"I rallied from the operation and, because of my almost entire freedom from pain, I thought myself cured, and the doctor declared that my return to perfect health was certain.

"After about five years of partial health I again broke down, completely, and returned to Dr. Battey's care.

"He said I was suffering with inflammation of the womb and bladder (which latter organ I afterwards learned was injured during the operation for removal of the ovaries) and gave me local treatment, for both conditions, for a year and a half.

"He patched me up sufficiently to live out of bed, but real health seemed very remote. Leaving his care, I lived in a very quiet, restful fashion, trusting that Nature might do something for me. Vain hope! Later I tried to reduce the uterine enlargement and relieve the irritation and pain in the bladder, by using various home remedies such as "Viavi," "Orange-Blossom," etc. These remedies, for a year or two, gave me some relief, but, at length, lost their effect entirely. At last, to add to my distress and despair, I became a victim of nervous prostration to such a degree that the physicians in Rome despaired of my life. "In this helpless and hopeless condition I was taken to New York, by my own desire, where you took charge of my case. The rest of medical history you know as well as I do myself. You can, better than I, tell of my cure, for cured I certainly am, because you know just what a physical wreck I was when you first saw me, and how, gradually though surely, through your ministrations, I was brought to my present state of health."

This graphic and impressive history fails to recite many conditions which added to the patient's suffering and drained her waning vitality. A careful examination revealed the following annoying and discouraging complications. Excessive anemia. much loss of weight and great muscular debility; almost constant neuralgia of spine, face and head; habitual insomnia; acute indigestion, in spite of the use of the plainest

and, for the most part, pre-digested foods; obstinate constipation; chronic posterior nasal catarrh; profuse, acrid leucorrhea and a deep fissure of the rectum. In fact, there was hardly an organ in the body which properly performed its functions.

Notwithstanding this formidable array of hitherto intractable disorders, so confident was I of restoring faulty processes and functions to a healthful condition by the kinesipathic resources at my command, that I did not hesitate to promise and expect a permanent cure, and both promise and expectation were fully realized.

By the following October, Miss W. went home very much benefited in every respect. She returned for treatment, at intervals, with constant improvement between them, however, until the Spring of 1898, from which time she dates her complete recov

ery.

The following extract from a letter, written May the twenty-sixth last, shows how permanent the cure has been. "It would do you good to see how strong I am. I am as busy as I can be; can work and house clean all day, and even lift heavy weights with no bad effects."

Were this article not already so long, it might be both interesting and instructive to give, in detail, a description of the different processes employed during the entire course of treatment. Suffice it is to say that they consisted, solely, of mechanical massage and Swedish movements applied, both in a general way for nutritive purposes, and in a specific manner to meet special indications as they appeared. The cystitis and rectal fissure were the last of the diseased states to disappear.

MASSAGE AND GYMNASTICS AS THERAPEUTIC MEASURES.

THAT massage and gymnastics in skilful hands constitute valuable and efficient therapeutic measures of a large range of

applicability, writes the editor of the Journal of A. M. A., is no longer questioned by those who have studied the matter conscientiously. In many of the European countries these forms of mechanical therapy are receiving much more attention and encouragement than seems to be the case in America. In Stockholm there has existed for years a fully equipped, legally authorized and regulated institution-"The Central Institute"-for the instruction and training of properly qualified men and women in massage and gymnastics for therapeutic purposes. In order to enter this institute the applicant must possess the degree of bachelor of arts and the course of instruction and training extends over two or more years. In Berlin we understand that these forms of mechano-therapy are represented by a regularly constituted chair in the university.

Graduates from the Central Institute in Stockholm and from other reputable institutes have settled in various parts of the world and successfully practised their calling, thus becoming in many instances the pioneers in introducing scientific massage and gymnastics. Not a few have found their way to the larger American cities, but up till the present time American physicians have not been sufficiently impressed with the varying degrees of qualification possessed by those who have established themselves as masseurs and gymnasts, and there is no doubt that lack of discrimination may have delayed proper recognition of the value of massage and gymnastics as therapeutic means. No doubt the lack of proper interest in massage and gymnastics on the part of physicians is traceable in large part to the complete absence until recently of any effort to teach students either didactically or practically so much as even the fundamental principles of mechano-therapy.

We have had since the beginning of medical teaching in this country regular courses of lectures on "materia medica and therapeutics," in which there have been marshalled before the bewildered student a vast array of mostly unimportant information

concerning the habitat and origin, Latin naming, modes of preparation and doses of medicinal preparations, together with extensive lists of diseases and conditions in which the various preparations, frequently obsolete, have been used with more or less empirical success. Only the other day the candidates for interneships in one of the largest general hospitals in the country were asked to give Latin or official names of some twenty-five substances used in material medica, among them being such potent and powerful substances as slippery elm bark. It is high time that this sort of teaching should be abandoned. Medical students have enough to remember of importance without being compelled to memorize literally the many useless facts of "materia medica and therapeutics" as ordinarily taught. Now the real place for teaching therapy is the clinic, stationary and ambulatory; it is here that massage and gymnastics, for instance, should be introduced to a greater extent that now seems to be the case; and for two reasons, first, because of the real service of massage and gymnastics when properly used in certain suitable cases, and second, in order that medical students, graduate as well as undergraduate, may observe the practical application of mechanotherapeutic measures by properly-trained persons and witness the actual results thus secured.

PHYSICAL DEGENERACY.

EVERY now and then, declares The Medical Brief, the alarmist rushes into print with the statement that the race is physically degenerating to an extent that promises early extinction.

early extinction. He points to consumption, anemia, early gray hair, the multiplication of dentists, the increase of deaf, dumb, blind and insane as confirming his assertion.

All these things exist, true enough, but not necessarily as demonstrations of his argument. The rapid development of mind

as a world force has diverted much nervous energy from the uses of the body to the sphere of mind. High intellectual centers have been specialized, temporarily weakening man's powers of resistance, making him more sensitive to his environment and more dependent upon art to maintain the equilibrium called health.

But degeneration is not a supreme force turned loose to wreak havoc on the race. There are reactionary factors at work. Life is a complex affair. That strange force called evolution has the whip hand of degeneracy.

If we are more delicate to-day than a hundred years ago, we have more vital tenacity, greater will-power, clearer perception. We have the strong arms of sanitation and hygiene to work in our behalf, advanced medical and surgical science to come to our aid in time of need.

If our physical senses are less keen, our body less swift to react and adapt itself to environment, if we are not so well nourished, we have acquired intellectual riches, expanded the boundary of our limitations. Life is longer, is fuller, possesses greater meaning.

Certain forms of disease have been completely eliminated, others are on the wane. Superstition and fear no longer dominate us. Contagion is less active. We are on the eve of subtle, revolutionary changes in the make-up of man. The study of the nervous system, the blood and the psyche, has given us a wonderful insight into biological law.

Degeneracy is a superficial view of the present status of man. It is real and must have the aid of art for its palliation, but in its very soil are sown the germs of a new and higher life.

THE HYGIENE AND MECHANICAL TREATMENT OF HEART DISEASE.

IN two ways the heart, says Boardman Reed, in American Medicine, may be in

jured by the toxic products of improper digestion as well as by suboxidation and other

faults of metabolism :

(1) Its muscles may be directly impaired by the circulating poisons, and at the same time be poorly nourished, in common with all the other muscles, by the blood previously impoverished from the same cause; and (2) its work may be much increased by the contradiction of the arterioles resulting from the reaction of the alloxuric bodies and other products of imperfect metabolism.

He further states that for the prevention of threatened cardiac hypertrophy and the renal changes that so often accompany it, a suitable diet, not too nitrogenous, and an amount of careful, moderate exercise in the open air, sufficient to oxidize fully the food taken, are indispensable. It should be still more important to regulate most carefully the diet and exercise where the heart and kidneys have already undergone pathological changes from the irritation produced of an incomplete proteid catabolism. The uratic group of products of tissue metabolism has now been studied much more fully than the other leucomains. Some of these catabolic products, while no less toxic than the zanthins, apparently act, to judge from clinical experience, in a different way, weakening the cardiac muscle and producing a rapid, irregular pulse with a tendency to degeneration or dilatation, rather than hypertrophy of the heart.

Summing up his interesting article, he

says:

Cardiac disease is often due to autointoxication, especially to poisoning by the alloxuric bases; cure or amelioration in such cases requires at first in addition to an appropriate diet, not too nitrogenous, the utmost practicable rest of the crippled organ. The cardiac rest may be further promoted by very gentle exercises which dilate the capillaries without taxing the heart; the Nauheim method of treatment spares the heart by dilating the too contracted arterioles in two ways: (a) by stimulating the peripheral circulation through carbon

ated saline baths; (b) by massage and forms of exercise so mild as not to quicken the pulse.-Charlotte Medical Journal.

THE ANTIQUITY OF THE VICES. THE letters and inscriptions of Hammurabi, a king of the Babylonian dynasty, dating back to 2200 B. C., which have recently been translated, throw most interesting light not only upon the antiquity of vices of a financial kind, but also upon the manner in which they were punished in those faraway days. In one of these letters Hammurabi notifies his correspondent that a case of bribery has been reported to him, and that the man who offered the bribe, the man who took the bribe, and a witness to the transaction are in Babylon. The officer is further notified to apprehend all these men, as well as to "set a seal upon the money or upon whatsoever was offered as the bribe, and cause it" and all the parties to be brought before him for summary punishment. The outcome of the case is not reported, but as Hammurabi, the Amraphel of Genesis, was absolute in power, it is not unlikely that two Babylonians lost their heads as a salutary warning to others.

The second letter bears upon the question of money lending in those ancient days. A serf had informed the king that Ani-ellati, a notorious usurer, had laid claim to certain lands which belonged to him and had appropriated his crops. The king, after looking into the matter, found that the usurer held a mortgage upon only a small part of the serf's acres, and ordered that his pledge should be returned to him and that the usurer should be brought to him for punishment, the registry of title being held sufficient to defeat a usurious claim a feature of land laws which, curiously enough, is now advocated in England.

Those two letters, over 4,000 years old, show not only the antiquity of the vices of greed, but also the excellent manner in which justice was administered sometimes

in the early days of the race. In the bribery case the briber was held as equally guilty with the bribed. In the usury case the Babylonian Shylock lost not only his interest, but his principal, and was punished besides. In the bribery matter the king was determined not to touch the hush money, 400 ounces of gold, so he ordered his officials to return it to the briber, after deducting 398 ounces for legal expenses and two ounces for fees to the servants, which showed that Hammurabi was crafty as well as just. Justice after all has not made much advance in the last forty-one centuries; on the other hand, its administrators to-day might learn a useful lesson from the study of the Hammurabi tablets.-Chicago Tribune.

"RIZZLING" AS A THERAPEUTIC AGENT FOR INDIGESTION AND NERVOUSNESS.

"RIZZLING" is a new term in therapeutics and everywhere else. It is thus explained by a physician, who states that it is the most wonderful aid to perfect health. "I masticate my food very thoroughly at dinner,” he says, “and make sure to have my family or friends entertain me with bright talk and plenty of fun. After dinner it is understood that I am going to rizzle. How do I do it? I retire to my study, and, having darkened the room, light a cigar, sit down, and perform the operation. How to describe it I don't know, but it is a condition as nearly like sleep as sleep is like death. It consists in doing absolutely nothing. I close my eyes, and try to stop all action of the brain. I think of nothing. It only takes a little practice to be able to absolutely stifle the brain. In that delightful condition I remain at least ten minutes, sometimes twenty. That is the condition most healthful to digestion, and it is that which accounts for the habit animals have of sleeping after eating. I would rather miss a fat fee than that ten minutes' rizzle every day."-Chatter.

Book Reviews

THE DIAGNOSIS OF SURGICAL DISEASES. By Dr. E. Albert, late Director and Professor of the First Surgical Clinic at the University of Vienna. Authorized translation from the eighth enlarged and revised edition, by Robert T. Frank, A.M., M.D., with fifty-three illustrations. New York: D. Appleton and Company, 1902.

This timely octavo of 420 pages, issued in the now well-known style of the Appleton house, which means superb paper and perfect press-work, is without a direct substitute or competitor in medical literature.

There is no dearth of works on medical diagnosis, but in the surgical field this branch of knowledge is for the most part scattered through text-books on surgery. Works exclusively devoted to surgical diagnosis are not only rare but the few that are available are little known and hardly satisfactory.

The distinguished author of the volume before us possesses those literary qualifications which are rare among medical writers -directness, perspicuity and terseness. Still more fortunate is the fact that his translator has not been tempted to detract from nor dilute his style, if we may so express it.

In his modest preface, Dr. Frank avoids even the remotest tendency to redundancy, and gives the reader in a nutshell an excellent earnest of the scope and plan of the work. He says:

"This volume presents to the practitioner and to the student the problems in diagnosis which confront them at the bedside. In order to achieve this object theoretical classifications are not adhered to; instead, diseases are grouped according to similarity of symptoms and points of general resemblance -considerations which in practice render their differentiation difficult. In this way the advantages of clinical teaching are most nearly attained, and by the presentation of a large number of cases, the value of this

arrangement is further enhanced. The fragmentary and disjointed instruction which clinical demonstration necessarily entails, even under the most favorable conditions, is thus systematized. Moreover, whenever feasible, the cases reported are followed to the operating table, at times to autopsy, either to confirm or to correct the diagnosis."

Certainly, there exists a demand for such a work, and this volume supplies the demand, and supplies it in a thoroughly satisfactory manner.

If we were to offer a single criticism it would be that the illustrations are not of as high order as we have a right to expect in these days of the illustrative mania and of inexpensive art. However, the cuts illustrate the text, and that is the purpose for which they are used. The criticism is based on an artistic and not a utilitarian sense.