the nail on the head, by refusing all diplomas | Antonio, float six hundred miles more down and credentials and demanding under a heavy the Madeira to the Amazon, and continue over penalty in money and imprisonment that every nine hundred miles further to Para. On these person before attempting to practise in her do- expeditions the owner is accompanied by his mains shall pass a rigid examination in the Portu- family and from thirty to sixty natives. The guese language before a medical board at Bahia. master is the surgeon of the expedition and There is no tampering there with pathies or carries his remedies along. Among these isms, no question as to the legality of diplomas, people we found that malarial fevers prevailed but an examination as to the qualifications of and those of the most marked type. Fully ten the applicants. That the standard of this ex- per cent. of the Bolivian laborers had evidence amination is very high, we are inclined to doubt, of secondary syphilis. The remedies that all judging by the practice in the hospitals of Para carried and used abundantly were guarana, of their most celebrated physicians. In fact quinia, and coca. Coca was used in leaf form the Paranese disposition to defer everything and chewed with the addition of lime or ashes. until to-morrow, allows every acute case to be In the first stages of fevers they used jaborandi in articulo mortis before the remedy is applied. to produce perspiration, and guarana to relieve Another habit, or custom comfortable to the head symptoms. Inflammatory rheumatism is doctor, but we should judge in many instances, treated upon Prof. Stillé's plan of letting it alone. rather distressing to patients and friends, is If the patient lives they bless the Virgin Mary. that all calls received after 6 P. M. must wait If he dies they pull to the shore and plant him until next day. Doctors pay no visits at night. sans cérémonie. The hospitals are, for that country, very fair specimens of cleanliness and comfort; in this country they would not be tolerated. The natives of all classes are fatalists and sink into the depths of despondency on the advent of disease. Disease is combated by medicine alone; hygiene and dietetics have no part in transformation. their practice. Malarial and syphilitic diseases preponderate. Acute inflammatory rheumatism is the scourge of the Amazon and its tributaries. Extreme moisture of the atmosphere and excessive heat seem to be the producing causes.

Aside from disease there is a host of other ills that flesh is heir to on the Amazon and its tributaries. Men were frequently brought to me with their great toe-nails raised from their beds, and upon examination I would find a beautiful nest of grubs, quietly awaiting the time of their

Others came with lumps like hickory-nuts on their legs, and laying them open with a scalpel, one would unearth as it were a grub, fat, plump and an inch in length. The natives would present themselves after these grubs had made their exit and you would At the time of our visit a committee of medi- find on one leg as many as three ugly excacal experts appointed by the government were vated sores or ulcers as large as a half dollar. endeavoring to discover the cause and give title | Very many of these natives had lost the great and classification to an affection of the lower toe to the first joint; several required amputaextremities peculiar to women. I did not see tion at the second joint. Snake bites, ant bites a case but obtained the following description and the stings of multitudes of insects kept the from a medical gentleman at Para. He claims flesh of the natives full of scars and furuncles that the foreign women after a short residence at all times. For snake bites and arrow poisons are suddenly attacked with enormous swelling a concoction of herbs was employed, together of the feet and legs, having all the appearances of phlegmasia dolens, without the concomitant symptoms, neither can it be classed as elephantiasis, and that the only available remedy is to put to sea at once. Eight or ten days at sea causes the whole trouble to disappear. It was impossible to get any correct details as to the condition of the circulation or the kidneys, although our informant stoutly denied that there was any edema. It would be interesting to have the report of the committee.

Much of the traffic on the Amazon is yet The carried on by the old plan of canoes. bark and rubber merchants of Bolivia ship their cargo of material in canoes on the upper

with a free use of the villanous native rum, casash, made from sugar-cane juice. The conclusion we arrived at was, that native remedies are over extolled, and that notwithstanding protective laws, medical intelligence was at a low ebb in the Brazils.-The Country Practitioner, Aug. 1880.

TREATMENT OF HAY FEVER.

Dr. R. H. Weber, Class, of '66 (Am. Journ.
of Pharmacy), recommends the following:-
R. Extracti hyoscyami, gr. xij.
Potassii iodidi, 3i.
Potassii bicarbonatis, 3ij.
Extr. glycyrrhizæ depurati, 3iv.
Aquæ anisi, Zivss.—M.

Madeira, paddle six hundred miles, then after S. A dessertspoonful every four hours, day and night,

carrying it around the falls, and reaching San unul relieved.

Our Library Table.

THE UTRICULAR GLANDS OF THE UTERUS, AND THE GLANDULAR ORGAN OF NEW FORMATION WHICH IS DEVELOPED DURING PREGNANCY IN THE UTERUS OF THE MAMMALIA, INCLUDING THE HUMAN SPECIES. By Prof. GIOVANNI BATTISTA ERCOLANI, Permanent Secretary of the Academy of Sciences of Bologna, etc. With a quarto Atlas of fifteen plates, engraved by Bettini, and reproduced by the Heliotype process. Translated from the Italian under the direction of HENRY O. MARCY, A. M., M.D. Boston: Houghton, Mifflin & Co.,

1880.

A PRACTICAL TREATISE ON TUMORS OF THE MAMMARY GLAND; Embracing their Histology, Pathology, Diagnosis, and Treatment. By SAMUEL W. GROSS, A. M., M.D. Illustrated by Twenty-nine Engravings. New York: D. Appleton & Co., 1880. 8vo., pp. 246. Price, cloth, $2.50.

This able monograph reviews the various neoplasms and cysts that are liable to occur in the mammary gland, in such a way as to clearly set forth their histological peculiarities and to define their several pathological relations. Having thus established the microscopical and clinical characters, the diagnosis and prognosis in any individual case becomes merely a matter of observation and experience. Dr. Gross, like his father (to whom this volume is very appropriately dedicated), is possessed of a very vigorous style of writing, and good descriptive powers, which make the book very readable; moreover, having made a special study of mammary tumors for several years, our author is able to speak from personal experience; and the histological and clinical observations are principally from his own cases. The original illustrations in this work are excellent.

The medical profession is greatly indebted to Dr. Marcy for the opportunity offered by him for the perusal and study of the original investigations of the well-known Italian physiologist and gynecologist. The translated work of Ercolani enriches medical literature on points of rare interest. Gynecology has for some time run steadily in the direction of precepts for practice, and bold and startling methods of treatment. It is well once in a while for its devotees to pause and recollect that some portion of its work is associated with the study of the true physiology of the organs, which, when diseased, need its practical attention. Every gynæcologist should be a physiologist, and to each this valuable treatise, with its accompanying atlas, will be a guide to accuracy in uterine investigation, and a mine of information to the physiologist, and the medical practitioner as well. It is clearly written, well translated, and intelligible to every reader. Appended is the monograph of Ercolani upon unity of anatomical type of the placenta in all mammalia, and physiological unity of nutrition of the foetus in all vertebrates. R. J. D. DISEASES OF THE PHARYNX, LARYNX, AND TRA-SECOND CHEA. BY MORELL MACKENZIE, M.D. Lond.,

etc.

8vo., pp. 440. (Wood's Library of Standard Medical Authors.)

The subjects are considered under thirteen chapters, as follows: Classification and Relative Frequency of Tumors of the Mamma; Evolution and Transformation of Mammary Neoplasms; Etiology of Neoplasms of the Mamma; The Anatomy of Connective Tissue Neoplasms; Fibroma; Sarcoma; Myxoma; Adenoma; Carcinoma; Cysts; The Diagnosis of Tumors of the Mammary Gland; The Treatment of Tumors of the Mammary Gland; Tumors of the Male Mammary Gland.

The book is clearly printed on tinted paper, and has a good index. F. W.

ANNUAL Report of the State Board

OF HEALTH OF THE STATE OF RHODE ISLAND for the year ending Dec. 31, 1879. pp. 314. Providence, 1880.

This emanation from the pen of a universally Few States have in so brief a period exhibited recognized authority on the subject is one of so much official activity in the study of State the most valuable volumes of this excellent medicine as Rhode Island, for although this is series. It is partly based on the courses of lec- only the second report of the work of the tures delivered annually at the London Hospital board it is already a voluminous document, Medical College during the past twelve years, presenting general and statistical details which and partly on a Prize Essay by Dr. Mackenzie could only be procured by intelligent and peron Diseases of the Larynx, but especially on an sistent practical labor. To the secretary, Dr. experience that few medical men can equal, and Charles H. Fisher, the credit is mainly due for a reputation that is acknowledged to be unsur- the results thus achieved; but the report includes passed in his specialty. The physician will also papers by other writers, on Artificial Feedfind in this treatise a full, thorough, and prac-ing of Infants, Proper Disposition of the Extical work which will be of immense value to him, and to which he can refer with the utmost confidence and satisfaction. R. J. D.

VOL. I.-19

creta of the Intestines and Kidneys, Color Blindness, Sewerage of the Dwelling, Ventilation of School-houses, etc.

R. J. D.

etc.

THE MEDICAL AND SURGICAL DIRECTORY OF

A TREATISE ON THE PRACTICE OF MEDICINE, | but there is not a dull page in the book. The FOR THE USE OF STUDENTS AND PRACTITION- questions at the end of each section are great ERS. BY ROBERTS Bartholow, M. D., LL.D., aids to beginners in fixing the main facts in New York: D. Appleton & Co., 1880. mind. The typography is clear, and the paper pp. 853. Price, cloth, $5; sheep, $6. and binding are good and durable. We are The widespread reputation of Prof. Bartholow pleased to see that the work has already been as an able medical essayist, possessed of very highly praised by the medical press. F. W. positive views upon the subject of the value of remedies in the treatment of disease (and, in truth, always able to give good sound reasons for the faith that was in him), has caused his writings to be eagerly sought after by the profession, and often quoted by the medical press. For this reason, in connection with his high standing in the medical profession, the demand for his work on Practice has been declared by his publishers to have been something unprecedented, even prior to its appearance.

THE STATE OF IOWA FOR 1880 AND 1881.
By CHARLES H. LOTHROP, M.D. Clinton,
Iowa, 1880. Evo., pp. 172.

State Directories are among the valuable and necessary issues of modern periodical literature. That of Iowa bears renewed evidences of accuracy and completeness, such as might naturally be anticipated from the experience and judg ment of its author, who understands perfectly what the profession requires in an annual diR. J. D.

NASO-PHARYNGEAL CATARRH. BY MARTIN F.
COOMES, M.D. Svo., pp. 160. Bradley &
Gilbert, Louisville, Ky., 1880.

The book is now before us. Of the merits
of this work, or of the soundness of its teach-rectory.
ings, we need not speak. The definitions are
clear and comprehensible; the descriptions are
graphic; the technology not too abstruse; the
directions for treatment are plain and practical,
and eminently rational. The language of Prof.
Bartholow is succinct and goes straight to the
point. On account of the clearness and con-
ciseness of this work, we have no doubt that
it will at once take a leading place among the
classical treatises upon the practice of medicine;
as there has existed for some time a great want
for a new Practice by an American author, a
hiatus which Bartholow's Practice admirably
fills.
F. W.

A NEW SCHOOL PHYSIOLOGY. By RICHARD J.
DUNGLISON, A.M., M.D. Illustrated with
one hundred and seventeen engravings.
Philadelphia: Porter & Coates, 1880. 8vo.,
PP. 314. Price, cloth, $1.50.

It is a difficult task to introduce a technical subject and present its fundamental principles in such a manner as to interest those who are totally unfamiliar with science, while conveying at the same time sound and reliable knowledge; to avoid scientific dulness on the one hand and jejuneness and superficiality upon the other. In the present volume the author has succeeded in this task admirably; besides being an experienced writer, he is possessed of a lucid, fluent style, in which, in the work before us, he con veys in popular language the principal facts of human physiology in conformity with the latest views upon this important subject. A general review of the science of human physiology is presented, and on nearly every page there are graphic illustrations of unusual merit, many of them being fine examples of engraving and equal in beauty to the French. The chapter on the special senses is especially attractive,

A troublesome affection of common occurits various forms until these latter days, here rence, not fully understood or appreciated in receives consideration in a monogram wholly devoted to its discussion. The author sensibly imparts to the reader at the outset a sketch of the anatomy of all the parts involved in these morbid pharyngeal, laryngeal, and nasal complications. R. J. D.

SCHOOL AND INDUSTRIAL HYGIENE. By D. F.
LINCOLN, M.D. 18mo., pp. 182. Philadel-
phia. Presley Blakiston, 1880. (American
Health Primer.)

This very acceptable little volume is from the pen of the Chairman of the Department of Health, Social Science Association. The subject of school hygiene is a fitting adjuvant and sequel to the information on physiology taught in many schools for the instruction of the young; but the principles upon which it is founded are such as need not be imparted to the scholar, provided they are rigidly appreciated and adhered to by the architect, the board of education, and the teacher. We refer particularly to the amount of study required and of exercise allowed, the arrangement of school desks and seats, the plan of ventilation and drainage, the care of the eyes, etc.

In referring to over-use of the hand in writing, the author states that "Dr. Frank Woodbury, of Philadelphia, has lately invented an ingenious pen-holder to prevent writer's cramp, by regulating the pressure at which the pen is used by a slight spring." R. J. D.

inheritance, form a considerable, and, we believe, an increasing proportion of the community in every large American city, as every physician can attest. There are secrets connected with many prominent families that are known only to the family physician. We note, in passing, that the great decline of the use of humanized lymph in vaccination, by careful physicians, is due simply to the fact that no one can guarantee any given crust to be entirely above the suspicion of syphilis. This dreadful disease, once contracted, impresses itself so fully upon the system as to be practically ineradicable; once infected, it follows the man to his grave. Besides the common mode of contamination by impure intercourse, syph

It happened to the writer to be recently ilis may be communicated by surgical and called to see a man of most respectable sur- other instruments; by borrowed pipes and roundings, who bore an unmistakable venereal segars; by car-drivers' whistles; by toys sold sore upon his lip, and subsequently manifested to children upon the street by vendors with all the features of secondary syphilis. It was poisoned lips or fingers; by drinking cups or said that this had followed a trifling surgical towels in railway stations; by public urinals and operation upon the part affected for the removal water closets; by hired bathing robes; by putof a slight deformity; the instruments or hands ting money or pins in the mouth, and in a thouof the surgeon communicating the specific sand other ways that are familiar to medical men. virus in the same manner, it will be remem- Every practising physician has seen cases in bered, that a New York dentist, not long ago, which syphilis was thus innocently acquired, communicated syphilis by his forceps; and a communicated by a Judas kiss, or inflicted upon well-known laryngologist inoculated a number a physician in the honorable pursuit of his callof patients with pharyngeal chancre. Whether the explanation given by the patient above referred to was correct or not in this special case, it will serve as a text for offering to our readers a few pertinent remarks upon syphilis that must claim the thoughtful consideration of every one whose look is forward; if they do not fill him with apprehension for the future of his race.

There is prevailing among us a disease as inoculable as smallpox, as disgusting as leprosy, as malignant as cancer. Unfortunately, it is comparatively slow in its operation, and its victims have time to marry and to be given in marriage, flattering themselves, perchance, that the destroyer has loosened his deadly grasp; thrice unfortunately, they are enabled by the friendly aid of the physician to propagate their physically depraved kind, victims of congenital syphilis, imbibing poison with their mother's milk. These syphilides, by inoculation or by

ing!

If the results are as stated, and the means of communication so easily and so completely beset us, is there no special obligation resting upon those to whom these facts are known and appreciated, to rouse the community to a sense of the magnitude of this danger? Medical men. alone realize the terrible ravages of syphilis; does not this knowledge bring to them a peculiar measure of responsibility?

Owing to the facilities offered in our cities, it is known that a certain number of thousands of young men about town will contract syphilis this year, just as many thousands did last year, and the year before; which may be looked upon as the legitimate harvest of certain evils that are permitted to exist among us. To these may be added the comparatively small number who acquire the disease accidentally, or by exceptional methods, and a total is reached that,