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MISCELLANEOUS VOLUMES.

THE psychological problem of womanhood is dealt with inLetters to Myself by a Woman of Forty (London: T. WernerLaurie. Pp. 206. Price 5s. net.). The writer describesthe thoughts and aspirations of a woman of 40 who is hopingto have a, child. She reviews her past life at its varyingperiods, and writes such letters to herself as she considers

might have helped her had she received them when a child,a girl, and a young woman. Much of her advice to herselfis quite sound, especially where she treats of upbringing insexual matters ; and in one chapter, that entitled ’’ The

Lucky People," she says with regard to bringing up in

general : "The old tendency to shape every child by onestandard was bad enough, but the modern tendency to leaveevery child to woik out its own salvation without the helpof any fixed standard at all is surely worse still." In our

opinion, learners, whether they be children in years as wellas in knowledge, or only in the latter capacity, need hardand fast rules for guidance. There is plenty of time forexceptions and for branch lines when the main course hasbeen settled. The book is well worth reading, even

though it does not pretend to treat the very importantmatters with which it deals in any profound manner.---Dr. EDITH B. LOWRY, of Chicago, in a book entitled Herself,Talks with Women Concerning Themselves (Chicago : Forbesand Company. 1912. Pp. 221. Price$1 net), quotes inher preface a passage from the Journal of the AmericanlYledicczl Association stating that no book of a satisfactorynature exists which describes the female generative organs,anatomically, physiologically, and pathologically, treatingalso of childbirth, written in language easily understood bythe laity, and suitable for a medical man to give to some ofhis young women patients. Dr. Lowry states that nearlyevery question in her book, which is put forward as anattempt to supply the above-mentioned need, has been

" written in answer to questions asked by women readers ofthe author’s magazine articles." While it is likely that theauthor sincerely thinks she is rendering a public service byputting into print for general reading the information

bluntly given in this book, we are distinctly of opinion thatmuch of it should never be put into print at all, but

should be imparted orally only by the proper person,

having due regard to the specialised individual requirementsof the neophyte. If it be urged that such a course presupposeson the part of every young woman facility of access to aninstructor who is capable, willing, and fitted to instruct inthe proper manner. a condition that it must be conceded is

rarely ftil,.ille(l, we reply that in our opinion the evils ofinjudicious or over-instruction are as great as, if not greaterthan; those of ignorance. We believe that a proper instruc-

tion of youth and womanhood concerning the essential

nature of sex factors is a desirable thing ; but we do notbelieve that such instruction can be universally, or even

generally, conveyed safely by any blunt printed statement.While some individuals may profit by it, others-and theseare probably greatly in the majority-according to theirindividual temperaments, will be led to pruriency ratherthan to purity. A really excellent chapter in the book isthat on " How shall the child be told ? " Unfortunately, thebook itself appears to us to be a negation of the admirableprinciple therein laid down--viz., that of waiting patientlyuntil a desire is expressed for information, then impartingit to such an extent and in such a fashion as the individualcase may demand. That is the natural and proper way;and that is just what no book can effect, since it offers

the same pabulum in the same way to all alike.

The foregoing strictures, however, do not apply to twoother little books by the same author- viz., 141se Modesty,

That Protects Vice by Ignorance (Chicago : Forbes and

Company. 1912. Pp. 110. Price 50 cents net), and

Confidences, Talks with a I azcng Girl Concerning Herself(Same publishers. Pp. 94. Price 50 cents net). The first

of these attempts to show the importance of early and properinstruction in matters relating to sex delicately given bythe mother, or someone competent to speak of such thingsto growing girls. The second is intended to aid mothers

in giving the necessary instruction to their daughters,--Similar natural and sound instruction, to be imparted by afather to his son, is to be found in Dr. LowRy’s Truths :Talks nith a Boy Concerning Himself (Chicago : Forbes and

Company. 1912. Pp. 95. Price 50 cents net). Thelast three books we can heartily commend.

Mr. HENRY W. SPAIGHT, Honorary Superintendent of St.

John Ambulance Brigade, has published a very practicallittle pamphlet, entitled Stretcher Drill and Flag Signallingfor Women (Helston : Lander and Son. Pp. 21. Price 3d.),,intended as a help to officers and members of Women’s

Voluntary Aid detachments. On reading instructions thatcall on the women bearers, with as little compunction asthough they were being told merely to sit down, to " climbover the wall," we begin to realise that the much deprecatedtom-boy of our earlier days is becoming a valuable assetin modern womanhood. It is not really strange, however,when one comes to think of it; for it is but a logical exten-

sion of the muscular effort already required of nurses,and hardly more than that daily exercised by thousandsof women on the tennis lawn or the golf course. -

A useful little book is How to Become a Certified lladwife., byE. L. C. APPEL, M.B., B.S., B.Sc.Lond. (London: TheScientific Press, Limited. Pp. 56. Price 6d. net), which nowappears in a new edition, revised and brought up to date byVICTORIA E. M. BENNETT, M.B., B.S. Lond., D.P.H.Cantab. The three chapters describe respectively the

method of obtaining a midwife’s certificate under the

Midwives Act, 1902, the rules and regulations of the

Central Midwives Board, which comprise the midwife’s

duties to her patient and to the child, as well as the generalregulations, and her relations and duties to the local

authorities of the area within which she practises.Appendices contain a list of institutions at which midwives

may be trained under the Rules of the Central Midwives

Board, the Board’s leaflets on ophthalmia neonatorum andcancer of the womb, and an explanation of terms used in thebook. In the present edition the latest (1911) edition of theRules of the Central Midwives Board has been conformed to

Dr. Bennett strongly advises intending candidates to secure acombination of institutional training and outside work in adistrict.

JOURNALS AND MAGAZINES.

, Tlte léllo7V F’ener Bureau Bulletin, No. 12.-This numbercompletes the first volume of the Bulletin, which was estab-lished rather more than a year ago by the late Sir RubertBoyce. He was succeeded as editor by Dr. Harald Seidelin,who has directed the publication ever since. It is now

proposed to enlarge its scope, and in future the Bulletinwill summarise also the literature respecting two other

diseases, dengue and Papataci fever, on the same lines ashas hitherto been done for yellow fever. It will now beissued as a quarterly publication. The present issue containsa number of short but interesting articles and reviews ofcurrent literature in connexion with yellow fever. A short

account is given of the present outbreak of yellow fever inEcuador, and this is of some interest from an epidemio-logical point of view. Owing to internal disturbances at

Guayaquil, the capital of the state, a large body of non-immune troops from the interior was, on Jan. 22nd of this.

243

year, drafted into the city where yellow fever had alreadybeen appearing. The troops, however, only remained therea few days, and while on their return journey about 200 ofthem were attacked by yellow fever, to which they mostlysuccumbed. In Guayaquil itself during the next four weeks98 other cases were notified, of whom 43 died. Other cases

were also reported in certain small towns, along the railwayroute followed by the troops, in one instance at an elevationof 4000 feet above sea level. In a tabular form the distri-

bution of yellow fever throughout the world in 1911 is

shown; and in another table similar information is furnishedfor the first four months of 1912. A short article gives anotice of a paper by Dr. A. Agramonte published in the-V,e,m lor7e Medical Record, entitled Notes upon a So-calledParasite of Yellow Fever," in which the author seeks to provethat the "bodies" discovered by Dr. Seidelin in the bloodof yellow fever patients are not parasites at all. To these

arguments Dr. Seidelin replies very shortly in a series offootnotes, at the same time cleprecating what he regards asthe very personal spirit in which Dr. Agramonte’s article hasevidently been written.

The Journal of Physiology. Edited by J. N. LANGLEY,Sc.D., F.R.S. Vol. XLIV., No. 4. June 12th, 1912.London : C. F..Clay, Cambridge University Press.

Pp. 243-358 + xi.-xxv. Price 7s.-Working in the

Cambridge Laboratory under Professor Langley and

Dr. Barcroft, F. Verzar has studied ’’ The Gaseous Meta-bolism of Striated Muscle in Warm-blooded Animals," Part I. The most satisfactory way of determining therespiratory processes of muscle is to estimate the gasesin the blood running to and emerging from it. Byspecial method the gastrocnemius of the cat was

prepared under practically normal conditions. The oxygen

absorption of the blood was measured by Barcroft’sdifferential apparatus ; first the absolute value of the

oxygen used in rest, the blood flow being speciallystudied during muscular activity, and also the CO2 pro-duction under different conditions. The oxygen used pergramme and minute of a resting muscle is 0-00448 c.c.The muscle uses not only during, but also for a

long time after, the contraction, more oxygen than

before. It is concluded that this means that the oxygenis probably used for a recovery process. CO, and other

acids (probably lactic acid) are produced in great quantitiesafter a tetanus. These acids turn out oxygen from theblood so that the muscle can use it more easily. The

quantity of blood in mnscles is about 2 ’ 5 per cent. The

rate of blood flow is decreased during muscular activity, andincreased after it-a fact noted by other observers. It

becomes quicker after cutting the sciatic nerve. From the

same laboratory is the paper on " The Relation of Blood

Flow to Metabolism in the Submaxillary Gland " by JosephBarcroft and Franz Miiller. The experiments were madeon anaesthetised cats. When the nerves were cut the

rate of blood flow varied in 15 experiments between0’25 and 0-45 c.c. per gramme per minute. The

oxygen intake varies between 0.017 and 0’027 c. c. pergramme per minute. Yohimbin causes no secretion of saliva,even when injected into the arterial system, but there is adilatation of arterioles which admits of about a tenfoldincrease in blood flow. This increase does not, however,cause any measurable change in the oxygen used by thegland. After such treatment stimulation of the chorda

tympani causes a good secretion of saliva, accompaniedby about a sevenfold increase in the oxygen taken up.S. B. Schryver describes a method for " The Prepara-tion of the Unconjugated Acids of Ox-bile," for whichthe reader must consult the original. The inquiry intc"The Causes of Absorption of Oxygen by the Lungs,’

by C. G. Douglas and J. S. Haldane, was begun in

1909 to determine whether and to what extent the

absorption of oxygen by the lungs is a process of simplediffusion, or an active process analogous to glandularsecretion or absorption by the intestine-a question that(lates back to 1871, and one associated with the names ofWoliYberg, Strassburg, Nussbaum, Fredericq, Haldane andLorrain Smith, and latest of all by Krogh. Leaving aside thedetails of the improvecl methods for using carbon monoxideto determine the arterial oxygen pressure in man and animals,the authors conclude that under resting conditions in

normal air containing an excess of oxygen the arterial andalveolar oxygen pressures are equal, and the passage of

oxygen from the alveolar air into the blood is due entirely,or almost entirely, to diffusion. A rise of arterial above

alveolar oxygen pressure is brought about by (1) a diminishedoxygen percentage in the air breathed ; (2) carbon monoxidepoisoning; and (3) muscular work. The common factor inthese conditions is lack of oxygen in the tissues or part ofthem. The rise of arterial oxygen pressure is due to activesecretion of oxygen inwards; and this active secretion is prob-ably localised in the alveolar epithelium and excited by pro-ducts of metabolism brought to the lungs by the blood fromtissues that are short of oxygen. The arterial oxygenpressures given by the aerotonometer are too low, andin some circumstances the same is true of the carbon

monoxide method; but, generally speaking, the latter method,if proper precautions are taken, gives practically correct

results. The Question of an Internal Secretion from theHuman Ovary is discussed by James Oliver, who gives theresults of his experience, chiefly clinical, during the last 25years.

New Inventions.AN IMPROVED MOUTH GAG.

THIS gag is a modification of a continental pattern. It is

especially useful in cases aboutthe mouth or throat where itis necessary to keep up theadministration of the anæs-

thetic. It is advisable to openthe mouth with an ordinarygag to the extent required andthen place this one in posi-tion. It takes up little roomand is not in the way of the

operator, fitting closely to thecheek, and by the tube attach-ment can be made to a Junker

apparatus.The instrument has been

made for me by Messrs. Allenand Ha,nhnrvs- Limited. of

Wigmore-street, W. It is represented at half scale.HUGH R. PHILLIPS, M.D. Edin.,

Senior Anæsthetist Italian Hospital ; Anæsthetist West-EndDawson-place, W. Hospital for Nervous Diseases.

MEDICAL MISSIONS INSTITUTE.-The GermanColonial Society has given 3000 marks to the TubingenInstitute for Medical Missions.

RADIUM TREATMENT IN VIENNA.-A "radiumstation " has been established in one of the rooms ofthe Vienna General Hospital. Salts and other substances

containing radium or emitting radium emanation for internalor external use-for inhalations and baths-of all kinds andof varying strengths, can thus be supplied for the use of thehospital physicians and surgeons. Arrangements are alsomade whereby practitioners can obtain the loan of "radiumcontainers " for a few hours. The director of the radiumstation is Professor Riehl.