The Physician's Pocket Account Book. By J. J.
Taylor, M. D. 212 pages.
Leather. Price
$1.00, postpaid. J. J. Taylor, publisher, 4105
Walnut street., Philadelphia, Pa.

The special feature of this book is a system of accounts, whereby each transaction can be recorded in a moment's time in plain language, so that it is strictly legal as evidence in a court without personal explanation, and so arranged that any patron's account can be ascertained on demand without any posting. There is only one entry of each transaction, and this is in such a form that no posting is ever required. It saves time, labor and worry, and insures that your accounts are always up to date, so that one can send out statements every month, and can inform any patron, wherever one may meet him, of the exact state of his account. This feature alone, in the course of a year, will secure payments that would otherwise be missed. It is one of the simplest, quickest and easiest account systems on the market. It also contains considerable miscellaneous information of value. For those who prefer to keep their accounts at their desk the same system has been enlarged into a desk size book of 400 large pages, the price of which is $5 per copy.

The Physician's Visiting List (Lindsay and Blakiston's) for 1911. Sixtieth Year of Its Publication. Dose Table Revised in Accordance With New U. S. Pharmacopeia. Philadelphia: P. Blakiston's Sons and Company. With the present issue the Physician's Visiting List enters upon the sixtieth year of its existence. Only those publications of decided merit outlive the generation in which they were born, and by far the larger number disappear after a few years of struggling existence. During the life of this book medical science has made greater progress than during the preceding five hundred years. The book has been seen and used by the most famous of American physicians and investigators, as well as by thousands of others whose names perhaps were never known beyond their own local scenes, but who have nevertheless done a large share toward the sum of human happiness. It has made long journeys in the buggy or saddle bag of the country doctor. It has been at the

The Practitioner's Visiting List. 1911. Records of Practice for Thirty Patients per Week. Philadelphia and New York: Lea and Febiger. This is another of the visiting and record books that have attained a national reputation. In addition to the ruled pages set apart for the patients' accounts, there are separate sections for records of obstetric cases and engagements, vaccinations, births and deaths, and a whole fund of miscellaneous reference and emergency information, including a list of poisons and their antidotes, a complex table of drug remedies and their dosage, an alphabetical index of therapeutic reminders, and a description of the technique for ligating various arteries. So that it is much more than a mere visiting account book; it is a vade mecum for the busy practitioner. The physical qualities of the book are all that could be desired. It is strongly and handsomely bound in red morocco, with a folding flap, and printed on excellent paper. It holds its own with the best of this type of book, and maintains the high standard set by itself.

The Practice of Surgery. By James Gregory Mumford, M. D.; Visiting Surgeon to the Massachusetts General Hospital; Instructor in Surgery, Harvard Medical School; Fellow of the American Surgical Association, etc. With 682 Illustrations. Philadelphia and London: W. B. Saunders Company. 1910.

We have more than once taken occasion to citicise the modern system of medical education on the ground of its tendency to divide the study and practice of medicine into watertight compartments. This is the inevitable result of the constantly increasing mass of our knowledge in the various branches of medicine, and the necessity for specialism in their teaching and in their

practice. The consequence is, that every teacher is in danger of teaching and administering his subject as though it were a distinct and separate subject, rather than as an integral part of the student's general medical education. Much the Much the same criticism applies to most of the present-day text-books-they teach their subjects exhaustively and specially, as specialties rather than as contributions to clinical medicine. It is, therefore, with considerable gratification that we welcome a text-book on surgery which contemplates the clinical practice of surgery by the general practitioner. Not since the days of Walsham's Surgery have we seen a text-book on general surgery which so aptly and adequately meets the requirements of the student and practitioner as this very sensible work of Mumford's. It is manifestly written, not for the sake of displaying the wide range of modern surgical science, but expressly for the purpose of furnishing the practitioner with all that he needs in the ordinary exigencies of his everyday practice. The author has wisely drawn the line between practical surgery and expert surgery-and has drawn it with rare discrimination and judgment. Physically the book is in Messrs. Saunders' usual unexceptionable style. The practitioner will find it a truly helpful addition to his working library. 济济济

The Prevention of Sexual Diseases. By Victor G. Vecki, M. D., Ex-President, San Francisco German Medical Society; Member, American Urological Association, etc. With Introduction by William J. Robinson, M. D. The Critic and Guide Company, 12 Mt. Morris Park West, New York. 1910.

The writer of this book evidently belongs to that class of men who believe in calling a spade a spade-who have positive views and opinions and are not afraid to express them. Such men are always good to read, not only because they appeal to the red blood that is our veins, but because they set forth the cause that they plead in clear and unmistakable fashion, so that we know, certainly and unequivocally, just what the issues are. Dr. Vecki makes a straightforward, plain-spoken plea for the regulation of the sexual evil in this country, and for the promulgation of sexual phophylaxis from its physical standpoint. He holds, first of all-as, of course, we all dothat there should be the widest education in all matters pertaining to sex relations and sexual diseases. But he also believes that, do what we will in this respect, there will always be a sexual problem. In other words, he does not think it practicable to do away with the prostitute and the brothel, and that being so, he regards it as

silly prudery to refuse such public supervision and regulation of these agencies as it is possible to establish, and to withhold from those who persist in visiting such places the means of protecting themselves, so far as may be, against the danger of infection. We may not all agree with the position that Dr. Vecki takes on every aspect of the question; but at least he compels our respect and consideration by his earnestness, his frankness, and his fearless advocacy of his own convictions. And we must admit that he has an experience which entitles him to be heard. His book should be read by all who are interested in the subject.

Lessons on the Eye. For the Use of Undergraduate Students. By Frank L. Henderson, M. D., Chairman of the Ophthalmic Section of the St. Louis Medical Society; Ophthalmic Surgeon to St. Mary's Infirmary; Consulting Oculist to the Wabash Railroad, etc. Fourth Edition. Revised. Philadelphia: P. Blakiston's Sons and Company. 1910.

Of all the branches of medicine and surgery in which the general practitioner is, as a rule, uninformed and largely helpless, ophthalmology leads the list. The average physician usually knows next to nothing about the eye and its diseases, and confesses that he is ignorant. It is not necessary, of course, that he should have an exhaustive and expert knowledge of the subject. That is the part of the eye specialist. But he should certainly have enough to enable him to treat the commoner and milder eye troubles, and enough more to tell him where the services of an oculist are needed. This is what Dr. Henderson essays to give him in this little manual-and we take pleasure in attesting the success of his endeavor. He assigns the book, in its title, the rather limited field of usefulness represented by the medical student-and, to be sure, that is where the information it contains ought properly to be instilled. However, unless we are greatly mistaken the work has just as large a demand and circulation among the ranks of general practitioners as among the schools; and, in the present state of affairs, it is well that it has. It will greatly help to lighten the situation which we have above referred to. It contains all that is necessary for the practicing physician to know concerning the anatomy, physiology and pathology of the eye, with the exception of refraction, upon which some further instruction would be required to enable the physician to undertake that work. We cordially commend the book, and are glad to see it in its fourth edition.

VOLUME XXXIV.

NUMBER 3

PHYLOGENIC ASSOCIATION

In a masterly address, under the above title, delivered before the Cleveland Academy of Medicine, Dr. Crile of that city called striking attention to the profound truth so often preached from these pages, and so all-too-seldom taken account of in our research and practice, namely, that the phenomena of health and disease are all ultimately resolvable into variations of the more basic and elemental principles and phenomera of biology.

The development and functionation of the body follow two series of progressions, which paralle! each other at every point, and whose proper inter-adjustment constitutes normality and health their interruption and mal-adjustment deformity and disease. These two procesess are the phylogenic and the ontogenic-the racial and the individual. There are certain underlying typetraits to which the normal body is predistined to conform by virtue of racial evolution. There are certain other characteristics of structure and function to which it conforms in accordance with individual requirements. And the health of the body depends upon a successful inter-adjustment of type and organism for the best interests of both.

The mind has a precisely similar and parallel duality of development. Its racial traits constitute what are known as the instincts, which determine the basic motives and ends of all human action, from which all conduct springs and toward which it moves. The individual qualities comprise those faculties of cognition and expression which are acquired by individual education. A sane mentality consists in the inter-adjustment of the two for the best interests of both.

When a body either under-develops or overdevelops any of the type-stigmata, we look upon it as a freak. When it exhibits a deficient or excessive development of individual structure or function, we call it deformed. When it fails to adjust individual qualities to type forms, we say it is diseased. In like manner, when racial qualities of mind exhibit either deficient or excessive development, we call the person a degenerate. When we see a mind deficient or precocious in

acquired faculties, we class it as defective. When, from any cause, the adjustment between the two is broken, we say the person is insane.

This, in the last analysis, is the base upon which the whole system of hygiene and medicine rests, and if we would but bear it in mind it would wonderfully simplify and orientate all our efforts to solve the vexed problems of etiology, pathology and prophylaxis. Such thoughtful essays as that of Dr. Crile are most timely, and should command the widest and most profound attention.

PREVENTION OF INSANITY.

Among the various prophylactic movements that characterize the activities of modern public medicine, the latest is a proposed crusade for the prevention of insanity. Just what the contemplated modus operandi of such a movement may be, does not seem quite clear. Unfortunately, as we have more than once pointed out, the present understanding and classification of the causes of insanity are not calculated to afford any very helpful data on which to base a crusade of prophylaxis. The strong probability is that the chief direction of such preventive efforts will be along sociologic lines, which, we are afraid, will of itself be inadequate for the purpose.

It is characteristic of the difficulty attending the problems of sanity that there are two aspects of the subject, the legal and the medical. From the legal standpoint sanity and insanity rest upon conduct; from the medical viewpoint this is not sufficient. We cannot, to be sure, do without the expressive phases-the words and conduct of the individual-since these constitute the only available means of ascertaining the state of his mind. On the other hand, words and acts do not, of themselves, afford a trustworthy index to the condition of mind, because the individual may, either purposely or through accident of education or circumstance, be exhibiting a perfectly conscious discrepancy between them and his thoughts. Only when we are able to establish an abnormality of word and action, flowing out of a corresponding abnormality of thought, are we justified in diagnosing insanity.

To pass upon and to regulate this dual relationship between the mind and its objectives would be none too easy even if its outworking were constant and uniform-if persons always spoke and acted alike under similar conditions. But such is not the case. There is no norm of mentality or of conduct. It might seem that a normal standard could be found, or hypothecated, in an equal balance of mental qualities and a uniform behavior under given conditions. But two considerations put such a standard out of court. (1) The question of sanity is concerned not with hypothetical but with real conditions. (2) The possible variation of both cognition and expression is so wide, and choice is so important a factor in the mental process, that such a poise of qualities and uniformity of behavior, if it could be found, would suggest a defective rather than a normal mentality.

A norm of sanity, therefore, if it exists, is to be sought in other directions than an average of mental faculties and a uniformity of conduct; hence it is hard to see how a normal prophylaxis can be educed out of a sociologic system which rests essentially and solely upon conduct. The problems of sanity have their root in biologic principles and phenomena, and nothing short of an intelligent and orderly application of these biological relations will suffice to adequately deal with the subject, whether for prophylaxis or for

STERILIZATION OF THE UNFIT.

This journal has consistently taken a position against the proposed-and in some States the enacted-policy of sexual sterilization of the insane and criminally unfit, not, as we have been careful to explain, on the ground of soft sentimentality toward the individual victims (for we recognize that no specially cruel physical infliction is involved in the practice), but on the general ground that it exceeds the moral, if not the constitutional, rights of the State over the individual. It is significant that in this position, while we find ourselves at variance with the majority of medical opinion, we are supported by almost every legal authority who speaks or writes upon the subject.

A capital article upon this topic appears in a recent issue of the Medical Record, from the pen of an able and eminent lawyer, which sets the matter in so clear and common-sense a light that we are constrained to quote verbatim from his writing. After characterizing the practice as one "which is debasing alike to the victim and the State," this writer goes on to say:

"No law of the State has any right to exact

revenge. Legal punishment has three functions: Medicinal, deterrent, and retributive. As a punishment is medicinal, it serves the offender; as it is deterrent, it serves the commonwealth; and as it is retributive, it serves the offended party, being a reparation offered to him. To deprive the criminal of the power to procreate, while leaving him the power to indulge in promiscuous intercourse, would not fulfill any of these three functions, even if the procedure itself were legally, ethically, or morally justifiable. As a specific for crime any punishment is a failure. Yet punishment of some kind and degree is necessary for the prevention of crime in general, and for the management of the criminal in particular, and every evil deed must be met with that form of punishment "which will enter into the mind of, excite horror in, and disenchant the recipient." But it is not necessary that it should include a manifestation of that innate savagery from which the human race is not yet quite free, despite centuries of progressive civilization. The first duty of society is self-defense, not revenge. Its next duty is to restore, if possible the criminal to the world as a healthy and useful unit, or, if he prove incurable and irredeemable, to seclude him permanently from society.

If the operation for sterilization is ever to command general approval, it must be voluntary on the part of the person undergoing it, and not compulsory. The idea of sterilization as punishment is not only barbarous, but degrading, and unlikely to have beneficial effect, as it would return the victim to society with all his antisocial instincts aroused and thirsting only for

vengeance.

SALT WATER AS A CAUSE OF CANCER.

In a recent Bulletin of the Ohio State Board of Health, Dr. John W. Hill, a member of the Board, raises an interesting question which, so far as we are aware, has never yet been ventilated, involving at once a contribution to the numerous theories of cancer causation and a novel phase in the matter of public water supply. He quotes a statement from an authority whose identity, unfortunately, he does not remember, that cancer most frequently occurs in people who are accustomed to a liberal use of salt, and over against this assertion he cites the remarkable increase in the cancer rate in the Dutch town of Leuwaarden following the tapping of Lake Leuwaarden of its water supply, a body of water greatly affected by the salt from the German ocean-an increase of over one hundred per cent.