PUERPERAL FEVER AT MAIDENHEAD

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Reviews and Notices of Books.Manual of Materia Medica and Therapeutics; being an

abridgment of the late Dr. PEREIRA’S "Elements of Materia.Medica." By Dr. F. J. FARRE, Professor BENTLEY, andMr. ROBERT WARINGTON. London: Longmans, Green,and Co.

ONLY 592 pages, while Pereira’s original volumes included2000, and yet the results of many years’ additional researchin pharmacology and therapeutics are embodied in the newedition. Unquestionably Dr. Farre has conferred a greatbenefit upon medical students and practitioners. He has cutout a great deal from our old classic; but it is surprising howwell we can spare it. If every author had a judicious friendor uncontrolled editor to cut out all that could be fairly omittedfrom his proposed big book without interfering with its directusefulness, or diminishing its value so far as its avowed pur-pose is concerned, the medical public would be greatly bene-fited. To the author everything which he has written seemsessential, and nothing superfluous : if he has any views of

classification, it is essential that they be discussed andset forth; his bibliographic researches must be done justiceto; his collections must be utilized. The work must be " com-

plete ;" and so in being theoretically made complete, the bookbecomes practically less useful and more burdensome. We

have all been alarmed and bored by the respected classic whichDr. Farre has cut down. It was a work of great research, ex-teB3ive learning, and contained much which did not concernthose who were not professed amateurs of pharmacologicallore. Dr. Farre has omitted the sections on the infiuence of

mind, of light, heat, electricity, food, exercise, climate, &c.He has also omitted the discussion of classifications not adopted.And in both respects we think he has acted very judiciously.The work is now condensed-brought fully into accordancewith the pharmacological opinions in vogue, and can be usedwith great advantage as a handbook for examinations. Dr.Farre has, however, respected the text of Pereira so greatlythat the book, in our opinion, very imperfectly represents themedical knowledge of the day; and the purely therapeuticalopinions expressed as to drugs are greatly in the rear of ourpresent medical science. Adhering with rigid fidelity to thelast edition of the Pharmacopoeia, Dr. Farre omits many highlyuseful remedies altogether; and this is the more to be regrettedbecause they will be included in the next edition of the Phar-macopoeia, so that the work so laboriously, and in most re-spects so ably, edited, will in a few months be behind the

official, as it is now behind the scientific, standard. Wecannot understand the reason for ignoring the existence of sucharticles as the Calabar bean, podophyllin, actsea racemosa,oxalate of cerium, and others in frequent use; and the absenceof all information concerning them certainly detracts from theusefulness of the volume. Other articles on recent substancesare too severely short. All the information afforded about thenses of glycerine is the following :—’’ Glycerine is a usefuladdition to lotions, which it preserves in a moist state; whenheated with starch (30 to 80 grs. to 1 oz.), it forms a ’plasma,’which may be employed as an ointment or as a material forthe formation of ointments. Glycerine, diluted with water, is

frequently applied to chapped hands." We regret the Spartan

severity of the editor; and in articles such as this we feel thathe has not maintained the reputation of Pereira by an outlineso scanty. But we can recognise with great satisfaction thescientific and technical accuracy of the materia medica depart-ment ; and, backed here by the eminent botanist and chemistwho have assumed the responsibility of these departments,Dr. Farre has presented us with a book of unequal value it is

true., but still of high character, and which has enough torecommend it as an authoritative class-book.

0)1 the Ctire of Club-foot without Crcttiry Tendons: and oncerfain lléW lIlethod8 of Treating other Deformities. ByRICHARD BARWELL, F.R.C.S., Assist.-Surg. Charing-crossHospital, &c. Second Edition, greatly enlarged. pp. 228.London: Hardwicke.

ON the appearance of the first edition of this work, we spoke(THE LANCET, vol. i. 1863, p. 527) with commendation of theearnest and ingenious endeavours made by the author to

advance an important branch of practical surgery. The views

propagated by Mr. Barwell are, it is well known, opposed tosome of the doctrines of the day. This is no reason, however,why they should not be true, or at least worthy of the careful

consideration of those members of the profession who moreparticularly interest themselves in orthopaedic surgery. Sofar as we are aware, the author’s opinions have not been com-bated with such practical demonstrations of their error aswould lead us to say less for them now than we did on a pre-vious occasion, when we suggested that, whilst " all club-feetmay not be readily cured without the severance of certaintendons, yet a great number perhaps may be satisfactorilytreated without such division."In this new issue, chapter ii., " On the Deformities of the

Foot and their Proximate Cause," has been rewritten; and anew chapter (vi.) has been added, in which Infantile Paralysis,with its after-effects and treatment, receives consideration.The illustrations on wood have been augmented in number,

and numerous instructive photographic illustrations of club-feet both before and after treatment have been added. Theselatter indeed make Mr. Barwell’s little treatise a museum aswell as a book on pedal deformities. They are as mere photo-graphs only of second-rate quality it is true, but they wellillustrate the author’s meaning, and for such purpose alonehave they been introduced. Mr. Barwell himself is " quite awareof their shortcomings, but they are unavoidable. Patientsmust be photographed when they come, or not at all; andmany of the plates were taken under the most adverse circum-stances of light and weather." We would direct attention inparticular to the engraving at page 105, representing thenormal outlines of the foot, and its outlines in different stagesof valgus. From these it is evident that in valgus, since boththe front and the back of the foot yield outwards, the axis ofthe member no longer forms one straight line, but an anglesituated at the medio-tarsal joint.In recommending this new edition of Mr. Barwell’s book

to the notice of our readers, we would commend the energyand perseverance of its author, and at the same time stateour conviction, from what little experience we have hadof the "new method of treatment," that it will surely, thoughperhaps slowly, make way with the profession to a great if notto the whole extent demanded by the Assistant-Surgeon ofthe Charing-cross Hospital.

PUERPERAL FEVER AT MAIDENHEAD.To the Eclitor of THE LANCET.

SIR,—In your notice of the outbreak of puerperal fever atMaidenhead, reference is made to one case where the patientwas attended in her confinement by my late assistant; andfrom the fact that he had visited other cases of puerperalfever, the inference is drawn that he imparted the disease. Ibelieve this to be erroneous, and that the attack may ratherbe attributed to the circumstance of the poor woman havingsat by the bedside of a little nephew suffering from scarletfever about forty-eight hours before her labour commenced. Ithink this the more probable as she suffered from sore-throat-a symptom wanting in the other cases that came under mynotice.The discussion lately brought before the profession, and, I

regret to add, the public, has induced me to address you.Your obedient servant,

I Maidenhead, Nov. 29th, 1865. SAMUEL PLUMBE, M.D.SAMUEL PLUMBE, M.D.

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