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urine was lost on the 22nd. The enemata were returnedsubsequently to the 20th, three or four motions beingdaily recorded; ’on previous days only one as a rule. i3. Four or five years ago I had two cases of pyloricobstruction in the Leeds Infirmary, in which visibleperistaltic movements were extremely well marked and ivery readily obtainable. At that time I found, uponrepeated trials, no trace of such visible movement in ordinarydilated stomachs, though slight occasional audible gurglingsgave evidence that a little movement does occur, probably idue to the intrinsic ganglia; the gastric branches or terminals sof the pneumogastric nerves, both sensory and motor, beingparalysed (from neuritis ?). I have since been accustomedto rely upon the degree of peristaltic movement obtainableas a differentiating sign between obstructive and paralyticcases of dilatation of the stomach, and have had manyopportunities of demonstrating the difference. In the presentcase of obstruction, however, increased peristalsis was notshown for the reasons above mentioned. 4. I did not proposepylorectomy; the operation has never, I believe, been success-ful in this country. About three years ago Mr. Jessop operatedupon a patient who was under my care in the infirmary, butalthough the operation was in itself completely successful,and appeared to promise well, the patient sank on thenext day. Jejunostomy or duodenostomy might havebeen applicable, but experience hardly yet warrants thebelief that in such a case life would have been much pro-longed ; it might of course have been much shortened.Some years ago I attempted to pass a long speciallymade oesophagus bougie onward through the pylorus ina very thin patient, whose stomach was dilated andhypertrophied from probably simple or non-malignantstenosis of the pylorus. The attempt was not success-
ful, and the patient declined any cutting operation.My colleague, Dr. Eddison, has since suggested that,the tube or bougie having been introduced into thestomach, the abdomen should then be opened and thetube guided and pushed through the pylorus without open-ing the stomach itself. I have tried this plan on the deadsubject, and believe it could be accomplished on the livingsubject, if the resistance was not very great. 5. The absenceof blood from the vomit and the motions, or any history of.its occurrence, might perhaps have been more strictly reliedupon to exclude ulceration and its results from the diagnosis.6. Feeding by enema was maintained for eight weeks-March 31st to May 24th; but for eight days-April 7th tothe 14th-there was no vomiting. Even after this timeprobably some food was at times absorbed from the stomach.The success of transfusion of a so-called normal saline solu-tion to replace the lost water and salts of the blood wasmore permanent than in cholera, where there is a poison ; orin cases of haemorrhage and anaemia, where blood cellsare also wanting. In this patient, the blood which escaped,after the transfusion, from a small artery, was of a remark-ably good colour and consistence. It is probable that byintravenous injection of a saline solution, or a mixture ofsuch a solution with blood, strength might be obtained toendure or to rally after an operation (of any kind) from whichsome exhausted patients could not otherwise recover. i
Notices of Books.A Text-book oj Biology, comprising Vegetable and Animal
Morphology and Physiology. By J. R. AINSWORTH DAVIS,B.A. With numerous Illustrations, Glossary, and Examina-tion Questions. Pp. 462. London : Charles Griffin and Co. I
.1888.-As the title shows, this book is of an ambitious cha- iracter, and aims at familiarising the student with the whole i_circle of biology, both animal and vegetable. There can beno question that the student of biology should commence i
his work by devoting some time to the careful observation of Ithe simplest forms of organised matter. It is only in this iway that he can learn the intimate connexion which exists Ibetween animals and plants, can recognise the difficultiesthat are experienced in drawing hard-and-fast linesseparating one from the other kingdom, and can appreciatethe gradual process of specialisation that is observable in Ipassing from the lower to the higher forms. The ability of Ithe writer of such a text-book as this is to be estimated j
by the selection he makes from the immense mass ofmaterial at his disposal, the plants or animals hetakes as types, and the importance of the facts in
regard to their structures and functions he considersthe student should be taught and made to comprehend.The plants selected by Mr. Davis have, we think, beenjudiciously chosen, and include the Yeast Plant, Bacteria,and White and Green Mould, amongst Fungi, to which oneof the higher forms might have been added with advantage;Protococcus, Pluvialis, Spirogyra, Fucus, Chara, and Nitellaamongst the Algse; Funaria and Polytrichum amongst theMosses; Bracken and Male Fern amongst the Ferns; Pinusamongst the Gymnogens, and various well-known and easilyobtainable plants amongst the Angiosperms. In the animal
kingdom the examples chosen are Amoeba and Vorticellaamongst the Protozoa; Hydra as a type of the Caelenterata;Distoma and Lumbricus amongst the Vermes; the Crayfishas a representative of Arthropoda; Anodonta, Unio, andHelix, of Mollusca; and amongst Vertebrata the Frog,Pigeon, and Rabbit, to which a Coluber might havebeen added. In each case-as, for example, in the caseof the Crayfish-the external morphological charactersare given in a highly compressed section, which isfollowed by a description of the digestive, respiratory,excretory, and reproductive organs, the muscular andnervous systems, and, finally, the physiology, includingthe development of the animal. Two good and originalchapters are introduced on Comparative Vegetable andComparative Animal Morphology and Physiology, in whichthe principal features of the several groups are succinctlygiven. Thus, in speaking of contrivances for securing crossfertilisation, Mr. Davis describes the cases of wind pol-linated, insect pollinated, water, bird, and snail pollinatedforms. Taking one of them, the insect pollinated, heremarks that "entomophilous flowers include the vast
majority. They exhibit many peculiarities, the most
important being irregularity, and other structural features,as well as the possession of colour (other than green), odour,and nectar. The last three features serve to attract insects;the others cause them to effect the purpose in view. Thecolours may attract insects generally or only special insects.Bees, for example, prefer blue, flies yellow or flesh colour;white flowers are often pollinated by night insects. Theeffect of colour is augmented in many cases by aggrega-tion, as, for example, in the capitulum of the daisy." Hethen proceeds to explain the structural peculiarities bywhich pollination is assisted, as in labiates, orchids, andpapilionaceous flowers. To render the work more useful tostudents a very good index glossary is added, in compilingwhich the author was aided by Mr. Marshall. The workis illustrated very well by 158 woodcuts. Many of theexamination questions at the London University are givenat the end of the work. If thoroughly digested, we do notdoubt that a student of this work would pass a very credit-able examination on Biology.
Land,iizctrks: Medical and Surgical. By LUTHER HOLDEN.Fourth Edition. London : J. & A. Churchill. 1888.-Thenew edition of this work is based upon the same linesas those which have preceded it, and there are com-
paratively few changes. The work is, however, improvedand somewhat enlarged by the introduction of a few addi-tional "landmarks." These are chiefly indications for
finding the principal nerve trunks in the various parts ofthe body, with directions as to the placing of the polesof the battery when galvanism is required. Amongst thenerves which are specially mentioned in this edition arethose of the scalp, the seventh, the spinal accessory, phrenic,anterior crural, sciatic, popliteal, and median and ulnar.More special attention is drawn to the position of thecarotid artery in the neck, whilst the point of com-
mencement of the inferior vena cava i’3 alluded to in the
landmarks of the abdomen. The anatomical peculiaritiesof suppuration under the tendon of the occipito-frontalismuscle are pointed out, and there are new paragraphs on thefontanelles, and their alteration under conditions of disease.The changes produced by tight lacing on the abdominalviscera &c. are brought forward. Indications for the
placing of the incisions used in various operations are givenwith needful accuracy, except in the case of Syme’s amputa-tion at the ankle joint, where the plantar incision is said toterminate at the tip of the internal malleolus, instead of a"point exactly opposite its commencement" from the outerside-that is, about half an inch below and behind the tip ofthe malleolus. The variations as to extension of the pleurabelow the last rib might be more fully given in the indica-tions for the incisions in lumbar nephrectomy. The diagramshowing the relation of the thoracic viscera to the bonyframework of the chest is retained, but no other diagramsare given, the author maintaining that the living modelshould be studied with the book, and the reader thus becomepractically acquainted with the normal feel and situation ofparts. One who works in this way to learn his surgicalanatomy not only does well in examinations, but gains thatknowledge of the human body so essential to one who is aboutto enter the profession. The general character of this work,to which we have alluded in reviews of previous editions,is so well known that it is not now necessary to say morethan that the book fully maintains its position in the frontrank of those on the subject of which it treats.The Bombay JY[ateria 1lTedica and their Therapeutics. By
R. N. KHORY, M.D. Brux., M.R.C.P., &c. Bombay :Printed at Ranina’s Union Press. 1887.-This is a bookto which we should be glad to extend every indulgence ifonly from the dread of discouraging native medical sciencein India, but, while making every allowance for the dis-
advantages under which the author has worked, we regretthat we can accord the book only very qualified praise. Itis a compilation from Persian, Urdu, and Sanscrit medicalworks, and is an attempt to popularise the use of nativedrugs. So far as it carries out this intention it is
sufficiently laudable, but it is a matter for regret thatDr. Khory should appeal not only to medical students andpractitioners, but also to the public at large. This,however, being the aim of the book, our remarks uponit are made upon the broader basis-the considerationof its probable influence for good or evil upon the generalpublic. In its general arrangement it is true to its title,but at the end three appendices reduce it almost to thelevel of a book on domestic medicine. One appendix consistsof an alphabetical classification of diseases, with numbersreferring to the prescriptions given in the body of the work;another gives an alphabetical classification of drugs used assubstitutes for other English drugs; and a third is an alpha-betical classification of drugs used as specifics in certaindiseases. It is difficult to gather the value assigned by theauthor to the term " specifics"; to judge from his employ-ment of it, he uses the term in a sense which is new; thusthe table includes " specifics" for heart disease, for fever,for liver diseases (sic), for apoplexy, and for cholera. It isto be hoped that the author has carefully considered thequestion of the substitution of native drugs for Englishdrugs ; he mentions substitutes for digitalis and quinine,although in European therapeutic work true substitutes arepractically unknown. The printing and paper leave muchto be desired.
A2estrian Health Resorts, and the Batter TVctte2,s ofHu7zcary. By W. FRASER RAE. Pp. 292. London :
Chapman and Hall. 1888.-This volume consists of a seriesof articles reprinted from The Times and the A7,iitfteenthCentury, but with considerable additions made as the resultof revisiting several of the places. We called attention tothe articles in The Times at the period of their publication.
The work is not intended as a guide to medical men in theselection of a health resort, and therefore, with the singleexception of Roncegno, of the waters of which Mr. Raecould find no description in any English work, there is noinformation given respecting the chemical composition ofany of the springs or the cases in which their use would,from a medical point of view, be advisable. Its purposeis rather to afford useful information to persons who may berecommended by their medical advisers to resort to any ofthem, or to those who may wish to visit them without anyintention of taking a course of the waters. The book is
very readable, and brings to notice a number of placeswhich are practically unknown to the English, and whichmay be advantageously visited by holiday makers who aredesirous of enjoying fine scenery and thorough change with-out finding themselves in the not very desirable position ofbeing a unit in an English crowd at a foreign health resort.It will also be found an interesting book by stay-at-hometravellers.Modern Education, its Defects and Remedies ; or, Ho2v to
Cope with Foreign Competition. By JOHN GIBSON, M.A.Pp. 32. London: Cornish and Sons. 1888.-This brochureis intended as an aid to the solution of the difficult and
important problem, "what to do with our sons." We arenot prepared to endorse all the author says on the subject,but he clearly points out important defects in the presentsystem of education, and especially during the earlier yearsof a boy’s life. His remarks on the duties of parents in thisrespect, and on the importance of care in the selection ofschools, preparatory and advanced, deserve the attentiveconsideration of all who have anything to do with theeducation of the rising generation. The necessity for anadequate knowledge of French and German by young menintended for a mercantile career is at last beginning to bebetter understood and appreciated in this country.
Sick Diet and Applications. By F. W. CORY. Pp. 8.Second Edition. London: Simpkin, Marshall, and Co.1888.-This is intended as a pamphlet for every home, andis published at a penny. It contains a useful collection ofinstructions for making some of the more necessary articlesof sick diet. It states clearly the quantities of the variousingredients required, and the time necessary for the cook-ing. The directions for making oatmeal porridge are verygood, but the additional boiling for fifteen or twentyminutes should be imperative instead of permissive. Themethod of cooking eggs is on the principle of the old-
fashioned ’’ egg-coddler." We can recommend the pamphletas containing good practical directions for the preparationof sick diets.On the Treatment of RllptU7’C of the Perineum. By
GEORGE GRANVILLE BANTOCK, M.D., F.R.C.S. Ed. SecondEdition. 1888.--The first edition of this little book ap-peared ten years ago. The details of the operation havebeen slightly modified by the author, and the matter some-what rearranged, while the course of time has furnishedadditional cases.
The Aselepiad.-No. 19, Vol. V., contains the followingarticles: Methylene as an Anaesthetic; the Art of Embalm-ing, including the latest methods, with three illustrations;Opuscula Practica; Laennec and the Discovery of MediateAuscultation by the Stethoscope; Some Original Observa-tions in Physiological Therapeutics made on the Fresh-water Jellyfish or Medusa; Items from ContemporaryPractice and Literature.
QUARANTINE.-The Board of Trade have receivedthrough the Secretary of State for Foreign Affairs informa-tion that quarantine has been imposed at Alexandria uponarrivals from Madras and Bombay. The Port of Diu isinfected with cholera, and all the other ports of PortugueseIndia are suspected of the same disease.