DOCK'S HISTORY OF NURSING. A History of Nursing from the Earliest Times to the Present Day, with Special Reference to the Work of the Past Thirty Years. Edited and in part written by Lavinia L. Dock, R. N., Secretary of the International Council of Nurses; Graduate of the Bellevue Training School, New York City. In four volumes, Volume III-IV. G. P. Putnam's Sons, New York and London. 1912.

In these two volumes Miss Dock discusses the rise of nursing to the modern stage now in vogue all over the world. For instance, about half of Volume 3 is devoted to a history of nursing in Great Britain and Ireland. Then follows a chapter on the marvellous development of nursing in the United States; then chapters on nursing in northern Europe and France.

In Volume 4 there are chapters on the rise of the German free sisters, and on nursing in Switzerland, Holland and Belgium; finally, nursing in the Orient-China, India, Japan, and "the islands of the sea", come in for discussion.

Especially interesting are those later chapters, many of which are really records of one phase of medical missionary work, which is filled with stories of heroism with which every American heart should be thrilled.

This is a most interesting book. Nursing is closely bound to medicine. The latter's success depends largely upon the former's efficiency. Every physician should understand what our sisters of the white cap have accomplished-and how better can he learn this than by reading this book?

There seems to be a recrudescence of interest in the Eclectic materia medica, thanks to the activity of a group of able and enthusiastic men, who happen to be good writers as well as energetic and conscientious Eclectic physicians. Dr. Fyfe's new book gives emphasis to this state

ment.

This volume is built around and upon the late Professor John M. Scudder's two books, "Specific Diagnosis" and "Specific Medication." the essential parts of these books have been reproduced in the author's own words, but much new material has been added, derived from a variety of sources, so as to bring the work thoroughly down to the times and abreast with modern advancement and discovery.

Professor Fyfe has done this work well, and the present volume is in many respects a remarkable one. We can hardly understand how any Eclectic can get along without it, and we are sure that no physician, whatever his sectarian affiliations, can read it without deriving therefrom very material help.

The book is well printed and bound. The setting is appropriate to the content of the volume.

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STENHOUSE'S EPITOME OF PATHOLOGY. A manual for Students and Practitioners. By John Stenhouse, M.A., B.Sc. (Edin.) M.B. (Tor.), formerly demonstrator of Pathology, University of Toronto, Toronto, Canada. Second edition, revised and enlarged; including selected list of State Board Examination Questions. 12mo, 27 pages, illustrated. Cloth, $1.00, net. Lea & Febiger, Publishers, Philadelphia and New York, 1913.

While this little book is, of course, not intended as an authoritative work for physicians, many of whom will prefer a larger and more exhaustive presentation of the subject, there are few who can not use it occasionally with very decided advantage. When it is desired to look up something quickly to get the gist of a topic in a very few words, books like this have a very real utility for

the general practitioner. Dr. Stenhouse's little work is certainly one of the best of its kind.

The writer of this review was particularly interested in the chapter on Immunity, which, considering the space consumed, certainly covers the topic in a satisfactory manner. The chapter on Post Mortem Examinations is also very practical and should be helpful to many a man forced to make an autopsy on short notice. One feature of the little book which will appeal to senior medical students is the list of questions on pathology asked in the various state examinations for licensure. The embryo doctor will think these worth the price, even if he doesn't read another thing in it. On the whole, therefore, we feel sure that any physician who may purchase this volume will feel well satisfied with his bargain.

DUDLEY'S GYNECOLOGY.

The Principles and Practice of Gynecology, for Students and Practitioners. By E. C. Dudley, A. M., M. D., ex-president of the American Gynecological Society; Professor of Gynecology, Northwestern University, etc. Sixth Revised Edition, with 439 Illustrations and 24 full-page color plates. Lea & Febiger, New York City, 1913. Price, $5.00.

Dudley's Gynecology is too well known to require any introduction to the readers of this journal.

The preceding editions have been reviewed in these pages, so that more than once we have had opportunity to testify to its value, especially to the general medical readers. This edition shows evidence of careful overhauling and very general revision. Several chapters have been entirely rewritten, and much new matter and a number of new illustrations added. The book is assuredly fully abreast of modern developments in gynecology.

While it is difficult to select any one part of the book as being better than any other part, we feel impelled to praise particularly the technical descriptions of operative work. In this special field Doctor Dudley has few peers, and he knows how to describe clearly as well as operate skillfully. Especially noteworthy is his description of the steps in perineorraply, an operation in which many physicians are greatly interested.

Dudley's Gynecology is a good book to own. While few physicians can be gynecologists, every physician should know something very definite and clean-cut about the diseases of women. This book is a reliable and helpful guide and-to stretch the meaning of the word somewhat-"encyclopedia" for this special field.

MANTON'S EPITOME OF OBSTETRICS. A Manual for Students and Practitioners. By W. P. Manton, M. D., Professor of Obstetrics and Clinical Gynecology, Detroit College of Medicine, Detroit, Mich. Second edition, revised and enlarged; including selected list of State Board Examination Questions. 12mo, 292 pages, with 97 engravings. Cloth, $1.00, net. Lea & Febiger, Publishers, Philadelphia and New York, 1913.

Here we have another volume in the excellent "Medical Epitome" series-not an exhaustive work on obstetrics, but a wonderfully complete condensation of facts with which every doctor should be familiar. As an outline for study it is excellent, and we imagine it will be principally used for that purpose. Medical students will assuredly find it a convenient pocket companion; and there are few physicians who can not get occasional help from its pages.

THE THERAPY OF CHRONIC COUGHS.

The logical therapy of chronic coughs does not lie in the use of soothing expectorants whose main purpose is the blunting of the mucosa's sensibility and which do not really help the bronchial tree free itself of the cough's cause such treatment is palliative.

The logical treatment of chronic coughs embraces the continued use of a tissue food which will enable the system to throw off a cough-Cord. Ext. 01. Morrhuæ Comp. (Hagee) for instance. Cod liver oil in the form of this cordial quickly demonstrates its marked value in this condition.

statement made by headquarters that Armour's Pepsin is without superior.

THE TREATMENT OF RHEUMATIC INFECTIONS.

The book bearing the above title comes from the press of Parke, Davis & Co., and is the story of the remarkable results achieved with phylocogens in the treatment of rheumatism.

After a preliminary chapter, telling of the history of these preparations, describing their modus operandi and giving details of their mode of employment, a special article on Rheumatism Phylocogen follows, with reports of many cases, drawn from the experience of many physicians. Certainly this is a book which will interest any physician having cases of rheumatism to treat. It is, presumably, furnished to physicians on request..

THE PNEUMONIA CONVALESCENT. While the course and progress of acute lobar pneumonia is short, sharp and decisive, the impression made upon the general vitality is often profound, and apparently out of proportion to the duration of the disease. Even the robust, sthenic patient is likely to emerge from the defervescent period with an embarrassed heart and general prostration. In such cases the convalescent should be closely watched and the heart and general vitality should be strengthened and supported, and this is especially true as applied to the patient who was more or less devitalized before the invasion of the disease. For the purpose indicated, strychnia is a veritable prop upon which the embarrassed heart and circulation can lean for strength and support. strength and support. As a general revitalizing agent is also needed at this time, it is an excellent plan to order Pepto-Mangan (Gude), to which should be added the appropriate dose of strychnia, according to age, condition and indications. As a general tonic and bracer to the circulation, nervous system and the organism generally, this combination cannot be surpassed.

Volume XXXVII.

Number 4.

APRIL 1914

THE USE OF NARCOTIC DRUGS IN THE

SOUTH.

That the use of narcotic drugs is increasing much more rapidly in the southern states than in the north, is a fact pretty generally understood, although the extent of this abuse of these dangerous agents is not generally appreciated.

According to Dr. Edward H. Williams, who has contributed an interesting article upon this subject to the Medical Record of February 7, the percentage of drug-takers in the hospitals for the insane of New York State is only 1 in 386 persons. On the other hand, in Georgia, this proportion is 1 in 42; in North Carolina, 1 in 84; in one Tennessee hospital, 1 in 74; in one Mississippi institution, it is 1 in 46, and in another 1 in 23. In other words, the proportion of drug-takers admitted to the insane-hospitals in the South is from five to fifteen times as great as it is in New York State. Nor is this increase entirely among the negroes. Indeed, as regards the use of morphine, the number of habitués of that drug seems to be greater among whites than among blacks.

The principal drug used, however, is cocaine, and this substance works its greatest injury among the colored population. Doctor Williams declares, further, that the majority of the cocaine-takers do not reach the insane-hospitals, and this mainly because they are intercepted on their way to that termination by various institutions for the punishment of crime. In other words, the cocainetaker is very likely to become a criminal, and some of the penal institutions of the South are already taxed to their capacity by these "fiends," and the authorities admit their inability to prevent colored people from getting their supply. There is an enormous underground traffic in the drug, and any negro who can scrape together the few cents necessary can secure a supply whenever he wants it.

Doctor Williams declares that the negro who has become a cocaine-dope taker is a constant menace to his community. "His whole nature is changed for the worse by the 'habit'. Sexual desires are increased and perverted, peaceable negroes become quarrelsome, and timid negroes

develop a degree of 'Dutch courage' that is sometimes almost incredible. A large proportion of the wholesale killings in the South during recent years have been the direct result of cocaine, and frequently the perpetrators of these crimes have been hitherto inoffensive, law-abiding negroes."

A peculiar feature to which Doctor Williams calls attention is the fact that the drug renders its user immune to shock to an astonishing degree. An ordinary bullet will not stop an individual who is crazed with the drug, and it is declared that the police officers in the South have increased the caliber of their guns for the express purpose of "stopping" the cocaine-fiend when he runs amuck.

Why is it that the negroes have taken to cocaine? Doctor Williams' answer to this question is a novel and interesting one. A colored man to whom he put the question, as to why he began taking cocaine, answered by saying, "Because I couldn't get nothin' else, Boss". This, Doctor Williams thinks, is the key to the situation. The use of cocaine has increased in the South for the simple reason that the negroes have been denied the use of alcoholic drinks.

During recent years this whole section has been swept by a wave of prohibition legislation. The white men themselves can secure all the alcohol they want without difficulty, but, realizing its disastrous effect upon the negro population, they have made it virtually impossible for the colored people to secure drink in any form. This is the reason, declares Doctor Williams, why the negro has taken to habit-drugs. They produce pleasant intoxicant effects that appeal to their senses. He declares that it is a significant fact that in such cities as Raleigh, Asheville, and Knoxville, where saloons have been abolished, the use of cocaine is increasing at an alarming rate.

Whether Doctor Williams' explanation is the correct one or not, we do not know, but, frankly, we view it with suspicion. It amounts to the statement that vice of some kind is a necessity, and that as between two evils we should accept the least. We have enough faith in human nature -even in negro human nature-to believe that it

is quite possible to wipe out all drug habits in the South-even the alcohol habit. But, the negro should be considered as a teachable child, and a course of systematic instruction undertaken which will show him where these vices inevitably lead. We have an excess of reformers here in the North; why not send some of them South for that educational purpose?

THE QUARANTINE OF CONTAGIOUS
DISEASES.

The Chicago Department of Health has at last recognized the fact that the iron-clad quarantine which has been in vogue in this city was in reality inoperative as the result of its very stringency, and Commissioner Young has, accordingly, evolved a new plan for the segregation of the patient, which, while on its face much more liberal than any heretofore attempted, really promises to accomplish far more than was possible under the old regulations.

The trouble with the older method was, that it imposed such actual hardships upon the people, and especially upon people who were compelled to work for a livelihood and to whom the compulsory quarantine was such a real disaster, that they sought every means of evading it. The attending physician was constantly put under pressure by his patients and their families, constantly being importuned not to report cases of this character. As a result, there probably were thousands of cases of diphtheria, scarlet-fever, measles, and other contagious diseases that never reached the attention of the health-authorities.

recent

Furthermore, as is pointed out in a Bulletin of the Department of Health, "there are a very considerable number of people who comply with the law to the extent of reporting their cases, but who, while to all outward appearances observing quarantine precautions, are rank violators with respect to complete isolation of the patient and attendant."

This second class is probably a source of even greater danger than the first, since the physician who takes upon himself the responsibility for the spread of the disease is likely to insist upon the maximum care in isolation and in household sanitation.

The new rules of the Health Department, which *ook effect March 1, undoubtedly will relieve much of the tension. The city is divided into one hundred school-inspection districts, and these districts are again subdivided into field-districts and quarantine-districts. A force of inspectors and nurses are to be assigned to each division, who will be charged with the enforcement of the regulations. Hereafter, when it is possible to isolate the

patient in a portion of the house so that he will not come into contact with other members of the family, such members will be permitted to go about their work in their usual way, with the exception that children in apartments or dwellings where the patient is quarantined must not be permitted to attend school or other public places of assembly. Furthermore, in cases of diphtheria, for instance. those living in such families and who wish to attend to their usual duties will be subject to inspection and will only be permitted to go about providing cultures taken from their throats show negative results as regards the presence of the organisms of the disease. Even the attendants who have direct charge of the care of the sick may be prohibited from leaving the house except under certain restrictions, the most important of these being the absence from their throats of the diphtheria bacilli.

The essence of this ruling is that the patient must be kept in a room apart from the rest of the house and that no one shall be permitted to enter this room except the personal attendants. It recognizes the fact, now well established, that the principal source for the conveyance of the disease is the "carrier," and that mere contact with a person sick, with diphtheria, scarlet-fever, measles, whooping-cough, and similar diseases is not sufficient for the transmission of the disease to a third party.

Naturally, we cannot give the details of the new regulations in their completeness. They are printed. in full in the Bulletin of the Department of Health for February 21, 1914, and those who are interested should secure a copy of this issue; however, we wish to register at this time our hearty approval of the plan, which is distinctly a step forward, and which, in our opinion, will have the effect of decidedly reducing the incidence of contagious diseases in Chicago.

We commend the method to other cities who still maintain the old-fashioned "shotgun quarantine" of our grandfathers. The day of unintelligent force and subservience to iron-clad rules, and of inadequate care in handling of the sick is rapidly passing. It has gone out entirely in the treatment of such diseases as yellow-fever and plague. It should go out at once in the management of diphtheria and scarlet-fever.