try to realise these facts, it might lessen the bitterness, and, I must add, unfairness with which these Acts have been assailed. I think that if the money spent in fruitless attempts to effect their repeal, which sum was stated by one of their own witnesses to be £3,000 a year, were used in assisting the existing Lock hospitals, and providing new ones where they are most required, it would be spent more profitably. And to those who are disposed to pin their faith upon the repressive measures at present adopted in Glasgow, I would repeat the admirable words of Sir Henry Thompson, published fifteen years ago:"I know of one way only on which we can rely for checking the disease; it is not by hunting down the prostitute, and chasing her from one retreat to another-a treatment which increases her recklessness and propagates contagion-but, on the contrary, by caring for her health and regulating her habits."

REVIEWS.

The International Encyclopædia of Surgery. Edited by JOHN ASHHURST, Jr., M.D., Professor of Clinical Surgery in the University of Pennsylvania, in six volumes. Volume II. Macmillan & Co., London. 1882.

THE Second Volume of this copious compilation is not long in following the issue of the First. Like its predecessor, it is composed of numerous articles, chiefly by American authors, the only non-American contributors being three Englishmen― Thomas Bryant, Watson Cheyne, and Howard Marsh. We shall adopt a similar method of review to that employed in the First Volume, giving a brief reference to the various articles separately.

The opening article, upon Contusions, by Hunter M'Guire, M.D., Emeritus Professor of Surgery in the Medical College of Virginia, Richmond, though brief, is a needless addition to and subdivision of a subject adequately treated of in the article upon wounds in general, which immediately follows.

Wounds, by Thomas Bryant, F.R.C.S., Surgeon to and Lecturer on Surgery, Guy's Hospital, London. One or two points are worthy of notice in the article by this experienced surgeon. Foremost is his attack upon and disbelief in the Germ Theory. In support of his opposition, Mr. Bryant adduces facts which,

so far as we can see, have no bearing whatever upon the question. His arguments, to begin with, are based upon a false premise. Thus, to quote his own words:-"Attempts have been made to assign to the presence of germs every evil influence, and to regard these as the cause of inflammation and suppuration in every open wound;" and then follow examples to show that in tenotomy, where air is excluded, inflammation and suppuration may take place, and in fractured ribs with emphysema there may be no inflammation and suppuration. These illustrations may support his own allegation, but in no way affect the true intent of the Germ Theory. Inflammation and suppuration are in many cases perfectly natural processes of repair, and those which nature adopts to get rid of what she cannot absorb. Not unfrequently, also, the antiseptic itself, from its possessing irritating properties, may be the cause of slight overaction. But inflammation may be moderate or excessive; pus may be laudable or putrid, and while germs may in no way affect the production of healthy inflammation, they may-as the germ theorists would assertbe the immediate cause of an unduly excessive inflammation or the discharge of putrid pus. Again, the fact of one wound presenting the appearance of undue overaction, while another, apparently under the same circumstances, shows no such signs of undue overaction, is no proof that the Germ Theory is untenable. Germs need a suitable nidus, and it is perfectly possible to conceive numerous conditions, such as those constitutionally affecting the patient or locally dependent upon the production of the injury which may, in some cases, conduce to excessive action, whilst in others to no such abnormal increase. If Mr. Bryant wishes to disprove the theory by facts, let him bring such forward as will show that under the strictest influence of those means that have been found to prevent the fermentation or putrefaction of organic fluids by the destruction of the germs upon which these processes depend, wounds will themselves become septic. Mr. Bryant professes to be an "antiseptic" himself, and uses as his "cleansing" agent a solution of iodine (20 drops to the ounce) which he maintains has, besides being an antiseptic, the additional advantage of arresting all capillary hæmorrhage. His opinion of the unhealthy action of a wound may be expressed in his own words-"I am disposed to think that it is not the mere exposure of a wounded part to the influence of air that does the harm, but its prolonged exposure." No attempt is made to ascribe any reason for this, but the germ theorists no doubt can readily enough assign one. We have

attacked what we think the weak side of Mr. Bryant's article ; on the other hand, did space permit, there is much worthy of notice, but we must leave it to reward those who will take the trouble to read what is a valuable contribution to the work.

The Antiseptic Method of Treating Wounds, by W. Watson Cheyne, M.B., F.R.C.S., Assistant Surgeon to King's College Hospital, and Demonstrator of Surgery in King's College, London. As Mr. Cheyne hails from the same hospital as the propounder of the great theory which his article illustrates, and as a known ardent disciple of the same, we may take it for granted that his contribution is but an epitome of the teaching and practice of Mr. Lister himself, and this fact alone will cause no little interest to be attached to it. One perhaps, of the most laudable points in Mr. Cheyne's article, is the clear distinction which he shows to exist between what is more generally known as "Antisepticism" and and "Asepticism" or "Listerism." While the former is a system claimed and practised by every surgeon, the latter is a principle based upon a definite theory, and carried out with an exclusive regard for that theory. Thus, the "Aseptic" or "Listerite" believes in the existence of certain particles in the air (germs) which have the power to excite in wounds a fermentative or putrefying process, and to prevent the influence of these germs, certain known re-agents destructive to them are used. These are various, and used in various ways. So that, as Mr. Cheyne points out, it is not upon any particular parasiticide used, or any particular method employed to use it, that Listerism depends, but solely upon the principle of the Germ Theory. The spray, with which some surgeons seem to delight as much in deluging their patients, as in sopping themselves and their assistants, is no essential in the aseptic method. "The spray is a convenience (?) not a necessity." On "dressings" a definite rule appears to be followed, and as we may assume it to be the practice of le grand chef, it is well to notice it as differing very much from the frequent practice of many of Mr. Lister's most ardent disciples. "The dressing is always changed on the day following the operation, and afterwards the rule is, that if at the hour of the ordinary visit discharge is found at the edge of the dressing, it is changed; if not, it is left till the next day, when the same rule is followed. The dressing is never left longer than a week unchanged."

Poisoned Wounds, by John H. Packard, M.D., Surgeon to the Episcopal Hospital, and to St. Joseph's Hospital, Philadelphia. Though fitting that to the subject of Hydrophobia, Malignant Pustule, and Glanders, a separate and distinct con

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sideration should be ascribed, yet it is a mistake that they should have been dissociated from the present article, under which they could and would have been most suitably discussed. They are briefly referred to by Dr. Packard, in contrast to other affections described, and for the better means of comparison, a complete description here would have been certainly preferable.

Sabre and Bayonet Wounds; Arrow Wounds, by J. H. Bill, M.D., Surgeon and Brevet Lieutenant-Colonel United States Army. The greater part of the article is devoted to the last class of injuries, and in a manner which suggests a perfect knowledge of this particular kind of wound. The experience of the author leads him to the conclusion that under all conditions, the arrow head must be sought for and removed.

Gunshot Wounds, by P. S. Conner, M.D., Professor of Anatomy and Clinical Surgery in the Medical College of Ohio, Cincinnati; Professor of Surgery in Dartmouth Medical College, &c. This appears to be a tolerably complete article upon the subject. The earlier portion is devoted to the consideration of wounds generally, the later to the injuries of special parts. The treatment recommended is, in most cases, ably supported by the results obtained from carefully tabulated statistics, collected from the various military reports.

The Effects of Heat, by T. G. Morton, M.D., Surgeon to the Pennsylvania Hospital, and to the Orthopedic Hospital; Consulting Surgeon to the Jewish Hospital, Philadelphia, &c. In this article are contained, besides the ordinary effects of burns and scalds, those resulting from Sunburn, Corrosive Acid, Caustic Alkalies, &c., and Lightning Stroke. The statistics with reference to the last form of injury are interesting, from showing the high annual rate of mortality it causes; thus, in France, "10,000 persons are reported as having been struck during a period of 29 years, and of this number 2,252 were instantly killed; while in the United States, during the year 1870 alone, 202 deaths from lightning stroke were recorded." Several interesting temperature charts are introduced, showing that, as the temperature rises after a burn, so does albumen appear, and its quantity proportionately increase, while the specific gravity, on the other hand, diminishes. As the fatal issue approaches, renal epithelium casts and blood corpuscles frequently appear in the urine. On the subject of treatment more might have been said upon the various methods of dealing with cicatricial deformities.

The Effects of Cold, by J. A. Grant, M.D., M.R.C.P., London, F.R.C.S., Edinburgh, Physician to the General Protestant

Hospital, Ottawa. This article deals with Chilblains, Frostbite, and the Constitutional Effects of Cold. It is very short and seems as much contributed to by the Editor as by the Author. Abscesses, by Howard Marsh, F.R.C.S., Assistant-Surgeon to St. Bartholomew's Hospital, London. Together with the discussion of Sinuses and Fistulæ, the article forms a very practical contribution.

Ulcers, by John T. Hodgen, M.D., LL.D., Professor of Surgical Anatomy in St. Louis Medical College, St. Louis. It is, we think, to be regretted that this article does not include every form of ulcer, restricted as it is to but about half-a-dozen, depending upon non-specific causes. Thus, ulcers resulting from Malignant Disease, from the different diathesis as Struma, Syphilis, Gout, &c., which are omitted, are often themselves the local diagnostic indication of the constitutional disorder, and not unfrequently the sole perceptible manifestation of the otherwise obscured diathesis.

Gangrene and Gangrenous Diseases, by E. M. Moore, M.D., Professor of the Principles and Practice of Surgery in the University of Buffalo. Under this head are included, besides the more marked forms of Gangrene, Noma, Bedsores, Boils, and Carbuncles. The portion of the article dealing with the last class is especially worthy of notice, and more particularly that part of it which describes its pathology and treatment.

Gonorrhoea, by J. William White, M.D., Demonstrator of Surgery and Lecturer on Venereal Diseases in the University of Pennsylvania; Surgeon to the Philadelphia Hospital, Philadelphia. This is an admirable article in every sense, alike as worthy of commendation for the style in which it is written as for the material which it contains. It is exhaustive on the literature of the subject, and eminently illustrative of the practical skill as well as the theoretical knowledge of the author.

The Simple Venereal Ulcer or Chancroid, by F. R. Sturgis, M.D., Professor of Venereal Diseases in the University of the City of New York; Visiting Surgeon to the Third Venereal Division of Charity Hospital, Blackwell's Island, &c., New York. In a clear disquisition on the subject, the author first discusses the nomenclature of the ulcer, showing the ambiguity with which the current terms "Chancroid" and "Chancre," are invested, and preferring in their place what rather approaches a definition than a name, "The Simple Venereal Ulcer" and "The Initial Lesion of Syphilis." The author ranks with the Dualists in his views, treating the ulcer as essentially local, perfectly distinct from syphilis, and never