1563REVIEWS AND NOTICES OF BOOKS.

unusual Mammary Development. The right mamma measured22 in. in circumference and 12 in. across, the left 18 in. incircumference and 10 in. across.-Dr. RICHARDSON showed alad aged nineteen in whom there had been great Dyspnoeaand Inspiratory Stridor, apparently from pressure of a largethyroid. After two months’ administration of thyroid extractthe circumference of the neck had diminished from 16-2L in. to14tin., and there was no dyspnoea.—Mr. MORGAN showed aboy aged eleven with Syphilitic Osteitis of the Tibia ; greatestenlargement 2t in. below knee, gradually shading away to4in. above ankle.-Mr. MORGAN also showed an unusualform of Congenital Spastic Paralysis in an infant ten weeksold. Difficulty in washing the child was noticed even at birth,owing to the marked rigidity of the legs and the frequenttlexion of the thighs on the abdomen. The masseters are

rigid, and the child cries with mouth closed and is unable totake breast or bottle. The thighs and legs are generally keptrigidly extended, and the child has never been noticed toflex the leg upon the thigh, considerable force being needed tobend the knees. The feet are in the position of talipes cal-caneo-valgus. There is no history of syphilis. Breech pre-sentation ; no apparent spina bifida.-Dr. MACKEY showeda man aged fifty with a raised Serpiginous Eruption, probablydue to syphilis, although there was no history. He alsoshowed a patient with Tachypnoea following Influenza ; thebreathing was generally 80 to 100, without a correspondingincrease of heart beats or marked signs of pulmonary

disease.-Mr. CALVERT showed a complete cast of theUterine Cavity from a case of Membranous Dysmenorrhoea.

. Dr. MACKEY read a paper on Some Sequels of Influenza,especially referring to different types which had come withinhis own experience. 1. Neurotic disorders of heart and lung,illustrated by the patient shown, with tachypncea, and by acase in which there were urgent complaints of palpitationand oppression. 2. Laryngeal affections; in one family fouradults and four children were attacked by influenza ; two ofthe adults developed laryngeal symptoms almost as severeas those of laryngitis ; three children were hoarse, the infantbeing so croupy and convulsed as to be thought to bedying for a time, and one of the children had attacksof tachypncea, so as to frequently have to stop playing.3. Nasal affections. Two patients within two weeks ofthe onset of influenza complained of extreme perversionof smell and taste, the offensive smell (an entirely sub-

jective symptom) being so extreme as to make their livesmiserable, and it was some time before it could be remedied.4. Jaundice sometimes occurs in very close relationship withinfluenza. 5. Neuralgia and neuritis. Sciatica is perhapsthe most frequent, and the intercostal form the most obsti-nate. In one case any movement seemed to be intolerable,and for at least twelve months the patient was on her backday and night, with very great detriment to her generalhealth and nerve condition. Recovery, however, at lastensued.

Reviews and Notices of Books.Leet1l’fes on Aitto-Intoxieation in Disease. By CH. BOUCHARD.

Translated, with a Preface, by THOMAS OLIVER, M.A.,M.D., F.R.C.P. Lond., Professor of Physiology, Universityof Durham, Physician to the Royal Infirmary, Newcastle-on-Tyne, &c. Philadelphia : F. A. Davis and Co. London :F. B. Rebman. 1894.

No apology is needed for the presentation of this workof Professor Bouchard to English readers ; for, whilst the

study of bacteriology as regards infective processes hasbeen carefully followed in England, by far too little atten-tion has been bestowed on the result that bacterial actionhas on organic matter in forming chemical compounds,basic in character, commonly known as ptomaines. Sudden

deaths, whether occurring among individuals, or amongmany members of a community, happening within a fewhours or days, in the case of those who were in apparentgood health, and in whose bodies after death no evidenceof definite lesion can be determined, or of an epidemicof a specific character can be recognised, have naturallybeen assigned to this cause, as due to the ingestionof either poisoned food or water. Dr. Oliver, in his

II....

preface, clearly sets before us the various circumstancesthat affect this development of ptomaines with respectto the nature of the micro-organism itself, the materialon which it acts, as well as the resistance offered to

the chemical action by the health of the individual. Obser-vations made on the soil also show similar conditions : thusin the case of the micro-organisms at the higher levels,where oxygen is abundant, the chemical changes lead tothe formation of carbonic acid and nitrification ; whilst theanaerobic bacteria, which exist at deeper levels, are more con-cerned with putrefaction. It is, indeed, a question yet tobe decided whether in the soil, at least, certain specificmicro-organisms do not become for a time inert-justas we are able to reduce the virulence of many patho-genic bacteria by culture in the laboratory-and in turn

regain their original specific character as they come underthe influence respectively of oxidation or putrefactive agency.At present, however, we cannot determine exactly whatpart oxygen plays in relation to putrefactive changes. No

doubt, as far as the human organism is concerned, oxygeneffects various changes, according to the relative amount

supplied to the tissues and organs, leading to perfectoxidation in some organs, in others only to partial changes,as, for instance, fermentation and putrefaction and theformation of ammonia compounds-amines. In no partof the body are such changes better observed than in theintestinal tract. As Professor Bouchard well observes: "Manis every moment of his life running the risk of being over-powered by poisons generated within his system, and

self-poisoning is only prevented by the activity of his,

excretory system." Nor is theoretic argument or experi-mental evidence required in proof of this ; while on thepractical side we find the good results that have followedon antiseptic therapeutics. It is in this department the prac-titioner will find the lectures full of "good things " andvaluable suggestions, and we would particularly draw hisattention to those dealing with such subjects as the thera-peutic pathogenesis of ursemia, poisoning by tainted meats ; pdilatation of the stomach, etiology, pathogenesis, and thera-peutics ; pathogenic therapeutics of typhoid fever, the anti-sepsis of the internal medium, and the dieting of fever

patients generally. We have alluded to only these points inthe thirty-two lectures, but each one is deserving of the mostcareful study and research. No one can read this work throughwithout having his eyes opened and finding an explanation ofmany a doubtful phenomenon that has often puzzled himin his daily practice. Besides opening up a new field forclinical observation and thought, it is a pleasant book toread, the style is fresh, clear, and easy of comprehension,and the reader will be led on from lecture to lecture without

fatigue and with increasing pleasure from beginning to end.Professor Bouchard has been fortunate in securing such anable translator as Dr. Oliver of Newcastle, who has success-fully given the crisp, neat sentences of the French original,and has also added a valuable introductory preface, whichall who are not yet well acquainted with the subject shouldcarefully peruse in order to gain a clear general view beforeentering on the more special details of the work.

A Retrospect of Surgery : January, 1390, to January, 1894.Prepared by FRANCIS J. SHEPHERD, M.D., C.M., Surgeonto the Montreal General Hospital; Professor of Anatomyand Lecturer on Operative Surgery, McGill University.Reprinted from the Montreal Medical Journal. Montreal

Printing Company.Tiais collection is comprised in a volume of 259 pages and

consists of a series of abstracts of cases or of papers on

surgical subjects which have appeared during the four yearsindicated above in the various medical papers. Thoseselected for comment are of considerable interest and

1564 NEW INVENTIONS.

represent nearly all the departments of general surgery-chiefly those in which the greatest activity has been dis-played. The comments, when Dr. Shepherd makes any, areuseful and to the point, and the occasional addition ofmemoranda of cases under his care which bear on a subjectare helpful. There is an index of subjects, and another of thenames of surgeons mentioned, so that it is possible to referto any of the subjects by looking it up in the index ; but thismust be done. All the references-such as those to paperson peritonitis-do not appear under that heading, but appearin order, according to the time of year at which they werereported. It would have been better for the reader if hecould have seen all the information on the subject withoutunnecessary labour. We regard the collection as undoubtedlyinteresting, but a collection like this is chiefly useful forreference; and with a much more complete summary avail-able in the yearly hand-books it is not easy to understand

why it was issued from the press. There is no preface.

Hombu’1"g Spa. An Introduction to its Waters and theirUse. By Dr. ARNOLD SCHETELIG. London : J. and A.Churchill. 1893.

THis little work contains in a short compass a fairlyadequate account of the well-known and fashionable spain the Taunus mountains. Homburg possesses the consider-able advantages of agreeable scenery and a tonic atmospherein addition to its waters. These belong to the class knownas natural acidulated brine waters and contain from 8 to 12

parts per 10CO of chlorides, together with a large amount ofcarbonic dioxide. They are found useful in dyspepsia,gastric catarrh, atony of the stomach, gall-stones, intestinalcatarrh, constipation, obesity, gout, and gravel. Their greatmerit lies in the fact that they are the most highly aeratedof all known brine waters. Baths, douches, and wet packsform part of the Homburg treatment. We may quote Dr.Schetelig’s views regarding the treatment of gout. He doesnot go in for a "blind elimination " in this disease.

’’ Strongalkaline doses are often known to develop an acute attack,nor is energetic treatment with hot baths and douches a verysafe remedy. Weak alkaline waters taken internally offerlittle hope of lasting improvement. The hot ones amongthem, if they help to expel gravel, have this power incommon with all other hot mineral waters, whatever the’rchemical constitution may be.......... This change of nutri-tion is what appears to be thoroughly needed by the gouty,and the chloride of sodium acidulated waters seem to

be more capable of stirring up vaso-motor nerves, of enteringinto the tissue fluids, and altering the whole cell life of thehuman frame than other waters." ,

The Vicrocosat and the Maerocosm : an Essay in, Philosophy.By BOLTON WALLER, A. B London : Kegan Paul,Trench, Tiiibner, and Co. 1894.

THE author of this little volume on a very large subject inhis preface to the reader states that, if this essay be thought-fully read by him once or twice a year during the next five orten years, he will probably be amply rewarded for his painsin obtaining an adequate view of nature. In reviewing hiswork we have the disadvantage in not having fulfilled theseconditions. We are inclined to think, moreover, that theonly person likely to falnl or to have fulfilled them is theauthor himself. If the result in his case has been that whichhe promises his readers, we sincerely congratulate him. Afterhaving gone carefully through the book we confess that weare sceptical as to its power of leading us into clearer light,even though we devoted a much longer period to its study.The main idea, so far as we can gather, of the author’sviews is the clear separation of perceptions of the senses fromconceptions of the mind, and the belief that the rôle of the

latter begins where that of the former ends ; moreover, hemaintains that the results of such conceptions are as

valid as those of perception and that the results ofboth combined produce that complete view of naturewhich he promises those who read his book in themanner prescribed. He appears to us in one place, never.theless (p. 84), to have some misgivings as to his own

contention, for he states that " the term conceie must

not be applied in a loose way as synonymous with

imagine"; but he does not give any valid criterion for

distinguishing these terms. Not having, however, devoteda decade to the study of the volume, we may be

premature in expressing ourselves so positively. The

conception of unity, he also remarks, cannot be tracedfrom any perception of sense and must therefore have

originated in reason. The recognition of a part, as such,appears to us to be sufficient evidence of its being a portionof a whole, but we should scarcely be in a position to

conceive the whole unless we also conceived that the part wasonly a portion. We may perceive apart, but we must conceivethat it is a part before we can perceive that it is a portion ofthe whole. The author admits some indebtedness to natural

science, but is evidently more of a metaphysician than of anaturalist, and therefore may be regarded as born not before,but after, his time. The philosophy of the future, we believewith a confidence almost equalling that of the author, willargue from the known very cautiously to the unknown, andwill only carry a sense of conviction if the argument, for theunknown is not in contradiction to the perceptions of oursenses. The unknown may or may not be agreeable to theconclusions which our perceptions lead us to ; but the argu-ment for or against it must for the modern thinker be non-contradictory to them. Towards the end of the book theauthor becomes eloquent and speaks of "eagle glances " andI mind outflashing the rays of the sunlight." We bave too

great a reverence for the mysterious in nature to indulge ineloquent prophecy. It is only a weak cause which needspowerful declamation. "Die That ist alles, nichts der

Ruhm." The deed, the fact is all, and many words aboutit nought. To those who desire to spend the next ten

years of their life reading Mr. Waller’s brochnre we wishenlightenment.

New Inventions.A " NON-LIGHTING-BACK " ATMOSPHERIC BURNER.

IN the report of THE LANCET Special Analytical SanitaryCommission on Smoke Prevention and Perfect Combustion

(No. III.-Gaseous Fuel, Gas heating, and Gas-cookingAppliances), published in THE LANCET of Nov. 25th, 1893,one serious disadvantage connected with the use of the Bunsen,or atmospheric, burner in gas fires was fully pointed out. Werefer to the tendency of the Bunsen flame to run down theburner tube to the supply nozzle-the phenomenon known as"lighting back, "-in which case incomplete combustion ofthe gas takes place, with the result that there may escapeinto the room a considerable quantity of such poisonous gasesas acetylene and carbonic oxide, or else these gases may burnat the mouth of the burner with a luminous flame, depoitingsoot upon the material or "fuel" of the fire. Not on thisaccount alone, however, is the atmospheric burner of gasfires unsatisfactory, for, as the tendency to "light back" isgreatly increased by reducing the size of the flame, it isalmost impossible to control the supply of gas, and thereforeto regulate the heat of the fire (except by means of a separatetap to each burner), by pardally closing the tap. The Com-mission found that very few of the gas fires examined could bewotked safely and satisfactorily when the pressure of gas inthe burners was less than 0’4 inch of water. Of the causes of"lighting back " our Commissioners sought explanation in thefollowing : a down draught acting against the pressure of