine examined. The value of

such charts is twofold: it saves time to the practitioner inmaking his notes, and ensures that his examinations shall besystematic and thorough. On each page the outline of the

report appears in duplicate, which not oply serves the purposeof making a double entry, but also furnishes an ample supplyof records within the compass of one volume. The

other series is issued by the well - known medical

publisher, Mr. H. K. Lewis, of Gower-street. Here each chartis on a separate sheet, and contains several more items.than the preceding, under the headings of "normal and"abnormal" constituents respectively, although, by the

way, the first five subjects (quantity, colour, specific gravity,&c.) should not have been classed as "normal constituents," "

There is some utility also in the memoranda of the normalcharacters which are appended to each column. We com-mend these publications to the notice o practitioners andhospital officers, who will find them Tery serviceable andconvenient.

THE HAMMOCK LEG-REST.

THIS leg-rest’,is patented by Mr. William Carter of Masham.Yorkshire, and like many useful inventions is extremely