common property of all cortical cells and fibres, which are able to receive and conduct external stimuli of all sorts." The inheritance of physiognomical expression he does not consider proved. At all events, he thinks Darwin could have made his views plausible only by showing that conscious movements originated in reflex actions. In the chapter following, the nutrition of the brain is considered. The circulation of the blood is minutely detailed, and the chemistry discussed. The Doctor enters upon the domain of weights of the divisions of the brain, and supplies new material as the results of his own labors in that direction. When speaking of the wealth of cerebral convolutions, he asserts that facts of comparative anatomy are not in accord with the view that the wealth bespeaks nutritive development, as the development of cerebral convolutions is governed by the laws of mechanics. But a little further on, he adds, " And yet we must not fail to mention that within one and the same species a certain relation does exist between the number of convolutions and the grade of intelligence." An appendice on the mechanism of expression concludes the book. An Atlas of Clinical Microscopy. By ALEXANDER PEYER, M.D. Translated and edited by ALFRED C. GIRARD, M.D., Assistant Surgeon United States Army. First American, from the manuscript of the second German edition, with additions. New York: D. Ap pleton & Co. This excellent work has its great value in the fact that it is truly an atlas. It is a picture book, containing print enough merely to explain the illustrations. The illustrations, however, are of such a quality as to require little explanation to an eye at all familiar with the subjects to which they allude. The first chapter is devoted to the examination of the blood, and consists of three plates, each plate containing four well drawn pictures of blood in health and in disease. The only one we would criticise is that of the anthrax bacilli, which, we think, might have been truer to nature. Chapter II. discusses the mammary secretion, and has but one illustrative plate. The third chapter, which is by far the largest in the work, is devoted to the urine. It embraces sixtythree handsome plates, and, with the exception of one or two pictures (notably plate five), is the best thing of the kind we have ever examined. This chapter discusses accidental foreign bodies, mucus, urates, uric acid, oxalate of calcium, hippuric acid, sulphate of calcium, neutral calcium phosphate, earthy and triple phosphates, ammonia urate, calcium carbonate, pigments of urine, leucine and tyrosine, cystine, blood and pus corpuscles. Renal crusts follow in six plates; and epithelium and bacteria end the first section of chapter III. In the second section the various deposits are grouped together as found in the different renal diseases. Section 3 is devoted to diseases of the bladder, and section 4 to chronic urethritis. Spermatorrhoea has ample space in the last section of this chapter. The microscopy of the expectoration next engages the attention. Chapter IV., with fourteen plates, is given to this important subject. The stool has not been overlooked in this book, chapter V. being devoted to its consideration. The author urges the importance of this field of microscopy, believing that much valuable information could be gained were it more generally attended to. The contents of the stomach are next considered in two plates, that of an ovarian cyst in one picture, the secretion of the female sexual organs in one plate; and, ending the book, a picture of some micro-organisms found in disease is presented. We would add, in terminating our notice of so valuable and unique a work, that it seems beautifully adapted to the wants of the general practitioner as well as the student of pathology. Manual of Microscopical Technology. By CARL FRIEDLANDER, M. D. Translated with the express permission of the author from the second enlarged and corrected edition, by STEPHEN YATES HOWELL, M.A., M.D., Buffalo, N. Y. New York: G. P. Putnam's Sons. reading this little book, is the amount of space That which would strike one forcibly while devoted to the consideration of micro-organisms. Their staining characteristics engage the attention throughout the work. Staining materials and staining processes, both of bacteria and of tissues, are nicely described. The examination of the fluids of the body, including urine and blood, is considered. However, the space devoted to the urinary secretion seems rather diminutive when compared with that of some other subjects, considering their relative values. Careful consideration is given to the septum. We are glad to see that the Doctor lays so much stress upon the microscopical examination of the blood. In speaking of diminution of red blood corpuscles in anæmia, he states that a little practice enables one to recognize the more marked alterations of this sort directly, and without the aid of a special apparatus-thus bringing the examination of blood down to a practicable thing. Ehrlich's researches on the properties of protoplasmic granules in white blood corpuscles are referred to. Secretions of the genital apparatus find consideration in the book. Examination of the solid structures of the cadaver, extirpated tumors, etc., forms the topic of the last chapter. This little work contains many valuable suggestions and directions for work, and is thoroughly up to the times. COMMERCIAL NEWS. A PURE COCA WINE. The most gratifying results have been obtained from the continued use of Llewellyn's Tonic Coca Wine in several cases that have come under our notice. This is evidently owing to the fact that it contains no sugar, therefore placing in the hands of physicians a remedy that will serve them well in cases of diabetes, rheumatism, gout, etc The powerful stimulant and tonic properties of Llewellyn's Coca Wine come entirely from the excellent quality of Coca used, and superior method of preparation, and not from excess of alcohol. It therefore produces no reactionary effects, and may be taken for any length of time without other than good results following its use. It contains no foreign substances, but represents alone the nourishing, strengthening, and sustaining powers of erythroxylon coca in a palatable though concentrated form, each tablespoonful containing the medicinal properties of fifteen grains of fresh selected leaves. See advertisement on page 12. PEDANTIC. The following is a verbatim copy of a prescription sent to a drug store in this State by a quack doctor_ R. Buissmous Cliseren Rose Watter Mix-q. t. of every sings. DR. ROSE'S PEPTONIZED BEEF. CHAPMAN, GREEN & Co., Manufacturing Chemists, Chicago. Gentlemen: I promised you when you sent in the sample of Dr. Rose's Peptonized Beef, to give it a thorough trial in my practice. I confess that I commenced with a prejudice against these preparations, never having seen the good effects promised for them. I commenced by using it myself, in warm milk, and found it delightfully agreeable and soothing, not only to the stomach, but the nervous system. I have prescribed it largely, and without exception, my patients are pleased with its effects. It is especially valuable in atonic dyspepsia, catarrh of the stomach and bowels, acid indi gestion, low fevers, diphtheria, and particularly in neurasthenia in all its forms. It is a real peptonized food, and I cannot imagine a case where it will not agree with the ⚫ stomach. As a food for infants, when all starchy foods are not well borne, this will act as a powerful nutritive agent, and a sedative to the whole system. As a dietetic agent, it is the greatest boon lately presented to the medical profession. Very sincerely, E. M. HALE, M.D. NOTE.-A one-half pound sample of Dr. Preston B. Rose's Peptonized Beef sent free to any physician who is willing to pay express charges. Address the sole agents, CHAPMAN, GREEN & Co., Little drops of water, Little grains of milk, Make the little doctors Of Homœopathic ilk. EPILEPSY. I have used Peacock's Bromides in my practice with success. A little girl of twelve years had been afflicted with epilepsy since she was three months old, having epileptic convulsions nearly every day until I put her on Peacock's Bromides, since then she has not even had a symptom of one. It is surely a great remedy. JEFFERSON WILCOX, M.D., Hazlehurst, Ga. A CURIOUS EPITAPH. The Boston Med. and Surg. Journal says that the following was found on a gravestone in a country churchyard in England, on Mrs. Arabella Greenwood, who died in childbed, written by Rev. Mr. Greenwood, D.D.— O deathe! O deathe! thou hast cutte down Her virtues and good qualities were suche She chose to take me, a Doctor of Divinitie, MALARIAL POISONING. I have much pleasure in bearing testimony to the remedial effects of Peacock's Fucus Marina. I am better pleased with its action than anything I have ever used as an antidote to malarial poisoning. J. T. HERNDON, M.D., Professor of Materia Medica and Therapeutics in the Jefferson The patients will become easily chilled, in Medical College. DELIVERED AT THE JEFFERSON MEDICAL THE fact they will often have severe rigors, followed by very high temperature. In fact a variation from below normal to four or five degrees above is very characteristic of this form of the disease. I wish more particularly to speak to you about the management of the disease, for, after all, this is the important point; the diag HE first case that I have to present to you to day, gentlemen, is a case of acute phthisis, commonly known as "galloping consumption," a very expressive phrase, for the disease neither walks nor trots, but, in truth, it really gallops. This case will illus-nosis will usually be easily made, for the distrate the terrific rapidity with which this terrible disease sometimes advances, for this young man was able to be at his work until December last, when, for the first time, he noted symptoms of ill-health, and his decline to the condition in which you now see him has been wonderfully and wofully rapid. His face presents the peculiar characteristics so often observed in acute phthisis; there is, as you see, great pallor, and at the same time he is very sallow, such as we see in broncho-pneumonia, with consolidation and resulting phthisis that is inflammatory in character. Let me explain to you that we have three distinct types of consumption. First, pure tuberculosis; second, catarrhal pneumonia, resulting in a breaking down of the pulmonary tissue; and third, the fibroid lung, which begins usually as a bronchitis, or very often as a pleuritis and finally invades the pulmonary tissue proper by extension by contiguity of ease will be only too evident. Notwithstanding the severity of this form of consumption, the prospects for recovery are often very fair. It is in this form that treatment may be expected to do good. The disease is inflammatory in type, there are extensive catarrhal deposits that undergo caseation, the fever is truly septic, there is really a septicemia, and the expression "hectic," which you so commonly hear, I consider to be a misnomer, for, as I say, it is really septic and should be so called. I have in such cases often seen very good results from the use of carbonate of ammonium given persistently in a solution of acetate of ammonium. This seems to produce dissolution and absorption of the exudate. If caseation has progressed far then the bacilli are formed, and we cannot then hope to do much, but in the inflammatory stage, before caseation has far advanced, we can do a great deal with these remedies, with which we may also combine the iodide of potassium, which | medicines should be given in this way, the greater portion of the drug will condense on the tubes and on the pharynx, very little will get as far even as the larynx, and it has required a very delicate chemical test to find any at all in the lungs. If then so little gets past the chink of the glottis as to require a delicate chemical test to determine its presence, I cannot see how such an infinitesimal amount can exert any influence worth speaking about on the disease, so then do not waste your time and trifle with your patients' health by using atomizers. These remedies that I have recommended are not irritating to the chink of the glottis, hence they are allowed freely to pass, but any remedies that are irritating cause spasm, closure, are unable to pass through, and are utterly useless. possesses absorptive power. In using these remedies we must be careful not to upset the stomach, and I therefore give them, in moderate doses, not more than three grains of the carbonate and five grains of the iodide at a dose. During the whole course of the treatment, unless some circumstances exist that absolutely prevent it, we should resort to inhalations of ethyl iodide or creasote and iodine or tincture of iodine and carbolic acid. I very decidedly prefer the former of these drugs, which will exert a very great influence in moderating the cough and relieving the oppression of breathing. It is also of great value, 'because by its use we can introduce iodine into the system with less derangement to the system than in any other way, and iodine is a valuable drug in this affection. It possesses a great advantage over all other ethers in that it has no tendency to derange the brain, as all the others do. It is not used so much for the ether that it contains as for the iodine, and this it introduces in a most satisfactory way, for it passes with the air into the most minute and distinct portions of the lungs and there exerts its good influence. I order it to be inhaled directly from the bottle, the heat of the hand suffices to vaporize it, and no elaborate apparatus is necessary. I always instruct the patients when using it to breathe deeply and slowly, thus they best suck it well into the lungs. As this disease is due to deposits, we must endeavor to act directly on them, and this we can best do in the way I have indicated, with ethyl iodide. One drawback to its use is that it is quite expensive, which puts it beyond the reach of the poor. When for this reason it cannot be used I am in the habit of substituting for it equal parts of carbolic acid and tincture of iodine or of creasote and tincture of iodine. Creasote exerts remark-who have unfavorably criticized its use, and ably good effects in these cases. It may be because it is an antiseptic or it may be for some other reason, but whatever be the cause, it is a well-observed clinical fact that it does do good. These drugs are to be inhaled in the same way as the ethyl iodide. A few drops are placed on a sponge, this is put in a small bottle, which is placed in hot water, and as the vapor arises it is inhaled. Let me here warn you against the use of atomizers, they are absolutely worthless and no good at all. It is a fallacious notion that Now then the question arises as to whether we should act on the high temperature or not. Quinine and antipyrine may do some good when the temperature is very high, but since this hyperpyrexia is in reality septic in its nature we cannot expect very much benefit from such drugs. Therefore I do not lay very much stress on their use. Now there is one drug in which I place great reliance, and that is aconite, the good it does is conspicuous, it not only checks waste by checking perspiration but it seems to exert an influence on the nerves of the lungs. It is of no use in tubercular or fibrous phthisis, save in so far as it serves to check perspiration and thus to prevent exhaustion consequent upon it, but in the variety under consideration, where there is caseous degeneration, it softens and promotes extension of the exudate and really seems to have some specific action on this form of phthisis. Some years ago I first made this recommendation, and it was taken up and favorably written upon by Dr. Fothergill, of London. Those this has been done by several, have done so under a misapprehension of my recommendation. They made a mistake in supposing that I had recommended it generally in all forms of phthisis, and being disappointed in its use in the tubercular and fibroid varieties, they condemned it. But I say distinctly that it is of no earthly use in those varieties, being only serviceable in the catarrhal variety now under consideration. So also I wish to impress upon you that it is only useful, even in this variety, at one period, that is comparatively early in the disease, before much caseation has taken | tissue waste, and will thus have a tendency to place and before the bacilli are deposited. It elevate the temperature and to more rapidly should be given morning and evening, and its consume the vital flame. use persisted in for a long time. A very important element in treatment is to maintain the nutrition, for which purpose we will order this patient small doses of cod-liver oil and put him on a diet that he can well assimilate; no matter what kind of food he takes, that is to say, that his diet need not be restricted, but whatever he can well assimilate, whatever is found to make flesh and strength may be allowed. However, this statement must be somewhat qualified, for while his diet need not be restricted, it will be of great importance to get him to consume as much animal food as possible. In this great consumption of animal food is to be found the method pursued by Debove in the treatment of phthisis, a method which is now attracting great attention in France. He passes dry and pulverized animal food through a tube into the stomach. A notorious New York quack has grasped this idea of treatment and is making a fortune out of it. Debove dries his meat, finely pulverizes it, and mixes it with condiments, as salt or pepper, and introducing a tube into the stomach, passes the pulverized meat through it. In this way two or three pounds of meat may be given at a time, and, what perhaps you are not prepared for, the stomach is able to take care of all that it receives. It digests it all and makes flesh and strength out of it. There is a popular notion that the stomach will only digest a certain amount, but this is an erroneous idea, for in truth it will take care of all that is given to it. In these cases we will often derive remarkably satisfactory results from the use of the mineral acids, notably from nitric acid. I know a physician who has resorted to this method of treatment and he has had certainly very good results. It may be used in full doses and pushed as long and as far as the patient will bear it. Now we come to the question of exercise, and this is a very important point in the therapeutics of this disease. The principle that I would formulate for your guidance in this direction is that when the temperature is above 102° F. the patient should avoid all exercise. He should be daily (when the inclemency of the weather does not forbid it) exposed to the air and sunshine, but active exercise will increase Now this She is Gangrene in Diabetes.-This woman presents an interesting point for our observation. You see that she has gangrene of the little finger, and I tell you that she has a history of diabetes. It is a peculiar fact that sometimes the first feature that will attract attention in a case of diabetes will be the occurrence of boils or superficial ulcers on various parts of the body. When you will meet, as you frequently will, a person about middle life, who commences suddenly to grow fat, who is seemingly in the best of health, and in whom a succession of boils occur, it will be well for you always to examine the urine for sugar, for in many such cases you will find it. woman's trouble began six years ago. thirty-seven years old, and when I inquire into her history, I find that she has lost one sister, but that the rest of her family are alive and well. This sister, she tells us, commenced suddenly to grow fat in early middle life, when she was seized with an acute attack of pneumonia and died therefrom. Now this is a very significant history, for I think it very likely that this sister had also diabetes, though it was not suspected, and we have therefore no history of it. But it is not at all uncommon for these victims of unsuspected diabetes to be suddenly carried off by pneumonia. We may draw a conclusion as to the result of treatment in diabetes from the condition of nutrition of the body. If the patient is of a full habit and the nutritive phenomena are going on fairly well such a person may live for years if they will carefully avoid that aliment that goes to make sugar. Those who offer to us a strumous or phthisical history and those who are thin, worn, and nervous have very poor chances, and such cases will give us a great deal of trouble. But, as I said before, in the former class of cases we can promise many years of life if our instructions are carried out. This woman passes about four quarts of urine daily, and it has the great specific gravity of 1050. By quantitative analysis we find that it contains twelve grains of sugar to the ounce. In all doubtful cases it will be well to compare the specific gravity with the amount of urine passed. When the quantity passed is persistently very great and the specific gravity very high, we have good reason to suspect the |
