DISEASES OF THE EAR AND NASO-PHARYNX.

By Macnaughton Jones and W. B. H. Stewart. Fourth Edition. (Bailliere Tindale and Cox, London). When a scientific work has readied a fourth

edition, one naturally supposes it to be above the average, and no one will be disappointed who adds to his library Diseases of the Ear and Naso-Phavynx bj Macnaughton Jones and W. R. H. Stewart, two well - known and reliable workers. The book contains two excellent coloured plates illustrating morbid conditions of the membrana tympatii, and no less than 152

drawings, all good, which explain the text and add to its value. The authors rightly point out that the general practitioner is, as a rule, some- what vague in his ideas concerning diseases of the ear, which for some occult reason he con- siders to be enshrouded in mystery. To remedy these defects of knowledge, the book starts with a chapter 011 the Anatomical and Physiological conditions of the external, middle, and internal ear. The most important part of this chapter is that in which clear instructions are given for tapping the mastoid antrum. This question in connection with pyemia, &c., is again referred to 011 page 272, and a table of land-mark measure- ments is given. In Chapter IV, which treats of Etiology, one finds some sound remarks as to the necessity for protecting the ears from severe vibratory shocks ; and drawings are given of Ward Cousins and Macnaughton Jones' sound deadener and ear protectors. As regards syr- inging The ears the authors remark that "we must be careful not to overlook the temperature of the water used. We have known neo-lio-ent

syringing with cold water cause sudden faint- ness to the patient and a great shock to the friends. This can always be avoided by using a metal syringe and accustoming the hand on

the cylinder to act as a gauge of the tempera- ture before injecting the water into the meatus." Chapter V is a continuation of Chapter IV, and in it great stress is laid on the more or less obvious fact that uncleanliness is a potent cause of disease of the ear. In Chapter VII the

appliances necessary for diagnosis and treatment, are discussed, and 011 page 120 there is an ex- cellent figure showing the direction in which the Eustachian catheter should be passed. While

Chapter VIII willbe most useful to the student who needs instruction in the art of examining a patient,Chapter IX, 011 General Therapeutics, will be read with great interest by the practi- tioner ; of the artificial membranes mentioned I can myself bear witness to the usefulness of that invented by Toynbee. ? Not unfrequently

most of us are called upon to remove foreign bodies from the ear, especially in the case of

young children, and the authors warn us against undue and misdirected force during these opera- tion?. They tell us, as the result of their

experience, that " it may be laid down as an axiom in aural surgery that in the case of any arrested body in the meatus when any space exists between the foreign substance and the walls of the meatus, the only agent which should be employed is water"; and that "syrincr- ing is the one safe and certain method of remov- ing foreign bodies from the ear," The book concludes with a chapter on Deaf-mutism, and a list of formula. Of the last it may be

said that they are generally good, but some err on the side of containing too many drugs.