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critically examine and comment on the probable value of recent work in the various departments of medicine. In the present volume are contained sections on Diseases of the Digestive and Genito-urinary tracts, on the Surgery of the Extremities, and a Practical Therapeutic Referendum.

We may glance at a few of the subjects which happened to strike the reviewer's attention. J. Dutton Steele edits the section on digestive diseases. Matthieu shows that the coating on the tongue is not a reflex of the condition of the digestive organs, for the surface of the tongue is analagous to the skin in structure, but represents a lingual desquamative dermatitis due to intestinal intoxication. Among the most valuable advances in diagnosis is the new test for "occult" blood in the stools and stomach contents indicative of cancer and ulcer. Osler's series of cases of abdominal pain, simulating many common abdominal diseases but forming entities associated with erythema, are remarkably interesting. Musser's masterful paper on, Abdominal Pain, is noticed at length, and Mayo Robson's new urinary test for pancreatic diseases receives due consideration.

Bloodgood devotes most of the space in his section to osteomyelitis, tumors and surgery of the joints. Great advances have been made in extending our knowledge of the etiology and pathology of osteomyelitis and corresponding changes have been wrought in the surgical treatment of this disease. Nichol's notable paper of the surgical treatment of this disease.

Belfield presides over the section on Genito-urinary Diseases but space will not permit of a review of reviews. As interesting to our local physicians, the comment on G. W. Hawley's article in the June, 1904, number of the Annals of Surgery, on Cancer of the Postrate, will prove of interest. Dr. Belfield writes that Hawley, of Seattle, presents the "most elaborate, judicial and lucid review of carcinoma of the prostrate yet published."

John Rose Bradford conducts the section on Diseases of the Kidneys, and H. R. M. Landis has charge of the Practical Therapeutic Referendum. WINSLOW.

Practical Dietetics. Diet in Health and Disease. By A. L. Benedict, Buffalo, New York, Member American Gastro-Enterological Association, Medical Society State of New York, etc. 12 mo.; 400 pages; green buckram, gilt side title and top; $1.50 net. Chicago, G. P Engelhard & Co.

This brief but comprehensive treatise considers dietetics by presenting the underlying physiologic principles and facts upon which the nourishment of the body depends in health and disease. It ignores all receipt and cook-book methods and is admirably written in its judicious sifting of the tares from the wheat, and in its broad and scientific spirit. The following subjects are considered: Analyses of the body; Essential Nutrients, their absorption, storage and elimination; Dietetic Needs in Health; Food Requirements in Terms of Natural Foodstuffs and Specific Foods.

Some points of interest are brought out in the latter, as that among

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civilized peoples bananas are the only form in which raw starch is ingested in any considerable amount, and that raw starch is absolutely indigestible in the stomach-hence their notable bad effect in children and those with weak digestions. The author states that the prejudice against pork is scarcely warranted and that, if similarity of diet counts for anything, pork should be the superior of beef for human diet and cites the fact that the cannibals of the South Pacific islands used to know pork and human flesh as short and long pork respectively. Under, Use and Value of Milk, the writer-after noting the dangers of impure milk-remarks caustically that the best milk can only be obtained "through individual care and implicit confidence must not be placed in dairies simply because part of the stock is held by physicians and a high price is charged."

The food value of alcohol is likened to the value of kerosene as a fuel in an ordinary stove. The body is no more constructed for the regular oxidation of alcohol than a stove for that of kerosene. A small amount of either may be consumed, but such substitution is dangerous and only permissible in an emergency. Among other subjects treated are: Dietetics of the Period of Growth; Organotheropy; Diets in the Various Special Diseases and Special Methods of Introducing Nutriment. We heartily commend the book.

WINSLOW.

REPORT OF CONTAGIOUS DISEASES.

TO THE WASHINGTON STATE BOARD OF HEALTH FOR DECEMBER, 1904.

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NORTHWEST MEDICINE

March, 1905.

ORIGINAL CONTRIBUTIONS.

PANCREATIC INFLAMMATIONS IN THEIR RELATION-
SHIP TO CHOLELITHIASIS, AND THEIR
TREATMENT.*

By A. W. MAYO ROBSON, F. R. C. S.
LONDON, ENGLAND.

Vice-President and Hunterian Professor, Royal College of Surgeons,
England.

Among the many complications of gall stones, pancreatitis in its various forms is now known to be one of the most important, though the relationship has only comparatively recently been recognized. The bile ducts and the pancreas are so intimately related in their development and their anatomy that it can excite no surprise to find them frequently associated in their diseases; and though we frequently find cholelithiasis without pancreatic troubles, it is much less common to have inflammation of the pancreas, whether acute, subacute or chronic, without finding common duct cholelithiasis. The reason for this association is not far to seek; it is due to the junction of the common bile duct and the duct of Wirsung at the ampulla of Vater and their common opening into the duodonum, a channel always containing organisms ready under certain circumstances to invade and become virulent.

Pancreatitis is probably always a secondary disease and usually dependent on infection spreading from the common bile duct or duodenum. It may be asked, if common duct cholelithiasis and pancreatitis are so often associated, why should some cases of common duct obstruction go on for months or years without the pancreas participating?

I must ask you to excuse me for taking you back to the dissecting room for a few minutes, as though doubtless you are well

Address in Surgery, read before the Canadian Medical Association, Vancouver, B. C., Aug. 24, 1904.

(By courtesy of The Montreal Medical Journal.)

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