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diagnosis, but are liable in the course of years to fall behindin the selection of the best procedure by which to deal withthe emergency which presents itself. Here lies the value of

the volume before us.

Systematic works on surgery, however encyclopaedic,either fail to give the details of procedure for handlingurgent conditions, or are so bulky as to render it difficult to,find them. The authors have laid down a general principleof great value, not to attempt to offer their readers alter-natives, or numerous methods of dealing with acute con-ditions, but have selected from their own experience andjudgment one method for each case, which may not in allcases be the best, but has proved to be one of the best. The

tone of advice in procedure is sound and thoughtful through-out, but the most modern, and even tentative methods, arenot overlooked. As an instance the treatment of simplefractures is laid down on conservative principles which tosome might appear old-fashioned, but the authors explaincarefully why treatment without splints is applicable to

only selected cases. The best parts of the book are thosedealing with acute abdominal conditions and with the

surgery of the brain and spinal cord, a province of operationwhich Mr. Sargent’s personal opportunities have enabled himto handle with the distinction of direct knowledge.The section on the emergencies of acute infective disease

is well conceived and indicates the value which attachesto a practical grasp of bacteriology. The use of informationin this department is also illustrated by an excellent adageformulated when treating of the subject of serious wounds :" The assumption that the wound is already infectedoffers no excuse for carelessness in any single detail. The

probable presence of micro-organisms in the wound is no

excuse for the introduction of others probably of a differentkind." "

The chapter on anaesthesia is scrappy, for it deals chieflywith spinal anaesthesia and with the dangers and emergenciesof general anaesthesia. In contradistinction the account ofshock and collapse and the methods of meeting or obviatingthese conditions is excellent. The illustrations are numerous

and admirable, and we are certain that this well-printed,carefully arranged volume will prove of great practical valueto its purchasers.

-

LIBRARY TABLE.Health’s Highway. By R. J. MECREDY. London : Yellon,

Williams, and Co., Limited. 1909. Pp. 172. Price 3s. 6d.net.-This is a book written by a layman and an en-

thusiastic cyclist which preaches the gospel of fresh airand sunlight. Of the value of these two adjuncts to healththere is no doubt, but the difficulty is, for most of us, toobtain them. Still, there is no harm in insisting upon theirdesirability. Mr. Mecredy gives us enviable accounts of

camping-out tours and other forms of fresh-air holiday.His remarks upon the use of alcohol and tobacco are

sensible in the main, but his story of a cycle accident israther dragged in from the temperance advocate’s poirt ofview. He fell on his left knee during a path race ’’ andthe patella was left absolutely bare, as though the flesh hadbeen punched off it. For five or six weeks I was attended

by the late Surgeon Wheeler, and he told me afterwards thathad it not been that I was practically a teetotaller and in thepink of condition the leg could not have been saved." Surelya flayed patella without the joint being opened is not so veryserious. We can imagine other than teetotallers keepinga limb in such circumstances.

The Practical Medioine Series, 1909. Vol. X. Nervousand Mental Diseases. Edited by HUGH T. PATRICK, M.D.,and CHARLES L. Mix, M.D. Chicago: The Year Book

Publishers ; Glasgow : G. Gillies and Co. Pp. 248. Price

58. net.-In this, the tenth, volume of the well-known

Practical Medicine Series are to be found abstractsof many important papers on nervous and mental topicsthat have appeared during the year, coupled with muchthat is of comparatively little value. It is true that the

apparent aim of the editors is to analyse especially thosearticles that are of diagnostic and therapeutic significance,and we find here in a handy form abstracts of much ofthe best work of English, Continental, and Americanauthors. But there are grave omissions, even if the volumeis to contain only papers of relative importance. Thus nota single contribution from the English neurological journalBrain is analysed. The few pages devoted to mental diseaseare utterly inadequate, and the selections in this departmentleave much to be desired. On the other hand, some of thesynopses are of entirely secondary importance, and the samemay be said of some of the photographs illustrating thevolume Seeing that the yearly output of neurological andmental literature is so immense, discrimination is a sine qutinon for the success of any analytical compendium of thisdescription.

.Where no Man Pursuetla An Everyday Story. By Mrs.BELLOC LOWNDES. London: William Heinemann. 1910.

Pp. 352. Price 6s.-We must protest against the subtitle ofMrs. Belloc Lowndes’s interesting and very clever book.

It is not an everyday story at all, but a tremendouslysensational drama of the kind that can but rarely happen.The protagonist in this record of a cold-blooded crimeis a doctor who commits bigamy, the ulterior objectof which felony is to poison the victim of his sham

marriage, his real wife consenting in the scheme and

collaborating in the attempted murder. Now this is

not an everyday story, but a very unusual and extra-

ordinary one, though Mrs. Belloc Lowndes’s skill in

telling it goes far to persuade us that such thingsmight easily happen. Curiously enough, some fiftyyears ago one Dr. Smethurst planned much such a

crime, and succeeded in murdering the unfortunate womanwho thought she was his wife, his real wife, perhaps,abetting ; but so far from escaping pursuit the law laid him bythe heels at once, and a jury convicted him of a cold-bloodedassassination. Smethurst was not hanged, his escape forminga most interesting chapter in forensic medicine,’ but his ex-perience, at a time when the safeguards against poisoningwere much weaker than now, is good ground for the beliefthat crimes of his sort rarely escape punishment, and cannotbe regarded as everyday occurrences. Mrs. Belloc Lowndeshas not found in Smethurst’s crime the motif for her novel ;this we happen to know, while in no single detail does herstory resemble the tragedy of Miss Bankes’s death, but

by an interesting coincidence her imagination has hit

upon the very complication of bigamy and collusion

between the murderer and his true wife which formed

the most extraordinary feature in the drama of real

life. We recommend " Where No Man Pursueth " toour readers because it is a thoroughly interesting book,and also because the insight into the troubles of the medicallife is remarkable. The sketches of the two young doctors,George Glyn, the sound man in whom experience has

begotten diffidence, and Peter Whitby, the cocksure and

impressionable man, are excellently drawn types of practi-tioner, and the hideous responsibility which a medical manmust take upon himself when he decides to act as thoughone of his patients were being secretly poisoned is vividlyrealised. The villain, Dr. Burdmore, we should not havebeen able to believe in had it not been for the fact thatDr. Edward Pritchard of infamous memory was just suchanother. We do not intend to say more about the book as,in particular, to disclose the intricacies of the plot might be

1 THE LANCET, Sept. 10th (p. 268) and 17th (p. 292), 1859.

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to spoil it for other readers. All who like a clever sensa-

tional novel should get "Where no Man Pursueth," andmedical men should know that they will find the medicalparts of the book skilfully done.

JOURNALS AND MAGAZINES.

Jahreskurse fiir Ar:::tlwhc -Z,’og-tbild?tng. March, 1910. Pub-

lished by J. F. Lehmann, Munchen. Price 16 marks

annually.-This number of the German post-graduatereview is one of considerable interest. Professor Fleiner

of Heidelberg deals with diseases of the stomach, and

after a careful description of the relations of the organand the methods of clinical examination during life,discusses the problems of digestion and its disorders.

The stomach is divided into functionally distinct com-

partments and this he considers of great importance.In the first place, the region of the lesser curvature mayact as a canal leading directly from the oesophagus to

the pylorus so that fluids are directed along its course

without occupying the fundus. Secondly, the division intoa cardiac portion and a pyloric portion which play perfectlydistinct physiological roles is proved by many differentobservations, and is, of course, permanent. During life and inthe upright position of the patient the gastric canal has aJ shape which differs somewhat in the two sexes. The

long limb of the J is the cardiac part, and the short limbthe pyloric. The former serves as a more or less relaxedfood reservoir, the contents of wlrich are so arranged thatthe last swallowed portions lie in the centre of the

mass and still remain alkaline, whilst the peripherycontains the first received food and is of an acid

reaction. The chief active movement in this partof the stomach (apart from vomiting) is a slow diastole

which it undergoes on the receipt of food. The pyloricantrum, on the other hand, contracts actively from two tosix times a minute, receiving the most fluid portions of thecardiac contents, and passing them on to the duodenum.The regulation of the reflex which opens the pyloricsphincter and its bearing upon pathological processes are

discussed at some length. Fluidity of the gastric contents onthe one side of the sphincter and alkalinity of the duodenalon the other side appear to be the chief factors in bringingabout this relaxation. In regard to motor sufficiency of thestomach, it is considered that, if gastric lavage in the

morning produces a clear washing free from food debris

of the preceding day, there is efficient motility. The

presence of hypersecretion of acid and digestive juicesin the stomach is regarded as pointing to the existence ofpyloric spasm, which hinders the outflow of the gastriccontents and allows an accumulation of secretion. Thus is

explained the excess of acid found in cases of ulcer of thepylorus or of the duodenum. Professor Luthje of Kiel dealswith the subject of metabolism and its disorders. He beginswith a concise review of the currently accepted theories

relating to the normal metabolism of the various foodstuffs.The nature and treatment of diabetes are then discussed.The existence of hyperglycasmia (excess of sugar in the

blood) apart from glycosuria and the relation of these twoconditions to one another ; the relative advantages of variousdiets in diabetes ; the special advantages of oatmeal diet ; thedesirability of combining a low proteid intake and a diet oflow caloric value with the oatmeal feeding ; practical sug-gestions regarding feeding with alternate meals of vegetablesand oatmeal are severally considered. For the treatment of

threatened acetonuria an oatmeal diet is considered the best,and large doses of alcohol are said to be beneficial. The

administration of bicarbonate of soda by the veins or by therectum is the only po-sible resource in the coma resultingfrom acid intoxication. The number is concluded by

Professor Erich Meyer of Strassburg with a short review ofblood diseases, including a consideration of the circum-

stances associated with excess of blood, loss of blood,variations in the relative proportion of serum, corpuscles,and hemoglobin.

School flygae7ae: : A J’Iontli1y Reriew for Educationists

and .Doctors.-The first numbers of this magazine have

been issued at the modest price of 6d. by the School

Hygiene Publication Company. Though in the main

published in English, it contains an article in German

by Professor H. Griesbach, President of the First Inter-

national Congress on School Hygiene, one in English bySir Lauder Brunton, President of the Second International

Congress on School Hygiene, and one in French by Dr. A.Mathieu, President of the Third International Congress onSchool Hygiene. These three articles insist on the import-ance of school hygiene, on the utility of the internationalcongresses held on this subject, and on the necessity of apermanent link to keep up the connexions established bythese congresses. The polyglot periodical is intendedto voice this view ; as Dr. Mathieu remarks, " Ici apparaitle bienfait certain de la collaboration internationale." Theother contents of the review are thoroughly international.For instance, Mr. C. Edward Wallis, M.R C.S. Eng.,L.D.S., describes the school dental cliniques in Germany.These are not limited to the examination and treatment of

decayed teeth, but there is also instruction given to parentsat the Parents’ Evenings." Here teachers and parents aregathered together and given lectures and lessons on dentalhygiene, so that they may be able to watch the children,and, if necessary, teach them dental drill. An interestingaccount is given of the measures taken at Schöneberg, nearBerlin, to stamp out an epidemic of ringworm. Some 10,000children were examined and 25 boys and two girls were foundto be infected. The old-fashioned treatment of head-shavingand unguents was relied upon, and the class-rooms

frequented by the children were disinfected. Teachers

and parents after the patient was reported cured keptstrict watch for six months in case of recurrence, andthe total cost of the measures taken amounted to a little

over .f:900. each patient treated and cured costing about .633.As the sanitatsrat, Dr. Friedemann. remarks, it was a brilliantbut expensive victory. Dr. Luther H. Gulick, President ofthe Playground Extension Committee, New York, deals withathletics for girls from the biological standpoint. He con-

cludes that boys’ games, football, cricket, tennis, golf, &c.,are all derived from the pursuits and necessities, the huntingand the fighting, by which the primitive man managed tosurvive. " The ability to run, to strike, to throw, is, on thewhole, a masculine ability." He points out that the averageboy is stronger than the average girl, except that the girlmatures earlier, so that at the beginning of puberty she maysurpass the boy of her age in height, weight, and speed.But he suggests that this superiority lasts a very little time,and he holds that the physical exercise and the musculardevelopment of woman must not be conducted on the samelines as those of man. Dr. Gulick maintains that : " So faras the subject has been experimented with, dancing seems tobe the form of exercise best adapted to the abilities andneeds of girls, and bids fair to take the place in the averagegirl’s education that athletics take in the case of the averageboy. Dancing is here used in the large, old sense-the sensein which it was used among the ancient Greeks. The two-

step and the waltz do not constitute a leading part of thedancing curriculum." "

The Phonographic Record.-The Society of Medical Phono-graphers was founded in 1894, and its bi-monthly publica-tion has now entered upon the sixteenth volume. The currentissue contains, besides the treasurer’s report for the year