senting a revision of the previous one. To others not familiar with the previous editions it may be said that the chief value of the work lies in the presentation of the ideas and practical methods of the writer. While the anatomical grouping of diseases is the one most frequently followed in gynecological text books it does not give as comprehensive a presentation of the subject as the pathological, for a given injury, infection or new growth may involve several organs or structures. In its limited way, this volume presents the subject of gynecology in an attractive manner; the illustrations for the most part represent what they are intended to show, the index is good and one may readily find the special subject which he wishes to look up. J. A. S. Bacterial Food Poisoning. A Concise Exposition of the Etiology, Bacteriology, Pathology, Symptomatology, Prophylaxis, and Treatment of So-called Ptomaine Poisoning. By PROF. DR. A. DIEUDONNE, Munich. Authorized translation, edited, with additions, by Dr. CHARLES FREDERICK BOLDUAN, Bacteriologist, Research Laboratory, Department of Health, City of New York. 8vo, 128 pages. Cloth. Prepaid, $1.00 net. E. B. Treat & Co., Medical Publishers, 241-243 West 23rd Street, New York. In this little book is given a very concise and valuable summary of the etiology, bacteriology, pathology, symptomatology, prophylaxis and treatment of so-called ptomaine poisoning. Poisoning through eating diseased meat is frequently due to bacteria of the colon group, such as the bacillus enteritidis of Gärtner or their products, and the symptoms are frequently very similar to those of typhoid fever. Poisoning from eating meat which has decayed after the death of the animal is usually due to the bacillus proteus or bacillus subtilis. It is especially likely to occur from eating chopped meat, patès, sausages, etc. The symptoms are usually those of acute gastro-enteritis without fever. The group of meat poisonings characterized by severe nervous symptoms, usually spoken of as "sausage poisoning," is due to the bacillus botulinus and the condition is known as botulismus. The organism is a strict anerobe, and is usually found in connection with foods that have been kept hermetically sealed. Secretory disturbances and symmetrical motor paralysis occur. Poisoning from cheese and ice cream is frequently due, not to tyro-toxicon, but to bacterial contamination. The author constantly emphasizes the value of bacterial as opposed to chemical methods of examining suspected articles of food, and gives methods for examination. Many interesting facts are given regarding outbreaks of food poisoning that have been reported in various localities. The book should prove of value to the physician, who may at any time be confronted with the conditions described. A. T. L. Medical Sociology. A Series of Observations Touching upon the Sociology of Health and the Relations of Medicine to Society. By JAMES PETER Warbasse, M. D., Surgeon to the German Hospital; Attending Surgeon to the Seney M. E. Hospital; Member of the American Medical Association, American Association for the Advancement of Science, American Society of Sanitary and Moral Prophylaxis, American Medical Library Association, Ethical Social League, etc. New York and London: D. Appleton and Company, 1909. This work is made up of observations pertaining to the sociological relations of medicine in all of its various fields of activity. Some of them are long enough to perhaps deserve the name of essays but most of them are merely brief statements of fact and opinion. The majority of them are pregnant with thought and ideas of value in a general consideration of the subject title of the book. Many are reprints of editorials by the author in The New York State Journal of Medicine or of addresses or parts of addresses delivered by him before various professional and lay audiences. The book "is inspired by the belief that the most important knowledge for the individual is that which promotes his physical efficiency and happiness. The knowledge that has the power to contribute the most to these ends is that which helps him to preserve himself in the best state of health." Such medical knowledge concerns deeply both individuals and the public, as there is still much need of an awakening of both the people and the state to these facts, especially as they are apt to consider that the only duty of a physician is to aid in the restoration to health of persons who are already ill and to lose track of the fact that perhaps the most important aspect of modern medicine is the attempt to keep people well, preventative rather than curative. The author has attempted to enlighten the public in regard to much of the work of the modern physician, and at the same time to remind the profession of the possibilities for good which its members possess, especially in view of the present day needs of the public at large. The book is divided into two parts, the first containing matter of especial interest to the lay reader, and the second that of more particular interest to the medical men who may peruse its pages. There are in all sixty chapters, but many of them are only a page or two in length. Suggestive titles of some of them taken at random are as follows: Public Policy and the Medical Profession; Federal Interest in the Health of the People; Some Medical Aspects of Civilization; The Alcohol Question; The Instruction of the Young in Sexual Hygiene; Sexual Morality and the State; Education and the Health and Efficiency of Girls; Fresh Air; The Evolution of Scientific Knowledge; The Beginnings and Progress of Therapeutics; The Fate of Medicine; The Future Fields of Medical Activity; College Preparation for the Study of Medicine; The Hospital Interneship; State and College Medical Examinations; The Medical Expert Witness; The Physician in Politics; The Future of Medicine. The book is very readable and contains much material worthy of close consideration and afterthought. If the public at large, and especially parents and teachers, knew more of some things which are here clearly set forth as to hygiene and preventative medicine, there would be much less suffering and unhappiness in the world to-day, and much less need for our services as therapeutists. If the members of the profession should take to heart and act upon many of the suggestions which are given in Part II, the practice of medicine would certainly stand on even a higher plane than it does to-day, and many of the misunderstandings between the laity and the profession would be entirely avoided. The book is worthy of wide circulation and careful reading. C. K. W., JR. The Medical Complications, Accidents and Sequels of Typhoid Fever and the Other Exanthemata. By H. A. HARE, M. D., B.Sc., Professor of Therapeutics in the Jefferson Medical College and Physician to the Jefferson College Hospital, Philadelphia, and E. J. G. BEARDSLEY, M. D., L. R. C. P., Philadelphia. With a special chapter on the Mental Disturbances Following Typhoid Fever, by F. X. DERCUм, M. D., Professor of Nervous Diseases in the Jefferson Medical College. Second edition, thoroughly revised and much enlarged. Octavo, 398 pages, with 26 engravings and 2 plates. Cloth, $3.25, net. Lea & Febiger, Philadelphia and New York, 1909. This work is a second, much enlarged edition of the well known monograph of the senior author originally published ten years ago. It is the only book devoted solely to the very important part of medical practice of which it treats, subjects necessarily considered only briefly in the many books devoted to medical practice at large. As such it is of great value and that this was appreciated by the profession can be easily seen by a consideration of the very large circulation which the first edition enjoyed. The new portions of the book are the chapters devoted to the complications and sequels of the exanthematous diseases other than typhoid fever, variola, scarlet fever, measles, chicken-pox, and rubella, and the chapter by Dr. F. X. Dercum on the mental disturbances following typhoid fever. The text is well written and very full, and it is followed by a good index. The text is full of references to the literature, given in footnotes, but this feature of the book deserves some criticism. Many important references are entirely omitted, and those which are given are in very many instances incorrect as to date and name of the journal in which the article in question occurs. There is no system apparent for the references, some are given by volume, number and page, some by date only, and some merely by title of work or journal. It would seem that more care should have been taken with this very important feature of a work of this kind. C. K. W., JR. ALBANY MEDICAL ANNALS Original Communications A CRITICAL ANALYSIS OF A SERIES OF 180 CASES OF ACUTE INTRAPERITONEAL INFECTIONS. Read before the Medical Society of the County of Albany, By E. MAC. D. STANTON, M. D., Schenectady, N. Y. The study upon which this paper is based was originally undertaken as a critical analysis of the results obtained by my associate, D. C. G. McMullen, and myself in the cases of acute intraperitoneal infection which have been treated by us during the past two years. Primarily this has been a critical study undertaken with the idea of discovering our mistakes in order that we may be able, as far as possible, to avoid the occurrence of similar errors in the future. Therefore, our failures and their causes, as far as we have been able to ascertain them, will receive more than the usual amount of attention in this paper. During the period under consideration, we have handled all cases of acute intraperitoneal infection according to a definitely systematized plan of treatment, the fundamental objects of which may be summarized under the following heads: First. The removal of the infection. Second. The removal of the source of the infection. Fourth. The reduction of the absorption of toxins from the area of infection. Fifth. The preservation of the patient's natural powers of resistance. Sixth. The removal of toxic material from the stomach by gastric lavage, when necessary. First, the removal of the infection.-This is the ideal therapeutic measure, and were it possible to always effectually remove the infection by operative procedures, the treatment of intraperitoneal infections would resolve itself into a simple question of operative technic. There can be no question of the possibility of completely removing the infection in cases of appendicitis, seen while the infection is still confined to the appendix; likewise, it is possible to accomplish this in many cases of pyosalpinx and empyema of the gall bladder. But experience has very definitely shown that in late appendix operations and in salpingitis and empyema of the gall bladder the operator is usually compelled to leave behind an infected field, the management of which is of vital importance. In our own work, we have made it a rule to operate at once when we believed the infection to be still confined to an offending organ which could be removed. We have also operated at once in most cases when we have felt reasonable certain that the peritoneal infection was less than from twenty-four hours to thirty-six hours old. Second, the removal of the source of the infection. This is absolutely essential in cases of gross perforation of the stomach or intestines because in such lesions the constantly increasing mass of infective material escaping into the peritoneal cavity makes the limitation of the area of infection by natural processes practically impossible. Murphy and many others have shown how satisfactory the results may be in this class of cases provided only that the leak be closed during the early stages of the peritoneal infection and a post operative regime be adopted whereby the peritoneum is given the best possible chance to take care of the remaining infection. It is a fact, however, that even as regards the therapeutic possibilities to be derived from removing the source of the infection, we must recognize certain very definite limitations. Thus, after the full development of the peritoneal infection the removal of an infected organ, or even the closure of an intestinal perforation does not in itself produce a cure, for here again the management of the secondarily infected peritoneum remains the most important factor in the treatment. In our own practice we have made it a rule to operate at once, in all cases of intestinal perforation, and as before stated, have made it a rule to remove the offending organ when we are reasonably certain that the peritoneal infection had not existed more |