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OBSTETRICAL SOCIETY OF LONDON.
353
Thumb-joints,in which inflammation of the carpo-metacarpal forating ulcer on the under surface of the ball of the great joints of both thumbs came on after the removal of two toe, which tended to ameliorate. The knee-jerks were ovarian tumours in November, 1885. The arthritis has con- normal; some anaesthesia was present.-Mr. WM. ADAMS tinued unabated, the veins about the joint are swollen, and suggested that lymph bands in utero might give rise to the there is increase of temperature; grating between the cicatricial markings in limbs by causing constriction. It
The thenar eminences was difficult, however, to understand the cases.-Mr. can be obtained. little wasted, but there is no reaction of degeneration, RITCHIE asked how much the malnutrition was due to only generally diminished reactions to both currents. Men- vascular and how much to nervous damage. Mr. SpENCEB WATSON showed some New Instruments for struation had ceased since the ovariotomy. Pain was the first symptom in the left thumb; the right followed later. use in the removal of Nasal Polypi. The reflexes at the wrists were perhaps a little exaggerated. Absence of rheumatism, gout, and the relation in time to OBSTETRICAL SOCIETY OF LONDON. ovariotomy and the appearance of the disease when the joints were comparatively quiet, suggested a causal relation between the ovariotomy and the arthritis. It was conRem01:al of botli Ovaries during Pregnancy. nected not with congestion, but rather with ansemia of the THE annual meeting was held on Wednesday, Feb. 3rd, genital regions. All treatment had proved of little avail.-7Ir. WM. ADAMS did not think it could be placed amongst J. B. Potter, M.D., F.R.C.P., President, in the chair. Mr. KNOWSLEY THORNTON read a paper on a case of ’the neurotic alterations in joints. The principle of "rest and sweat" night and day should be employed in treat- Removal of both Ovaries during Pregnancy. M. Wiz, ment.-Mr. B. JESSETT recommended complete rest of the married, aged twenty-two, in the third month of pregnancy, joints.—Dr. WM. ORD believed that the case was one in was known to be large twelve months before marriage. She which reflected " uterine"irritations were at work ; the is now beyond the size of pregnancy, and has a large ovaries had been removed, but we did not know what the fluctuant tumour in the abdomen, which is growing fast. state of the uterus was.-Dr. MAGUIRE, in reply, said he Has suffered from several attacks of pain in the abdomen, with rise of temperature, sickness, and faintness. Diagnosis: presented the case simply as a clinical fact. Mr. FRANCIS MASON exhibited a young man on whom he ovarian tumour complicated by pregnancy. Ovariotomy had performed Excision of the Left Elbow-joint, with good advised, and performed Feb. 4th, 1885. Dermoid tumours of ,-result in a freely movable joint. Since the operation a tuber- both ovaries removed. Rapid and uninterrupted recovery. cular testis on the right side had developed, with infiltration Premature delivery at eighth month. Labour uncomplicated. in the right side of the prostate and the base of the bladder.- Lochia normal. Fine healthy child, and plenty of milk to nurse Mr. IIURRY FENWiCE, who showed this case in conjunction it. On examination, uterus found atrophic ; patient, while with Mr. Mason, suggested that the testicle became diseased nursing, suffering from flushes, chills, &c., just as others do who have an artificial menopause brought on by operation. as the result of infection from the joint, possibly about the time of the operation, and in consequence thereof.—Mr. The author made remarks on the interesting physiological .STEPHEN PAGET did not perceive the reason why the testis and pathological problems which this unique case suggests.should not have been produced under the same influences Dr. JOHN WILLIAMS said that in a note read before the that gave rise to the tumor albus of the elbow-joint. Society in 1884 he described the involution of the puerperal Dr. RADCLIFFE CpocxEB exhibited a boy, aged sixteen, with uterus in the absence of the ovaries. In that case the left Tubercular Leprosy, who had lived in Dominique, but was ovary had been removed some years previously, and the of Scotch parentage. There had been no privation; the boy right was removed soon after labour set in. The course of fuad eaten fish. The leprosy appeared first in 1882, one year the process of involution might have been affected directly after the boy came to England to go to school. Febrilesym- by the interference of the operation in his case; but in ptoms preceded the development of tubercles ; the progress Mr. Thornton’s it could not have been so, for the operaiiad been saltatim; febrile attacks accompanying each fresh tion had been performed some months before labour set crop of tubercles; the glands in the groin and elsewhere en- in. He would ask Mr. Thornton if any observations had larged just before the febrile attacks. There were no definite been made on the process of involution in his case.tracts of anaesthesia; the ulnar nerves were not materially Dr. ROUTH remarked that the atrophy of the uterus could thickened; the mucous membranes of the tongue, epiglottis, not impede lactation, and quoted Dr. Livingstone, who and vocal cords were affected with tubercles; the nails had stated that the wives of the African kings were not been destroyed in places ; sometimes the tubercles ulcerated; allowed to suckle their own children, as it was thought The child was given to the grandmother, and the typical bacilli had been detected. Gurjun oil had derogatory. been employed with a little benefit.-Mr. SPENCER WATSON generally an old woman, to whose mammse and pudendum certain plants were applied and the child put to her -related a case. Dr. RADCLIFFE CROCKER also showed a case of Pityriasis breasts, with the result that she was able to suckle the ’Circinata in a man aged twenty-seven. It began on the child. He also alluded to well-authenticated cases in which He objected to the conclusion that abdomen a month ago in oval or round patches, enlarging men had suckled. peripherally and disappearing centrally; at first bright red, menstruation always depended upon ovulation; this question becoming brownish and scaly. The disease generally ran its he considered undecided, and facts were accumulating to course in from one to two months. Vidal described a fungus show that menstruation had really very little to do with microsporon, probably a micrococcus, but no real parasite ovulation. Dr. MATTHEWS DUNCAN regarded tapping as had been discovered. Calamine lotion and liquor carbonis the best treatment in cases of simple parovarian cyst. It indetergens were used locally.-Dr. STEPHEN MACKENZIE volved less danger than extirpation, and was often successful. said that the micrococcus was an epiphenomenon, and might The extirpation of small papillomatous ovaries involved ’be found in any scaly debris from skin disease. The disease many difficulties. He did not believe any operation could was not parasitic. Boracic acid was better than carbolic cure where malignant disease had extended to several acid, though the latter relieved itching.-Dr. CoLCOTT Fox different parts of the peritoneum. He also reminded the r aid the eruption was more scanty in children, and occurred Society that Dr. Tyler Smith had supported the view that entirely on the trunk. It looked like psoriasis at first sight, the commencement of’labour was a function of the ovaries. ’but the distribution was different. A micrococcus was alwaysThis view was now rendered almost untenable by Mr. I present, but as an epiphenomenon.-Dr. R. CROCKER, inThornton’s case. He had no doubt whatever that the ovaries Teply, said he considered the disease to be the same in were indissolubly connected with menstruation. children as in adults, between which there were all links. The following specimens were shown:-Dr. W. Griffith : Mr. J. H. MORGAN showed a case of Congenital Constric- (1) Uterus showing a Dilated Cavity; (2) Sarcoma of tion by a Band producing Perforating Ulcer of the Foot, in aUterus. Mr. Thornton: Papilloma of Ovary. The Society then preceeded to the business of the annual .9ainter aged thirty-eight. On the right hand the fourth digit had no terminal phalanx and only a rudimentary secondsecondmeeting. The treasurer’s report was adopted, on the motion phalanx; the second and third digits were fused, and had (:)f Dr. Playfair, seconded by Dr. Carter; the report of the only a proximal phalanx; there were no nails on these digits. 1ion. librarian, on the motion of Dr. Godson, seconded by The left hand index finger had a rudimentary second phalanx 7Dr. Horrocks ; the report of the chairman of the Midwifery and no nail. The right lower limb showed a firm cicatricial JBoard, with a vote of thanks, on the motion of Dr. Matthews Aontraction, which surrounded the knee below the patella; 1Duncan, seconded by Dr. Malins, and supported by Dr. the leg was smaller on this side, and had a chronic sclero- (xraily Hewitt. The scrutineers (Drs. Thomas and Lewers) dermatous-like condition of the skin. There was a per- cleclared the list of officers and council proposed by the
arthritic surfaces are a
-
I
354 Council
adopted.
The President delivered the
annual
operation
wnicn
nas
always possesseu
a
Hpeuini
iascmu-
address, for which a vote of thanks was proposed by Dr. tion, and the history of which is connected with many Graily Hewitt, seconded by Dr. West. A vote of thanks of the brightest names in surgery. The careful dissec-
retiring officers (Dr. Herman and Mr. Thornton) proposed by Dr. Gervis, seconded by Dr. Watt Black; and one to the retiring Vice-Presidents and other retiring members of Council was proposed by Dr. Routh, seconded to the was
by Dr. W.
Duncan.
Reviews and Notices of Books. lieference Handbook of the Medical Sciences. Vol. 1. Aac-Cat. By various Writers. Illustrated by Chromolithographs and fine Wood Engravings. Edited by BUCK, -7vl.D. New York: Wm. Wood and Co. work, of which the first instalment is before us,
ALBERT H.
THIS
which is to comprise eight volumes of about eight hundred pages each, will undoubtedly mark an era in the literary history of medicine and the allied sciences. It is quite impossible in the space at our disposal to give an adequate description of the merits of the production, whether we turn to the rare knowledge and skill which the several contributors have brought into requisition, or to the excellent arrangement of the subjects treated of, the type, and, last but not least, the admirable illustrations. Our readers ! will be able to form some idea of the completeness of the text and its illustration when we inform them that in the article " Applied Anatomy of the Arm " thirteen pages are ’ devoted to the former and twenty-six woodcuts to the latter, I How consistently and thoroughly the plan of the editor is carried out may be gleaned from a brief comparison of widely different subjects. Thus, almost immediately suca classical dissertation on "Army Diseases" and ceeding " Army Hospitals " is a brief description of " Arnica," which includes the characters of the plant, its chemical and therapeutic properties, and other interesting details, to which is added an excellent chromo-lithograph. The pathological anatomy of disease is given in sufficient detail. Take, for example, the subject " Adenoma," the description of which is graced with four well-executed drawings. The article " Bloodwill earn for the author considerable repute. It contains a well-digested account of the salient features of that fiuid," both in its physiological and morbid conditions. It contains fifty diagrams, of which the greatest interest will attach to those representing the different instruments for estimating the number of corpuscles and the quantity of colouring matter in a given preparation; and the spectroscopical appearances, twenty-four in number, of blood under as many chemico-physical conditions. It remains to be said that each subject is fully up to the present state of knowledge and research. Attention may be called to " the running titles at the upper corners of the pages; these are intended to aid the reader in searching for a particular topic." A full index will be introduced at the end of the work. America is said to be the land of big things, and its title to the claim will not be belied by the Handbook now under review. We look forward, with much interest to the production of the remaining seven volumes.
tion through the abdominal wall on to the front of the distended and raised bladder bears but a very slight resemblance to the bold and rapid plunge into the viscus from the perineum, which in the hands of Fergusson and other brilliant lithotomists was the admiration of all spectators. The claim of the supra-pubic operation, however, is very strong, and the publication of Sir Henry Thompson’s book will do much to impress its merits upon the minds of British surgeons, who have been slower to recognise them than their continental brethren. Two names will be associated with the revival of this operation-Garson and Petersen. To Dr. Garson of the Hunterian illuseum belongs the credit of demonstrating the remarkable influence upon the bladder of full distension of the rectum, which so raises the viscus as to expose a considerable extent of itsanteriorsurface bare of peritoneum above the pubes. To Petersen belongs the credit of availing himself of this anatomical demonstration and of supporting Dr. Garson’s argument by clinical experience. All this, and very much more, of the history of the operation is told by Sir Henry Thompson, who gives a lucid description of the details of the procedure and the subsequent management of the patient, and appends notes of the, cases in which he has himself practised the supra-pubic method. These cases include six instances of the removal of large stones, and two of the removal of large tumours. Dr. Tremaine of Buffalo has lately recorded three interesting cases in which he has successfully performed what he would have us call epicystotomy. In one case a stone measuring 2s in. by Iin. was removed from a child three and a half years old; in the second case fragments weighing altogether over three ounces were removed from a man aged thirty; and in the third case from a man aged seventy-three a mulberry calculus measuring 1 in. by 1 in. was removed. In the last case the peritoneum was wounded, and the intestines protruded from the wound after the man was returned to bed. In the second case the wound in the bladder was sutured. In neither case was Petersen’s distension of the rectum employed. Dr. Tremaine, like Sir Henry Thompson, found the fingers the most convenient means of extracting the calculi.
Acne; its Etiology, Patholoqy, and Treatment:
a
Practical
Treatise based on the study of 1500 Cases of Sebaceow. Disease. By L. DUNCAN BULKLEY, A.M., M.D., Physician to the New York Skin and Cancer Hospital, &c. Pp. 280. London: J. and A. Churchill. 1885. THis well-got-up volume is in some respects a companion one to that on Eczema which has been favourably noticed in these columns. It is written in a similar practical way, is largely in accordance with views held in this country,. and is characterised by careful details as to treatment, by a copious formulary, and a chapter on diet and hygiene. The pathological anatomy of the eruptions is minutely studied, and the beautiful illustrations of Dr. Bulkley’s specimens form a striking feature of the work, and are especially valuable. We must also mention the addition of a very extensive bibliography, so that the volume is one On the Supra-pubic Operation of Opening the Bladder for which is very acceptable both to the worker at these diseases the Stone and for Tumours. By Sir HENRY THOMPSON, and to the practitioner. The author uses the term acne in F.R.C.S., Surgeon Extraordinary to His Majesty the King its widest sense, and defines it as a functional or inflamof the Belgians, Consulting Surgeon to University disease of the sebaceous glands, exhibiting excessive late cf and PathoProfessor matory College Hospital, Surgery and abnormal or deficient- secretion of sebum; or the logy to the Royal College of Surgeons-6i England, &c. London: J. and A. Churchill. 1886. inflammatory elements of congestion, papules, pustules, or THE operation of supra-pubic lithotomy is undergoing a tubercles, located in and about the sebaceous glands, or in revival, as frequent notices in our pages during the last few any or all of these features combined. The term therefore years have sufficiently shown. It bids fair to supplant includes the diseases known as seborrhoea, comedo, and acne perineal lithotomy altogether; it is not without a pang milium, sebaceous cysts, the ordinary inflammatory Molluscum. and cachecticorum. A. A. an and with rosacea, atrophica, of regret that older surgeons especially will part .
Thumb-joints,in which inflammation of the carpo-metacarpal forating ulcer on the under surface of the ball of the great joints of both thumbs came on after the removal of two toe, which tended to ameliorate. The knee-jerks were ovarian tumours in November, 1885. The arthritis has con- normal; some anaesthesia was present.-Mr. WM. ADAMS tinued unabated, the veins about the joint are swollen, and suggested that lymph bands in utero might give rise to the there is increase of temperature; grating between the cicatricial markings in limbs by causing constriction. It
The thenar eminences was difficult, however, to understand the cases.-Mr. can be obtained. little wasted, but there is no reaction of degeneration, RITCHIE asked how much the malnutrition was due to only generally diminished reactions to both currents. Men- vascular and how much to nervous damage. Mr. SpENCEB WATSON showed some New Instruments for struation had ceased since the ovariotomy. Pain was the first symptom in the left thumb; the right followed later. use in the removal of Nasal Polypi. The reflexes at the wrists were perhaps a little exaggerated. Absence of rheumatism, gout, and the relation in time to OBSTETRICAL SOCIETY OF LONDON. ovariotomy and the appearance of the disease when the joints were comparatively quiet, suggested a causal relation between the ovariotomy and the arthritis. It was conRem01:al of botli Ovaries during Pregnancy. nected not with congestion, but rather with ansemia of the THE annual meeting was held on Wednesday, Feb. 3rd, genital regions. All treatment had proved of little avail.-7Ir. WM. ADAMS did not think it could be placed amongst J. B. Potter, M.D., F.R.C.P., President, in the chair. Mr. KNOWSLEY THORNTON read a paper on a case of ’the neurotic alterations in joints. The principle of "rest and sweat" night and day should be employed in treat- Removal of both Ovaries during Pregnancy. M. Wiz, ment.-Mr. B. JESSETT recommended complete rest of the married, aged twenty-two, in the third month of pregnancy, joints.—Dr. WM. ORD believed that the case was one in was known to be large twelve months before marriage. She which reflected " uterine"irritations were at work ; the is now beyond the size of pregnancy, and has a large ovaries had been removed, but we did not know what the fluctuant tumour in the abdomen, which is growing fast. state of the uterus was.-Dr. MAGUIRE, in reply, said he Has suffered from several attacks of pain in the abdomen, with rise of temperature, sickness, and faintness. Diagnosis: presented the case simply as a clinical fact. Mr. FRANCIS MASON exhibited a young man on whom he ovarian tumour complicated by pregnancy. Ovariotomy had performed Excision of the Left Elbow-joint, with good advised, and performed Feb. 4th, 1885. Dermoid tumours of ,-result in a freely movable joint. Since the operation a tuber- both ovaries removed. Rapid and uninterrupted recovery. cular testis on the right side had developed, with infiltration Premature delivery at eighth month. Labour uncomplicated. in the right side of the prostate and the base of the bladder.- Lochia normal. Fine healthy child, and plenty of milk to nurse Mr. IIURRY FENWiCE, who showed this case in conjunction it. On examination, uterus found atrophic ; patient, while with Mr. Mason, suggested that the testicle became diseased nursing, suffering from flushes, chills, &c., just as others do who have an artificial menopause brought on by operation. as the result of infection from the joint, possibly about the time of the operation, and in consequence thereof.—Mr. The author made remarks on the interesting physiological .STEPHEN PAGET did not perceive the reason why the testis and pathological problems which this unique case suggests.should not have been produced under the same influences Dr. JOHN WILLIAMS said that in a note read before the that gave rise to the tumor albus of the elbow-joint. Society in 1884 he described the involution of the puerperal Dr. RADCLIFFE CpocxEB exhibited a boy, aged sixteen, with uterus in the absence of the ovaries. In that case the left Tubercular Leprosy, who had lived in Dominique, but was ovary had been removed some years previously, and the of Scotch parentage. There had been no privation; the boy right was removed soon after labour set in. The course of fuad eaten fish. The leprosy appeared first in 1882, one year the process of involution might have been affected directly after the boy came to England to go to school. Febrilesym- by the interference of the operation in his case; but in ptoms preceded the development of tubercles ; the progress Mr. Thornton’s it could not have been so, for the operaiiad been saltatim; febrile attacks accompanying each fresh tion had been performed some months before labour set crop of tubercles; the glands in the groin and elsewhere en- in. He would ask Mr. Thornton if any observations had larged just before the febrile attacks. There were no definite been made on the process of involution in his case.tracts of anaesthesia; the ulnar nerves were not materially Dr. ROUTH remarked that the atrophy of the uterus could thickened; the mucous membranes of the tongue, epiglottis, not impede lactation, and quoted Dr. Livingstone, who and vocal cords were affected with tubercles; the nails had stated that the wives of the African kings were not been destroyed in places ; sometimes the tubercles ulcerated; allowed to suckle their own children, as it was thought The child was given to the grandmother, and the typical bacilli had been detected. Gurjun oil had derogatory. been employed with a little benefit.-Mr. SPENCER WATSON generally an old woman, to whose mammse and pudendum certain plants were applied and the child put to her -related a case. Dr. RADCLIFFE CROCKER also showed a case of Pityriasis breasts, with the result that she was able to suckle the ’Circinata in a man aged twenty-seven. It began on the child. He also alluded to well-authenticated cases in which He objected to the conclusion that abdomen a month ago in oval or round patches, enlarging men had suckled. peripherally and disappearing centrally; at first bright red, menstruation always depended upon ovulation; this question becoming brownish and scaly. The disease generally ran its he considered undecided, and facts were accumulating to course in from one to two months. Vidal described a fungus show that menstruation had really very little to do with microsporon, probably a micrococcus, but no real parasite ovulation. Dr. MATTHEWS DUNCAN regarded tapping as had been discovered. Calamine lotion and liquor carbonis the best treatment in cases of simple parovarian cyst. It indetergens were used locally.-Dr. STEPHEN MACKENZIE volved less danger than extirpation, and was often successful. said that the micrococcus was an epiphenomenon, and might The extirpation of small papillomatous ovaries involved ’be found in any scaly debris from skin disease. The disease many difficulties. He did not believe any operation could was not parasitic. Boracic acid was better than carbolic cure where malignant disease had extended to several acid, though the latter relieved itching.-Dr. CoLCOTT Fox different parts of the peritoneum. He also reminded the r aid the eruption was more scanty in children, and occurred Society that Dr. Tyler Smith had supported the view that entirely on the trunk. It looked like psoriasis at first sight, the commencement of’labour was a function of the ovaries. ’but the distribution was different. A micrococcus was alwaysThis view was now rendered almost untenable by Mr. I present, but as an epiphenomenon.-Dr. R. CROCKER, inThornton’s case. He had no doubt whatever that the ovaries Teply, said he considered the disease to be the same in were indissolubly connected with menstruation. children as in adults, between which there were all links. The following specimens were shown:-Dr. W. Griffith : Mr. J. H. MORGAN showed a case of Congenital Constric- (1) Uterus showing a Dilated Cavity; (2) Sarcoma of tion by a Band producing Perforating Ulcer of the Foot, in aUterus. Mr. Thornton: Papilloma of Ovary. The Society then preceeded to the business of the annual .9ainter aged thirty-eight. On the right hand the fourth digit had no terminal phalanx and only a rudimentary secondsecondmeeting. The treasurer’s report was adopted, on the motion phalanx; the second and third digits were fused, and had (:)f Dr. Playfair, seconded by Dr. Carter; the report of the only a proximal phalanx; there were no nails on these digits. 1ion. librarian, on the motion of Dr. Godson, seconded by The left hand index finger had a rudimentary second phalanx 7Dr. Horrocks ; the report of the chairman of the Midwifery and no nail. The right lower limb showed a firm cicatricial JBoard, with a vote of thanks, on the motion of Dr. Matthews Aontraction, which surrounded the knee below the patella; 1Duncan, seconded by Dr. Malins, and supported by Dr. the leg was smaller on this side, and had a chronic sclero- (xraily Hewitt. The scrutineers (Drs. Thomas and Lewers) dermatous-like condition of the skin. There was a per- cleclared the list of officers and council proposed by the
arthritic surfaces are a
-
I
354 Council
adopted.
The President delivered the
annual
operation
wnicn
nas
always possesseu
a
Hpeuini
iascmu-
address, for which a vote of thanks was proposed by Dr. tion, and the history of which is connected with many Graily Hewitt, seconded by Dr. West. A vote of thanks of the brightest names in surgery. The careful dissec-
retiring officers (Dr. Herman and Mr. Thornton) proposed by Dr. Gervis, seconded by Dr. Watt Black; and one to the retiring Vice-Presidents and other retiring members of Council was proposed by Dr. Routh, seconded to the was
by Dr. W.
Duncan.
Reviews and Notices of Books. lieference Handbook of the Medical Sciences. Vol. 1. Aac-Cat. By various Writers. Illustrated by Chromolithographs and fine Wood Engravings. Edited by BUCK, -7vl.D. New York: Wm. Wood and Co. work, of which the first instalment is before us,
ALBERT H.
THIS
which is to comprise eight volumes of about eight hundred pages each, will undoubtedly mark an era in the literary history of medicine and the allied sciences. It is quite impossible in the space at our disposal to give an adequate description of the merits of the production, whether we turn to the rare knowledge and skill which the several contributors have brought into requisition, or to the excellent arrangement of the subjects treated of, the type, and, last but not least, the admirable illustrations. Our readers ! will be able to form some idea of the completeness of the text and its illustration when we inform them that in the article " Applied Anatomy of the Arm " thirteen pages are ’ devoted to the former and twenty-six woodcuts to the latter, I How consistently and thoroughly the plan of the editor is carried out may be gleaned from a brief comparison of widely different subjects. Thus, almost immediately suca classical dissertation on "Army Diseases" and ceeding " Army Hospitals " is a brief description of " Arnica," which includes the characters of the plant, its chemical and therapeutic properties, and other interesting details, to which is added an excellent chromo-lithograph. The pathological anatomy of disease is given in sufficient detail. Take, for example, the subject " Adenoma," the description of which is graced with four well-executed drawings. The article " Bloodwill earn for the author considerable repute. It contains a well-digested account of the salient features of that fiuid," both in its physiological and morbid conditions. It contains fifty diagrams, of which the greatest interest will attach to those representing the different instruments for estimating the number of corpuscles and the quantity of colouring matter in a given preparation; and the spectroscopical appearances, twenty-four in number, of blood under as many chemico-physical conditions. It remains to be said that each subject is fully up to the present state of knowledge and research. Attention may be called to " the running titles at the upper corners of the pages; these are intended to aid the reader in searching for a particular topic." A full index will be introduced at the end of the work. America is said to be the land of big things, and its title to the claim will not be belied by the Handbook now under review. We look forward, with much interest to the production of the remaining seven volumes.
tion through the abdominal wall on to the front of the distended and raised bladder bears but a very slight resemblance to the bold and rapid plunge into the viscus from the perineum, which in the hands of Fergusson and other brilliant lithotomists was the admiration of all spectators. The claim of the supra-pubic operation, however, is very strong, and the publication of Sir Henry Thompson’s book will do much to impress its merits upon the minds of British surgeons, who have been slower to recognise them than their continental brethren. Two names will be associated with the revival of this operation-Garson and Petersen. To Dr. Garson of the Hunterian illuseum belongs the credit of demonstrating the remarkable influence upon the bladder of full distension of the rectum, which so raises the viscus as to expose a considerable extent of itsanteriorsurface bare of peritoneum above the pubes. To Petersen belongs the credit of availing himself of this anatomical demonstration and of supporting Dr. Garson’s argument by clinical experience. All this, and very much more, of the history of the operation is told by Sir Henry Thompson, who gives a lucid description of the details of the procedure and the subsequent management of the patient, and appends notes of the, cases in which he has himself practised the supra-pubic method. These cases include six instances of the removal of large stones, and two of the removal of large tumours. Dr. Tremaine of Buffalo has lately recorded three interesting cases in which he has successfully performed what he would have us call epicystotomy. In one case a stone measuring 2s in. by Iin. was removed from a child three and a half years old; in the second case fragments weighing altogether over three ounces were removed from a man aged thirty; and in the third case from a man aged seventy-three a mulberry calculus measuring 1 in. by 1 in. was removed. In the last case the peritoneum was wounded, and the intestines protruded from the wound after the man was returned to bed. In the second case the wound in the bladder was sutured. In neither case was Petersen’s distension of the rectum employed. Dr. Tremaine, like Sir Henry Thompson, found the fingers the most convenient means of extracting the calculi.
Acne; its Etiology, Patholoqy, and Treatment:
a
Practical
Treatise based on the study of 1500 Cases of Sebaceow. Disease. By L. DUNCAN BULKLEY, A.M., M.D., Physician to the New York Skin and Cancer Hospital, &c. Pp. 280. London: J. and A. Churchill. 1885. THis well-got-up volume is in some respects a companion one to that on Eczema which has been favourably noticed in these columns. It is written in a similar practical way, is largely in accordance with views held in this country,. and is characterised by careful details as to treatment, by a copious formulary, and a chapter on diet and hygiene. The pathological anatomy of the eruptions is minutely studied, and the beautiful illustrations of Dr. Bulkley’s specimens form a striking feature of the work, and are especially valuable. We must also mention the addition of a very extensive bibliography, so that the volume is one On the Supra-pubic Operation of Opening the Bladder for which is very acceptable both to the worker at these diseases the Stone and for Tumours. By Sir HENRY THOMPSON, and to the practitioner. The author uses the term acne in F.R.C.S., Surgeon Extraordinary to His Majesty the King its widest sense, and defines it as a functional or inflamof the Belgians, Consulting Surgeon to University disease of the sebaceous glands, exhibiting excessive late cf and PathoProfessor matory College Hospital, Surgery and abnormal or deficient- secretion of sebum; or the logy to the Royal College of Surgeons-6i England, &c. London: J. and A. Churchill. 1886. inflammatory elements of congestion, papules, pustules, or THE operation of supra-pubic lithotomy is undergoing a tubercles, located in and about the sebaceous glands, or in revival, as frequent notices in our pages during the last few any or all of these features combined. The term therefore years have sufficiently shown. It bids fair to supplant includes the diseases known as seborrhoea, comedo, and acne perineal lithotomy altogether; it is not without a pang milium, sebaceous cysts, the ordinary inflammatory Molluscum. and cachecticorum. A. A. an and with rosacea, atrophica, of regret that older surgeons especially will part .