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Second Annual Report of the Henry Phipps Institute for the Study, Treatment, and Prevention of Tuberculosis.

The second report of the Phipps institution is a volume of 452 pages. In the vast amount of information furnished in this it would be somewhat difficult to select that which would be most interesting to readers of the JOURNAL were not special sections devoted to the Neurological Work and Mental Attitude in Tuberculosis, the former covering forty-four pages and the latter ten. The neurological report has been made by Dr. D. J. McCarthy, who has been assisted in his work by Dr. Carncross, who reports directly upon the mental attitude in tuberculosis. Dr. McCarthy, however, takes up the mental attitude in less detail than does Dr. Carncross. Justice could not be done to these reports by as brief an abstract as would have to be made here, but those interested are referred to the original as being most interesting. The institution has for some time been experimenting with Maragliano's serum and with serumtherapy in general. This report has been made by Dr. Ravenel, who studied under Prof. Maragliano and in other parts of Europe. He gives a history of the work preceding that of Maragliano, describes the method of preparation of the serum, and also reviews the work of Marmorek. In another part of the book are reports of three cases which have been treated with Maragliano Serum, two of these having been compared with seven other cases treated without. The conclusion of Dr. Stanton is that "as far as it is possible to judge from so limited an observation, the use of Maragliano serum is not indicated in cases of moderate or advanced degree." His other conclusions deal more with details. The single case reported by Dr. Landis is reported principally because of the "untoward effects" caused by each injection. The report is a most interesting one.

W. R. D.

Department of Neurology, Harvard Medical School. Contributions from the Massachusetts General Hospital, The Boston City Hospital, The Long Island Hospital, and the Neurological Laboratory. Vol. I. (Boston, 1906.)

The staff of the Neurological Department of Harvard University, consisting of Drs. Jas. J. Putnam, G. L. Walton, Philip C. Knapp, E. W. Taylor, and E. W. Waterman, have collected the papers, numbering twelve, which have been published by them during the past three years and with them have made an attractive volume. Unlike a number of collections of this character there is a uniformity in the size of the pages, type, etc., which makes the book most attractive. In addition to this the wide margins add much to the appearance of the pages, and the tasteful gray covering makes it a most dignified volume. With the names of the authors it is hardly necessary to state that the papers are most interesting and well done. All but one of the papers have been published in the Boston Medical and Surgical Journal. The preface informs us that it is the intention of the Neurological Department to hereafter publish approximately once

yearly its work in this form in order that it may be conveniently preserved.

Of the value of the publication to those interested in neurology it is unnecessary to speak, and an addition to the volume, which it is intended to print in each volume that hereafter appears, is the appendix giving a complete bibliography of each of the different men. It is not stated how this work may be procured, but probably a letter to any one connected with the Neurological Department would elicit this information.

W. R. D.

Philadelphia Hospital Reports. Vol. VI. 1905. Edited by HERMAN B. ALLYN. (Philadelphia: Printed by Bradley Printing Company, 1905.) This volume contains a number of papers on neurological subjects and two of special psychiatric interest, viz.: The Delirium noticed in Cardiac Disease, by Roland G. Curtin; and Three Cases of Mental Disorder associated with Multiple Neuritis (Korsakoff's Disease). Reported by S. A. Carpenter. Besides these there are a number of papers upon medical and surgical subjects. The first paper, entitled "An Account of the First Clinical Reports," issued from the Philadelphia Hospital, by H. M. Landis, is of considerable historical interest, and in closing Dr. Landis says: "From this brief account of the prevailing conditions seventy-five years ago it will be seen how closely the habits and traditions of the hospital have clung to it. There is no apparent change in the class of patients; no decrease in the wealth of clinical material; the mortality rate remains high; clinic days are the same, and habits, meriting 'severe reprehension,' still continues." It seems superfluous to speak of the high quality of these papers, as the list of authors includes such men as Roland G. Curtin, Chas. K. Mills, F. X. Dercum, Alfred Gordon, G. E. de Schweinitz, Wm. E. Hughes, Robert N. Willson, Orville Horwitz, and many others equally well known.

The volume proper contains 276 pages, but the inclusion of 13 papers, reprinted from other publications, adds considerably to the size. Unfortunately, these latter are separately paged and are not indexed. In mechanical details, however, they are superior to the body of the book, which is poorly printed. The whole is neatly bound in cloth.

Manual of Psychiatry. By J. ROGUES DE FURSAC, M. D.

W. R. D.

Translated by

A. J. ROSANOFF, M. D. (New York: John Wiley & Sons, 1905.) A small text-book on Mental Diseases is a dangerous thing. Brevity tends to dogmatism, asserted or suggested, and of all sciences psychiatry is the one in which dogmatism is most out of place. The 350-page manual of de Fursac, now in the second French edition, does not altogether escape this danger; it is, however, a serviceable handbook. The author is a close disciple of Kræpelin, and thus adds his influence in spreading the Heidelberg doctrines in France. In treatment the book follows the plan

of most modern text-books, introducing the subject of the individual psychoses by a section on general symptomatology containing an abundance of concise descriptions and definitions, including numerous quotations from various authorities. In this part the views of French alienists are given full credit, and the book is particularly interesting as a fairly unbiased French presentation, with French symptomatology and nomenclature, of a system of psychiatry, in its larger outlines essentially German. The translation seems to be satisfactory, and the book, either in English or the later French edition, can be recommended.

FARRAR.

Thirty-Fourth Annual Report of the Board of Commissioners of Public Charities of the Commonwealth of Pennsylvania for 1903.

From this report we learn that there are in Pennsylvania 71 prisons, 70 almshouses, 15 institutions, II State hospitals for the insane, 7 State hospitals, 105 general hospitals, and 157 homes. These are all under the supervision of the Board, of which there is a distinct, and to some degree, independent Committee on Lunacy, with its own chairman and secretary or executive officer. The report of this committee covers 115 pages. Three hundred and twenty-five pages are devoted to the report on general hospitals, almshouses, and other institutions. On September 30, 1903, there were 12,732 insane persons under care, of whom 1030 were private patients. In the two years preceding publication of the report the average increase in number of the insane has been 49.2 per annum. In order to care for this annual increase it is proposed to build relatively small buildings on the grounds of existing institutions, practically the adoption of the cottage or colony plan. This has been done to a limited degree at Warren and has been satisfactory. The statistical tables cover 69 pages, and the majority are intelligible, but a number are of such form as to be rather confusing to the seeker for detailed information. The report on a whole is a satisfactory one.

W. R. D.

Abstracts and Extracts

The Sphincter Reflexes in Tabes Dorsalis and Paresis. By COLLIER F. MARTIN. Journal of Nervous and Mental Diseases, Vol. 33, p. 527, August, 1906.

The author's investigations as to the condition of the sphincter reflexes in cases of certain of the organic nervous diseases particularly tabes and tabo-paresis have been carried out for some years past, and he states that the idea of making these studies presented itself when, in examining the rectum in cases of tabes, he found that when the finger had been introduced into the rectum and firm lateral pressure made, relaxation would result, and it was not necessary to resort to the use of a speculum.

In a series of 28 paretics the loss of muscle tone was found in 24. In one case the contraction was normal, and in three cases the condition of the muscle was doubtful. In nine purely mental cases the reflexes were normal. Eight cases of tabes dorsalis gave positive evidence of lessened myotatic irritability.

In some of the cases of tabes the relaxation of the external sphincter was quite noticeable, although the disease was in an early stage. The author believes the absence of normal contraction to be due to a lessened myotatic irritability associated with a sensory paralysis, involving the skin margin of the anus and rectal mucosa. In four of the cases of tabes, rectal crises were also present.

The internal sphincter in these cases shows considerable power, but without the associated contraction of the external sphincter when the finger is introduced into the rectum. The rhythmic character of the contraction of the normal sphincters is absent, the author finds. It is also noted that if the anus is dilated, the sphincter remains relaxed for some time; this may be due to a loss of muscle sense. In cases where there is a deficient development of the sphincter, a condition somewhat similar to sphincter paralysis is present, but is to be differentiated by the presence of the rhythmic contractions above referred to. In many of these cases of lessened sphincteric tone the anus is funnel shaped, and there may be a prolapse of rectal mucosa.

In the author's experience, extreme spasm of the sphincter is absent in tabes, although tenesmus may be present during the attacks of rectal pain. Obstinate constipation and a sense of rectal discomfort suggesting a desire for stool are often present. In cases where this condition of sphincter paralysis is present, the patients soil themselves almost constantly. In tabes the symptom of sphincter paralysis develops early, according to the author, and this, of course, is of considerable import, and should be of value to the neurologist.

The author then briefly sums up that, in certain cases, principally in tabes and in paresis, there is interference with the sensory distribution to the nerves supplying the sphincters characterized by loss of muscle tone, partial or complete incontinence due to relaxed musculature and loss of sensation of the rectal mucosa and contiguous structure, the patient being unaware that his bowel should be evacuated. These symptoms and the presence of severe pain in the rectum, where there is no lesion to account for it, are at least suggestive of an early tabes or paresis, although they may be found more rarely in other nervous conditions.

FITZGERALD.

Calcio e magnesio delle urine nei dementi precoci. Ricerche del ANTONIO D'ORMEA. Giornale di Psichiatria Clinica e Tecnica Manicomiale, Anno XXXIV, p. 28, 1906.

This research is a continuation of the investigation which the author had previously conducted with Dr. Maggiotto (see this JOURNAL, Vol. LXI, p. 555, and Vol. LXII, p. 533).

After referring to the above research the author states that he concluded that it would be of interest to observe the proportional diminution between the alkaline phosphates (sodium and potassium), and earthy phosphates (calcium and magnesium), and for this purpose has carried out the present investigation, which he believes has an important physiological value as well in the normal individual as in the diseased. He then briefly refers to the literature of the subject, describes his method of investigation and the tests employed, and gives the results obtained in the same careful manner which distinguishes his past work. Two men and two women in each of the three forms of dementia præcox (hebephrenic, catatonic, and paranoid) were the subjects, normals having been established from four nurses, two men and two women.

D'Ormea finds that in dementia præcox the elimination of calcium and magnesium is slightly diminished, and more of magnesium than of calcium; that the diminution of calcium and of magnesium, but of calcium especially, is more marked in women than in men; that in regard to the three forms, the diminution both of calcium and magnesium is more marked in the catatonic, less marked in the hebephrenic, and still less in the paranoid; and finally, that in dementia præcox the greatest diminution of the phosphates eliminated in the urine is of the alkaline phosphates and only in a small degree of the earthy phosphates.

W. R. D.

Ricerche sfigmo-manometrische in alcune forme psicopatiche. Dei PIETRO CONDULMER E GUISSEPPE BORDON. Giornale di Psichiatria Clinica e Technica Manicomiale, Anno XXXIV, p. 61, 1906.

The authors have observed the blood-pressure in 223 cases of epilepsy, melancholia, mania, circular insanity, delusional insanity, dementia, paresis, pseudo-paresis, both alcoholic and syphilitic, pellagra, and congenital con

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