BRAINARD MEDICAL SOCIETY. The program for the meeting of the Brainard Medical Society to be held at the Milwaukee Hospital on Wednesday, July 8, is as follows: Diagnosis of the Position of the Foetus in Utero......Dr. Wm. Scott Management of the First and Second Stages of Normal Labor... The Third Stage of Labor. .Dr. G. A. Heidner ..Dr. B. McShane .. Meningitis Discussion will be opened by Drs. Neilson, Blank and Faber. BOOK REVIEWS. ANESTHESIA AND ANESTHETICS GENERAL AND LOCAL-FOR PRACTITIONERS AND STUDENTS OF MEDICINE AND DENTISTRY. By Joseph M. Patton, M. D., Chicago, Professor of Physical Diagnosis and General Anesthesia in the College of Dentistry of the University of Illinois; Professor of Diseases of the Chest in the Chicago Policlinic: Associate Professor of Medicine in the Medical Department of the University of Illinois, Chicago.-Cleveland Press. The past ten years has seen a very decided change in the attitude of the surgeon toward the anesthetist. The opinion appears to have been that any one was fully competent to perform the service of anesthetist. Students and nurses were commonly assigned to this duty, notwithstanding the fact that accidents and fatalities are not infrequent in the operating room. For the proper discharge of the duties. of anesthetist, knowledge and skill are absolute prerequisites. This fact is being more and more widely recognized, and of late there has been a strong tendency, not alone in hospital but also in private practice, to pay more attention to the qualifications of the anesthetist. It falls to the lot of every practitioner of medicine to administer anesthetics more or less often, and it is therefore important that he should inform himself on the general subject of anesthetics both general and local, their physiologic action, their dangerous effects on particular organs, conditions which may influence the choice of drugs, idiosyncrasies, methods of administration, precautions to be observed, treatment of accidents, etc. While there is to be found scattered here and there in the literature more or less information on these subjects, students of medicine, as well as practitioners, need this information in a handy and compact form, and the volume before us fulfills this requirement. The work is manifestly the result of careful literary study, mature deliberation, ripe experience and skill, and in it the student will find embodied the most recent conclusions of science as to the various drugs used for the purpose of inducing anesthesia. He will find judicious counsel in the selection of the anesthetic in given cases and classes of cases, and he will find a most interesting chapter on the history of the discovery and early experience in the use of anesthetics. The chapter on nitrous oxide will be found specially valuable to the dentist, and that portion of the book treating of spinal anesthesia will place the reader in possession of the most recent knowledge on this important subject. (W. H. W.) HERMANN VON HELMHOLTZ. Leo Koenigsberger, Heidelberg. Volume II., 383 pages, with two portraits, and Volume III., 142 pages with four heliogravures and facsimile letter. Braunschweig, Friedrich Vieweg and Sohn, 1903. In the March number of the JOURNAL we reviewed the first volume of this excellent biography of von Helmholtz, which is of the greatest interest to the whole scientific world and large circles of educated laymen. In the second volume the exceedingly productive activity of von Helmholtz as professor of physiology at Heidelberg from 1861 to 1871, and as professor of physics at Berlin from 1871 to 1888, is described. A table of contents of seven pages gives, in chronological order, the titles of the vast array of scientific works published by von Helmholtz during this period. In 1863 appeared his famous book on perception of sound as a physiological base for the theory of music, a model of exhaustive and, in the best sense of the word, popular representation of the subject, with an abundance of original investigation and entirely new facts. In 1867 the first edition of the hand-book of physiological optics "the bible of the scientific ophthalmologist" was completed. Gradually von Helmholtz was, by the nature of his works, led into purely physical investigations, and in 1871 was appointed professor of physics in the University of Berlin. The negotiations between von Helmholtz and the Prussian Government preliminary to this appointment, and the reports of the philosophical faculty of Berlin, given in extenso, are very interesting. They show how the celebrated. physiologist was universally considered as the greatest physicist whom the largest university was eager to gain for the foremost chair of physics in Germany. Also the correspondence of v. H. with du BoisReymond, Ludwig, Donders, Lord Kelvin, his famous pupil H. Hertz, and others, presented in this volume, is of the greatest interest for the appreciation of the eminent man and investigator. Then again we read parts of his speeches held at important occasions, e. g., at the 500th anniversary of the University of Heidelberg, during his rectorate of the University of Berlin, and at the Ophthalmological Congress at Heidelberg, when the von Gracfe medal was presented to him. A portrait of v. H. by von Lenbach, made in 1884, and a pastel by von Lenbach, made in 1894, are excellently reproduced in heliogravures. From the now following History of the foundation of the PhysicoTechnical Institute at Charlottenburg by Werner von Siemens, we learn how the latter's choice for president had been von Helmholtz, who, in that position, would be enabled to devote himself exclusively to scientific researches, being freed from other duties naturally connected with his professorship. The third volume contains the biography of v. H. while in that capacity, from 1888 up to his death September 8, 1894. In 1890 v. H. published the first report of the Physico-Technical Institute, which shows what an immense amount of work had been done by him and by others under his supervision. Besides meteorologial and electro-dynamic investigations he again had taken up physiological researches while preparing the second edition of his hand-book of physiological optics from 1885 to 1894. His autobiographical remarks at the celebration of his 70th birthday, the address of the Academy of Berlin at the 50th anniversary of his promotion as Doctor of Medicine, his visit to the United States as commissioner of the German Empire for the International Electrical Congress during the World's Fair at Chicago, his and Mrs. von Helmholtz's letters, describing their impressions of this country, are exceedingly interesting. An apoplectic stroke prevented v. H. from delivering his address "On Lasting Forms of Motion and Apparent Substances," before the Congress of German Naturalists and Physicians in 1894 at Vienna, a part of which is given. here. His death occurred September 8, 1894. The commemoration, celebrated in the Singakademie, at the instance of the Physical and Physiological Societies of Berlin, the unveiling of the statue of von Helmholtz at the entrance of the university, with an extract of the ovation held by Waldeyer, are narrated. The author quotes the following words of Lord Kelvin from his short summary of von Helmholtz's works: "Of the whole of Helmholtz's great and splendid work in physiology, physics and mathematics, I doubt whether any one man may be qualified to speak with the power which knowledge and under standing can give; but we can all appreciate, to some degree, the vast services which he has rendered to biology by the application of his mathematical genius and highly trained capacity for experimental research to physiological investigation." We have nothing but words of the highest praise for this beautiful biography, fully worthy of the great man of whose scientific achievements and whole life it gives a thorough and splendid picture. Two heliogravures represent portraits by von Lenbach made in 1894, one the bust of v. H. by A. Hildebrand, 1891, and one the portrait of Mrs. Anna von Helmholtz, 1895. A facsimile letter of von H. to his father, dated December 17th, 1850, is appended, which is of especial historical interest, as in it v. H. mentions. for the first time, his invention of the ophthalmoscope. The handsome external appearance of the three volumes corresponds with the superiority of the work. (C. Z.) CURRENT LITERATURE. MEDICINE. W. H. Washburn, M.D., Jos. Kahn, M.D., L. F. Jermain, M.D., Therapeutic Inoculations of Bacterial Vaccines.-A. E. WRIGHT (Brit. Med. Jour., May 9, 1903) points out that the principle of serumtherapy, that is, the idea of transferring to patients already the subjects of bacterial infection immunizing substances withdrawn from animals vicariously inoculated, appeals in a very forcible way to the medical mind by the fact that it promises a rational treatment of all bacterial diseases, and by the fact that it has fulfilled that promise in the case of diphtheria.. The prestige which it has derived from this signal success has led to the use of serumtherapy in connection with almost every bacterial disease with the result that it has almost everywhere failed to do appreciable good while positive harm may follow. In default of an active production of immunizing substances on the part of the animal vicariously inoculated, the sera which are drawn off will inevitably possess the toxic properties of the vaccines originally inoculated. He asserts that there is in connection with every immunization process a sequence of negative and positive phase, during the first of which resistance is lowered, followed in case the inoculation is successful by the maintenance of a higher base line of immunity.. The inoculation of excessive doses may result in the undue prolongation of the negative phase, while the inoculation of a series of doses of a vaccine may cause the production of a cumulative negative phase. The cumulative positive phase which is sought can be achieved only when the successive doses are properly adjusted and interspared. The success of serumtherapy in diphtheria and its comparative failure in other diseases is explained by the fact that in the first case we are able to secure the elimination of all negative phase blood and to induce in the vicariously inoculated animals a cumulative phase of absolutely phenomenal dimensions. In the case of patients who, though suffering from localized bacterial invasions, are possessed of a considerable balance of resisting power, it is possible without risk to undertake therapeutic inoculations of bacterial vaccines, provided always that the results are controlled by subsequent blood examinations. The success in each case must depend upon the power of response possessed by the individual. This power may fail in some particular patient or in connection with some particular bacterial infection but success will almost certainly be achieved in the case of simple staphylococcus infections occurring in the young and robust and very probably in certain coli infections as well. (A. W. M.) Pernicious Anemia.-ANTON KROCKIEWICZ (Wiener Klin. Wochenschr., May 7, 1903) reports a case which was under his care for fifty days, in which the clinical history and autopsy demonstrated the presence of progressive pernicious anemia, but repeated examinations of the blood showed variations from the conditions usually considered diagnostic of this disease. Normoblasts and megaloblasts were never found, poikilocytosis was slight, the red blood corpuscles showed a diminished quantity of hemoglobin and polychromatophilia was not well marked. When first seen there were 460,000 red blood cells and 6,000 leucocytes per cubic millimeter, and 25 per cent. of hemoglobin. The number of red blood cells was reduced to 240,000, the leucocytes to 1,600 and the percentage of hemoglobin to 9 at the time of death. Aside from the progressive loss of strength and edema, the only symptoms were some digestive disturbances. The autopsy showed intense anemia. There was no fatty degeneration of the heart, liver, kidneys or blood vessels. The bone marrow was a bright red and there was some atrophy of the glands of the stomach and intestines. The author believes that his case strengthens the theory of Grawitz that the diagnosis of pernicious anemia depends more upon the clinical history than upon the microscopical examination of the blood. (J. K.) A Case of Myelogenous Leukemia, with Several Unusual Features.— CHAS. E. SIMON (Am. Journal of Med. Sciences, June, 1903) reports a case of spleno-myelogenous leukemia which presents several points of interest. The. patient, a painter, 42 years of age, first came under observation in October, 1900. He had never been sick before except for several attacks of dysentery. After these attacks he recovered his health very slowly. When first seen his complaint was of mucus in his stools, and general lassitude. He had lost 15 lbs. in weight. He improved somewhat, under treatment, and reported in January, 1901, that he was feeling quite well. At this time he presented a very marked pallor and the blood examination showed only 40 per cent. hemoglobin and 1,350,000 erythrocytes. A differential count of the leucocytes |