body is at rest the respiratory and cardiac action is lessened and temperature is lowered. The rest may be taken in the open air and should be continued for

making the diagnosis of the condition of a heart.
He spoke of loud systolic murmurs at the base of the
heart that were transmitted into the vessels of the
neck that were not necessarily indicative of aortic a long time.
stenosis. Heart lesions, on the other hand, may
exist without the appearance of a murmur. The
treatment should be based on the condition of the
pulse, the size of the heart, the character of the first
sound, and the absent or feeble apex beat. He does
not think that the costal fringe is a sign of great im-
portance in cardiac disease.

DR. BABCOCK, of Denver, said that myocardial changes in rheumatism in children were common. He thinks that the myocardium is the most important factor in the prognosis of a heart lesion.

DR. WITHERSPOON, of Nashville, Tenn., said that in his experience death in cases of aortic stenosis was due to the condition of the blood-vessels, particularly those of the brain. A heart that is compensated needs

no treatment.

PULMONARY TUBERCULOSIS; PRESENT CONDITION OF
CASES TREATED DURING 1898 AND REPORTED
LAST YEAR AT THE COLUMBUS MEETING,
by DR. C. P. AMBLER. Cases of pulmonary tuber-
culosis should not be reported cured until a long time
had elapsed. Of 46 cases called class "A," 35 were
apparently cured, nine were greatly improved, and one
was stationary. Of 28 cases called class "B," six
were apparently cured, 13 were greatly improved,
eight were improved, and one died. Of 32 cases
called class " C," nine were greatly improved, five were
improved, six were stationary, 11 were worse, and one
died. The treatment was (1) by hygienic supervision,
(2) by climatic influences, (3) by medication, (4) by
serum therapy. Cases apparently cured under serum
therapy are less liable to relapse.

TUBERCULOSIS OF THE LUNGS.

DR. S. SOLIS-COHEN said that the costal fringe is an evidence that myocardial change is possible if not probable. Organic murmurs do not solely mean valvular disease, but may indicate disease of the papil- DR. A. F. LEMKE, of Chicago, said tuberculous lary muscles, etc. Hemic murmurs should be differ-lesions probably never heal by resolution-always by entiated; they may be vascular or muscular as well as cicatrization; hence in attacking them it is rational to hemic. He is an advocate of venesection in cases of threatened cardiac collapse.

DR. L. F. BISHOP said that loud murmurs are often due to dilatation of the heart.

DR. MORRISSEY said that he thinks that tachycardia and bradycardia are not distinct entities. It is difficult to diagnose between dilatation, fatty degeneration and myocarditis.

IN WHAT RELATION DOES OCCUPATION STAND TO
TUBERCULOSIS?

DR. W. FREUDENTHAL, of New York City, read
this paper.
In 1,500 cases of tuberculosis tailors
were the most frequently affected, those who work in
sweat-shops and who live in dark, unventilated rooms
particularly. Tuberculosis is a trophoneurosis com-
bined with a vascular insufficiency which produces a
favorable seat for the growth of the micro-organism.
Such favorable soil is frequently produced in the re-
tropharyngeal space.

DR. J. M. ANDERS, of Philadelphia, read a paper

entitled

DIAGNOSIS AND TREATMENT OF THE PREBACILLARY
STAGE OF PULMONARY TUBERCULOSIS.

The prebacillary stage is of long duration and signifies the entire time before the bacilli are found in the sputum. During this period the diagnosis is to be made by (1) the use of the x-rays, (2) the application of the tuberculin test, (3) a careful study of history, symptoms and physical signs; among the most important of the symptoms is a two-hour temperature record. This will show an elevation of temperature at a given time daily.

THE IMPORTANCE OF

further the natural tendency to cicatrization. Healing
of a focus of tuberculosis in the lung is probably al-
ways altogether the result of tissue changes which
diminish or inhibit the absorption of proteins derived
from the bodies of tubercle bacilli. Good effects of
compression, locally, are brought about by the limita-
tion of areas of disease already existing by favoring
fibrosis in and about these areas; by occluding the
avenues of dessemination of the virus, and by com-
pressing cavities to enable them to heal mechanically.
Other effects of compression are due to rest to the or-
gan as a whole, emptying of secretions, prevention or
diminution of absorption of toxic bodies, prevention of
secondary infections, and the diminished tendency to
hemorrhage. There is no evidence that fresh tubercles
can develop in a compressed lung. The average quan-
tity of nitrogen which may be introduced into a pleural
cavity without untoward effects is 120 cubic inches.
Healthy lung tissue may be compressed for a year or
more and retain its capacity for expansion upon the
removal of pressure. Uses of intrapleural injections of
nitrogen (1) Curative in pulmonary tuberculosis; (2)
palliative -to prolong life for weeks or months,
though the disease be too extensive to make recovery
probable; to diminish fever and expectoration; (3)
to check pulmonary hemorrhage; (4) to compress
cavities, tuberculous and others, and establish mechan-
ical conditions that will permit their healing, and (5)
to compress the lung just prior to surgical operations.
DR. THOMAS J. MAYS, of Philadelphia, read a
paper entitled

SILVER INJECTION TREATMENT OF PULMONARY
CONSUMPTION.

In discussion DR. VICTOR C. VAUGHAN, of Ann REST IN PULMONARY TUBER- Arbor, Mich., said that tuberculosis should be diagnosed in the prebacillary stage, if possible, if anything is to be accomplished in the way of treatment. He believes that the temperature of tuberculosis is more characteristic than that of typhoid fever; but many things cause it to vary. Rest is one of the great benefits of sanatorium treatment. When the temperature

CULOSIS, by DR. CARROLL E. EDSON, of Denver, Col. The indications for rest in pulmonary tuberculosis are the same as those for rest in joint and bone tuberculosis. Local tissue rest is very essential, although the obtaining of absolute rest of the lung is difficult. When the

is not high a moderate amount of outdoor exercise of coma. Such a condition may lead to the diagnomay be indulged in. Many patients suffering from sis of uremia. Urines of low specific gravity may argyria as a result of the use of silver in the treatment contain sugar, and, consequently, every specimen of epilepsy developed tuberculosis. should be examined for glucose. It is important to

DR. DELANCEY ROCHESTER, of Buffalo, thinks recognize the form of the diabetes. A convenient that the spread of the disease may be in a measure ac- classification is into (1) mild, (2) severe, and (3) counted for by the habit that tailors and sewing malignant. women have of wetting the thread that they use in the making of clothes.

DR. S. SOLIS-COHEN, of Philadelphia, said that there is a disease before the bacillus gets into the tissues; when the bacillus arrives there is a certain toxemia set up, and then there follows a secondary infection with pus cocci. In tuberculous patients between 12 noon and 2 P. M. is the time of highest temperature in the incipient cases, except in those cases of inverse temperatures. In cases of reported recovery it is essential to state the time that has elapsed since the cessation of symptoms.

DR. KNOPF, of New York City, is glad to know that the idea of a specific climate for tuberculosis had been abandoned. A class of persons almost as frequently affected with tuberculosis as the tailors is that class that are engaged in assorting the soiled clothes in laundries and those that assort rags. The rest cure should be alternated with gentle exercise or with massage. In order to improve and lessen the number of tuberculous cases it is necessary to improve the housing of the poor by doing away with the present class of tenement houses and replacing them by sanitary dwellings. It is necessary to have special hospitals in every city for the consumptive poor, so that to their tuberculosis they may not have nostalgia added by being sent away from home.

DR. NEWTON, of New Jersey, cited a case that seemed to show that certain cases of anemia presented an evening rise of temperature, similar to that seen in tuberculosis.

FOURTH DAY.

CONTINUATION OF THE DISCUSSION ON TUBERCU

LOSIS.

DR. C. P. AMBLER said that he was not connected with any sanitarium and that the cases that he reported were cases in private practice.

DR. MAYS said that he thought that the doses of silver nitrate that he uses would not produce argyria. He has never seen toxic effects. He believes that no tuberculous patient would throw off the liability to the disease no matter how long he should live, but if a tuberculous patient is relieved of his symptoms for a year he is practically well.

DR. LEMKE said cases of pneumothorax end fatally either because too large an amount of air is forced into the pleural cavity or because there is an infection.

DIAGNOSIS OF DIABETES.

MORTALITY FROM DIABETES MELLITUS IN THE CITY OF NEW YORK DURING THE DECADE 1889-99. DR. HEINRICH STERN, of New York: In 1860, of the deaths from diabetes, nearly 50 were in females. The number of deaths from diabetes has been increasing since 1894. The mortality from diabetes is greatest in October and least in November. The greatest mortality is between the forty-fifth and fiftyfourth years. The mortality in females, 64, after the forty-fifth year, is possibly explained by the degenerative changes following the menopause. In childhood and adolescence diabetes is rare. In the colored population during this period there were only 15 deaths.

Ery

DR. MILTON B. HARTZELL, of Philadelphia, called attention to the fact that in many instances the skin presents pathologic changes accompanying diabetes. The greater number of skin lesions are inflammatory in character. There may be desquamation from deficient secretion of sweat and serum, accompanied by changes in the hair and nails, and by pruritus. thema, urticaria, eczema of the genitalia, acne cachecticorum, crops of boils, carbuncle, papillomatosis diabetica, gangrene of the skin, bullous serpiginous gangrene and exanthema diabeticorum are common lesions. Psoriasis dermatitis herpetiformis, abnormal deposits of pigment and purpura are rare. Local

treatment is the same as that of similar conditions in non-diabetics, but the treatment of the underlying cause is the most important.

DR. S. SOLIS-COHEN, of Philadelphia, dwelt upon the importance of examination of the urine in every case; but every case of glycosuria is not diabetes. usually unrecognized symptom of diabetes mellitus is bilateral sciatica.

A

DR. JAMES J. WALSH, of New York City, called attention to the fact that diseases that were formerly considered rare are in reality more frequent. The common occurrence of tuberculosis and nephritis in such cases often leads to an error in diagnosis.

DR. WATKINS, of New York City, spoke of the increase of the biconcavity of the red blood corpuscles in advanced cases of diabetes.

DR. MORRISSEY, of New York City, said that it was necessary to treat the patient and not the disease. In life insurance examinations he finds a large number of alimentary glycosurias. Opium is still the standby in the treatment.

DR. WAHRER, of Iowa, said that it was easier to diagnose the disease than to treat it. He does not believe in a rigid diet without sugar.

DR. JAMES B. HERRICK, of Chicago, said the crucial test for the existence of diabetes is the finding of sugar in the urine and determination of the permanence or transitory nature of the glycosuria. He spoke of certain symptoms that would lead one to suppose that DR. A. E. ROUSSELL, of Philadelphia, said glycosugar would be found in the urine. Impotence and suria is sometimes an indication of myxedema, which psychic disturbance are often early symptoms. Cases would be benefited by thyroid treatment. He is of are overlooked because there is an error in the technic; the opinion that the diets as laid down are too rigid. the urine may not be examined for sugar, or the sugar DR. OSBORNE, of New Haven, Conn., called attenmay not be present. Casts are frequently found in tion to the relation between pancreatic disease, myxediabetic urine and usually indicate the development | dema, nervous disease, exophthalmic goitre and dia

betes. He also thinks the diet should not be too rigid.

DR. HERRICK said that the apparent immunity of the colored race might be due to the manner of living of that race. He called attention to the rarity of the disease in hospital patients and its frequency in private practice as confirmatory evidence of this influence of living on the disease. He does not believe in the too rigid enforcement of diet.

Dia

DR. STERN said 70 per cent. of deaths from diabetes occurred in the tenement houses, 15 per cent. in hospitals, and 15 per cent. in private practice. It is common in the Irish population. He divides the disease into the preglycosuric stage, the stage called diabetes mellitus, and the postglycosuric stage. betes is a plasmolysis; he recognizes it by an increased output of nitrogen in addition to the glucose. The oxybutyric acid is the result of a diet of fat and meat. The existence of Kussmaul's breathing is necessary to the diagnosis of diabetic coma.

EXOPHTHALMIC GOITRE.

DR. EUGENE WASDIN, of the United States MarineHospital Corps, said that it was undoubtedly a fact that the bacillus of Eberth caused the disease. Typhoid fever is no more a local disease of the intestines than small-pox is a local disease of the skin. All the acute infectious diseases are produced by agents that are toxic on the one hand and septic on the other hand. Between these extremes there are all gradations. The typhoid bacillus has little toxicity but is extremely septic, and typhoid fever is a septicemia. He believes that the portal of entry of the typhoid infection is, in the majority of cases, through the respiratory tract.

LESIONS OF THE CAUDA EQUINA AND CONUS
MEDULLARIS,

by DR. BERTRAM W. SIPPY, of Chicago. When
lesions of the conus medullaris exist sensation will be
impaired in the integument of the pelvis, the dorsal
surface of the scrotum, the perineum, the anus, the
inner aspect of the buttocks, the posterior surface of
the thighs. He reported 7 cases, of which 1 came to
autopsy. He called attention to slipper anesthesia
as an indication of these lesions.

GENERAL PRACTITIONER.

OF THE

DR. A. MARCY, JR., of Riverton, N. J., read this paper.

DR. O. T. OSBORNE, of New Haven, Conn., is of the opinion that the name is a misnomer and suggests the name of Graves's thyroid disease. Of the cases 80 per cent. occur in women during the most acute MOVABLE KIDNEY FROM THE STANDPOINT period of their sexual life. He believes that the symptoms are due to hypersecretion of the thyroid body. The course of the disease is divided into (1) prethyroid period; (2) period of incipient symptoms; The most important etiologic factor in the produc(3) period of active symptoms; (4) defervescence or tion of movable kidney is the absorption of the perirestage of complications resulting in death. The treat-nal fat. He prefers to examine for this condition ment should be such as to lessen the secretion of the gland. He recommends absolute rest in bed. There is no question of the advisability of removing parts of the gland when pathologic conditions are present. He doubts the value of suprarenal extract, but thinks that thymus gland extract is better.

DR. JAMES B. HERRICK, of Chicago, said that there were undoubtedly many patients that have the symptoms of the disease before they consult a physician and before the symptoms fully develop. He is of the opinion that he has seen a patient that was benefited by the increase of fibroids of the gland following the opening of a cyst of the thyroid.

DR. S. SOLIS-COHEN, of Philadelphia, believes that there is something more than hyperthyroidation in the etiology of this disease. After rest he believes that the best treatment is by extract of suprarenal body. Digitalis is not to be given in every case. Good results have followed the use of go grains of hyoscin hydrobromate over long periods of time and or grain of picrotoxin. Ergot has been found

useful.

DR. OSBORNE said that the affection properly belonged under the head of functional disturbance.

TREATMENT OF TYPHOID FEVER WITH BACTERIAL
IN CONNECTION WITH OTHER AGENTS.

DR. JAMES M. PECK, of Arlington, Ky., thinks that in private practice the nearer that the physician can reach the conditions of the Brand method the better will be the results. He uses calomel and chlorine, followed by washing the bowel with sterile water. He believes that intestinal antisepsis strengthens the wall of the bowel and prevents sloughing. He reported 77 cases in which the treatment was used, with recovery in every case.

when the patient is in the upright position. The ideal treatment is surgical and nephrorrhaphy in his experience is the most satisfactory operation.

DR. CLEVELAND, of Cincinnati said that in his experience movable kidney is almost always associated with enteroptosis or gastroptosis and should be classed as a general abdominal condition. He thought that operation would hardly be efficient.

THE ANTISEPTIC TREATMENT OF DIPHTHERIA.

DR. D. BENJAMIN, of Camden, who read this paper, advocates the local application of antiseptics to the false membrane in the throat.

DR. WM. M. WELCH, of Philadelphia, said that it is well known that local applications do not kill the organisms in the false membrane.

THE CLIMATOLOGY OF ARIZONA.

DR. WILLIAM DUFFIELD, of Phoenix, said that Arizona is a territory 400 by 350 miles in extent containing almost every physical feature and variety of climate known. The mean temperature varies from 50.7° to 64° in the different parts of the State. There is very little vegetation except in the irrigated districts. On the plain the mean temperature is 70°; total precipitation is 5.19 inches; mean relative humidity 49 per cent. There were 245 clear days in an average year. The climate has a maximum of sunshine, a minimum of humidity and a possibility of constant outdoor life.

DR. HOWARD S. ANDERS, of Philadelphia, read a paper entitled

CERTAIN CLINICAL FEATURES OF INFLUENZA RE

CENTLY EPIDEMIC.

The paper was based on a study of 128 cases.

In

duly exaggerated. One important omission is to be
noted. The author deals all too briefly with the sub-
ject of laminectomy, and in dealing with spinal injur-
ies sums up by stating that "fracture of a vertebra
followed by symptoms of compression requires ex-
ploratory trepannation (sic) in every instance." Al-
though, in the strict sense of the words, this is true,
yet to the ordinary reader it would seem to recommend
laminectomy in nearly every case of fracture.
the vast majority of cases, however, the fracture is at-
tended with contusion or crushing of the cord instead
of simple compression, which is only in the rarest
instances the result of fracture.
In such cases
of crush laminectomy is, of course, unwarranted,
and the author ought to have made the distinction
clear. Certain over-statements as to the relative fre-
quency of cerebral abscess, multiple sclerosis, etc.,
impair the value of the book by exciting an unwar-
ranted suspicion of inaccuracy. A certain over-em-
phasis of statement in regard to various subjects, as,
for instance, in his justifiable condemnation of opera-
tions for so-called "reflex" disturbances, such as need-
less gynecological interference in hysteria, tends to
weaken the force of his criticism and thus unfairly to
depreciate a most excellent work.

Le Lesioni Traumatiche dei Centri Nervosi. By
SALVATORE SALINARI. 8vo. Pp. iv, 320. Rome:
Press of the Giornale Medico del Regio Esercito.
1900.

In view of the fact that many of the methods of treatment employed in nervous affections are of a special and somewhat technical character, it is somewhat singular that we have had to wait so long for a comprehensive treatise on the whole subject, giving a full account of these various methods and assigning to each its relative position more justly than the hand-books devoted to any single method are apt to do. The need of such a treatise has been apparent to all save those who still believe that diagnosis and not therapeutics is the goal of all neurological study. The volume before us meets that need in admirable fashion. It treats the subject thoroughly and completely, it recognizes the limits of our therapeutic resources, but it presents those resources in abundant detail and it is in the main a judicious and trustworthy guide to the practitioner. The first part of the work deals with the causes, origin and prevention of diseases of the nervous system; chapters of marked interest which may be read with profit by every physician. Of the various causes, more stress is laid upon syphilis than any other, and the writer, recognizing that syphilitic lesions in the nervous system may do irreparable damage before treatment can modify them, This monograph on the traumatic lesions of the nerand that treatment is often ineffective when syphilis vous centres was awarded the Riberi prize in 1898. involves the nervous system, urges energetic and per- The work is divided into two parts, the first treating of sistent treatment of the disease as soon as it is recog-traumatic lesions of the brain and its membranes, and nized, even in its "primary" stage-advice which the second the lesions of the cord. The direct traumust commend itself to all who are familiar with thematic lesions of the brain are classed as commotion, course of syphilitic nervous affections. In dealing compression, contusions and wounds. Commotion is with other important questions in the causation and retained as a convenient clinical term for the cases of prophylaxis of nervous disease, education, temperance, rapid and complete suspension of all the cerebral sexual indulgence, the marriage of the neurotic and the functions, from which the patient may rapidly or like, he takes in the main safe and conservative ground. | slowly recover, or which may prove fatal without In the second part the author discusses various meth-discoverable lesion of the brain. These latter cases, ods of treatment - drugs, hydrotherapy, electrother- however, the writer admits might be more properly apy, massage, exercise, rest, occupation, diet and classed as cases of contusion, since minute hemorpsychotherapy. Certain of these methods have in the rhages are sometimes found. Indeed the writer past been somewhat unduly extolled as panaceas by hardly goes far enough in this regard, for he does unwise advocates. In the present volume they are not lay sufficient stress upon the fact that fatal cases given their just position, the technique of their use is of cerebral injury without discoverable lesion are for fully described, and the physician can learn just what the most part of ancient date and that modern authoribenefit is likely to be derived from them. The main ties like Phelps refuse to consider them. In cases of portion of the book deals with the treatment of vari- compression he inclines toward operative removal of ous diseases and morbid states. Of necessity each the compressing substance in every case. The dischapter begins with a brief account of the causes and tinction between compression and contusion, however, symptoms of the disease of which it treats, and this is is not easy; he lays most stress upon the presence or followed by a detailed account of the methods to be absence of general symptoms of pressure. but he employed in the treatment. Of this part we can but recognizes that both conditions may co-exist. repeat our previous commendation, that the author in the majority of cases of open wounds and bullet the main is a safe guide. In many instances, of wounds, he advises against operative interference. course, there is room for differences of opinion in re- As complications of the original lesion, he considers gard to treatment, based upon the differences of indi- foreign bodies, blood clots. meningo-encephalitis, vidual belief and experience; for example, certain dis- hernia and abscess. Serous meningitis and edema tressing cases of the morphine habit forbid us to are not considered. Chapters on the localization of accept his dictum that there is no danger of forming a symptoms and on the technique of operations conhabit by using morphine in the crises of tabes; we be- clude this part. The question of the seat and nature lieve that he undervalues the efficacy of large doses of of the lesion is first considered in dealing with injurpotassic iodide in the treatment of non-syphilitic ticies of the spinal cord. This chapter is far from satisdouloureux; and his hope of benefit from trephining factory; the importance of the syringomyelic dissoin traumatic epilepsy and cerebral tumor seems un- ciation of sensibility (that is, the loss of sensibility to

In

Nervous and Mental Diseases. A Manual for Stu-
dents and Practitioners. By CHARLES S. POTTS,
M.D. Small 8vo. Pp. 455, with 88 engravings.
Philadelphia: Lea Brothers & Co. 1900.

pain and temperature, with retained sensibility to says about the contagious diseases, as, for instance, touch) is ignored, and the sensory and motor areas of where he speaks of one attack of measles regularly the different spinal segments, so essential in localiza-protecting from a subsequent one. This is well tion, are not well described. He admits the existence known not to be the case, as undoubted attacks of of a spinal as well as a cerebral commotion, but his measles occur in the same individual twice, and even illustrative case of the severer type showed positive oftener. The prodromal symptoms which are given signs of hemorrhage at the autopsy. In cases of in measles are not such as are usually seen in that compression and contusion, which are of course very disease, the headache, vomiting and prostration being difficult to differentiate, and for the possible differen-more significant of scarlet fever than of measles. tiation of which he omits certain important symptoms, such as syringomyelic dissociation, he inclines strongly toward operative interference. The prognosis in open wounds of the spine is of course much more serious, and operative interference seldom affords much chance of relief. The late effects of injury, tabes, multiple Brief manuals, written to order as part of a series, sclerosis, progressive muscular atrophy, epilepsy and are seldom of value and still less frequently of interthe traumatic neuroses are very briefly touched upon, est. If they present the main facts of a subject and a chapter on surgical technique concludes the clearly and correctly they fulfil their mission. The work. The work, as a whole, is a careful study of the subject, from the standpoint of the military surgeon, but the benefits of operative interference are viewed somewhat too optimistically, and in pathology and symptomatology the results of more recent work are not sufficiently taken into account.

Diseases of Children. By GEORGE M. TUTTLE, M.D., Attending Physician, St. Luke's Hospital; Martha Parsons Hospital for Children, and Bethesda Foundling Asylum, St. Louis. Lea's Series of Pocket Text-Books. Series edited by BERN B. GALLAUDET, M.D. Illustrated with five plates in colors and monochrome. Philadelphia and New York: Lea Brothers & Co. 1899.

tance of the chief tracts in the projection system. The section on mental diseases is put by itself and not incorporated with the other diseases of the brain. It follows the conventional and somewhat antiquated lines of the average treatises in English, paying slight attention to the more modern views of mental disease.

present volume, in a series of pocket text-books edited by Dr. Gallaudet, is unusually successful in this respect and is far superior to the' ordinary work of its class. The author has succeeded in the opening chapters in impressing the broad outlines of the structure and functions of the nervous system so simply and so comprehensively, with the aid of a few well-selected diagrams, as to make it comparatively easy for the student to understand the essential plan of his future study. The succeeding chapters on the various diseases, although exceedingly condensed, are reasonably accurate and up to date, and give in a few words the most important facts. The grouping of the various systemic diseases into one chapter as an introduction to the chapters on the general diseases of the brain The author states that in preparing this manual for and cord is a useful innovation and is well calculated publication he especially has in view the require-to help the beginner by emphasizing again the imporments of the beginner in the study of pediatrics. He has endeavored to cover the subject fully, yet in a concise form, and does not profess that there is any originality in his work, but makes free reference to the standard text-books on pediatrics. In the early part of the work, where he is dealing with the anatomy and physiology of the infant, the statements are in the main correct and to be depended upon, but when he The Nervous System of the Child; its Growth and approaches the subject of feeding he shows a lack of Health in Education. By FRANCIS WARNER, proper appreciation of the vital principles of this important subject, namely, in the small amount of M.D., F.R.C.P. 12mo. Pp. xvii, 233, with one plate. New York: The Macmillan Co. 1900. space which is given to it. The difficulty in writing a book of this kind is that the writer is so apt to The present volume is addressed rather to the teacher misinterpret what he is practically copying out of the than to the physician. It presents the rudiments of cerelarger text-books, and that in attempting to condense bral physiology and the development of the mental facthe statements of other authors the real opinion of ulties in a simple way, with clear directions for observthese authors on different subjects is lost sight of. ing the normal and abnormal phenomena of speech and The part of the book which is devoted to gastro-action manifested by the child in his early years. enteric diseases is insufficient for practical purposes, For the physician the treatment is too elementary and even if a treatise of this kind is desired, and in some too incomplete, although he may occasionally find parts a student, or one who was not actually familiar some useful suggestions in it. For the teacher, howwith the disease which is spoken of, might do much ever, it forms a useful and fairly trustworthy introharm by following the treatment indicated. Thus, in duction to the study of the mental development of the speaking of the treatment of intussusception, the child and his education. proper danger of both inflation and hydrostatic pressure is not sufficiently emphasized. In reviewing a work of this kind, however, we should consider exactly what is intended to be accomplished in such a small space, and certainly in comparison with other books which have dealt in this way with so large a subject as pediatrics this book of Dr. Tuttle's can be spoken of favorably. It would be well, however, if the author had been a little more careful in regard to what he

A WHOOPING-COUGH PARTY.-A little girl of Huntington, S. I., recently gave a "whooping-cough party." She was a sufferer from whooping-cough at the time of her birthday, when she was accustomed to entertain her young friends, and her mother solved the difficulty by inviting only such children as were known to have the disease, which was prevalent in the village, or to have recently recovered from it.