It familiarizes one with the various operations and the instruments used. Much is gained in this respect by the introduction of halftone groups of instruments, giving nomenclature of same. In all there are seven hundred and forty-nine illustrations, fifty of which are colored.

All the more recent and approved advances in surgery are embodied in this book. Due reference is made to the various methods, making the work a comprehensive one, valuable for the surgeon as well as for the student who follows surgical clinics.

The publishers have maintained their usual standard of excellence as regards the paper, type, and illustrations. If Volume II shows equal merit this third edition is guaranteed an even greater success than the previous editions.

REPRINTS AND MONOGRAPHS RECEIVED.

The Vital Statistics of Massachusetts for 1897, with a Life Table based upon the Experience of the Five-year Period, 1893-97. By Samuel W. Abbott, M.D., Secretary of the State Board of Health of Massachusetts.

Excision of High Rectal Carcinoma without Sacral Resection. By N. Senn, M.D., Ph.D., LL.D. Reprinted from the Philadelphia Medical Journal.

The Etiology and Classification of Cystitis. By N. Senn, M.D., Ph.D., LL.D. Reprinted from International Clinics, Vol. II, eighth series.

The Caxton Caveat. Chicago: George H. Benedict & Co. December 15, 1899.

Baking Powders: A Treatise on the Character, Methods for the Determination of the Values, etc., with Special Reference to Recent Improvements in Phosphate Powders. By Charles A. Catlin, B.S., Ph.B., F.A.A.A.S. Providence: Rumford Chemical Works.

The Propagation of Diseases by Means of Insects, with Special Consideration of the Common Domestic Types. By W. M. L. Coplin, M.D. Reprinted from the Philadelphia Medical Journal.

[Read before the Boston Homœopathic Medical Society.]

Ladies and Gentlemen, Standing as we do upon the threshold of 1900, you will not be surprised if I am tempted to use this occasion for a brief contrast between the condition of the medical world now and when 1800 was just dawning. You will notice I do not say the beginning of the century, for when Transcript correspondents and college presidents disagree, who would venture to say whether the new century begins this year or next. We are at least through with 1800 except as long habit drops the old familiar figures from our pens.

Imagine yourselves transported to the other side of the water and to the year 1800. It had been a stormy time, you remember, on the continent of Europe, with all the horrors. of the French Revolution just subsiding under the sway of Napoleon. We cannot linger over general conditions, but must confine our observations to the medical aspect, which, however, may be suggestive of the bloody Revolution.

Medicine at this time was a conglomeration of systems, each expounded by some leader and taken up by a varying number of followers. There was a kind of mystery and awfulness about the physician (as well there might be about the man who could demand one's lifeblood), which placed him upon a little pedestal above the ordinary mortal. We can picture the typical doctor, powdered wig, regulation dress, with ruffled linen, silk stockings, and buckled shoes. His

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lightest word was heavy with a meaning that only the practitioner of the same system could hope to fathom. It seems almost incredible that such theories should have met with any favor, but since they did, let us see what a very few of them were.

There was Stoll, who numbered many physicians from all parts of Europe as his disciples. His system was based on the principle that all diseases arise from the influence of a predominant constitution which is determined by the prevailing weather and epidemic fevers. Latent bile and latent inflammation were especially dangerous, and in consequence purgatives and emetics were employed until he must have been an extraordinary patient who could have been accused of retaining anything, latent or otherwise. Nevertheless, Stoll is spoken of as the greatest physician of his time, attending all the intelligent persons in Vienna, and as he had been dead but twelve years when 1800 came in, his system was still in vogue.

Kämpf, a contemporary of Stoll, placed the seat of most diseases in the abdomen and gave the name of infarctus to the offending cause; he really explains what he means, and I will give you his own description, which may make you wonder how any one could survive even that.

"By infarctus I understand an unnatural condition of the blood vessels, especially of the portal veins and larger blood vessels in which they are plugged and distended in various places by ill concocted, variously degenerated fluid, bereft, inspissated, viscid, bilious, polypous, and coagulated blood tarrying and eventually sticking in the circulation, or in which the inspissated serum in the blood, in the glands, in the cellular tissue, together with the above-mentioned blood dregs, collects, corrupts, dries, and takes on various forms of degeneration in the digestive passages."

You may be sure the treatment was fitted to the disease. Clysters were the favorite means of disposing of such conditions; one physician is reported as having given as many as five thousand to a number of his patients. When we consider the composition of these clysters, "senna, spirits of

wine, dandelion, rhubarb, sal-ammonia, mercury, dog's grass, and antimony," we do not wonder that one writes of them as cleansing the tubes and passages of the human body like brooms, scrubbing brushes, and clearing rods.

Another system which had many adherents at the beginning of 1800 was that set forth by one John Brown, who, with the Scotch positiveness that makes good teachers and leaders, affirmed that he was presenting a real scientific view of medicine, and this soon received the title of the "Science of Nature." With his first proposition most of us will truthfully agree, namely, "Every human being possesses a greater or less degree of irritability. Health depends upon the possession of just the right amount of irritation."

Too much irritation produced the sthenic type of disease, too little, the asthenic type; and by a very simple line of reasoning, remedies were adapted to the two types. troubles of the sthenic sort, "irritation diminishing" means and drugs were employed, the patient being subjected to a course of bleeding, cold, emetics, purgatives, and diaphoretics. On the other hand, when too little irritation was present all existing irritation 'was bottled up within the system, and any additional means used that the physician could think of, that is, meat diet, wine, spices, and drugs, such as musk, am monia, and camphor. It required judgment to decide which type one had to deal with, but after that the choice of treatment was simple and the result was called “the ways of Providence!"

Just one more method I shall name because the sound of it has a familiar ring even to-day in Boston. In every age there are those who love the vagueness of language which seems to have its chief mission in concealing thought. The "Natural Philosophy" of the year 1800 abounded in such brilliant statements as these: "Life is cause; phenomena and existence are its results." "Life, as cause, is immortal, for immortal cause is life." These are almost as intelligible as another definition, found a little farther on, would be to a starving man. This says, "Hunger is internal tension of

the assimilation, under the influence of the mass opposed to external, hence the feeling of hunger at the cardiac orifice of the stomach.”

We will not pause to note any more of these methods; suffice it to say that the various systems vied with one another in seeing how much could be poured into the patient for later extraction after the most heroic and approved fashion.

What the physicians were thinking all this time only their Creator knows. One of them has truthfully expressed his own feeling, and this may have been the general sense. It sounds like the wail of a discouraged soul as he says in his own defence, "As the healing art has no fixed principles, as nothing is demonstrated clearly in it, as there is little certain and reliable experience in it, every physician has the right to follow his own opinion. When there is no question of real knowledge, when every one is only guessing, one opinion is as good as another. In the dense Egyptian darkness of ignorance in which physicians are groping their way, not even the faintest ray of light has penetrated by means of which they can steer their course. If any practitioner is not satisfied with my opinions, let him examine his own conscience and ascertain of how many medical truths he is certain. He who can point out to me one certainty in medicine may throw the first stone at me."

Physicians were not unprejudiced observers; they saw only what they wished to see a fault still extant, but surely not so prevalent as then. The rank and file of the medical profession were willing to follow blindly in the chosen way, caring little for real knowledge and progress. The hatred that existed among the different systems was of an heroic nature also. One writing at that time says: "Physicians split into sects, every one of which embitters the other by violent and often unfounded contradictions, and so prevents all possibility of doing good."

In the midst of this confusion and uncertainty there comes to us a voice of growing power and authority, one that promises hope and comfort to the weary sick folk, and a satisfying