reviews and notices of books

497

by Dr. Willshire, and found to be covered with a variolousernption at the early stage, accompanied by other unmistakablesymptoms, and was at once sent away.

UNIVERSITY COLLEGE HOSPITAL.

ONLY one case of variola has been received into the wards-that of an elderly man, who is now nearly well, and in whomthe disease assumed a modified form.About two months ago a female wps admitted into the wing

of the hospital, and on examination she was found to be suffer-ing from small-pox. She was at once sent away. One of the

physicians’ assistants contracted the disease from her. He leftthe hospital on the day after (Sunday), feeling very unwell,for the country, and the next day the eruption came out. Herecovered well.As has been the case at other places, many out-door patients

suffering from small-pox have been treated.

SMALL-POX HOSPITAL.

ON inquiry, Mr. J. F. Marson, the resident surgeon at thehospital, has kindly furnished us with the following informationrelative to the extent of variola :-The hospital has been constantly fall of patients for the last

six months. There is accommodation for ninety patients gene-rally, and two wards in addition for occasional use, separatefrom the main building, in which to place cases of erysipelas&c. that are deemed desirable to be kept apart from the rest.These wards are suitable for twelve or fourteen beds, andthus accommodation in the hospital is made available for IOCpatients.Upwards of 500 patients have been already admitted thi.

year, and several applicants for admission were refused foiwant of room. The mortality has been seventeen per cent.,being four or five per cent. above the general mortality of lateyears. The vaccinated patients have formed a numerous class,and several have died of small-pox who had in early life beervaccinated, or, as Mr. Marson remarks, badly vaccinated, bulstill vaccinated in the manner a very large proportion of theinhabitants of this country unfortunately are.

Reviews and Notices of B ooks.The Urine in Health and Disease; being an Exposition of the

Composition of the Urine, and of the Pathology and Treat-meNT oF Urinary and Renal Discorders By ARTHUR HILLment of Urinary and Renal Disorders. By ARTHUR HILLHASSALL, M.D., &c. Second Edition, pp. 416. LondonChurchill.THE first edition of this work, published some years ago, was

a small thin volume ; the second is a closely printed and tole-rably thick book. The difference in size between the two in-dicates the extraordinary advance which has taken place inour knowledge of urinary physiology and pathology; and afteran attentive perusal of Dr. Hassall’s work, we can state thathe has done full justice to the expansion of the subject. The

following different topics are discussed :-1st. The chemical history of the urinary ingredients.2nd. The mode of determining their amounts.3rd. Their physiological origin and significance.4th. Their variations in disease.5th. The treatment to be employed to control these varia-

tions.The whole work is so full of facias, and is written in so con-

densed a style, that it is out of the question to give any ab-stract. But a good idea of the method and value of the workwill be afforded by taking a single chapter, and showing whatis contained in it.We will select for example the sixth chapter, on Oxalic

Acid. The history and chemical characters of oxalic acid andoxalate of lime as occurring in the urine are first given. Theamount of oxalic acid in health is then considered, though onthis point scarcely anything can at present be said, and thenthe relations between oxalic and uric acids are fully discussed.

The determination of oxalate of lime in the urine forms the

subject of the next section, and in this and the following pages.are some very beautiful and correct woodcuts. Indeed it maybe said that throughout the book the illustrations are extremelygood ; there is no attempt at excessive refinement in outline,but the objects are shown as they really occur in nature. Thenfollows the characters of the urine depositing oxalate of lime,and then the important question is opened, "Is oxalic acidformed in the blood or in the urine ?" This cardinal point isnecessarily left unsettled ; but, after considering all the knownfacts, the author inclines to the occasional blood or tissue

origin. The question of the " sources of oxalic acid" forms thenext heading, and this is attributed to certain articles of food,to certain medicines, to disorders of the respiratory organs im-peding their functions, to mala3similation, to metamorphosis oftissue, and possibly to transformation of uric acid in the system.Then follows the subject to which all the previous matter issubservient-viz., "the pathology of oxalic acid and of oxalateof lime in the urine, and its treatment." Dr. Hassall holds amedium course between the two extreme views, that large de-posits of oxalate of lime indicate a marked nutritional disorder;and, on the other hand, that they are of no pathological signi-ficance whatever. He directs attention to the necessity of dis-tinguishing their sources, and believes that when the oxalateof lime is accompanied by excess of urea and extractive matter,and is therefore probably derived from increased or alteredtissue changes, the accompanying symptoms are really similarto those described by Dr. Bird under the head of Oxaluria.We will only remark on this point that we cannot attach muchimportance to Golding Bird’s statement, that the urea is in.creased in oxaluria. The increase was inferred apparentlysimply from the crystallization of nitrate of urea when nitricacid is added to urine-a result which it is now known mayarise either from deficiency of water (when the urea is in rela-tive excess), or from increase of the urea (when the urea is inabsolute excess). Nor, considering the great difficulty of deter-mining the exact amount of "extractive matter," can weattach great weight to Mr. Stallard’s observations, that thesesubstances are increased in oxaluria. In fact, we believe thatthe exact chemical relations of these substances must be heldto be still undetermined. And yet we believe Dr. Hassall isquite correct in the view he takes, and that there are cases ofa nutritional disorder in which one of the marked urinarysymptoms is an excess of oxalate of lime deposits. But thewhole subject is one which demands a fresh examination.With respect to the treatment of oxalate of lime deposits

(a most important topic if merely considered in its relation tocalculus), Dr. Hassall directs attention first to the source ofthe deposit, whether derived from food or medicine, or mal-assimilation or other cause ; and then notices the treatmentrendered necessary by each cause.The other subjects are treated in the same careful manner.

The chapter on the Phosphates is particularly good, and theplates are beautifully exact. Figures are given of crystals ofphosphate of lime and of phosphate of magnesia, first describedby the author in 1850 and 1853, as well as of the more commontriple phosphate.But we cannot extend our description of this work. We e

need only say, in conclusion, that the practitioner will find itan exact, a safe, and a comprehensive guide to urinary patho-logy. It is marked by the same conscientious industry whichdistinguishes Dr. Hassall’s other publications; and is, in ouropinion, a very valuable addition to medical literature.

UNIVERSITY OF CALCUTTA.—Two hundred students havepassed the " little-go" examination since its establishment in1857. Of these, eighty-nine have taken the degree of B.A.,and six that of M. A. In the professional faculties for degrees,in which it is neces-ary to take that of B.A. first, twenty haverpassed as Licentiates in Engineering, twenty-one as Licentiatesin Medicine, four have taken honours in Medicine, and one has.become M.D.