198 MEDICAL JOURtNAL ] REVIEWS. [JULY 25, igo.8

OPHTHAILMOLOGICAL SOCIETY OF THEUNITED KINGDOM.

MARCUS GUNN, F.R.C.S., President, in the Chair.Friday, July 10th, 1908.

EXHIBITS.MR. W. H. JESSOP showed a case of pseudoglioma and aseries of photographs of the fundus oculi taken by Pro-fessor Dimmer. Electricity was the illuminant. Mr.BARDSLEY showed several ingenious mechanical improve-ments in instruments. One was a new form of needleholder, another an adjustable modified trial frame, and athird an improvement in the " Moorfields" ophthalmo-scope, introducing a double hole for indirect vision.

PIG31ENTARY DEGENERATION.Mr. M. L. HEPBURN read a paper, with lantern illustra-

tions, on the visual fields in pigmentary degeneration ofthe retina. The contribution was based upon 26 cases,which were tested in various ways, owing to the risk oferror, and the knowledge that much depended on theintelligence of the patient. His chief concern had been toestimate the amount of relatively functioning area re-maining; in other words, how much of the retina hadescaped destruction in such cases. Unless the rods andcones had been hopelessly damaged, the retention ofvisual acuity was a matter of degree. Where the patientshowed uncertainty the matter could be placed beyonddoubt by stronger illumination. As it was desirable tohave a definite standard to work to, he had taken as hisstandard a 10 mm. test object in natural light. He pointedout the relationship between the several varieties, andshowed slides in illustration. The pathological changes inchronic inflammation of the choroid were of two kinds,and were represented by two kinds of visual fields. Heraised the question whether the islands of vision occasion-ally seen through scotomata represented portions of retinawhich had escaped disease ; did they, on the other hand,represent the re-establishment of the circulation, or anew system of vessels ?

ASSOCIATION OF REGISTERED MEDICAL WOMEN.-At ameeting on July 7th, Dr. MAY THORNE in the chair, Mrs.SAVILL showed a woman in whom lichen planus and lichenspinulosus occurred together. The former lesion hadgreatly improved since phosphoric acid had been given bvthe mouth. A discussion on normal menstruation anddysmenorrhoea was opened by Mrs. STEWART, who hadexamined the curettings from 21 successive cases ofdysmenorrhoea (mostly of the spasmodic form) and foundthat 14 of these showed a papilliferous glandular hyper-plasia, while 2 -showed simple hyperplasia, 1 interstitialchange, and 4 no abnormal appearances. Of 26 curettingsfrom cases of menorrhagia, sterility, etc., 17 showed simpleglandular hyperplasia, 3 showed interstitial change and 6were healthy.- Miss LONG, in the course of a paper onnormal menstruation, remarked that women often ex-aggerated the pain and discomfort at the periods, thatbaths should be continued as at other times, and thatdysmenorrhoea -largely depended on constipation. Mrs.SCHARLIEB read a paper on dysmenorrhoea, in which shepointed out the difficulty of estimating its degree indifferent patients, and remarked that when a woman wascompletely incapacitated by the pain its duration rarelyexceeded four hours. T-he speaker classified the causes ofdysmenorrhoea and agreed that constipation was at theroot of many cases. Miss STURGE mentioned the goodresults obtained in a certain scdhool where, during the firsttwo years after puberty, the girls were kept in bed for thefirst two days of each menstrual period. Miss BENTHAMconsidered that 50 per cent. of girls in good position hadno dysmenorrhoea. Mrs. DUNNETT said that most cases ofdysmenorrhoea occurred between the ages of 24 and 30,and suggested-that many of these were due to neglect ofrest during menstruation in the earlier years. Mrs.GRAINGER EVANS found that -dysmenorrhoea -was verycommon among elemientary school, teachers, who hadworked hard for examinations~during -early girlhood.

SURGERY OF TJLIE URINARY ORGANS.MAX NITZE died on February 22nd, 1906, leaving unpub-lished the manuseript of the second edition of his textbookof cystoscopy.1 The cystoscope may be said to have begunwith Nitze, for, although instruments for the illuminationof the bladder had been conceived before his day, he pro-duced the first of real practical value. This was in-1879;and in this instrument was employed for the first time themethod of illumination by passing the light-source intothe organ examined. All surgeons know how Nitze laterdeveloped the uses of the instrument and placed eystoscopyon a sure foundation. The first edition appeared so farback as 1889, and the present is for the most part a newbook. The first part treats of the theory and technique ofcystoscopy. It displays the foundation on which theauthor's inventions were basted-.his knowledge of optics..It further deals with the whole subject of the method ofusing the cystoseope, the difficulties met with, and theways in which they may be overcome. It is interesting tocnote that Nitze advised the use of a local anaesthetic in allcases. Part 2 describes the endoscopic findings in the-normal and diseased bladder, and treats in series ofcatarrh, tuberculosis, stone, changes in the ureteral[orifice, prostatic hypertrophy, and bladder tumours.Part 3 treats of the importance of cystoseopy as a.method of examination, comparing it with other avail-able methods and showing its advantages in clearness-of demonstration and its easy tolerance by patients. In-cluded in this part is a discussion of catheterization of theureters. The drawbacks are not minimized, as is showlnby the following: " Catheterization of the ureters, in thecases in which it is most required, in those in which it.might afford the most important diagnostic information,cannot for the most part be used without some hesitation."The same is true, in some respects, of the less exact,instrument, the separator. The volume ends with a.chapter on the relation of endoseopy to treatment. Afterpointing out what the method has done for the earlierdiagnosis of bladder lesions, the author passes to the con-sideration of endovesical operative procedures. This is asubject in which Nitze took a special interest, and whichhe did much to develop. The removal of simple new-growths by the galvano-cautery is more particularly dealt/with. The book is one to read and reread. It is a valu-able possession for its own sake and for its historical asso-ciations as the record of a man who was a pioneer insurgery. Appended is an atlas with eleven plates illustrat-ing the more common morbid conditions seen with theeystoseope. Thirty-six of the pictures are photographs,the remainder coloured plates. The photographs form a.remarkably successful series.

Dr. FREYER has published a fresh edition of his lectureson enlargement of the prostate and stone in the bladder,with the addition of others on allied affections, deliveredfrom time to time, the whole forming a comprehensivework on the Surgical Diseases of the Urinary Organs.rThe first portion of this series of lectures deals withurethral stricture, and the last with renal diseases an&disorders, including movable kidney. The book is ren--dered a fairly complete treatise on the subject with whichit deals by the presence of chapters on cystitis, bladdertumours, and calculous and other obstructions of theureter. These lectures, originally given to post-graduatehearers, seem welliadapted in their organized atid ampli-fied form to the needs of modern practitioners. They dealwith comnmon and for the most part serious ailments, tomany of which fresh methods of treatment and of diagnosishave recently been applied. The sound practical instruc-tion thoy contain is imparted in a plain and simple style,and the relative merits of rival plans of treatment are inmost instances discussed in a candid spirit. Much of thepathological work might be considered as traditional, but

1 Lehrbuch der KystoscoPie: Ihre Technlk und klinische Bedautune[Textbook of Cystoscopy: Its Technique and Clinical Significance]. ByDr. Max Nitze. Second edition. Wiesbaden: J. F. Bergma,nn. 190-7.(Roy. 8vo, pp. 410; 11 plates, 133 figures in text.),2 Clinical Lectures on the Su-rical iDiseases-of th7e UJrinary Organs.By P. J. Freyer, M.A., M.D., M.GJh., Surgleonl to-King Edward's Hospital!for Officers, and to St. Peter's Hospital, etc. Ljondon: BailliEre,,Tindall, and Cox. 1908. (Demy 8vo, pp. 43.3; 141 illustrations. 12s. 6d,

JULY 25, 1908.] (Thu BurnesMumoAz. JOVU 199

the teaching with regard to the dianosis and therapeuticsof the different affections with which Dr. Freyer deals isbased. on the results of a large experience in whichmodern methods have been airy tested. The pages ofthis book abound with useful hints on treatment. Theauthor evidently does not, as a rule, favour risky andso-called heroic methods of surgical intervention. Herefuses to recognize any indications for abdominalnephrectomy, and regards mtraperitoneal extraction of a

ureteral calculus as a dangerous operation. On the resultsof the modern treatment of urethral stricture he holdsoptimistic views, believing that this affection is capable ofpermanent cure, and that the old stock phrase of" once a

stricture, always a stricture" no longer contains any largeelement of truth. The operative treatment of movablekidney, on the other hand, is regarded as the least satis-factory in the whole range of renal surgery. Dr. Freyer'sconclusion on this point is rendered obscure and question-able by the statement that relapses are as common aftersuch treatment as after the operation for radical cure ofhernia.

THE USE OF IONS IN MEDICINE.Electric Ions and Thteir Use in Medicine, by ProfessorLEDUC,8 which has been translated into English by Dr.MACKENNA, is a book that should be read by aU who are inany way interested in the administration of drugs by theelectric current. It opens with an account of osmoticpressure, and shows how osmotic phenomena mimic thephenomena of life, continues with a theoretical account ofthe ion, and concludes with a description of ionic treat-ment and an account of several cases in which it has beensuccessfully applied. Professor Leduc shows that certainsolvents much used in medicine, such as alcohol, chloro-form, glycerine and vaseline, do not dissociate the electro-lytes, and that consequently the latter do not exhibit theirusual chemical properties when mixed -with these solvents.It is for this reason that phenol in pure glycerine is almostnon-caustic, and only slightly toxic. Several illustrationsare given of the fact thatthebactericidal and physiologicaleffects of substances are dependent on their degree ofdissociation, and great emphasis is laid on the importanceof considering the density (the intensity of the currentdivided by the surface of the electrode) when administer-ing drugs electrically. Details as to the type of apparatusto be used, as to technique, and as to special dangers tobe avoided are given. Among the cases quioted is that of a

soldier who was treated for complete ankylosis of thefingers in a military hospital, and as there was no

improvement, was eventually dismissed the army.

After two electrolytic seances with his handl in abath of a

solution of chloride of sodium, which tookthe place of thecathode, for periods, of thirty minutes with a current of30 milliamperes,he recovered the power of movements8)completely that no trace of ankylosis remained.

Rheumatic seleritis and periscleritis have yielded to thetreatment, without any failures, though several old-stand-ing cases have been treated, and among other diseasestreated are pleurisy, scoliosis, nenralgia, metrorrhagia,cerebral affections, and neurasthenia. Professor Leduc'sbook has been well translated by Dr. Mackenna,wh oa asadded a useful appendix on certain methods of electrictreatment.

Dr. TBBnLEs'sB Theory of IonsI is an attempt to dealwith the importance of ions in biology and in therapeutics.The book is in no sense a practical guide to their use inmedicine. Thesubject is treated almost entirely from thetheoretical standpoint, and, as the author states, has beenderived to a very large extent from Pauli's PhysicalChehistry in the Service of Medicine, from Hammarsten'sPhysiologicalChemistry.from Newth'sInorganic Chemistry,and from other similar works. The book suffers from thefault that the author continually hiesitates whiether toma'ke his appeal to the elementary or to the adlvancedstudent. Thus, he devotes a great deal of valuable space

to the statement of such facts as that pure water is a non-

Electric ons and Their Use iz Mediine. By Professor S. Leduc.Translated from the French by R. W. AMackenna,MIA.. M.B.. Ch.B.Ed.London: Rebman Ltd. 1906.(Demny 8vo, pp. 70. 2s. 6d.)

4 The Theory ofIo1s: a Contsiderationt of its Plece int Biology andTherapeutics. By William Tibbles. M.D. (Hon. Causal Chicago,LL.D.,L.R.C.P.E., M.R.C.S., L.S.A., etc. Loudon: Reb'man Ltd 1906.(Post 8vo,'PP. 140. 2s. 6d.)

4

conductor, and then goes into detail about the intricaciesof the vortex theory. There are also several instances ofloose writing. At the same time the book contains muchvaluable information in a very handy form. The theory isapplied in great detail to the chain theory of molecularconstitution, and the author' attemDts to show the evolu-tion of plants from a* few simple combinatiohs of ionsdissoiated from CO0 and water. These two-subtanees arebroken by the energy of sunlight into CO, OH, H, and0 ions, and as a result of their action together a carbo-hydrate is formed. Unfortunately, the ionic theory as

expounded by Dr. Tibbles seems in this case to lead verylittle further than the theories taught for years past in

elementary botany. It amounts to little more thai a veryfree use of the term "ion." The physiological section,which deals with the behaviour of anaesthetics, and ofdrugs when introduced electrically into the body, is moresuccessful, for here Dr. Tibbles is dealing with facts whichare susceptible of experimental verification. There ismuch of interest in the paragraphs he devotes to thephysiological antagonism between monovalent kations suchas1Na, K, NH4, Li, and the divalent kations Ca,Ba, Sr, etc.,and in the numerous examples he brings to illustrate thefact. He expresses the opinion that there is a continuityof structure between the living and the non-living, andthat the latter is changed into the former through theionization of materials; and the formation of meres.

THE EVOLUTION OF FORCES.DR. LE BON hias many critics, and their number will notbe decreasel by his publication of The Evolution ofForces5 in the International Science Series. Whateverhis failings and shortcomings may be, however, his worknever fails to be interesting and suggestive. It is an

excellent thing in the interests of science that men ofDr. Le Bon's ability sshould attack the respectablyorthodlox, ashe does inhisfirstchapter with the sig-nificant title,"The Present Anarchy of Science," and atthe present time itmaybe noted that a number of otherworkers are trying to advance on similar lines. Theauthor investigates the current fundamental conceptionsof science, and after finding them wanting, attempts toshow the destructibility of energy, the transformation ofmatter into heat, light, electric waves, and so forth. Allthese contentions are so intimately bound up with thediscovery of recent phenomena, and their necessarilyincomplete observations, that they can only be here fairlycriticized by the statenment that in many instances theysuggest profitable lines of experimental research, but thatthe author's enthusiasm forthle new has inducedhim toadvance broad generalizations on the basis of highly dis-putable observations. Thie latter portion of the work willappeal to a wide circle of readlers, for the author gives amasterly and Iiighly intelligible account of the phenomenaof phosphorescence,quoting a large number ofhis own

experimeents,andlsuLiggesting thephysical interpretation ofphenomenawvliicfi, if reprodluceed uinder the glamour of an

Eastern atmiosplere, woulld appear suipernatural. Thefollowing is an instance: A statuette is coated withcalcium sulphide, and after insolation is kept In the darkfor a few days until all trace of visible piosphorescencehas vanished. It is placed uipon a table, and the dark raysfrom the infra-red of the spectrum are projected in dark-ness on to it from a lamip completely enclosed in an opaque

box, and consequiently inivisible. *At the end of one or twominutes the statue lights up and appears to come out fromthe darkness.The experiment (says Dr. Le Ron) is a very curious one, and

hias always visibly impressed the spectators. It is, ii fact, verystrange to seeth e (lark ra(liations of the lamp,adlded to the(lark radiations of the sulphil)eprid(leuce visible light. It isalmost the coniverse of the celebrated interference experimentof Fresnel, in whichl liglhtadeded to light producedl darkness.In my experiment it is dlarkDessaddl(edl to darkness which givesbirth tolight.The caus-es of this and iiatysimfiilarphlienomena are fully

dIfscuse.It s hould be a(l_CdthatDr. Le Ronhas devoteda short cliapter to the for-ces mianifested by living beings.In this he welcomes the suggestion that a quantity of thework of the bodydlependss on the utilization of intra-atomicenergy.________

5

The Evolutio?i*fForces. By GustavaeLeBon, Meinbrede l'Acod5mie

de Helgiquie. Edited by F. Legge. The International Scientific Series.Lo icon: Kegan Ilan], Trench, Trtlbner, and Co. (Cr. Sto. pp. 404. 5s.)

REVIEW8.

REVIEWS.

OPHTHALMOLOGY.LIKUTICNANT-COLONIEL F. P. MAYNAUD of Calcutta, wlho isone of the bet known ophthalmic surgeons in India, haswritten a Manual of Oph°thalnmic Operations6 which is amost practical work. The first three chapters deal with

the preparation of the surgeon, patient, instruments,lotions, operating room, etc., and contain a discussion ofthe advantages and disadvantages of the various localaestndtics. In speaking of the risks of chloroform

anaesthesia, it is si that they are very remote, owing tothe fact tt most operations in India are practically per-fbrmed out of doors, and in any case with very free accessof air, "1 unlike the condition prevailing in many of theEuropean operation theatres, which are sometimes thesubject of comment among surgeons from India visitingthem." In addition, by following the teachina of Lawriethe greatest attention is directed to the respiration. In

dealing with the general principles of intraocular opera-tions, Colonel Maynard makes some of the most practicaland common-sense remarks we have ever seen in anybook,. remarks which should encourage the nervousbeginner, thus:

Though a steady handl is a valuable possession in oplithlalmicsurgery, it is not an absolute necessity. Moreover, steadiness

umust not be confused with rigidity. Suppleness and a readiness.to adapt oneself immediately to unforeseen conditions is prefer-able to steadiness per se.

Some of the worst eye operators ever seen have beenthose heavy, stolid surgeons whose hands are like arock for steadiness, and who are quite incapable ofadapting them to the delicate adjustments necessaryin ophthalmic surgery. All the illustrations in the bookare drawn- as the patient appears to the surgeon whenhe is standing at the head of the table, and not as thespectator ses him; thus, at first sight one is apt to thinkthat an iridectomv or an extraction, which is really beingdone upwards, is being performed in the lower segmentof the cornea, but this is at once explained in the text,and the appearance is only due to the fact that theillustrations in almost all books are figured from thepoint of view of the spectator, and not that ofthe- operator. Besides the ordinary operation forglaucoma, a very detailed account of Herbert's opera-ti'on is given. As regards extraction, the author is verydecidedly in favour of combining it with an iridectomy.There are several stereoscopic pictures illustrating thevarious stages of the removal of the lens. Then followsa most useful chapter on accident.s and complicationsduring and after the operation. Chapter VII deals withthe expression of the lens in the capsule by Smith'smethod, which the autlhor does not favour, and also thesubconjunctival extraction of Czermak. Operations onthe conjunctiva and cornea are next described, followedby lid operations and the treatment of trachoma and its i

complications, and after that comes operations on thelacrymal sac, together with the details for its extirpation, iand the various operations for excision of the eyeball. 1Finally, there is an account of WVorth's operation foradvancement. No one wlho reads this volume can failto realize the vast experience of the author. The book isfull of little poinits which are only to be found out by Ilong practice, and which are usually conspicuous by tthe.ir absence in te-xtbooks. The book could be greatlyenlarged, but the anthor has evidently confined himsef ato describing thte operations lie most believes in. Any 4one wishing to supplemient his practice by the richexperience of such a surgeon as Colonel Maynard could anot do better thani study this volume. a

0FucHuS's Texthook of L)phthalnoloqy',7 has now arrived at b

the tlhird English edition, translated from the eleventh r

revised and greatly enlarged German edition. It now con- t]tains441 illustrations, with some coloured plates. The trans- p

lator of this, as of previous editions, is Dr. A. DUANE, of bNew York. As a standard work it has maintained its56Mas,ql of Ophth',lmie Operatio,us. Bv Lieutenant-Colonel F. P. B

Mayuiard, M.B., F.tI.U.5.,I.S.5., Professor of Ophthalmiic Surgery, TLMledioal College,Calcutta. Calulttaand London:W.Thacker and Co. ti

(Dety 8vo, pp1). 244; 6 stereoscopic plates; 104 illustrations. 9s.)

Textbook ofOphthalmnologyi. By Dr. Ernst Fnchs, Professor of Y'Ophthalmology in the University of Vienna. Authlorized translation B.

fromthe eleventh revised and greatly enilarged Germani edition, with cciutuminerotis additions by Alexander Duane. M.D., Surgeon,,Ophthalmicand Aural Institute, -New York. Third Edition. Philadelphia and T,London: .J. B. Lippiun,iottCompany. 1908. Uloy. 8vo, p.924; 441 illustrx.- ltions.. 25s.) Kg

place for a long time. Alterations are found everywhere,:and the translator is responsible for a good deal of newmatter, particularly in the sections on functional exami-nation of the eye, motor anomalies, refraction, and opera-tions. In spite of much that is excellent, ther is sUroom for improvement. The statement that "congenitalcoloboma of the iris is always below" is cerany notcorrect. The chapter on colour blindness is particularlydeficient, and gives only theories and tests, most of whiare notoriously deficient, while the work of Edridge-Greenis not even mentioned. The book is beautifully got up andis in many ways one of the best in existence, but we aresurprised to- find no reference to a great deal of new worlqespecially by English authors.

The second edition of A Mantual of thc Diagnosis andthe Treatment of the Disea.wes of the Eye," by EDWARDJACKSON, of Denver, Colorado, appeare(d last year. Thefirst edition was published in 1900, and in the new issuethe size is practically the same as before. The new editionhas been a good deal modified. Most of what is new hasbeen incorporated, though the author apologizes in thepreface for not giving great attention ti the very latestideas which have yet to be proved, for he feels that somany of these so quickly disappear that the permanentvalue of the book will be enhanced by leaving a good manyof these out of account. EITors of refraction are as fullydealt with as we should expect by one who has given somuch time and attention to this subject. The theory ofcolour vision is very lightly touiched upon. The illustra-tions are excellent, and there are two coloured plates,showing twelve conditions of the fundus, which are pre-cisely the same as in the first edition. The book is sound,and will doubtless find many readers.

A very useful and practical book on Diseases of the Eye9is that which appears under the joint authorship of Dr.CHARLEs H. MAY, of New York, and Mr. CLAUD WORTH, ofLondon. This is the second edition published in Englandcthough five editions of Dr. May's book have alreadyappeared in America, while it lhas been translated into thefollowing languages: German, Italian, French, Dutch,Spanish, and Japanese. Two years only have elapsedsince the first edition was published by the two auithors,consequently there is not miuch change to notice in. thetext, but some sections have been rewritten, and the wholecarefully revised. It is essentially a book written for thegeneral practitioner rather tllan the ophthalmic surgeon,and consequently we find the commoner diseases treatedat length while the rarer ones are little more-than menttioned. The chief characteristic of the book is the largenumber of illustrations and particularly the profusion ofcoloured plates showing various conditions of the fundusandl of the external diseases of the eye. The book hasproved of great utility to many students and practitioners,and it is one which may well claim to be a standardvolume among the many medium-sized manuals on thesubject.

Since l904 Tle Commoner Discases of the Eye,'0 byDrs. CASEY WOOD and T. A. WOODRUFF, has reached atlhird edition; it is slightlv enlarged, carefnlly corrected,and several new chapters and illustrations have beenadded, one of the longest additions being a chapter on'the commoner relations of nasal and neighbouring cavityliseases to the eye," written by Dr. I rank Brawley, andweIl worthy of its place. After a description of theinatomy and physiology of tlle eye we conme to a chapterin "the metlhodical examination of the eye," and thisbears a strong family likeness to a book of- that titleublished by Lang several years ago, anid at least one of-he drawings is taken fromi that book. It is ratther sur.?rising to find in the directions for examining for colour)lindness that Holmgren's errors are reproduced. Thus it8 A AMVantual of thte Diagtzosis and TreItnietnt of thle Diseases of the Eye.Iy E'dward Jackson, A.M., M.D. Secon(d edlition. Philadelphia and.ondon: W. B. Sauniders Compazny. 1907. (PosI 8vo, 1)1). 615; 182 illas-rations and 2colouredplates. 10s. 6d.'U A Mans'lqi of Diseases of Iltv E-. By Charles H. May, M.D., New'ork, and Claudl W1-orth, F.R.C.5., Lon1doni. Second e(lition. Lonidon:lailli6re, Tiiidall, andi (ox. 1908. (DeImy 8vo, pp. 413, illuistrations 336oloured p)lates 22. lOx. 6M1.)'0The ConimoJer Dive-iw.s of thle E?/e: Howv toDetect mir7lHot to Trealt'hews. By (asev A. Wooxl, 'IM.D., (.-1., D.C.L., and(I Thomas A.Vondrix1W, MI.D., C.M1.. L.lR.C.P.Loud. Third editiotn. Chicao: W'. T..eener ani Co. 1907. (Post 8vo, pp. 598. 2.50'dols.)

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200 1 [JULY 25, 1190&

JULY 25, 1908.] REVIEWS. I KZ=iAL JoumrsAL 20I

is stated that "if " with the first (green test) "he accu-rately chooses all greens the investigation need proceed nofurther; he has normal colour sense-is not colour blind."This has been proved' over and over again to be absolutelyincorrect, for many colour-blind people can do this. Thediseases of the eye are systematically described. Greatattention is given to the directions for slitting up thecanaliculus and the passing of probes, but nothing is saidabout the removal of the sac. The illustrations are good,and as a handbook it falls into line with many of the olderbooks which are brought up to date.

Small books distinctly have their use, and should find aplace among the more complete works dealing with anysubject, and the Aids to Ophthalmology," by N. BIsHoPHARMAN, is a really first-class little book consisting of 160pages. It is, of course, of the nature of a cram-book, andno one need expect to learn ophthalmology from it, butstill, it is so well and judiciously written that any one couldin a short time with its help recall to mind the chief pointsnecessary for a worker in ophthalmology to know. Mr.Harman haas shown' in this volume that he is able toseparate the important from the unimportant details, andit will be very useful to any one who wishes to quickly turnup a description of a certain disease, or to refresh hismemory for examination purposes. At the end of thebook are some examination papers. Rare diseases are nothere discussed; but it is astonishing how much which ismodern and useful can be found in so small a space. Mr.Harman is to be congratulated on the result of his labour,though it should be noted that the book was originallywritten and the first three editions brought out by Mr.Jonathan Hutchinson, jun.

A practical little book on Manipulation and Fittingof Ophthalmic Frames"2 has been written by Mr. HARRYL. TAYLOR of Birmingham, who is, no doubt, an optician.The first chapter deals with the fit of the frames, and itwould- be a comfort to the surgeon if all opticians took toheart what is said regarding the importance of getting theframes to fit correctly. He deals next with the variousmaterials used in the manufacture of spectacles. Otherchapters are then devoted to the question of the measure-ment of the frames, the measurement of the patient's face,and he describes the different forms of bridges in use andother details required to enable an optician to make a well-fitting article. Next follows a chapter on astigmaticclips and other forms of spring eyeglasses; anotherchapter is given to the consideration of the spectaclessuitable for presbyopes, and the rest of the book is givenup to the consideration of the tools required for the manu-facture of frames and the way in which these are used.The final chapter describes frames for special purposes,such as the large glasses used by sportsmen and billiardplayers,' the protecting goggles used by arctic explorers,and the method of fixing the orthoptic discs so muchfavoured by marksmen. The book is altogether mostpractical, and one which would be of great use to theoptician. It would also be of considerable service to anophthalmic surgeon at a distance from a capable optician,and who would thus have to. measure, his patients for theframes.

KEEN'S SURGERY.THE contributors to the second volume of KEEN'S Surgery"3are all American surgeons of established reputation. Thevolume commences with Chapter xxxiii, on diseases of thebones. The article on osteomyelitis is extremely good;there is some question, however, whether the acuteinfective periostitis of the older textbooks is correctly in-terpreted as really a mild superficial osteomyelitis; is itnot rather an acute infective process primarily commencingin the yQung periosteal bone? Among the signs andsymptoms of acromegaly a more definite reference to theeye phenomena is required. The subject of fractures iscomprehensively dealt with by Dr. Eisendrath, a greatpart of the chapter being devoted to methods of examina-

1Aids to Ophthalmology. By N. Bishop Harman, M.A., M.B.Cantab.,F.R.C.S. Fourth edition. London: Baillire, Tindall and Cox. 1908.(Foolscap 8vo, pp. 173 ;-illustrations 70. 2s. 6d.)12The Manipulation and Fittina of Ophthalmic Frames. By HarryL. Taylor. Birmingham: J. and RI. Taylor. 1907. (Crown 8vo,

pp. 119. 4s.)13 Surgery: Its Principles and Practice. By Veious Authors. Edited

by W. W. Keen. Vol. ii.- London: W. B, Saunders Co. 1907. (Roy. Bvo,pp. 920;' illustrations 572. 30.)

tion and treatment, both general a4d spocial, and theillustrations are excellent. The same remarks apply alsoto the same author's later chapter on dislocations. Agreat part of the chapter on surgery of the joints istaken up by tuberculosis. Dr. Lovett's name is aguarantee that the subject is effectively treated.Dr. Nicholls collaborates on the morbid anatomy ofjoint diseases; he admits that no sharp classificationbased on pathological changes can-at."present be made ofthe varieties of chronic non-tuberculous arthritis.- Itmight have been expected, however, that a more completestatement would have been made regarding the pathologyof pneumococcal, gonorrhoeal, typhoid, and other infec-tions. In this respect the chapter is unnecessarily vague.Dr. Lovett is also responsible for the subject' of ortho-paedic surgery. The chapter is both attractive andinstructive, and the author's ripe experience shows itselfthroughout. Among the most interesting pages are thoseon congenital dislocation of the hip. The end results ofLorenz's American cases are noteworthy, and in another5ense so is the 621 per cent. of anatomical reductions bythe bloodless method obtained at the Boston Children'sHospital. It is somewhat of a surprise to find thatoperation for Morton's metatarsalgia is discouraged.After chapters on the lymphatic system and the skin,the remainder of the volume is occupied by the surgeryof the nervous system. Dr. William G. Spiller writes anexcellent introductory chapter on the pathology cf thechief surgical disorders of the nervous system and itsimportance in clinical diagnosis. Traumatic neurasthenia,hysteria, and insanity are included among the subjectstreated, and Dr. Dercum discusses their diagnosis anddifferential diagnosis. This and the following chapter, onsurgery among the insane are new to surgical textbooks,but fully justify their position. There can be no questiop.that this is a textbook of the first rank; the equality andbalance of the chapters is evidence of experienced andcapable editing.

THE MUSCLES OF THE EYE.The Muscles of the Eye,'4 by LucIEN HOWE, of Buffalo, is avery large book in two volumes, the first of which dealPwith the anatomy and physiology of the eye muscles,including a description of the instrumecnts used for testingthese muscles, and the methods of measuring their power.The whole subject is treated elaborately and with greatdetail, as may be judged by referring to the second page,where a good deal of space is given up to an illustration ofsaws, scalpels, forceps, etc., mostly of the ordinary dissect--ing-room type, which are the instrumients required for the-dissection of the orbit and the muscles. This apparentexcessive detail' is due, the author explains, to the fact" that the study of the anatomy of the ocular muscles issadly neglected." There are forty-two pages of biblio-graphy at the end of the volume, and the primary andsecondary insertions of the ocular muscles are describedwith great minuteness. There are 228 diagrams andillustrations, and at the end are portraits of; Sir DavidBrewster, Helmholtz, Donders, Hering, and Tscherning,with short biographical notes.

The second edition of Tests and Studies of the Ocula,-Miescles,"5 by E. E. MADDOX, consists of 225 pages with110 illustrations. It is a very learned book, and goesinto the whole question of the movements of the eyeball,both in its normal condition, and after the action of one ormore muscles have been impaired or abolished Itis divided into 14 chapters. The matter is highlytechnical; and, although it possesses certain clinicalimportance, yet few may have the mathematical knowledgeto appreciate the full vakle of the book. Those whohave will find it one of the best books -in existence.A fresh chapter is added on nystagmus, and there' aremany references to the work of Worth and others onsquint, while the muscular paralyses are clearly described.The book has been thoroughly revised, the illustrationsare excellent, and any one interested in these studies willfind in it all he can desire.

14The Muscles of the Eye. By Lucien Howe, M.A., MD, Vol. i.New York and London: G. P. Putnamns Sons. ,The, KnicierbockerPress., 1907. (Roy. 8vo, pp. 467. 4.26 dols.)

1l Tests antd Stiudies of the Ocular Muscles, ¢-'By rnest,E. Mddox,M.D.,, F.R.C.S.E. Second edition. 'Philadelphia: The KeystonePublishing Company. 1907. (Demy 8vo, pp.. 261; 1X0. illustrations.63. 3d.) * - .;

262 MXDICAL JOURNAL] NOTES ON BOOKS. [JuLY 25, i908.

THE LAW IN GENERAL PRACTICE.UNDERX the title of The Law in General Practice,'6 Mr.STANLEY B. ATKINSON has furnished the medical professionwith a useful little manual.' It'c'onsists' of 239 pages,divided' into eight chapters,'with a suitable index at the'enid, and,deals with matters of great 'importance to thegeneral practitioner, about which it is'. to be feared manyhave only a limited 'knowledge. It' is hardly a treatiseon forensic medicine, but contains in a very readableform practical information that is often absent from workson that subject. In his chapter on Cautions and Pre-cautions the author gives tactful advice as to the conductof the practitioner in dealing with' some of the per-plexities of professional life. His remarks prove that hepersonally uxiderstainds' the subject, and his quotationsthat heYis well read 'in the opiiiions of authorities who,have ',w)itte'n about 'it. In the chapter on MedicalPRideic and Witnesses he-' gives excellent advice:"Remember you are not a,partisan: value accuracy 'ofobservatipti and of statement as you- do your' professionalreputatioii." This ought always to be the attitude dfthe medical witness. ,The author is not always quiteclear in the information he gives. Thus, on page 67,'he says (Fee- allowed):" Signing depositions made beforecoroner when called as a skilled common witness,fee £1' ls." Some of his readers might imagine thiswas in addition to'' the 'fee 'for giving evidence.Sometimes' 'he' is not quite 'accurate-for example,on''page 220: "Medical practitioners should discover'from whom they' can claim their fees when calledin aid by 'a midwife, wihere the patient is unable topay.persona,lly; usually it is from the Poor-law guardians."Medical practitioners; under the 'present state of the law,cannot claim their fees from any one but the patient. Afew boards of guardians pay them as an act of grace, andthe Local Government Board will sanction such payment.On p. 126 he says: " A pupil, or assistant, who has paid apremium, could not be--discharged for mere intoxication,etc." Knowledge of this rule in the days of apprentice-ship mi-ght have been important; but it is misleading tomention assistants in connexion with' it. Assistants do notpay premiums, and can be legally discharged on the spotby. their principals for intoxication alone, and all principalsought to be aware of this. The chapters on the Law ofDefamation-and the Law of Negligence treat simply of asomewhat complex subject, and although a few of theopinions of the author are open to criticism, the advice.given to the reader is nearly always sound and to be com-,medied. 'This little manual should be carefully read byall young practitioners. It need not take long to masterits contents, and it is highly desirable that everypractitioner should be acquainted with the law relative tohis or her profession, at least as far as laid down in Dr.Atkinsoh's book.

HAY ASTHMA.THE advent of summer is denoted by a considerablephalanx of sufferers from hay fever and asthma, andmany will turn to the second edition of Mr. WILLIAMLLOYD'S book on the subject17 in the hope of finding somenew means of combating their enemy. They will pro-bably skip the earlier part of the work, in which the historyof the disease and the theories of its causation are veryfully recorded, and will turn to the later chapters wheretreatment is described at considerable length. '.They willread that 80 per cent. of their number may be curedt and20: per eent. relieved by applying the means laid down bythe author. These means, however, involve a good deal ofs.urgical interference with the nasal mucous membrane,aad it is possible that some may prefer the disease to theremedy. It is to be hoped that the improved technique inintranasal ourgery, as. here described by Mr. Lloyd, maybe attended with greater success than has hitherto beenachieved;' but time is needed to establish the permanencyof' the Aelief afforded and to justify the 80 per cent.prognosid of reovery. The use of the serum known as

16 The Lat*in General Practice: Some Chapters inEveryday ForensicMfedicine. ;y Stanley B. Atkinson, M.A., M.B., B.Sc., of the InnerTemple,' BEfrister-atlawv- J.P. for the 'County of- London; 'Memberef- the Central Midwives 'Board;~Honorary S3ecretary of. the Mdidico-Stoughton. 1908.; (Post 8vo, pp. 248. 7s. 6d.)17Hav Fever. Hay Astl&ma: Its Causes, Diagnosis, and Treatment. ByVihllam'Lloyd, -F.11.0.5. Second edition. L,ondon: Henry J. G}laisher.

pollantin, from which much had been expected, does notappear to have produced the curative or prophylacticresults that were at first claimed for it. The monograph,well printed on good paper, contains a clear and compre-hensive account of the disease, and is concluded- by aseries of illustrative cases.

NOTES ON BOOKS.IN the Hygienic Laboratory Bulletin No. 40,18published underthe auspices of the Treasury Department of the UnitedStates, are some interesting papers by Stiles and Gold-berger on animal parasites. These are as follows: 1. TheOccurrence of a Proliferating Cestode Larva (Sparganumproliferum) in man in Florida, and 2, A Re-examination ofthe Type. Specimen of Filaria restiformi8 (Leidy, 1880)=Agamomermi8 re8tiformi8, both by Ch. Wardell Stiles. 3.Observations on Two New, Parasitic Trematode Worms,Homaloga8ter philippinen8i8 n. 8p., Agamodi8tomum nanusn. sp.;- and 4, A Re-examination of the Original Specimenof Taenia saginata abietina (Weinland, 1858), both byMessrs. Stiles and Joseph Goldberger. Though technical,the papers should prove of great use to helminthologists.The style of the publication, like many others produced bythe American Government, is very good; it is clearlyprinted, well illustrated, and of convenient size. All appli-cations for; these pubLications should be addressed to the" Surgeon - General, United States Public Health andMarine Hospital Service, Washington, D.C." Many otherinteresting papers on other subjects than helminthologyappear from time to time.

Mr. FREDERICK J. HANBURY has prepared a new (tenth)edition of The London- Catalogue of British Plants,19 whichwill be found useful for marking desiderata, as an indexcatalogue to British herbaria, for indicating the species oflocal districts, and as a guide to collectors. The index togeneric names printed on the cover of the pamphlet can behad separately on a card.

Dr. GEORGE LINCOLN WALTON of- Massachusetts asksthe old question Why Worry? The answer may be foundbetween the lines of the compact and well-printed littlevolume before us.20 By quotations from Epicurus andMarcus Aurelius the writer proves that non-worriers werejust as ready to give gratuitous advice to worriers -.in thedays of the Roman Empire as they are now. Humannature is much the same in mQdern as in ancient days.Worriers, like the poor, are always with us, and commonexperienie has generally shown that advice is thrownaway upd them. Like the Ethiopian and the leopard,they cannot change their natural attributes, but, as theseare mental rather than physical, they may at any rate beheld in check. On perusal of this work, the constitutionalworrier may perhaps see himself in a new light, and maygather hints as to the most effective -means of control.Whether he be the victim of "undue solicitude " aboutordinary, affairs, or of the "doubting folly," or ofneurasthenia or sleeplessness, at home or abroad, orwhether he be merely a faddist, he will find his casefully discussed with the calm impartiality characteristicof thc non-worrying critic. He may perchance pick upsome hints whereby his troubles, real or imaginary, maybe minimized. If such perusal should lead the worrier ofeither sex to realize the amount of irritation and wasteof time caused by the unrestrained exercise of their consti-tutional habit the book will not have been written invain.

The first edition of Mr. LEEDHAM-GREEN's book on TheTreatment of Gonorrhoea in the Male2l was favourablynoticed in the BRITISH MEDICAL JOURNAL only about twoyears ago, and the appearance so early of a second editionshows that the work has been widely appreciated. Thenew edition, which has been corrected and revised, islarger by nine pages than the old one. The additions,which increase the value of the book, include a shortdescription of Goldschmidt's irrigation urethroscope, andof Bier's hyperaemic treatment as applied to gonorrhoealarthritis. There are also eleven new illustrations.

18 Treasury Departnient, Public Health and Marine Hospital Serviceof the United States, Walter Wyman, Surgeon-General. HygienicLaboratory Bulletin No. 40, M. J. Roseneau, Director; May 25th, 1908.Washington: Government Printing Office. 1908.19London: George Bell. 1908. (Cr. 8vo, pp. 50. 9d.)20 Why Worry? By George Lincoln Walton, M.P., Consulting

Neurologist to the Massachusetts General Hospital. Philadelphiaand London: J. B. Lippincott Company. 1908. (Cr. 8vo, pp. 276.4s. 6d.)

21 The Treatment of Gonorrhoea in the Male. By Charles Leedham-Grper, M.B.. F.R.C.S. Second edition. London: Bailli6re, Tindalland Cox. 1908. (Demy 8vo, pp. 172. 5s.)