The Practical Medicine Series of Year Books. Ten Volumes. Issued under the general editorial charge of Gustavus P. Head, M.D., Professor of Laryngology and Rhinology in the Chicago Post-Graduate Medical School. Vol. X. Skin and Venereal Diseases, Nervous and Mental Diseases. Edited by W. L. Baum, Hugh T. Patrick, William Healy. Series 1906. Chicago: The Year Book Publishers. (Price, $1.25; entire series, $10.00).

A Treatise on Orthopedic Surgery. By Royal Whitman, M.D., Instructor in Orthopedic Surgery in the College of Physicians and Surgeons, New York; Chief of Orthopedic Department in Vanderbilt Clinic, New York. Third edition, revised and enlarged. Octavo, 900 pages, with 554 illustrations, mostly original. Lea Brothers & Co., Philadelphia and New York, 1907. (Cloth, $5.50 net).

Starr on Nervous Diseases. Organic and Functional Nervous Diseases. By M. Allen Starr, M.D., Ph.D., LL.D., Professor of Neurology in the College of Physicians and Surgeons, New York. Second edition, revised. Octavo, 824 pages, with 282 engravings and 26 full-page plates. Lea Brothers & Co., Philadelphia and New York, 1907. (Cloth, $6.00, net; leather, $7.00, net).

By

Lea's Series of Pocket Textbooks. Diseases of Children. George M. Tuttle, M.D., Attending Physician to St. Luke's Hospital, St. Louis, Mo. 2d edition, revised. Edited by Bern. B. Gallaudet, M.D. phia and New York, 1907. (Cloth, prices).

12m0, 392 pages, with 5 plates. Lea Brothers & Co., Philadel$1.50; flexible leather, $2.00 net

Syllabus of Lectures on Human Embryology. With a Glossary of Embryological Terms. By Walter Porter Wanton, M.D., Professor of Clinical Gynecology and Professor adjunct of Obstetrics in the Detroit College of Medicine. Third edition. Illustrated. 12mo., Pp. 136. Philadelphia: F. A. Davis Co.

1906.

Plaster of Paris and How to Use It. By Martin W. Ware, M.D., Adjunct Attending Surgeon, Mount Sinai Hospital; Surgeon to the Good Samaritan Dispensary; Instructor in Surgery, N. Y. Post-Graduate Medical School. 12m0; 72 illustrations, about 100 pages. New York: Surgery Publishing Co. (Cloth, $1.00).

Practical Dietetics, with reference to Diet in Disease. By Alida Frances Pattee, Late Instructor in Dietetics, Bellevue Training School for Nurses, New York. Fourth edition, 12mo, cloth. 300 pages. New York: A. F. Pattee, Publisher, 52 West 39th Street. (Price, $1.00 net).

Tumors of the Cerebrum. Their Focal Diagnosis and Surgical Treatment. By Charles K. Mills, Charles H. Frazier, William G. Spiller, George E. de Schweinitz, and Theodore H. Weisenburg. Small 8 vo., pp. 35. Philadelphia: Edward Bennock, 3609 Woodland Avenue. 1906.

Woman. A Treatise on the Normal and Pathological Emotions of Feminine Love. By Bernard S. Talmey, M.D., Gynecologist to the Metropolitan Hospital and Dispensary, New York. 12mo., pp. 300. Illustrated. New York: Stanley Press Co. (Price, $3.00).

Conservative Gynecology and Electro-Therapeutics. By G. Betton Massey, M.D., Attending Surgeon to the American Oncologic Hospital, Phiadelphia. Fifth edition. Illustrated. Octavo, pp. 467. Philadelphia: F. A. Davis Co. 1906.

By Boardman Reed,

Diseases of the Stomach and Intestines. M.D., Late Physician in Chief to the Samaritan Hospital, Philadelphia. Second edition. Illustrated. Octavo, pp. 1021. New York: E. B. Treat & Co. 1907. (Price, $5.00).

The Hygiene of Pregnancy. By Walter B. Jennings, M.D., Attending Physician to St. Mary's Free Hospital for Children. New York: Medical Review of Reviews. (Price, 25 cents).

Vol. 24.

Transactions of the American Surgical Association. Edited by Richard H. Harte, M.D., Recorder of the Association. Philadelphia: William J. Dornan, Printer.

The Harvey Lectures, delivered under the auspices of the Harvey Society of New York. 1905-1906. Philadelphia and London: J. B. Lippincott Co.

Transactions of the Maine Medical Association. Vol. XV. Part III. Walter E. Tobie, M.D., Secretary.

LITERARY NOTES.

P. BLAKISTON, SON AND COMPANY, Philadelphia, announce that timeliness of interest, aside from any other condition, lends especial importance to the early publication of Foods and Their Adulteration, by Harvey W. Wiley, M.D., to be immediately followed by a companion volume, Beverages and Their Adulterations. Dr. Wiley is Chief Chemist to the United States Department of Agriculture, at Washington, and his wide researches in the interests of purity in food commodities give anything he might write on the subject an authoritativeness that is unquestioned. The fact that the new National Food and Drugs Law became effective January, 1907, and that public interest in it is now intense, will no doubt result in a demand for both volumes. The books will be generously illustrated from original photographs and drawings.

W. B. SAUNDERS COMPANY, Philadelphia and London, have just issued a revision of their illustrated catalogue of medical, surgical and scientific publications. This is one of the most elaborate and useful catalogues we have seen. The descriptions of the books are. full, the specimen illustrations representative of the pictorial feature of the books from which they are taken, and the mechanical get-up is entirely in keeping with the high order of the context. The authors listed are men of eminence in every branch of medical science. The catalogue is well worth having, and a copy will be sent free upon request.

ITEMS.

THE ANTIKAMNIA calendar for 1907 is an exquisite bit of art work entitled "The Convalescent." The picture is a reproduction of the painting by Miss Magnus which was exhibited in the Manchester Academy.

THE STATE CIVIL SERVICE COMMISSION will hold examinations in all parts of the State February 23, 1907. Among the positions to be filled are, apothecary, $540 to $900 and maintenance; homeopathic pharmacist, $900 and maintenance; pharmacist, Erie County service, $720; physician, sixth grade, $900 and maintenance; pupil nurse, Erie County Hospital, $10 a month and main

tenance.

The last day for filing applications for these positions is February 18th. Full information and application forms for any of these examinations may be obtained by addressing Charles S. Fowler, Chief Examiner of the Commission at Albany.

In

NEW REGULATIONS PROPOSED FOR THE HEALTH DEPARTMENT OF BUFFALO. The charter revision committee, through its subcommittee, has drafted resolutions governing the health department. The regulations provide that the health commissioner is to be appointed by the mayor (as he is now), and must be a reputable, licensed physician with actual experience in practice of not less than seven years. The commissioner is to appoint his assistants and, with the council's concurrence, shall fix their salaries. time of "great and imminent peril to the public health," the commissioner of health may take such measures for safety as he deems necessary. As at present he will have supervision over dead bodies, and the registration of births, marriages and deaths. It is also provided that he shall make rules and regulations for enforcement of all laws and ordinances for the protection of public health and care of vital statistics. One section not only authorizes but requires him to prepare ordinances for licensing all persons offering to give massage and medicinal baths, and all persons and organizations advertising to practise medicine in any of its branches. He is further empowered to enforce all health ordinances and is given greater power over tenements than is provided for in the present charter. All drainage, plumbing, etc., in all kinds of buildings shall be subject to the commissioner's approval and if not prohibited by statute or law, the commissioner is empowered to permit or prohibit the building of dwellings to be used by more than two families, of livery stables, barns in which live stock is to be kept, slaughterhouses or rendering plants: or the transforming of present buildings into structures for any of such uses.

O my mind a discussion of the surgical aspect of gastric ulcer in no way indicates a conflict between the surgical and medical viewpoints of the subject, nor do I mean to say that the surgical or operative treatment of gastric ulcer is of paramount importance in the treatment of all such cases. I am free to say this subject has a broad medical basis of diagnosis and treatment upon which in appropriate cases treatment rests. The burden of diagnosis falls upon the internist in fact, and also the treatment in practically all cases for the first few days, weeks or months, sometimes even for years. I think it is fair to say that the importance of the discussion of the medical aspects of gastric ulcer is not lessened, but the essential features of diagnosis and treatment are emphasized when it is granted that certain classes of gastric ulcer need surgical treatment.

In a free discussion leading to the classification of cases which are surgical, I may go over ground already ably covered by Dr. Woehnert in his discussion of the etiology, symptomatology and treatment of gastric ulcer. This risk of repetition I must run, or feel that as a surgeon I am reduced to the position of a mere mechanic for whom diagnosis is made and a command issued by the internist to do for one case a gastrojejunostomy, for another a pyloroplasty, pylorectomy, a gastrostomy, a gastroplication or a gastrectomy. If the internist and surgeon do not work in harmony in these cases, we find the former timid and procrastinating, the latter making too many exploratory operations, or adding to the records of needless operations. Under such circumstances both internist and surgeon are prone to make false deductions from their experiences, and progress in scientific medicine is retarded.

1. Read before the Section on Medicine, Buffalo Academy of Medicine, January 15, 1907.

It is said that from five to thirteen per cent. of people suffer at some time of their lives from gastric ulcer, and in the different authorities, statistics can be quoted of interest from many points of view as to age of patient, location of ulcers, number of ulcers, single or multiple, number in which hemorrhage is a feature, proportion of cases in which perforation or malignancy later develops, and so on. Upon these phases of the subject it is not

my purpose to dwell.

Diagnosis of gastric ulcer is not possible in all cases. Hemmeter said at the 1906 meeting of the American Medical Association that diagnosis of gastric ulcer depends largely upon the exercise of the sixth sense. The usual procedure in arriving at diagnosis is by exclusion of other diseases. In many cases

of acute or chronic dyspepsia (using the word dyspepsia in a broad sense, including patients suffering from indigestion) regulation laboratory methods, examination of stomach contents and stools, and a close study of the history in the individual case help us with reasonable certainty in the diagnosis of gastric ulcer.

Diagnosis being made, we find prognosis most uncertain. The acute dyspeptic of this week may be a patient with perforating ulcer or acute hemorrhage next week. The acute or chronic dyspeptic of this month may be entirely relieved under proper medical treatment in another month. When the dyspeptic is brought to operation on a diagnosis of ulcer of chronic type, internist and surgeon must realize that there is always an exploratory feature in an operation in suspected cases of gastric ulcer. In my own experience in consultation work, as a result of close study or as a result of exploratory operation, some supposed cases of gastric ulcer were found to be cases of chronic cholecystitis with calculi, some were cases of reflex gastric neurosis due to nephroptosia, chronic appendicitis, chronic pelvic disease, or beginning malignancy. One case diagnosticated as possible gastric ulcer was found to be a massive hydrothorax of the right side with marked downward displacement of the liver.

Hemmeter is working at present to develop a pathognomonic sign of gastric ulcer by x-ray and fluoroscopic findings upon giving bismuth to patients suffering from gastric ulcer. He says there seems to be a peculiar affinity between the exudate in these ulcers and bismuth, the x-ray plainly showing it. It seems to me, however, that in cancer with erosion the same findings would be present.

I had the pleasure of watching Moynihan's work in Leeds for two days last June. In two cases out of four he demonstrated a sign of gastric ulcer the day before he operated upon them. Gently pinching up small areas of skin all over the epigastrium