to a periodical swelling, which causes trouble till it subsides; here it is often difficult to know whether or not to operate, and the practitioner may be justified in temporizing. As to reflex neuroses, Sir Felix Semon is utterly sceptical; such disorders may coexist with adenoids, but the removal of the latter has, in his experience, no effect in relieving the former.

It is in the interior of the nose, however, that operative fanaticism finds fullest scope. As Indian philosophers strive to solve the riddle of the universe by the contemplation of their own navels, so some rhinologists seem to hope to find the secret of all diseases by fixing their attention on the nose. To them that feature is, in a pathological sense, the "center of our sinful earth." In their eyes it is like a slumbering volcano, which may on the slightest provocation burst into devastating activity. Sir Felix Semon gives a formidable list of morbid reflex phenomena that have been attributed to some supposed center of mischief within the nasal fossæ. There is no organ, scarcely even a point, in the body that may not, in the opinion of some "advanced" rhinologists, be the seat of pathological manifestations radiating from the nose. In the light of this theory its devotees are necessarily suspicious of the slightest deviation from normal conditions, and accordingly they think it right to attack the root of the evil, as it were, with fire and sword. If the nose were really the source of such disturbance in the human economy, the shortest way would surely be to remove it; and, indeed, as far as the interior is concerned, that consummation has almost been reached in certain quarters.

Sir Felix Semon has opportunely come to the rescue, and we trust his remarks will have the effect of saving the nose from meddlesome surgery and from artistic zeal of enthusiasts who apparently think it their mission to shape ends which have only been rough-hewn by the divinity. The late Bishop of London in a sermon delivered to the St. Luke's Guild some years ago referred to the "marvellous prospect open to the medical man" by the doctrine of the resurrection. The marks of the surgeon's skill would, he said, be stamped on certain human frames, to be carried by them into eternity. His lordship thought this view would give the surgeon a higher sense of responsibility. It is undoubtedly a consideration likely, as Touchstone says, to make a man stagger in the attempt to cure all diseases with the "spokeshave." The possibility of their own handiwork rising up in judgment against them at the last day may perhaps stay the hand of some too eager operators.

We do not wish to be understood as wishing in the slightest degree to depreciate the excellent work done in laryngology, rhinology, and otology of late years, and we are proud of the share taken by our countrymen in the progress that has been achieved in those branches. If there has been some excess of zeal, this is the defect of a quality. It is largely a matter of temperament. If we may follow Sir Felix Semon's example, and quote Gilbert, we would remind him that

Ev'ry boy and ev'ry gal

That's born into the world alive,
Is either a little Liberal

Or else a little Conservative.

The "little Liberal," if he takes to surgery, will be bold in the active reform of whatever appears to him to be wrong in the nose or elsewhere; the "little Conservative" will conserve. But, just as the reformer may be too active, so, on the other hand, the Conservative may be too inactive. The true rule of practice lies between.-Brit. M. J.

On Coming Back. The proper conduct of a holiday is a subject upon which many writers have expatiated from different aspects. We have pointed out in these columns the futility of making a holiday only a change of work, and have urged upon persons no longer in their first youth to refrain from rushing to Switzerland, immediately to climb mountains regardless of the facts that their arteries are no longer so elastic as formerly and that their heart muscle is somewhat more easily tired than of yore. But if the change from work to play has its dangers, so also has the return from holiday-making to the daily grind of professional or office work. The change in methods of life is not properly appreciated, and in the desire to extend the holiday to its utmost limit the return journey is apt to be made at the greatest possible speed, so much so that we know of certain instances where the repatriated travelers have been compelled to rest for a week to recover from fatigue. But allowing that the holiday has been a real holiday, a time of rational enjoyment and of healthful exercise duly adjusted to the physical condition of the holiday-maker, the return to work is often accompanied by attacks of ill-health. It is not at all uncommon in our experience for those who return to London (or to any large city) from a country holiday to complain of suffering from a form of sore-throat. The explanation of this is probably to be found in the presence of dust in the air; and this dust, in London at any rate, is mainly composed of horse-dung, particles of wood, and the various débris to which four or five millions of human beings constantly moving about naturally give rise. All this foreign matter sets up an irritation in the air-passages and pharynx. After a residence of some weeks in the midst of a more or less polluted atmosphere the tissues get acclimatized to the irritation and the cough and sore-throat subside, but they are one source of malaise which has to be looked for after a holiday. We do not suggest that. because continued residence in a large town begets a certain amount of tolerance, therefore it is of no avail to go away; for although a holiday may make the tissues more responsive to external irritation yet the same holiday increases the resisting Dowers of the body, so that it repels with greater ease the attacks of other poisons. Therefore too much importance must not be laid upon the fact that many persons who felt in robust health while away on their holidays, upon returning have the sensation of being worse in health than they were before they went away. Their natural disappointment at these sensations can as a rule be justly removed by a few optimistic words. Yet again, too little is made of the change from active exercise to sedentary life. From passing most of his time in the open air engaged in some form of exercise a man turns suddenly to working in an office or study-in the case of members of our own profession to going from one sickbed to another. There is no section of the community so notoriously careless of its own health as is the medical profession, and while its members would impress upon the returned worker to avoid errors in diet we doubt whether it is their habit to be careful themselves in this respect. It cannot be too much insisted on that, although on a holiday a large breakfast, a large luncheon, and a large dinner may be partaken of with impunity, under the altered conditions of the working life no such heavy feeding can be right. To a man employed in fishing or shooting most of the day, or to one who spends his time in walking or bicycling, a dose of alcohol may give a feeling of contentment as well as wholesome slumber at night, which it will completely fail to do when the daily round of work is taken up again.-Lancet.

Book Reviews

THE ROENTGEN RAYS IN MEDICINE AND SURGERY AS AN AID IN DIAGNOSIS AND AS A THERAPEUTIC AGENT. By Francis H. Williams, M.D. We well remember the day when Roentgen made his first demonstration of the wonderful rays which he, with becoming modesty, named X, but which many other people quite properly preferred to call the Roentgen rays. We happened to be in Berlin at the time, and for many days to come this was the only topic of discussion, especially in the University, in hospitals, and in scientific circles. The hopes then entertained-not by the inventor or true scientists, to be sure that the employment of those rays would work a radical revolution in medicine and surgery, have not been fully realized; but even making due allowance for all the failures, sufficient is left to justify one in declaring the Roentgen rays the greatest discovery of the last decade of the nineteenth century. The book we are now considering is the best on the subject; we are not aware of any other approaching it in thoroughness and completeness. It forms a magnificent volume of over 650 pages, profusely illustrated (391 illustrations) and luxuriously printed. We are pleased to see that the author is not a crank on the subject, and does not make any extravagant claims for the X-rays as a therapeutic agent. The statements are moderate and well considered, and the entire exposition of the subject has been made in what seems to us a scientific and impartial spirit. We warmly recommend the volume to any one engaged or about to be engaged in X-ray work. (The Macmillan Company, 66 Fifth avenue, New York. Price, $6.)

DISEASES OF THE INTESTINES. Their Special Pathology. Diagnosis, and Treatment. With Sections on Anatomy and Physiology, Microscopic and Chemic Examination of the Intestinal Contents, Secretions, Feces, and Urine. Intestinal Bacteria and Parasites; Surgery of the Intestines; Dietetics; Diseases of the Rectum, etc. By John C. Hemmeter, M.D., Ph.D., professor in the University of Maryland. We don't think we will be accused of undue enthusiasm for declaring that we consider "Hemmeter's Diseases of the Intestines" a monumental work. While there are excellent treatises on the subject in the German and French languages, this is the only thoroughly exhaustive one in the English language with which we are familiar. The work is in two volumes. The first, which is now before us, treats of the anatomy and physiology of the intestinal canal, of intestinal bacteria, methods of diagnosis, therapy and materia medica of intestinal diseases; diarrhea, constipation, enteralgia and enterodynia, meteorism, dystrypsia, enteritis, colitis, dysentery, intestinal ulcers, intestinal neoplasms, etc. The section on the anatomy and histology of the intestines is from the pen of J. Holmes Smith, assistant professor of anatomy; the section on the examination of the feces and urine, from Harry Adler, assistant professor of diseases of the stomach; the section on intestinal bacteria is by William Royal Stokes, assistant professor of bacteriology and pathology-all three from the University of Maryland, while the section on diseases of the rectum is by Thomas Charles Martin, professor of proctology, Cleveland College of Physicians and Surgeons. The therapeutic part of the book-the part that is most important is very complete. The illustrations,

some of which are in color, are excellent. Each chapter contains an exhaustive bibliography of the subject, and a very complete index enhances the value of the volume. (P. Blakiston's Son & Co., Philadelphia. 1901. 740 pages. Price, $5 per volume.)

In the June issue of the ARCHIVES we reviewed briefly the first two volumes of the SYSTEM OF PHYSIOLOGIC THERAPEUTICS, edited by Solomon Solis-Cohen. Volumes III and IV are now at hand, and excellent volumes they are. They form as complete a treatise on climatology, health resorts, mineral springs, etc., as we have ever had the good fortune to see, while that part which treats of the climate and health resorts of the United States is the most complete ever issued. The author of the two volumes is the well-known climatologist, F. Parkes Weber, with the collaboration for America of Guy Hinsdale, secretary of the American Climatological Association. There is also a special article by Dr. Titus M. Coan on the climate of the Hawaiian Islands. The first part of the treatise deals with the fundamental factors of climate, their influence in health and disease, etc. The second part describes the health resorts of Europe, Asia, Africa, Australia, and America. While the description of the individual health-resort is brief, it is sufficiently explicit to allow us to derive an idea of its indications and contra-indications. Part III deals with the various diseases and their climatic treatment, pointing out what resort is most indicated in a given disease. It also deals with the general management of patients at health resorts, touches upon the milk cure, grape cure, mineral-water cure, etc. In short, any physician who has occasion to send patients to some health resort or give advice about a change of climate, cannot afford to be without this treatise. (P. Blakiston's Son & Co., Philadelphia. Eleven volumes. Cloth. Price for complete set, $22.)

The popularity of Hare's TEXT-BOOK OF PRACTICAL THERAPEUTICS continues unabated, as is evidenced by the fact that the first 2,000 copies of the seventh edition were exhausted within six weeks of the day of issue. The eighth edition, which is now before us, has been thoroughly revised, enlarged, and partly rewritten. It is a good book. Its secret of success lies in the fact that it is true to the adjective in its title-namely, it is thoroughly practical. Hundreds of pages are not occupied with laboratory experiments upon animals, with their questionable results and still more questionable deductions. The information about drugs is concise and to the point, and is just what the physician wants in his every-day practice. The remedial measures other than drugs, such as climate, heat, cold, lavage, transfusion, are treated of briefly but satisfactorily. Two excellent indices increase the value of the book. (Lea Bros. & Co., Philadelphia and New York.)

John Uri Lloyd, who has been long and favorably known as a chemist and botanist, is decidedly improving as a litterateur, and is on the way to make for himself an enduring name in the field of belles-lettres. His "Stringtown on the Pike" was an interesting book, though the melodramatic and mystical element was still too strongly in evidence; in WARWICK OF THE KNOBS, Professor Lloyd's latest book, we have a work well worth reading. In Preacher Warwick and Joshua he has succeeded in giving us living types and not marionettes; and though there is practically no plot in the book, it will be read with interest from

beginning to end. The book has no satisfactory ending. May we venture the guess that Prof. Lloyd is engaged in writing another story, in which Mary, Joshua, Lionel, etc., will reappear under different circumstances, and in different relations to each other? At any rate, such a book would be of great interest to all those who read "Warwick of the Knobs." (Dodd, Mead & Co., New York. Price, $1.50.)

LIBERTINISM AND MARRIAGE. By Dr. Louis Jullien, Professeur Agrégé des Facultés de Médecine de Paris, etc. This is a peculiar book. It is devoted entirely to the social aspects of gonorrhea or urethritis: What effect it has or should have on the postponement of marriage, how it affects the married couple, how to attempt the cutting short of an acute gonorrhea, if a postponement of the marriage ceremony is impossible, how to find out whether a wife infected her husband, or whether it was simply the reawakening of a latent gonorrhea in the latter, what a danger lurks for the wife in a latent, apparently cured gonorrhea in the husband, etc., etc. spite of a good deal of superfluous verbiage and an extremely flowery style-which is due to a faithful translation from the French-the book contains much that will prove of interest to the physician who has a large practice in genitourinary diseases. (F. A. Davis Company, Philadelphia.)

In

LES MALADIES DE L'ORIENTATION ET DE L'EQUILIBRE. Par J. Grasset, Professeur de Clinique médicale à l'Université de Montpellier. The important and difficult question of orientation and equilibrium has always been of great interest to physiologists and biologists. But very little has been done in this direction until now, because experiments on animals alone do not suffice to explain the more complex functions of the nervous system in man. It is only by the method which Charcot has named the anatomo-clinical, that we can arive at more or less trustworthy results. It is this method that Grasset has applied to his work in trying to explain the complex symptoms that we meet at the bedside-such as vertigo, ataxia, disorders of the muscular sense, etc. This work may be said to be the first in this line. (Felix Alcan, Paris. Price, 6 francs. Cloth.)

Last year we had occasion to comment on the fiftieth anniversary of Blakiston's PHYSICIANS' VISITING LIST. The fifty-first edition is now before us. It of course contains all the valuable features that have endeared it to the profession for the past half century. (P. Blakiston's Son & Co., 1012 Walnut street, Philadelphia. Prices range from $1 to $2.25, according to size and binding.)

The

DR. JESSNER'S COMPEND OF SKIN AND SYPHILITIC DISEASES is very favorably regarded in Germany, and a second edition-thoroughly revised and enlarged-has recently made its appearance. We have given the volume a careful examination and consider it one of the best books on the subject, both for student and general practitioner. classification is good, the description of the various types of disease is clear and concise, and the differential diagnosis is treated with considerable detail. The therapeutic part of the work is remarkably complete, and the directions given are plain and to the point. The physician is not left to guess at the quantities of ingredients, etc., but complete formulæ are given. An interesting

chapter on cosmetics, treating of soaps, fats, powders, rouges, hair oils, hair pomades, hair dyes, depilatories, etc., adds value to the book. A formulary containing 166 formulæ of various salves, mixtures, applications, etc., completes the volume. (A. Stuber's Verlag, Würzburg.)

THE WÜRZBURGER ABHANDLUNGEN AUS DEM GESAMTGEBIET DER PRAKTISCHEN MEDIZIN continue to appear with commendable promptness and regularity. The tenth number of volume I is by Prof. W. Kirchner, and treats of injuries to the ear; No. II is by Prof. F. Riedinger, and considers the treatment of empyema; No. 12 is devoted to the principles of dietetic treatment of stomach diseases, and is from the pen of DocentDr. N. Strauss. No. 1 of volume II, in a concise but thoroughly satisfactory manner, treats of the causes and treatment of rupture of the uterus, and is from the pen of Prof. Otto von Franqué. The significance of bacteriology in the pathology of the eye is the subject of No. 2 of this volume. The author is Dr. P. Römer. The number will be read with interest, even by those who make no specialty of treating eye diseases. Incidentally, the question whether bacteria can penetrate a perfectly healthy mucous membrane, or whether some lesion be absolutely necessary before they can make their entrance, is touched upon. The latest issue to reach the library table is No. 3 of the second volume, which deals with the treatment of versions and flexions of the uterus, the writer being Prof. Wilhelm Nieberding. It is a very readable brochure. The author is not so opposed to pessaries as are most of the present-day gynecologists. He insists, of course, on care and skill in their introduction. (A. Stuber's Verlag, Würzburg. Price of each number, 75 Pf.)

DIE AMBULANTE BEHANDLUNG DER UNTERSCHENKELGESCH WÜRE. In this brochure of fifty-three pages, the well-known dermatologist, Dr. S. Jessner, considers in detail the treatment of ulcers of the leg (without confining patient to bed). He dwells upon all the modern siccative and antiseptic preparations, and gives in detail his own method of treatment, based on experience with hundreds of patients during a period of many years. The method appears promising and rational, and has the advantage of making the cost of the treatment very slight, which with poor patients the class of people who most frequently suffer with varicose ulcers-is an important consideration. (A. Stuber's Verlag, Würzburg. Price, 80 Pf.)

DIE SCHWINDSUCHT PRAKTISCHE WINKE FÜR GESUNDE UND KRANKE. Von Dr. Med. Fischer. A popular pamphlet, of about fifty pages, on the prophylaxis of tuberculosis, etc. It is well written, but presents nothing new or original. The author strongly warns against drinking raw milk "as one can never be sure that it is free from tubercle bacilli." This was written before July 23, 1901. (A. Stuber's Verlag, Würzburg. 75 Pf.)

THE TRANSACTIONS of the State Medical Association of Texas, for 1901, form a creditable, wellbound volume of about 400 pages. The papers in this volume are of the average quality-not bad. but not any too good. Dr. Q. C. Chase's paper protesting against the use of calcium carbide in inoperable carcinoma of the uterus was published in abstract in the columns of the ARCHIVES, in the October number of this year. (H. A. West, of Galveston, Secretary.)