the student's benefit, has a province peculiarly its own. This class of work does not abstract its subject, but presents it fully and in a manner that will afford the student's ready grasp of its every detail. The chief virtue of this work will be found in the fact that it gives consideration to only such matter as can be applied practically by the student. It differs from the regular text-book on materia medica in that it eliminates all superfluous matter which can have little import to the student who is preparing for general practice, and yet discusses that which it does present in an ample and thorough manner.

Of course this book will have more pertinent interest to the students of the Memphis Hospital Medical College, inasmuch as it comprises the lectures delivered by Prof. F. D. Smythe, of that institution, but it deserves wider circulation on account of its exceedingly practical review of its subject. Dr. J. L. McGehee, who compiled the work, displays considerable ability as an editor, having with rare discrimination prepared the lectures for publication, and arranged them in a most acceptable form. A feature which he has added to the work and which will be appreciated by every reader, is the schema appearing in the front of the book, which is an elaboration of that of Bartholow. He also adds a section on poisons and antidotes taken from Schumaker's Materia Medica and Therapeutics.

The book is from the press of Paul & Douglass, of Memphis, and its typographical execution and binding are ample evidence of the facilities for good book-making now offered by local concerns.

The Practice of Obstetrics. Designed for the Use of Students and Practitioners of Medicine. By J. Clifton Edgar, Professor of Obstetrics and Clinical Midwifery in the Cornell University Medical College; Attending Obstetrician to the New York Maternity Hospital. With 1221 illustrations, many of which are printed in colors. Cloth, $6; sheep or half morocco, $7 net. P. Blakiston's Son & Co., 1012 Walnut street, Philadelphia, 1903. The author of this work has entered upon a field that has already been thoroughly exploited, and it would seem that there was scarcely room for further contributions to the text-books on this subject. But the reader of this work will at once comprehend that it presents points of merit which will speedily gain for it approbation in the eyes of students and practitioners. The author has drawn upon his extensive experience in hospitals and private practice and as a teacher, and displays in this work his cosmopolitan knowledge of literature and methods. With rare good judgment he has culled the best of everything pertaining to the science of obstetrics, and combining this with his own large fund of clinical knowledge, he has given us a very superior text-book. That much of his work is original is borne out in the fact that the illustrations are largely from original sources, and are not the stereotyped cuts that ordinarily greet the eye of the reader when he opens a new volume of a similar work. The student and practitioner alike will find this work of eminent practical and scientific value.

Hale's Epitome of Anatomy. A Manual for Students and Physicians. By Henry E. Hale, A.M., M.D., Assistant Demonstrator of Anatomy, College of Physicians and Surgeons (Columbia University), New York. In one 12mo. volume of 384 pages, with 71 illustrations. Cloth, $1 net. Lea Bros. & Co., publishers, Philadelphia and New York, 1903.

As a help to the student in brushing up for examinations, this epitome will be found very useful. It is based upon Gray, and will no doubt prove quite helpful at times when there is urgency without opportunity for reading the larger work.

Modern Surgery; General and Operative. By John Chalmers DaCosta, M.D., Professor of the Principles of Surgery and of Clinical Surgery in the Jefferson Medical College, Philadelphia. Handsome octavo volume of 1099 pages, with over 700 illustrations, some in colors. Philadelphia, New York, London: W. B. Saunders & Co., 1903. Cloth, $5 net; sheep or half morocco, $6 net.

Surgery is the most progressive of the departments of medicine, and its advances are so rapid that a text-book that is new today may be old tomorrow. Therefore, it becomes essential that the modern text-book of surgery should in a concise form present the fundamental principles of this art. DaCosta's work meets this demand in every particular, for the author has herein presented the results of observation derived from his own extensive experience as a teacher, and has taken great pains to exclude anything that might be superfluous in the preparation of his work. As an exposition of up-to-date surgery and surgical principles, we know of no more reliable work on the market. This recent edition has been thoroughly revised and altered in a number of respects. Much new matter has been added, and over 200 excellent and practical illustrations have been added to the already full number contained in the volume.

A Text-Book Upon the Pathogenic Bacteria. For Students of Medicine and Physicians. By Joseph McFarland, M.D., Professor of Pathology and Bacteriology in the Medico-Chirurgical College, Philadelphia: Pathologist to the Philadelphia Hospital and to the Medico-Chirurgical Hospital, Philadelphia. Handsome octavo volume of 629 pages, fully illustrated, a number in colors. Philadelphia, New York, London: W. B. Saunders & Co., 1903. Cloth, $3.50 net.

We have had occasion to review previous editions of this splendid work of Dr. McFarland, and can add nothing much to what we have heretofore said concerning its value as a medium for conveying knowledge upon the subject of pathogenic bacteria to students and practitioners. The time that has elapsed since the appearance of the last edition has been comparatively short, but the progress made in the subject of bacteria since that time has been exceedingly rapid, thus necessitating a new edition of this work. Much new material has been added in the revision, and the chapters on infection and immunity have had incorporated within them all the new facts recently added to our knowledge of this subject. In every respect the work has been scrutinized and overhauled before this edition was issued. We have no hesitation in expressing the belief that it will continue to meet every demand made upon a work of this character.

The American Illustrated Medical Dictionary. For Practitioners and Students. A Complete Dictionary of the Terms used in Medicine, Surgery, Dentistry, Pharmacy, Chemistry, and the kindred branches, including much collateral information of an encyclopedic character, together with new and elaborate tables of Arteries, Muscles, Nerves, Veins, etc.; of Bacilli, Bacteria, Micrococci, Streptococci; Eponymic Tables of Diseases, Operations, Signs and Symptoms, Stains, Tests, Methods of Treatment, etc., etc. By W. A. Newman Dorland, A.M., M.D., editor of the American Pocket Medical Dictionary". Handsome large octavo nearly 800 pages, bound in full flexible leather. Philadelphia, New York, London: W. B. Saunders & Company, 1903. Price, $4.50 net; with thumb index, $5 net.

In this we have the third edition of this popular dictionary. To it have been added several hundred of the new terms, and many of the tables have been amplified and otherwise brought up-to-date. The work is a very reliable and satisfactory one at a medium price.

The Medical News Visiting List, 1904. Philadelphia and New York: Lea Bros. & Co., 1903.

No visiting list that is published is better adapted to meet the requirements exacted of it than is that one published by Messrs. Lea Bros. & Co. The list is well arranged, contains much valuable information, and is gotten up in a very attractive form. This list deserves the praise which it receives from all its users.

Adrenalin and Its Uses in General Surgery.

UNDER the above title an article appears in the October issue of the Indian Medical Gazette, from the pen of Harry Gidney, F.R.C.S (Edin.), D.P.H. (Camb.), etc. The author finds that "the clinical usefulness of adrenalin is very great and extensive, and owing to its power of rapidly and effectively producing vasomotor constriction, it is adapted to the treatment of all inflammatory conditions. The drug is also of extreme value in arresting hemorrhage during all surgical operations. It is indicated whenever and wherever any local hyperemia exists, more especially in inflammation of mucous surfaces such as those of the eye, throat, larynx, pharynx, urethra, bladder, nose, rectum, vagina, uterus, stomach, etc. It is used not only to stay hemorrhage when it exists, but also as a preventive or controlling remedy, given either internally or externally prior to an operation, so as to lessen the amount of bleeding during the performance of that operation. It is a non-irritant to mucous membrane unless when used too frequently and in ex

cess.

"On reading the literature on the subject," says the writer, "I find that adrenalin is admitted to be the most powerful and rapid cardiac stimulant and tonic we have, being chiefly used in cardiac affections, hæmatemesis, hemoptysis, hemophilia, hematuria, menorrhagia, post-partum hemorrhage, purpura, scurvy, etc. It is said to be the most rapid restorative in chloroform and other forms of anesthetic syncope, and in such cases it is advisable to administer it intravenously."

The author reports the results of several operations, major and minor, in which adrenalin was employed. The first case was one of fracture of the vertex of the skull. As one of the larger branches of the middle meningeal artery had been torn there was profuse dural hemorrhage and capillary oozing which were controlled by the use of the 1-1000 solution. In

the second case, one of hemorrhoids, profuse bleeding was checked by the rectal insertion of a plug of cotton wool soaked with adrenalin chloride solution.

The third case was one of skin grafting in which the author tried pressure to stop the capillary bleeding. As the procedure was somewhat tedious he applied adrenalin chloride solution with almost immediate cessation of all oozing, and what is usually a lengthy and sanguinary operation was converted into a short and comparatively bloodless one.

The fourth case, one of hemorrhage after the extraction of teeth, and the fifth, which appears to embrace the author's experience in a number of cases of epistaxis, afforded additional opportunity to test the hemostatic effect of adrenalin.

In sixth case a post-partum hemorrhage was checked by swabbing the uterine cavity with adrenalin solution, while the same happy result was obtained in a case of secondary hemorrhage following an operation for the relief of a mammary abscess.

The author has found that the instillation of a 1-5000 to 1-2000 solution of this drug reduces the inflammation and considerably cuts short the process of conjunctivitis. He usually applies it (diluted) over the inflamed parts by means of a soft camel's-hair brush. He always uses the preparation containing chloretone, which has a decided local anesthetic action relieving much of the photophobia and pain. He is fully convinced of the power of adrenalin to arrest or lessen the bleeding that arises from the cut ends of the iris after iridectomy. He speaks highly of its efficiency in chemosis, cataract operations, evisceration of the eyeball, operations for ectropion, symblepharon and trachomatous pannus.

The author concludes that in all cases of minor surgery in which it is desired to arrest bleeding from any cut or exposed surface we have in adrenalin a most useful, powerful and rapid drug-one that is non-poisonous, non-irritant and nonaccumulative, especially in operations upon the conjunctiva and eyelids.

ACUTE INTESTINAL OBSTRUCTION.*

JERE L. CROOK, A.M., M.D.

JACKSON, TENN.

RICHARD DOUGLAS, whose recent work on "Surgical Diseases of the Abdomen" should be a source of pride to every Southern physician, defines intestinal obstruction as "an arrest of alimentation and digestion, an occlusion of the lumen of the bowel, irregular or arrested peristalsis, impeded or strangulated circulation." Nicholas Senn says: "Intestinal obstructionIleus of the German authors-is a complete or partial arrest of the intestinal contents due to either mechanical or dynamic causes."

While the division of this subject clinically into acute and chronic is of great importance as regards the treatment, yet the following classification, based on etiological pathology embracing all forms of obstruction, is a better one-namely: 1, from without by compression; 2, from within by obturation; 3, by structural changes in the wall of the intestines; 4, adynamic or paralytic. This classification by Douglas is complete, clear and comprehensive, and is an excellent foundation for the very exhaustive treatment he accords this important subject in his recent book.

A subject of so great importance from both a medical and surgical aspect, a condition which presents such unusual diffi

* Read before Tri-State Med. Assn. (Miss. Ark. & Tenn.) Memphis, Nov. 18, 1903 Vol. 24-5 57