1103

’the kidney, but it must be absolutely pure. There is increase<risk also of poisoning by antiseptics such as carbolic acidcorrosive sublimate, and iodoform ; therefore these should bE

employed with caution. The results of nephrectomies fo]

tuberculous kidney are far from good, although, according t(Steinthal’s statistics, in half the cases the other kidney &Icirc;!

’healthy, yet it may not be able to assume the neces.

.sary functional activity to compensate for the loss oj

the diseased organ, and as also tuberculosis of the

kidney is very frequently accompanied by tuberculosis else.where the cases which are really suitable for nepbrec-- tomy are rare. The lumbar route is preferred, but ProfessoxSenn suggests that transperitoneal nephrectomy mightbe deprived of much of its danger to life by the

operation being performed in two stages-the first part of theoperation consisting in making an abdominal incision andsuturing the margin of the posterior peritoneal incisionto the peritoneum of the abdominal incision and then

packing the cavity with sterile gauze and closing the

rest of the incision by temporary sutures. The suggestionis certainly ingenious. The whole book is very care-

fully written and numerous references are given to the

writings of others. The printing and get-up of the workare good.

The Unconseioug Mind. By ALFRED T. SCHOFIELD, M.D.Brux., M.R.C.S. Eng. London: Hodder and Stoughton.Pp. 436.A PROMINENCE has been given of late to the discussion of

psychical subjects not only in magazine articles but in thedaily press of this country, which no doubt is partly due tothe remarkable presidential address of Sir William Crookes,at last year’s meeting of the British Association. The

-appearance of the present volume written by a practicalphysician may be regarded as one of the signs of the

times. The endeavour of the work is to establish the’fact of an unconscious mind in man. It is interesting- and instructive as an assemblage of extracts from theworks of men of acknowledged talent, including some

of the profoundest intellects that have engaged in psycho-logical or metaphysical investigations, and the author

frankly admits that in writing this book he has soughtto establish every point and every statement on the

authority of others with the result that it appears to be

mostly a collection of the opinions of other people. While

pursuing his study in the field of psychology and kindred.sciences the writer found the whole subject of the

phenomena of unconscious mental action in a state of chaos,"vaguely denied by some and gravely asserted by others."Dr. Schofield urges the importance of the principles ofunconscious education to teachers, arguing that often thebest and most efficacious form of training in youth is

.addressed to the unconscious self. Several of the chaptersdiscuss the general relations between the unconscious mindand the body, and the chapters especially interesting to

practitioners are those dealing with the unconscious

mind and disease and their relation to therapeutics which- are all well worth reading with care. In speakingof quacks and their" cures " he says : "One of the mostextraordinary paradoxes of to-day lies in the fact that,simultaneously with an advance in scientific medicine whollyunparalleled in the world’s history, there is on every side aquackery that flourishes and triumphs as much as. or more 1than, in the darkest of the dark ages." The author ]holds that the charlatan’s modus operandi is explained i

by the action of the unconscious mind of his patient. <In the midst of the many extracts from the works sof others the writer gives a few interesting personal gexperiences. 1 1

LIBRARY TABLE.

An Atlas of Syphilis and the Venereal Diseases, including,

a Brief Treatise on the Pathology and Treatment. By Professor Dr. FRANZ ’MI?ACEK of Vienna. Authorised tran-lation from the German, edited by L. BOLTON BANGS, M.D.,Consulting Surgeon to St. Luke’s Hospital and the City Hos-pital, New York; late Professor of Genito-Urinary Surgeryand Venereal Diseases, New York Post-Graduate MedicalSchool and Hospital. With 71 coloured plates. London:The Rebman Publishing Company, Limited. Philadelphia :W. B. Saunders. 1898. 8vo. Pp. 122. Price 16.<. net.-

This is one of the Lehmann Medicinische Handatlanten, avaluable series by no means so well known in England asin continental countries, and this is to be ascribed to thefact that hitherto no English translation has existed. Thisvolume contains 71 plates, which are equally creditable tothe artist and to the printer, for they are very life-likeand give an excellent representation of the various skinlesions in i-yphilis. Each plate is accompanied bya description which includes a short history of thecase and the treatment adopted. A brief account of

syphilis is also given at the end of the volume, but the mostvaluable portion of the book certainly consists in the plates.It would have been well if more care had been taken totranslate the German expressions into terms which are

commonly used in this country; for instance, a primarysyphilitic sore is in nearly every instance spoken of as a

"sclerosis." This is very liable to confuse a student whohas been accustomed to apply the term sclerosis to anypathological condition in which there has been an increase offibrous tissue. Again, in Plate 29 is shown a portion of aleg with syphilitic ulcers with exuberant granulations andthe plate is described as showing "proliferating pustularulcers (frambesia or yaws)." The average student would notunderstand that the plate represented what has been called" syphilitic frambesia,",but would think that he was shown anexample of the frambesia or yaws of the West Indies. *Except for these comparatively slight defects nothing butpraise can be awarded to this useful little volume. We

noticed the German edition in our issue of May 7th, 1898,p. 1264.Mamcal of Diseases of the Skin, ?vit7i an Aiialysis of 0,000

Consecutive Cases and a Formulary. By L. Duwcnw

BULKLEY, A.M., M.D., Physician to the New York Skin andCancer Hospital, Dermatologist to the Randall’s Island His-pitals, &o. Fourth Edition, revised and enlarged. London :J. & A. Churchill. New Ycrk: G. P. Putnam’s Sons.1899. Pp. 362. Price 6s. 6d.-The preceding editions ofthis little work have been so well received that it is evidentthat it has proved useful, and for those, both practitionersand students, who desire a brief account of the diseases

affecting the skin we can warmly recommend this treatise.This fourth edition has been revised and to some extent

enlarged, but the book is still fmall. A great deal of atten-tion has been paid to treatment and the list of prescriptionsis likely to prove useful. The index is complete and a" Diagnosis Index " is also supplied, to which the reader mayturn in attempting to diagnose a doubtful case. The absence3f illustrations must, however, detract somewhat from thevalue of the book.

A Sun of l2imzmon. By ATHOL FORBES, London : Jarrold and3ons. Pp. 240.-Mr. Forbes’s preface led us to imagine that hisMok was all about witchcraft, but it is not. We quite agree,hat the belief in witchoraft is not dead and it is not im-

possible that there may be certain persons who can influencetthers for evil in a physical sense, for there is no doubt thathere are persons who influence others for evil in a moralense. But Mr. Forbes’s Raath, who turns out to be our old.cquaintance Hazael who succeeded to the throne of SyriaIY the simple process of murdering his predecessor, is a

1104

most unconvincing necromancer. Bulwer Lytton’s Arbacesis worth twenty Raaths and Meinhold’s incomparable Sidoniais superior to both. Mr. Forbes has descriptive power and Ithe account of the battle in Chapter XX. is very good. I

JOURNALS.

Annales de Gynecologie et d’ Obst&eacute;trique. August-September. Paris: G. Steinheil. 1899. Price 8 francs.-This double number contains some of the more importantreports and papers read before the Amsterdam Congress ofGynmcology and of Obstetrics. Professor Pinard presented areport upon the Indications for Cassarean Section comparedwith the Indications for the Operations of Symphysiotomy,Craniotomy, and the Induction of Premature Labour. His con-clusions are as follows : In the treatment of contracted pelvesand the induction of premature labour, all operations suchas the application of forceps or version, implying the extrac-tion of the foetal head by force against the bony resistanceof the pelvis, whether the bony resistance situated at the

brim, in the cavity, or at the outlet, and embryotomy uponthe living child, should be given up. His view is that

in such cases the treatment should consist of momentaryenlargement of the pelvis by symphysiotomy, pubiotomy,ischio-pubiotomy or coccygotomy, conservative Csesareansection or partial or total hysterectomy, and embryotomyupon the dead child. Further details are given of the casesof symphysiotomy at the Clinique Baudelocque from 1897 to1899, bringing the total number up to 100 with 12 maternaldeaths. Professor Lebedeff and Dr. P. Bartoszewicz pre-sented a report upon the Variability of the Pelvic Measurementsin Different Attitudes of the Body. Professor Porak read a

paper upon Omphalotripsy, advocating the application of

pressure forceps applied for from 10 to 15 minutes as a certainand sufficient means of arresting haemorrhage from thecord. Professor Baldy’s paper upon the Surgical Treat-ment of Fibroids of the Uterus and Professor Hartmann’s

paper upon the Relative Value of Antiseptics and ofPerfection of Technique in the Actual Results of Opera-tive Gynaecology are given in full. The rest of the

number, consisting of some 370 pages, is of greatinterest and value, containing as it does the pro-

ceedings and full reports of the discussions and papersread at the Congress. The editors are to be congratulatedupon presenting so full an account of the proceedings of theCongress to such of their readers as will not have access tothe complete Transactions.

THE TYPHOID FEVER EPIDEMIC AT TRING.-A site at Tring has been given by Lord Rothschild for anisolation hospital which the urban district council hasresolved to erect, at a cost of f,2500, in consequence of theoutbreak of typhoid fever in the district.

THE PFAUDLER VACUUM SYSTEM OF FERMENTA-TION.-The application of this system to the production oflager beer on a very large scale has recently been commencedat the brewery of Messrs. Allsopp at Burton-on-Trent. Wehope shortly to return to this subject, inasmuch as thedeparture is quite new in regard to the English brewingindustry and has an important bearing upon the beve-rage of the people. We have often confessed surprisethat English brewers did not pay attention to thebrewing of lighter - beers like those consumed on theContinent. We are confirmed in our opinion by the

important step which Messrs. Allsopp have recently takenthat there is a growing demand for a lighter. beverage. Ina future number we propose to publish an account of themachinery at Burton which was inspected last Wednesday bya very large company of visitors from London. At the sametime we think that it will be instructive to our readers if we

print the result of a series of analyses, which will be under-taken in THE LANCET laboratory, dealing with the com-position of the new English lager beer. -

New Inventions.IMPROVED OVUM FORCEPS.

THE Ovum Forceps depicted in the accompanying illustra-tion has been made for me by Messrs. Allen and Hanburys,48, Wigmore-street, W. I think it meets a felt want. The

ordinary ovum forceps is well known, having a pair ofblades which meet at a point at the end, the only place at.which they are in contact, and the theory of its actionseems to be that the egg-shaped ovum will fall into the ovalaperture of the blades and, lying there, be easily extracted.In fact, as all practitioners know, it does nothing of the

,SV1 U. VL&ouml;U fjjjultgil iiii V Y fAlL1 1;,0-

torn in the act of extracting it andtorn in the act of extracting it andthen a portion being left and beingbesides attached to the uterus, can-not be removed by the ordinaryovum forceps which grasps it onlyby the extreme tips of the blades.Finding this difficulty in many ofthe cases in which I was asked tcassist practitioners I first got theordinary ovum forceps flattenedout, so that the blades should be incontact all the way along and not’

merely at their tips. The serrationat the blades gave a rather bettergrip and a little more power of ex-traction was gained. Still, however,too often the blades slipped over a.portion of the attached placenta, andother means had to be used to ex-tract it. Curetting is objectionablerin many of these cases because itinjures the delicate mucosa. So Isuggested the instrument shown, a.

kind of evolution of the ordinaryovum forceps and a considerable im-provement on it. The edges ofthe blades, whose general curve andshape have been retained, as theyrequired no improvement, have=been bevelled, so as to avoid injuryto the uterine mucosa. After theirintroduction the blades are openedand moved in the direction of theoattached placental tissue which canoften be just touched but cannot beextracted by the tip of the index ormiddle finger. When the bladesare opened the placenta or ovum’can be grasped between them andthen the projected teeth, projecting

on the other, each fitting into the openings on the

opposite side when the blades are closed, grip theovum or placenta and extract it. I have found thisinstrument serve me well on several occasions. Practi-tioners are usually struck by its adaptability to the,intended purpose, and more than once have I heard it saidthat it was the " very thing." Messrs. Allen and Hanburyshave suggested and carried out the further improvement ofan aseptic joint which allows of thorough cleansing of theblades each one separately after use. It is, of course, usedwith strict aseptic and antiseptic arrangements. By its useI have often been able to obviate the necessity of widely andforcibly dilating the os and cervix, which it is better toavoid when Dossibln in the management of these cases.

A. RABAGLIATI, M.A., M.D., F.R.C.S. Edin.,Honorary Gyn&aelig;cologist, Bradford Royal Infirmary,

I Bradford, Yorks. -

THE DUNKLEY (GAS) MOTOR CAR.THE motor car represented in the accompanying illus-

tration is intended for two adults, as a phaeton, or for twochildren and a governess, or for one adult. It is driven by aDunkley gas motor, which is constructed either so as to I)ecapable of taking in gas from any ordinary gas-pipe, with agas-bag attached, or to work with gas that is generated as