Current Medical Literature

REVIEWS AND NOTICES OF BOOKS

Medical Gynecology. By SAMUEL WYLLIS BANDLER, M. D., Fellow of the American Association of Obstetricians and Gynecologists; Adjunct Professor of Diseases of Women, New York Post-Graduate Medical School and Hospital; Associate Attending Gynecologist to the Beth Israel Hospital, New York City. Second revised edition of 698 pages and 150 illustrations. Philadelphia and London, W. B. Saunder Company, 1909.

In the preface to the first edition the writer states that the book has been prepared as a result of frequent inquiries for a work dealing with the non-operative side of gynecology. The various topics have been viewed from the standpoints of the symptoms, the disease, the bimanual and microscopic findings, and the general physical and nervous state. In order to do this repetition and reiteration are necessary but these emphasize the important points and make each section complete in itself, thus diminishing as much as possible the necessity of referring to other sections except for more complete elucidation. He has endeavored to show the relation which pelvic abnormalities really bear to the physical and mental state of the female in order that we may deal intelligently with the gynecologic diseases and not confine our diagnosis and therapeutic methods to the pelvis. The writer states that he has consulted particularly the writings of Kirsch (puberty); Joseph (syphilis and gonorrhoea), Bumm, Wertheim and Finger (gonorrhoea), Oshar Frankl (electricity and hydrotherapy), and especially Winter for much that has appeared in the book.

In the preface to this the second edition he states that the chapters on electricity and hydrotherapy have been enlarged and various other additions have been made to the book as a whole.

The first section is devoted to gynecological examination; the next to a description of the various methods used in the medical treatment of gynecological conditions. This is followed by a very important feature of the book, i. e., the study of the principal symptoms arising from gynecological diseases by stating the causes of each and methods of diagnosis and treatment. The chapters on associated nervous conditions, constipation and gonorrhoea are very thorough and practical. The various gynecological diseases are presented by describing the pathological conditions present, its symptoms, diagnosis, and the treatment indicated. The work is particularly valuable to the general practitioner because it presents the subject just as it occurs in practice, i. e., from the standpoint of the patient as a whole and not from the consideration of the pelvis alone.

J. A. S.

Modern Surgery: General and Operative. By J. CHALMERS DACOSTA, M. D., Professor of Surgery and of Clinical Surgery in the Jefferson Medical College, Philadelphia. Sixth edition, greatly enlarged. Octavo of 1502 pages, with 966 illustrations, some in colors. Philadelphia and London. W. B. Saunders Company, 1910. Cloth, $5.50 net; half Morocco, $7.00 net.

Notwithstanding the fact that the fifth edition of this work was published less than three years ago, the material progress that is being made in surgery, demanded, in the author's opinion, a thorough revision of the work at this time. Almost every section of the book has been altered or added to for the sixth edition. Of the more important of the newer methods which receive particular mention are,-arteriorrhaphy; Crile's arteriovenous anastomosis for affecting tranfusion of blood; Brewer's tubes for transfusion; the use of Halsted's aluminum bands in the treatment of aneurism; the operative treatment of recent fractures; Hoesley's operation for chronic spinal meningitis; the use of positive and negative air pressure in intra-thoracic surgery; Murphy's method of treating acute peritonitis; Cushing's operation of decompression for brain tumors; Bier's intravenous local anaesthesia; the intra-glandular extirpation of goitre; Bier's treatment of inflammation; Wasserman's reaction for syphilis and the serum diagnosis of cancer.

The work consists of but a single volume of 1,500 pages. One is impressed, however, with the thorough and comprehensive manner in which the author has dealt with so extensive a subject.

The subject matter is well classified and is arranged in forty chapters. The illustrations are numerous and very satisfactory. I should place this work in the first rank of modern text-books on surgery.

G. E. B.

Diseases of the Genito-Urinary Organs, Considered from a Medical and Surgical Standpoint, Including a Description of Gonorrhea in the Female, and Conditions Peculiar to the Female Urinary Organs. By EDWARD L. KEYES, Jr., M. D., Ph.D., Clinical Professor of GenitoUrinary Surgery, New York Polyclinic Medical School; Surgeon to St. Vincent's Hospital. With 195 illustrations in the text and seven plates, four of which are colored. New York & London. D Appleton & Co., 1910.

The subjects treated in this volume include the diseases of the urinary organs, both male and female, the diseases of the male genital organs, and syphilis. They are considered from a medical as well as a surgical standpoint. The volume is apparently intended for the use

of the student and general practitioner, for the refinements of urology are not treated in sufficient detail to be of practical benefit to the specialist.

The volume contains a large amount of valuable information and should have a wide range of usefulness in the particular field for which it was intended. The illustrations and colored plates are excellent and the volume is a splendid example of good bookmaking.

The propriety of including syphilis in a work purporting to deal entirely with genito-urinary diseases is very doubtful.

G. E. B.

Preparatory and After Treatment in Operative Cases. By HERMAN A. HAUBOLD, M. D., Clinical Professor in Surgery and Demonstrator of Operative Surgery, New York University and Bellevue Hospital Medical College, New York, with 409 illustrations. New York and London, D. Appleton & Company, 1910.

It

In the opinion of the author of this volume there should exist a closer relationship between the surgeon and physician in the management of operative cases. From this viewpoint this book has been written. deals with the preparation of patients for operation and their postoperative care, and is intended to instruct the general practitioner in all of the many details for the management of operative cases.

The book contains thirty-four chapters. They deal with the important factors of preparation for operation, the patient, instruments, dressings, solutions, suture and ligature material, assistants and the operating room. Then the after care is taken up, of the wound, drainage, dressings, haemorrhage, post-operative complications, and feeding. Operations in difficult regions are then discussed.

The text is well illustrated and the book presents a very attractive appearance.

G. E. B.

The Conquest of Disease Through Animal Experimentation. By JAMES PETER WARBASSE, M. D., Surgeon to the German Hospital Brooklyn. D. Appleton & Company, 1910. New York and London.

The aim of this small volume is to give some correct information upon animal experimentation, with the hope of correcting in the mind of the general public some misconceptions. It unquestionably is a step in the right direction and the book should have a wide circulation. G. E. B.

DERMATOLOGY

Edited by Frederic C. Curtis, M. D., and Harry W. Carey, M. D. The Vaccine Treatment of Acne Vulgaris.

G. T. WESTERN. British Journal of Dermatology, January, 1910.

The writer defines Acne Vulgaris as a condition in which there is a hypersecretion of sebaceous material associated with or caused by a microbacillus. It is believed that the Acne bacillus described by Unna, Sabouraud and Gilchrist is the infecting organism. The staphylococcus is frequently associated with the Acne bacillus in producing the lesions characteristic of the disease. The experiments of Fleming sustain the theory that this bacillus is the cause of the comedo and pustules.

By rubbing cultures of the Acne bacillus into the sterilized skin of susceptible individuals a pustular folliculitis is produced from which the Acne bacillus can be recultivated. The opsonic index of Acne patients is not normal and an excessive dose of Acne vaccine produces a negative phase and a new crop of pustules.

It is supposed that a seborrhoea caused by some functional disorder forms a favorable point of entry for the Acne bacillus.

Three types of Acne are mentioned-First in which the comedo forms the chief lesion, second where induration predominates and third the pustular type. In the first type the Acne bacillus is generally found to be the infecting organism, in the second type the infection is usually mixed-Acne bacillus and staphylococcus and in the third type the infection is most often due to the staphylococcus.

Before attempting vaccine therapy it is essential to determine the nature of the infection by the use of smears and cultures made from the lesions.

Either a stock or an autogenous vaccine may be used. The author finds the stock staphylococcus vaccine satisfactory but an autogenous Acne bacillus vaccine is preferable although a stock vaccine will suffice in many cases.

The dose of Acne bacillus vaccine is much smaller than most vaccines varying from three to fifteen million bacteria per dose administered at intervals of eight days.

Local therapy should be carried out in conjunction with the vaccine treatment. The author summarizes cases typical of each group in which successful results have been obtained.

Recent Investigations of the Cause of Syphilis. (Neueste Fortschritte in der Erforschung des Syphiliserregers.)

HOFFMANN. Berliner klinische Wochenschrift, No. 1, 1910.

The Giemsa stain based upon the Romanowsky method is still considered to be the best stain for the spirochaete pallida. It has the disadvantage of deteriorating with time and requires much care in its preparation and preservation. The demonstration of the spirochaete is rendered easier and more rapid by the dark field illumination. By this

method it is possible to see the living organisms in the fluid from syphilitic lesions. It requires a special appliance for attachment to the microscope.

A still better method, the best so far found, is carried out as followsA small amount of fluid is removed from the depth of a suspected lesion and placed on a slide, to this is added a drop of india ink diluted in nine parts of water. The drops are thoroughly mixed, spread in a thin layer on the slide and allowed to dry in the air. Under the microscope the spirochaetes are unstained and are transparent from the light reflected through them. The rest of the field has a brownish color from the india ink. Other organisms are also visible but they will hardly be confused with the spirochaete.

For demonstrating the spirochaete in tissue the improved method of Levaditi is in general use. It is well to counter stain the sections with Hematoxylin after the method of Heidenhain.

Many efforts have been made to cultivate the spirochaete on artificial culture media but until recently they have been failures. Schereschewsky in Neissers clinic inoculated specially prepared horse serum with syphlitic tissue and after several days succeeded in obtaining a mixed culture in which the spirochaetes developed and multiplied. In the media sulphuric acid was formed indicating putrefactive changes. Inoculation of animals with this culture was not successful. Mühlens grew a pure culture of the spirochaete from a syphilitic gland and developed cloudy colonies in the depth of horse serum agar. They grew only under the strictest anaerobic conditions. Subcultures in serum bouillon were deposited in the form of small clumps. Haendel also obtained a virulent culture from the testicle of a rabbit.

In the transmission of syphilis efforts have been directed toward finding other animals susceptible to the virus. The inoculation of rabbits has been successful first in the cornea and then in the testicle. The lesions produced had all the appearance of syphilitic origin and contain the spirochaete. Grouven inoculated syphilitic tissue into the anterior chamber of the eye of a rabbit which died in sixteen months of severe general symptoms-allopecia, emaciation papular macular and ulcerating lesions in various portions of the body. In these lesions as well as in some portions apparently not affected by the disease the spirochaete were found in large numbers.

The Effect of Measles on Psoriasis. (Einwirkung von Masern auf Psoriasis Vulgaris.)

FRIEDJUNG. Deutsche medicinische Wochenschrift, No. 8, 1910.

and

A Case Showing the Effect of Measles on Psoriasis. (Ein Fall von Einwirkung von Masern auf Psoriasis Vulgaris.)

RUBENS. Deutsche medicinische Wochenschrift, No. 3, 1910.

The articles comprise the report of two cases of Psoriasis which developed Measles. In the first case the psoriasis was of universal distribution and of a severe type. After ten days of observation the patient