It is believed that no very significant fact has escaped review in the pages of the Year Book. No attempt has been made to give a literary review of all published matter but a summary of medical progress has been attempted and accomplished. The sixteen departments in the volume are all deserving of praise for the intelligence and judgment manifested in the consideration and selection of material. The work is profusely illustrated by numerous wood-cuts in text and thirty-three handsome half-tone and colored plates. We can commend the work as one of the best annuals ever published.

THE DEFORMITIES of the HUMAN FOOT. By W. J. Walsham, F.R.C.S., etc., and Wm. Kent Hughes, L R. C. P., etc. Octavo, Pp. 550. Wm. Wood, & Co, N.Y., 1895.

This book, the result of many years experience in the Orthopedic Department of St. Bartholomew's Hospital, in London, by its authors, is an exceedingly practical and complete treatise upon the various de formities of the human foot and the treatment of the same.

The authors go deeply into the detail of anatomy and physiology of the foot, devoting many pages to the pathological auatomy of the various forms of talipes. The treatment given embraces the best methods in use both in England and foreign countries; preference being given, however, to those methods which, in the hands of the authors, have proved most successful.

To our mind, it is the most complete work upon deformities of the feet which has ever come to our notice, and it should find a place in the library of every surgeon who does anything in the way of orthopædica. We are sorry to note that the authors seem to have been unaware of the most excellent work upon the treatment of flat foot or weak foot accomplished by Dr. Royal Whitman, omission of which is the only incompleteness which we note in this valuable work.

THE PHYSICIANS VISITING LIST. (Lindsay & Blakeston's) For 1896. Forty-fifth Year of its Publication. Philadelphia. P. Blakeston Son & Co., 1102 Walnut St.

This well known Visiting List presents several improvements in the new edition for 1896.

More space has been allowed for writing the names, and to the "Memoranda Page" a column has been added for the "Amount" of the weekly visits and a column for the "Ledger Page."

The publishers announce that before making these changes they have personally consulted a number of physicians who have used the book for many years, and have taken into consideration many suggestions made in letters from all parts of the country.

use.

A REGIONAL AND COMPARATIVE MATERIA MEDICA. By John Gilmore Malcolm M.D., and Oscar Burnham Moss, M.D. Chicago, Ill., Malcolm & Moss, 1895, Pp. 919. The methods of arrangement followed in this work give it great practical value. In the forty-two chapters comprising the volume are grouped the remedies pertaining to the chief regions, organs and functions of the body. That is, in diseases of the "Throat or "Abdomen " or "Heart," in the chapters devoted to these topics may be found alphabetically arranged the remedies and the most approved indications for their Characteristics" are marked with a (*) and “ Special Symptoms " by a degree (°). It will be seen that with the symptoms arranged in their appropriate regional chapter, comparisons may be rapidly and accurately made. To aid in comparing the different remedies a repertory of topics and symptoms is added to each chapter. At the end of the volume is placed an index to the repertories which shows at a glance all the chapters referring to the various diseases and symptoms covered by the symptomatology. The work will be a great aid to every homoeopathic physician and few will be without it when its great value is known.

SURGICAL TECHNIQUE.

EDITOR OF THE NORTH AMERICAN:—

The December number of the JOURNAL, contained an admirable editorial article, under the above title, that, nevertheless, left the subject somewhat incomplete, as to treatment. The injunctions as to asepticism, in its widest sense, and the necessity for anatomical knowledge were unexceptionable and beyond criticism, but no recognition of other, and equally important, to say the least, conditio sine qua non was given. For instance, the duration of anaesthesia, rapidity of work, smoothness and cleanliness of the wound, and the minimum handling of parts involved, particularly in abdominal operations, are all very essential factors in the progress of the case. As a matter of fact, I attach, possibly, more importance to these questions than to asepsis, important as that is. We have all seen deplorable results, in comparatively simple operations, even when all the details of asepticism, yes anti-septicism, have been observed, and the factors I have mentioned ignored, or imperfectly applied. We have all, again, seen brilliant results, when asepticism was impossible, and the operation made rapidly, with short anæsthesia, no handling of exposed parts, and the necessary incisions smooth, clean, and of ample dimensions. But to fulfil these indications more is needed than mere "dead-room" anatomy. For this reason I am disposed to put at the head of the list of requirements, knowledge of living anatomy, as related to sight and touch-not only do normal structures look differently in the living and dead subject, but they behave differently. It requires a different kind and degree of manipulation to divide dead and living tissues. Again, normal structures are often out of normal relations, pushed aside, included in morbid growths, atrophied, hypertrophied, changed in color and texture while still functionating normally, and only experience in similar conditions can enable the observer to recognize structures when encountered under such abnormal circumstances. As to pathological states, nothing but experience can enable the observer to recognize at a glance, or by palpation the nature of the process. I think the ancient method, in surgical education is the proper one; at least it has always given the best results. That is, the surgeon graduates, passing from dresser to assistant, and the latter position to be a prolonged one. A young man who attempts a major operation, formal in character, which he has never seen done by an expert, and seen at close hand, with an opportunity to "touch and see, "as it has been put, is taking chances that no man is justified in taking, and is taking liberties with the life and health of his patient that are unpardonable.

IOWA CITY, IOWA.

JAMES G. GILCHRIST, A. M., M.D.

(The Editorial referred to, did not hope to consider in detail the entire field of Surgical Technique, in the space of two pages. While we appreciate most highly the importance of "duration of anesthesia,

rapidity of work, smoothness and cleanliness of wound, and the minimum handling of parts involved," we do not see the force of the argument. "We have all seen deplorable results in comparatively simple operations, even when all the details of asepticism, yes antisepticism have been observed." Just here we wish to emphasize the fact, that the apparent observation of these rules, is not always the actual observation of them; and also the fact, that our being obliged to apply these rules voluntarily and with forethought often accounts for the weakness of our attempted aseptic technique. This weakness is to a great extent overcome by those surgeons who have been educated, in part at least, in the bacteriological laboratory, where observance of the principles of asepsis become involuntary or "second nature." Brilliant results without the apparent observation of the principles of asepsis, can be credited to nothing except unusual resistance upon the part of the patient's tissue and luck.

In reply to the last half of the above valued contribution, it is only necessary for us to refer to the last part of the Editorial. "When we can give our young surgeons this elementary education-if you choose so to term it-and can round out their judgment by placing them in close relation with experienced skilled surgeons, who shall act as supervisors of the earlier work of their young confreres, then will the number of human lives which it takes to make a good surgeon decrease tenfold." ED.)

THE STANDING OF THE STUDENTS OF THE NEW YORK HOMOEOPATHIC COLLEGE AND HOSPITAL.

TO THE EDITOR OF THE NORTH AMERICAN:

My dear Sir:

It gives me great pleasure to announce, through your columns, the high standing that the students of the New York Homeopathic Medical College and Hospital have taken in their examinations before the Board of Regents of the University of the State of New York. The absolute fairness as well as the rigidity of these examinations are well-known and, therefore, I think the following extract from an official letter written to me in my capacity of Dean of the College, by Mr. James R. Parsons, Jr, who is the director of the examining board, should be made public. After debating some other items relative to the business of his office, Mr. Parsons writes: "For several days I have been at work on the statistics of the licensing examination and I think you will be interested to know, that the New York Homeopathic Medical College and Hospital stands at the very head of all the Medical Schools in New York State [italics mine] in the per cent. of men who have passed the licensing examination with honor, since these examinations were first established." Such a statement, coming as it does officially from the director of the Examining Board, will be gratifying to every homeopathist especially to those residing in the State of New York.

I am, very truly yours,

WM. TOD HELMUTH.

Conducted by

T. F. ALLEN, M. D., LL. D.

An Introductory Discussion by T. F. Allen, M. D. The establishment of a department of Materia Medica and Therapeutics in the JOURNAL affords an opportunity for developing methods of study of the Materia Medica and of illustrations in therapeutics It is the intention of the Editor to make notes of more recent additions to Materia Medica, to compare these additions critically with our previous knowledge of the drug, that some estimate may be formed of the probable value of recent additions, and their employment in therapeutics.

The action of Jequirity upon the mucous membrane, specially of the eye, is doubtless well-known to our readers, producing, as it does, the most violent muco-purulent inflammation. This has been taken advantage of by some oculists, who considered that, in the production of an acute transient disease, old and chronic diseases might be cured, notably, granular lids, and most obstinate catarrhal inflammations. While this has not proved so successful as was hoped, yet our knowledge of the action of the drug has been thereby considerably extended. Still, much remains to be learned concerning this curious substance. It had been supposed that its activity was due to a sort of vegetable ferment, which seemed to be somewhat similar to that known to exist in the pawpaw and, doubtless, this view is, to some extent, correct, but it does not account for the fact that preparations of this bean, when inserted under the skin, have proved fatal, in a short time, even to large animals, apparently, without the intervention of any fermentative process or, at least, quite independent of such action. Furthermore, it has been ascertained that there exists in this bean a toxic globulin, as distinct from an albuminose, that this globulin is not materially impaired in its toxicity by either heat or cold, acids or alkalies, and, in this respect, is somewhat analogous to the peculiar substance in the virus of animals, notably of snakes.

If these chemical investigations be reliable, as it now seems, there is a very interesting field opened for the extension of our knowledge as to the action of Jequirity upon the organism in general, aside from its local action on mucous membranes.

We propose to place before our readers at an early date, some investigation into the nature and effects of this peculiar substance, which we trust, will prove extremely interesting, as well as instructive.

We are obliged to accept the method of building up our Matera Medica bit by bit, and all records or observations concerning the positive effects of drugs, deserve to be recorded and preserved for future reference and comparison, so that in the end, a complete and reliable Materia Medica may be prepared. There are, indeed, in the Materia Medica very few substances, about which our knowledge even approaches completeness, and it will doubtless be many generations or even many centuries before it will be possible to eliminate anything which does not correspond to something else. When observations shall have multiplied to such an extent that they only duplicate pre-existing observations, then will be the time to determine, by comparison of drug-effects, alone, what is reliable and what unreliable. At present, it seems well to accept tentatively all observations made concerning drug action upon the healthy organism, utilize them for the treatment of the sick, and if found useful, recommend them as probably valuable.

Such considerations seem to us to have a very important bearing upon the subject which is now agitating physicians of our school, namely, the preparation of a reliable Materia Medica. The coming con

terences of students of Materia Medica are looked forward to with extreme interest by the profession throughout the country, and something useful will, without doubt, come out of them.

A few words may be said concerning our therapeutics, or rather, concerning the methods of applying our Materia Medica. Even before Hahnemann died, while the number of drugs which had been proved amounted to scarcely more than one hundred, the difficulty of selecting the similimum became enormously perplexing,-so perplexing, in fact, that Hahnemann himself, accepted eagerly Boenninghausen's suggestion of analyzing the symptoms themselves, and utilizing only the three essential features of the symptoms in general. This analytical method of symptomatology renders it possible to select with accuracy symptoms essentially similar to those of the patient. By means of remedying and correcting the faulty records of the provers, supplementing many points which had been overlooked by some provers, and which had been noticed by others, correcting, indeed, the statements of the patients themselves, the physician is enabled to reduce a vast Materia Medica to a small compass, applicable not only to the time of Hahnemann, but also to our own day, and apparently also applicable to an indefinite extension of our symptomatology;-the only method, in fact, which seems to us possible for utilizing an enormously developed symptomatology Besides this, Boenninghausen's method takes cognizance of the entire clinical experience of our school in its use of the symptomatology, simply by giving rank to various medicines under every section or sensation or condition of the body. This method has been rejected by many writers and teachers, as well as students, but it was utilized by Hahnemann, by Herring and Lippe; I, myself, was brought up with it under P. P. Wells, and thrived on it while associated with Dr. Dunham, who, himself, was a student and enthusiastic admirer of Boenninghausen, and constantly employed his method. I have never been more impressed with the utility of it than in the experience of a recent convert from the old school. This gentleman found it exceedingly difficult to apply Hahnemann's rules, which he endeavored to follow, and becoming greatly disappointed with his results, in the main, came to me in his perplexity, and in his dispensary practice I showed him how to use the Boenninghausen method, which he has followed to the almost complete exclusion of other repertories. Only a few days since he told me that he preferred it, even in the simplest cases, to the localized symptoms of any diseased organ, from the fact, as it appeared, that such symptoms were usually very incomplete in their record, and, in most cases, too few to be adapted to the sick who came to him. He found that as soon as he became so successful, his practice rapidly advanced under the new method, whereas, it had declined under the method of repertory work in general, from not being able to make brilliant cures in his patients.

There has been very little discussion of this method in this JOURNAL or in our Societies. Our physicians do not seem to get hold of it. But there is nothing difficult about it. It requires only time, and, to our mind, it must always be used in the analysis of complicated chronic cases, and that, while the success of the physician, in many cases, is tolerably good when based upon the treatment of isolated striking symptoms,-so-called, "characteristics," yet it doubtless would be better, were those isolated symptoms combined with a study of the more remote constitutional symptoms of the patient, which nearly always are cotemporaneous.