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Reviews and Notices of Books.The Principles and Practice of Medicine. Edited and com-

pleted from the manuscript of the late CHARLES HILTONFAGGE, M.D., F.R.C.P., by PHILIP HENRY PYE-SIITH,M.D., F.R.S. Second Edition. London: J. & A.Churchill. 1888.

A Handbook of the Theory and Practice of Medicine. ByFREDERICK T. ROBERTS, M.D., B.Sc., F.R.C.P. SeventhEdition. London: H. K. Lewis. 1888.

THE appearance, within a few weeks of each other, ofnew editions of these admirable text-books is well-timed,and will doubtless be gratefully appreciated by the largebody of students who will flock to the schools in October.In including them under one notice, we must disclaim anyintention of instituting a comparison between works whichare, except for their subject, dissimilar in almost everyrespect. Yet they are both equally to be commended, andeach is, in its sphere, of great utility. The high estimationin which Dr. Fagge’s work is held is sufficiently shown by therapid appearance of a second edition, which, in the case ofa book that appeals rather to the "advanced" student andto the practitioner and hospital physician is remarkable.In truth, the profession soon found out the sterling qualitiesof the work, and regarded it-as it deserves-as the expres-sion of the personal experience and thought of a highlytrained and cultured physician. Indeed, no one who entersupon the perusal of Fagge’s "Medicine" will care to

leave a single page unread, and the task will be foundconsiderably lightened by the attractive way in which thebook is written. The author speaks throughout from hisown knowledge, and discusses moot points in pathologywith rare independence. It will be remembered thatDr. Fagge did not live to complete the work upon whichhe had expended the labour and thought of years; andthat Dr. Pye-Smith, who edited the volumes, himselfadded the sections upon Diseases of the Skin, andentrusted to Dr. Wilks those upon Diseases of the Heart.In this second edition the section on Insanity has beencontributed by Dr. Savage. Dr. Pye-Smith has submittedthe whole work to the most careful revision, with theresult that it is not only brought fully up to date, but isfar more complete and "finished" than it was originally.Evidences of the editor’s painstaking and care are to befound in every part of the two bulky volumes, some-

times in the form of foot-notes containing definitions orhistorical references, again in excellent discussions uponthe principles of nosology, and mainly in additions to oralterations in the text. Amongst the more important ofsuch changes may be mentioned the sections on Pyæmia,Febricula, and Vaccinia; the rewriting of the chapter onRubeola; extensive additions to those on Cholera, MalaritlFever, and Diphtheria ; the introduction of articleson Actinomycosis, Peripheral Neuritis, and Friedreich’sand Thomsen’s Diseases; and considerable expansions ofthose on Anaemia and Arthritic Affections. But this bareenumeration by no means includes all that Dr. Pye-Smithhas done. It is clear, from the abundant references to

literature of the past three years, that he has spared nopains to make the book thoroughly abreast of advancingknowledge; whilst there are frequent’ citations of factswhich have come under his own notice, and the recordsof Guy’s Hospital are largely drawn upon. In all thisit will be seen that the editor has continued the workin the spirit of its author, who desired to write a- bookwhich should embody in large measure the fruits ofobservation in the wards of that great institution. Wetrust that the accomplished physician who has so faith-fully and judiciously edited it in the spirit of his lamentedcolleague may long enjoy the satisfaction of seeing manymore editions of a like character through the press. Of

the scientific character of a work on medicine thus

produced it would be superfluous to speak, but perhapsthe following excerpt from the first of the editor’s foot-notes may be cited as testimony of this. After speakingof a definition of disease, lie adds: "It is clear thatif disease is not a single state, nor the result of a singlecause, it cannot be removed by any single method or onany universal principle. Hence all systems ’ of medicine,like all ’universal remedies,’ are of necessity false.latro-mechanical and iatro-chemical schools, Brunonianand Antiphlogistic theories, Allopathy and Homoeopathy,are all equally unreasonable; not wrong solutions of a

scientific problem, but ignorant answers to an absurd

question." Here we have the judgment, not of a dogma.tist,but of the man of science, who, in medicine as in other de-partments, has overturned many a doctrine based on insuf-ficient data. Before leaving this book, the study of whichwe cannot too highly commend, it may be as well to mentionthat in this edition the typography has been vastly improvedwithout unduly adding to the size of the volumes. Thosewho are acquainted with the close printing of the firstedition will be grateful for this change. There has alsobeen considerable, but not quite sufficient, improvement inthe bibliographical index.When a text-book reaches its seventh edition there is

little left to be said upon it. This is the case with theHandbook of Dr. Frederick Roberts-one of the most

popular text-books of the day. The merit of the work con-sists in the very systematic and orderly grouping of facts, andin the clear and terse descriptions of disease and its treat-ment, which make it so useful to the student. The authorhas submitted it to thorough revision, and he is to be con-gratulated upon the success which has attended his labours.

OUR LIBRARY TABLE.

On Transfusion of Blood and Saline Fluids. By C.EGERTON JENNINGS, F.R.C.S. &c. Third Edition. Pp. 133.London: Bailliere, Tindall, and Cox. 1888.-This edition

presents evidence in support of the author’s original view ofthe practicability of directly transfusing human blood, andof, repairing the loss by the intravenous injection of salinefluid. In the autumn of 1884, Mr. Egerton Jennings per-formed numerous experiments at Ghent, of which he

published an account in our columns; he found that if

depletion and intravenous injection were performed quicklyafter apparent death, cardiac pulsation was restored.These researches, and their important bearing upon thetreatment of chloroform poisoning and asphyxia, form aninteresting appendix to the work as originally published.The circumstances under which transfusion is commonlyrequired are of such urgency that this attempt to minimisethe dangers and difficulties should be warmly welcomed andwidely read.

Lct Digitcle. By HENRI HUCHARD. Pp. 136. Paris :0. Berthier. 1888.-This is an inquiry as to when andhow digitalis should be prescribed. An attempt to deduceconclusions from physiological experiments leads the authorto consider that it is incorrect to regard this drug as theopium of the heart or the cardiac quinine, since it will actas sedative or tonic according to the circumstances of its

employment. He prefers to regard it as a regulator of thewhole circulatory system, looking rather to the generalevidence of cardiac failure than to the special valvularlesion. He believes that all considerations of the orificeaffected occupy a very secondary position as indications fordigitalis. The indications he considers most important arethe following : enfeeblement of cardiac contraction, loweringof arterial tension Nvitli increase of venous tension, anddiminished renal excretion coexisting with dropsy and withsigns of congestion of the viscera. The author expresses hisviews strongly, but perhaps with an over-tendency to make

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a sombre picture of the conditions in which digitalis is

injurious, useless, or of doubtful efficacy. In common withmost French therapeutists, he believes in the ill effects ofthe continuous employment of moderate doses, fearing cumu-lative action. He thinks it should be used for four or five e

days, and then discontinued for at least ten or fifteen days.The matter is regarded almost solely from a therapeuticpoint of , and therefore suffers from the comparativeabsence of illustrative cases, their place being taken byrather wide generalisations. As a fairly representativeexposition of French ideas of the actions, uses, and dangersof digitalis, this little book will doubtless prove interest-

ing.The Student’s Handbook of the Practice of Medicine. By

H. AUBREY HUSBAND, M.B., C.M., &c. Fourth Edition.

Pp. 510. Edinburgh: E. & S. Livingstone. 1888. - Thefourth edition of this little handbook will be welcomed bythose who like their information in compact form. Theauthor has endeavoured to bring the book up to date byconsiderable additions and alterations of the section devotedto diseases of the nervous system. Several new tables havebeen added which will facilitate the work of the student,even though they occasionally give a greater appearance ofprecision than is entirely warranted. Some illustrationshave also been added to this edition, but it is to be regrettedthat in three instances their well-known source is mentionedin a barely recognisable misprint. Although the authorclaims to have adopted the nomenclature of the RoyalCollege of Physicians, lie has disregarded the work of the (last Pharmacopoeia in the half-dozen pages of prescriptionsat the end of the book.

A Practical Dccirraccl System foo Great Britain and herCulonies. By P,. T. ROHDE. London : Effingham Wilson.-Mr. Rohde has devoted much time and energy to the veryuseful, but withal somewhat disheartening, task of advo-cating the adoption of a decimal system of money weightsand measures for use in Great Britain and her colonies. It is

quite unnecessary to say that he succeeds in making abun-dantly clear the great advantages which would accrue inmany ways from the reform that he advocates. Everybodywho takes up the theme at all succeeds to that extent. In-

deed, so far as we are aware, there is not to be found outsidethe very narrow circle of those who have a superstitiousveneration for our existing system, or rather aggregate, ofmeasures, any man who seriously argues for the superiorityof the present over the decimal method of subdivision.The difficulty does not lie there. The real trouble is thatwe are all supplied with measuring instruments of one

kind and another graduated to existing scales. Theseinstruments are ready to hand, and familiar by long I

acquaintance to our imagination. «Te grudge the troubleand expense of making a change. For instance, one part i

of Mr. Rohde’s scheme is to subdivide the foot into tendecimal inches, and then again into ten still smaller isubdivisions. Now, it is plain that the introduction

i

of such a scale would mean a very serious outlayupon new "two-foot rules on the part of the workingpopulation, and would result in an amount of imme-diate confusion between old-fashioned and new-fashionedinches not at all pleasant to contemplate. On theother hand, the benefits to be gained from the changewould in this instance be reduced to a minimum. It is

comparatively seldom that inches are brought into arithme-tical operations. Let any reader, for example, ask himselfhow often within recollection lie has required to add orsubtract, to multiply or divide, a quantity expressed ininches. Very rarely, we will undertake to say. They are i

almost always employed for the purposes of descriptiononly-purposes which the duodecimal inch subserves quite Ias well as any other. In other parts of Mr. Rohde’s scheme,

however, these conditions are reversed. Thus the change ofthe monetary scale involves the disadvantages only at theirminimum, and would confer upon the community the maxi-mum of benefit. No one has any private " plant ofmoney that would be depreciated by the proposed alteration,whereas the constant employment of money terms in thearithmetic of accounts renders their simplification a matterof the greatest importance. With this part of his subjectMr. Rohde has dealt, as we think, quite satisfactorily, andwe highly commend his little pamphlet to those who canunderstand and appreciate the importance of his theme.A Practical Manual of Venereal -Diseases, including

Disorders of Generation, Spermatorrhœa, Prostatorrhœa,Irrapoterace, and Sterility in both Sexes. By M. K. HAR-GREAVES, M. D. London: R. Kimpton --"This book hasbeen written with the primary intention of bringing in apractical and concise form before the senior student and

general practitioner information on a most importantbranch of medical science, which unfortunately receivesfar too little attention and study during the usual cnr-riculum." It is, however, difficult to see what a "seniorstudent or general practitioner" who has read the ordinarymanuals of surgery and diseases of women has to learnfrom Dr. Hargreaves’ little book. One is tempted to ask,What advantage can there be in multiplying treatises onsuch subjects?

New Inventions.PESSARY FOR PROLAPSE OF THE BLADDER.BEING dissatisfied with other instruments, I had made

the specimen figured in the accompanying woodcut. Itwas originally constructed for a special case, in which itsucceeded admirably, and it has been used successfullyin several cases since. The material is vulcanite. It

consists of a horse-collar shaped loop, to the small end ofwhich is attached the stem, bent about two inches from the

loop, so that the stem is at about 90° with it. The loop(with or without crossbars) is passed into the vagina, andwhen the instrument is fixed supports the anterior wall ofthe vagina, and prevents it descending. The stem passesup over the pubes, where it is fixed by a broad band passing

round the pelvis in the position of an ordinary truss. It isso fixed in the band that the instrument is unable to descend,

’ and the broadness of the band prevents the instrumentbeing forced out of the vagina. On the other hand, it’ does not exert any injurious pressure, but acts purely as a

support, preventing the bladder from descending ratherf than exerting any lifting force upon it. It is stated to be

quite comfortable to wear, and it successfully keeps theparts from prolapse. It is very essential that the stem’ i passing up over the pubes be fixed in a band at least twoinches in width. Messrs. Arnold and Sons, of West Smith-

’ field, have well carried out my instructions.T. FREDERICK PEARSE, M.D., F.R.C.S.