The Washington Life Insurance Company, a small concern, and therefore, perhaps, the more virulent, when an examination had been made by Dr. La Plant, at the request of their agent rejected the papers and sent the following insolent letter to the candidate for a policy : "Your application through Dr. La Plant has been received and submitted to this company. The company does not use for its examiners the new school doctors. Before your application can be acted upon, an examination by an old school physician is required." Dr. La Plant pertinently inquires at the close of his letter, Shall we insure with these companies?" Dr. A. C. Reed, of Georgetown, Mass., writes that he has been an examiner for the Metropolitan in several places and cannot understand why Dr. Keith, whose letter appeared in the last number of the JOURNAL, was rejected. Dr. Keith, however, does not consider that he is mistaken in his account, but will again question the agent and ascertain if he can throw any further light on the subject.

The Ann Arbor School.-Our correspondent at Ann Arbor writes that the homœopathic department has registered so far fortyfour students, that the new homoeopathic hospital is full of patients, that notable additions have been made to the library, and that the future of the school looks very bright. Certainly this is welcome news to all of us, for a strong and flourishing department at Ann Arbor would be of great value to the homoeopathic school. And we feel like congratulating the new faculty on its present unity, energy and enthusiasm, and wishing that their earnest labor may bring forth much fruit. But without the continued and honest support of the Regents, and particularly of President Angell, the most zealous and able faculty in the world could do nothing. The school has never had such support-is it to have it now? Is history to repeat itself, or has a new era arrived? Are we again to trust the Regents and be betrayed, or is the department, the faculty and students to be fairly, honestly and loyally sustained by those whose bounden duty it is to do so? These are questions asked not in levity but in soberness of purpose. They are vital questions, for in the answers depend the future success or failure of the school.

The Hahnemann Monument.-One hundred and fifty-nine dollars has been subscribed to the Rush Monument Fund since April 17, 1896. The sum now in hand is $3,886.39. After many years our allopathic friends have raised the truly magnificent sum of nearly $4,000 for a monument that is intended to cost $100,000. Just how long it will take them to raise the balance of the required amount is a problem for experts. But how is the Hahnemann Monument Fund progressing? And what are those members of the profession doing who have hitherto contributed nothing? Cannot the committee have a representative at each State Society meeting to formally interview the members? There are many who would be glad to contribute something if directly approached. The monument as planned is a grand and noble work worthy of the man and of the school. It must be completed. We cannot go back. With the revival of business let there be also a revival of interest in our monument.

EDITOR NORTH AMERICAN JOURNAL OF HOMOEOPATHY:

Yesterday while paying a visit to Dr. François Cartier, the editor of the Homœopathic Annual, I chanced to see for the first time in eighteen months a copy of the NORTH AMERICAN.

It was the September issue, and I took great pleasure in perusing Professor Helmuth's letter in which he so graphically describes the methods of production of the serum medicaments for diphtheria and hydrophobia After reading the account in which Professor Helmuth says that his words may prove of use to our school in the future in deciding as to the benefit of these new productions of the laboratory, it occurred to me that possibly some further information upon the curative effect of these products, gleaned from the place where they are most used, might also be of assistance to the numerous members of our school in deciding upon the merits or demerits of the additions to our therapeutic armament.

I had not only the pleasure of visiting St. Anne's Hospital in Vienna in company with Professor Helmuth when he gathered the statistics which he quotes, but also had opportunities for watching the results of the serum treatment in this institution during the past winter when the wards were well filled with diphtheria patients.

After this experience, I felt like voicing the remark of Professor Wiederhoffer (the chief of the hospital), with whom I had the pleasure of making a visit one morning in February last. When he said, with a smile upon his face, addressing the assembled assistants, "Gentlemen, you cannot imagine how different my feelings upon entering this pavilion this morning from what they were on similar occasions before the advent of serum therapy. Then I came here with dread knowing that I possessed no means of combating this disease. Now it is a pleasure to come for I know that I possess a sure weapon against the destroyer."

It has been asserted by opponents of the new therapy that the good results obtained in institutions using serum are due to the fact that they treat all forms of throat disease as diphtheria and make up their statistics accordingly. I am, however, convinced from long and unbiased personal observation that no cases are allowed upon the records but those of true diphtheria. The diagnosis is made in every case not only clinically but by the aid of the microscope. There can be no possible doubt about the reliability of the reports which are given out. This also applies to the other institutions of which I will speak later

Dr. Helmuth has presented you with all the statistics necessary from the hospital, therefore I will not again burden you with the same figures, but proceed at once to Berlin, where at the new Kaiser and Kaiserin Frederick Children's Hospital I had an opportunity for a long talk with the chief upon the subject of serum in diphtheria. He at first said, in answer to my question for his opinion upon the subject, "My dear doctor, there is only one opinion in Berlin on this subject, and that is that antitoxin in diphtheria is an established fact. We make no attempts to convince anybody any more. The results speak for themselves, and with a mighty voice."

Here as in the case at St. Anne's the diagnoses are made only after careful microscopic examination of the exudates and cultures made therefrom. There is no question but that they have severe cases. I saw my

self many sufferers that three years ago I would have said could not possibly live, and yet in these same cases to-day the prognosis is good.

The hospital was opened about five years ago. Is built of brick on the pavilion plan, and is thoroughly modern and well equipped in every respect. I affix a few statistics from the diphtheria pavilion. I will give but few figures, for I know that they are very tiresome reading, yet they speak so positively I cannot refrain from quoting them.

For the year August 1st, 1890, to July 31, 1891 (before the days of antitoxin), there were treated in the diphtheria pavilion 239 cases varying in age from infancy to fifteen years, with a total of 95 deaths. Upon these cases there were performed 68 tracheotomies and 14 intubations. It will be observed here that the death-rate was not remarkably heavy. It was probably materially influenced by the complete sanitary condition of the hospital, the better nursing possible, etc.

For the next period from August 1st, 1891, to December 31st, 1891 (still before the antitoxin), the total number of cases was 341, with 121 deaths. There were 108 tracheotomies and 19 intubations performed. Here the death-rate is slightly increased over the previous record.

We now turn to the year 1895, January 1st to December 31st, when nothing but antitoxin was used for diphtheria in this hospital, and we find 535 cases treated, ages varying as before from infancy to 15 years, with but 60 deaths, and only 26 tracheotomies necessary. Intubation was performed upon 74 cases during the year.

Mark the difference. More than double the number of cases with less than one-half the number of deaths. Certainly some cause, and some very powerful cause has produced this change in the mortality, and so far as I am able to judge, from careful observation, it is not due to the severity of the cases or epidemic as so many have asserted. Neither is it due to improved methods of nursing for that remains the same as before.

I have not quoted extensively from the statistics of this hospital, nor have I presented anything but plain facts which are easily understood. I think, however, I have said enough to cause your readers to think that perhaps Herr Chef" has some reason for his opinion that serum in diphtheria, at least, is an established fact.

I also visited the Statische Krankenhouse and Urban in Berlin which is a large modern general hospital built on the pavilion plan of yellow brick and stone. There are eleven detached pavilions with accommodations for 660 patients. This, like most hospitals of Austria and Germany built within the past five years, has mosaic floors in each ward with all corners rounded, to prevent the accumulation of dust, etc. Running the entire length of each ward are strips of linoleum which serve admirably to deaden the sounds caused by persons moving about and at the same time does not collect and hold dust. I was also much interested here in the handsomely equipped and sumptuous back rooms adjoining each ward, especially so as in the older hospitals here back rooms are an unknown quantity, and in many bathing is not indulged in to any great

extent.

I was unable to see the chief of the diphtheria pavilion here as he was on vacation, but had a good opportunity to talk with the head nurse of the department who has been in charge since the opening of the hospital about five years ago.

She could give me no positive statistics, but the expression of her face as she said, "I would not now know how to take care of a patient without antitoxin,'' was proof positive that she, at least, was a firm convert to the new therapy. As a matter of fact, the results here are about the same as in the other hospitals quoted.

I do not wish to tire you with this subject.[so I will only add that the above opinions correspond exactly with those of the physicians of Paris

who have had experience in the use of antitoxin, and who have been kind enough to talk with me about it.

After all of this evidence it seems to me even at the present time that a physician assumes a grave responsibility who attempts to treat a case of diphtheria without the use of antitoxin if it is obtainable. It certainly produces the best results of any form of medication known at the present day. What we may have five years from now is an unknown problem in these days of rapid progress. Very truly yours,

Paris, France, October 6th, 1896.

WILLIAM H. VANDEN BURG.

BOOK REVIEWS.

SYSTEM OF SURGERY. Edited by Frederic S. Dennis, M.D., assisted by John S. Billings, M.D. Lea Bros., New York and Phila., 1896, Vol. IV., Pp. 955.

Vol. IV. completes the work, and is made up of chapters as follows: Tumors, by Frederic S. Dennis; Hernia, by William T. Bull; Surgery of the Alimentary Canal from the Pharynx to the Ileo-Cæcal Valve, by Maurice H. Richardson; Appendicitis, by Frank Hartley; Surgical Treatment of Appendicitis, by Charles McBurney; Surgery of the Alimentary Canal from the Ileo-Cæcal Valve to the Anus, by Lewis S. Pilcher; Surgery of the Liver and Biliary Passages, by Robert Abbe; Surgical Disorders and Diseases of the Uterus, by William M. Polk; Surgical Diseases of the Ovaries and Tubes, by Joseph Taber Johnson; Minor Gynecological Surgery, by Henry C. Coe; Symphysiotomy, by William T. Lusk; Surgery of the Thyroid Gland, by Robert F. Weir; Surgical Peculiarities of the Negro, by Rudolph Matas; Diseases of the Female Breast, by Frederic S. Dennis; The Use of the Roentgen or X Rays in Surgery, by W. W. Keen.

This list of contributors upon these subjects is sufficient guarantee that Vol. IV is not only fully up to the standard of the first three volumes, but is all in all a most perfect contribution to the field of surgery which it covers. To speak of each chapter in detail would require more space than it is possible for us to devote to the subject. They all possess an excellence which is rarely found in a general work upon surgery, and both the editor and publishers are to be congratulated upon the skill with which they have selected the contributors and assigned the subjects of which they treat. If we were to make special mention of any of these chapters, it would be those upon Hernia, which is very complete, the two chapters upon Appendicitis, and the chapter upon Symphysiotomy. Two somewhat unique features of the book are Dr. Matas chapter upon Surgical Peculiarities of the Negro, and the last chapter upon the use of the Roentgen Rays in Surgery, both of which are up to the high standard of the rest of the book. As a whole, Dennis' System of Surgery is to our mind the most complete work upon general surgery now extant and both the authors and publishers have evidently spared no pains to make the work not only up to date, but to give due weight to the various methods of the treatment of each particular condition. It, of course, goes without saying that no surgeon should be without this book; the only question arising is how far it will be useful to the general practitioner, and in this connection we can only say, that its size, expense, and technical nature will necessarily somewhat limit its sale. At the same time if it is purchased by the general practitioner, he is sure of having a work which covers the field of Surgery and Gynæcology in a most complete manner.

TREATMENT OF APPENDICITIS. By John B. Deaver, M.D. P. Blackinson, Son & Co., Phila., 1896. Pp. 168.

Monographs upon appendicitis are springing up like mushrooms, which expression is not to be considered in its uncomplimentary sense, for the above work bears the stamp of being the product of experience and careful thought. It is well arranged, well printed, beautifully illustrated, and covers the ground quite completely Like all other works of its nature it advocated strongly the early surgical treatment of the condition, although we do not consider the author's ideas quite as radical as those expressed by Drs. Morris and Fowler in their works upon the same subject. Taken all in all the book is a good one, and may perhaps be regarded as the most serviceable one of the three.

TWENTIETH CENTURY PRACTICE. An International Encyclopedia of Modern Medical Science. Edited by Thomas L. Stedman, M.D. In Twenty Volumes. Vol. VIII, "Diseases of the Respiratory Organs and Blood and Functional Sexual Diseases." William Wood & Co., New York, 1896. Pp. 796.

As it was necessary to publish Volume VIII before VII, the series of this great undertaking is now conclusive up to Volume VIII.

The present volume is the work of ten different authors, none of whom as it happens are Americans. Among the sections of the work deserving special mention are those on Diseases of the Blood," by Alfred Stengel, M.D., of Philadelphia. 'Rachitis," by Jules Comby, M.D., Paris. "Functional Diseases of the Male Sexual Organs," by Charles W. Allen, M.D., of New York and the "Chemical and Microscopical Examination of the Urine," by James M. French, M.D., of Cincinnati.

Dr. Stengel's article is very complete and especially good in its description of the various methods of examining the blood. His account of the various diseases of the blood is also excellent and could hardly be improved upon. The monograph on the examination of the urine is very satisfactory. It is very complete in classification and description and the tests given are practical, of proven value and so clearly described that they may be readily employed. The remaining articles in the volume are all well worth reading and if criticism were made it would be because of brevity. The series is nearly half issued and so far keeps well up to the high standing of the first volumes.

A MANUAL OF CLINICAL DIAGNOSIS BY MEANS OF MICROSCOPIC AND CHEMICAL METHODS. By Charles E. Simon, M.D. With 132 Illustrations in Wood and ten Colored Plates. Lea Brothers & Co., Philadelphia, 1896. Pp. 504

This is a rare book and worthy of rare commendation. Dr. Simon has well improved his opportunities and has given the profession a work of great value. The chapters on the gastric juice, the blood and urine are alone worth many times the price of the book. Dr. Simon has had the advantage of acquaintance with the best methods developed in European clinics and laboratories and to this he has added the experience gained in private practice and in one of the largest and advanced American hospitals. Readers of this work will find complete and thoroughly practical explanations of the diagnostic indications which can. be obtained from the blood, secretions of the mouth, the gastric juice and contents, the feces, the nasal secretion, the sputum, the urine, transudates and exudates, cystic contents, meningeal fluid, semen, vaginal discharges, and the mammary secretion, so plainly set forth that the practitioner or student who has not had special training in such manipulations may nevertheless be enabled to obtain satisfactory re

sults.