NA TURE 



461 



THURSDAY, MARCH 14, 1901. 



A MANUAL OF MEDICINE. 



A Manual of Medicine. Edited by W. H. Allchin, 



M.D., F.R.C.P., F.R.S. Edin. Vol. i. Pp. viii + 



. 442. Plates 2 ; and Vol. ii. Pp. viii + 380. Plates 2. 



(London : Macmillan and Co., Ltd., 1900.) yj. 6d. 



net each. 



THE work before us is to consist of five volumes, and 

 will thus eventually cover some 2000 pages ; the 

 term manual, therefore, by which it is designated, applies 

 rather to each individual volume than to the whole work. 

 It is essentially a system of medicine. It can be seen at 

 a glance that the book is of an essentially different type 

 from AUbutt's system, recently completed. It deals much 

 more succinctly with the respective subjects, and contains 

 no bibliographies. We assume from this — there is no 

 preface — that the work is intended not so much for a book 

 of reference as a text-book for students, and as a handy 

 reference book for practitioners. In the space at our 

 disposal it is impossible to consider at all fully the two 

 volumes before us, and nothing remains but to take a 

 few of the most important monographs as types. 



Vol. i. begins with an introduction by the editor, in 

 which he discusses the bases of our conception of disease 

 and the classification of diseases. He concludes by adopt- 

 ing the orthodox classification, viz. local, or diseases of 

 individual organs, and general, or those diseases in which 

 the entire body is concerned and no preponderance of 

 symptoms in one region occurs. It is with this latter 

 class of diseases that both the volumes before us are 

 concerned. The general diseases are again divided into 

 those of extrinsic and intrinsic origin ; the former in- 

 cluding abnormal states caused by atmospheric influences, 

 parasites, vegetable and animal, and poisons introduced 

 into the body as such ; the latter comprising primary 

 perversions of general nutrition and diseases of the 

 blood. 



The infections are treated by Dr. Sims Woodhead. 

 The article includes the bacteriology of the subject, in so 

 far as its essentials are concerned, and bacteriological 

 chemistry, a consideration of toxins, anti-toxins, im- 

 munity and, finally, a classification of the infective diseases 

 met with in man, arranged according to their cause. 

 The same author writes upon sapraemia, septicaemia and 

 pyaemia. Dr. Hale White communicates a succinct article 

 upon fever. He discusses the factors at work in the 

 production of fever which differ from the physiological 

 standpoint, and enters at some length into the parts played 

 by increase of heat production and diminution of heat 

 loss. According to him fever cannot, from the standpoint 

 of its physiological cause, be regarded as an entity, the 

 method of its production varying with the cause. The 

 author concludes by indicating the methods which should 

 be employed to reduce fever. Dr. Cayley contributes a 

 full clinical monograph upon typhoid fever. The article 

 is very carefully written, and, considering the space it 

 covers (twenty odd pages), is very complete. It is inter- 

 esting to note that the author considers " the evidence 

 for the preventive action of the typhoid vaccine much 

 stronger than that for the curative action of the serum," 

 NO. 1637, VOL. 63] 



and recommends its trial "during epidemics and in 

 persons, like nurses, who are especially exposed to 

 infection." 



Plague and cholera are dealt with by Dr. Cantlie. 

 The author gives the results of Hafkine's inoculations in 

 both these diseases. The articles upon dysentery, 

 leprosy, malaria and several other tropical diseases are 

 also written by Dr. Cantlie. The chapter on diphtheria 

 is by Dr. Foord Caiger, and includes a most instructive 

 table compiled from the total admissions into the Metro- 

 politan Asylums Board hospitals of patients suffering 

 from this disease. The table deals with a total of 25,000 

 cases, the ages of which vary from one year to sixty, and 

 shows that while the average mortality of the whole is 247 

 per cent., the mortality in children between one and two 

 years old is 50*2 per cent. The satisfactory results of the 

 treatment of diphtheria by anti-toxic serum are evidenced 

 by the dictum of the author " that a dose of from 2000 to 

 8000 units of anti-toxin should be given at the earliest 

 moment in every case when the patient is a child." The 

 articles on Rotheln, measles, scarlet fever and chicken- 

 'pox are from the pen of the same author. 



Dr. Monckton Copeman supplies two monographs, 

 upon small-pox and vaccinia respectively. In the article 

 on small-pox reference is made to the work of Mr. Power 

 concerning small-pox hospitals acting as a source of 

 infection through the small-pox contagion being carried 

 from them for a certain distance through the air. The 

 importance of this fact cannot be over-estimated, and it 

 is to be hoped that definite results, quantitative with 

 regard to distance, will be obtained in this regard for 

 other infectious diseases. The article on vaccinia in- 

 cludes extracts from the Report of the Royal Commission 

 on Vaccination (1898), and also a consideration of the 

 technique of vaccination. 



In vol. ii. general diseases are continued. Dr. T. W. 

 Shaw and Dr. James Cantlie contribute articles upon the 

 diseases caused by parasites. Dr. Poore, conjointly with 

 the editor, writes upon diseases determined by poisons 

 introduced into the body as such — alcohol, morphine, 

 cocaine, phosphorus and the ordinary metallic poisons 

 being dealt with. Dr. Lazarus-Barlow contributes a 

 general article upon inflammation and its sequels, and 

 the editor one upon malignant disease. The possible 

 parasitic origin of malignant growths is discussed shortly 

 but adequately, and the references to the chief of the 

 many exhaustive monographs upon this subject are given, 

 a method, it may be noted in passing, which might have 

 been advantageously adopted more frequently throughout 

 the book. A short but interesting essay upon rickets is 

 contributed by Dr. Coutts. The aetiology of this disease 

 is only very shortly discussed ; but it is instructive to 

 note that the author directly contradicts the assertion 

 that rickets never occurs in children fed entirely on 

 mothers' milk. It is of the greatest possible importance 

 to the public health to be quite clear upon this subject ; 

 the universality of rickets and the profound extent to 

 which it affects the subsequent growth and activity of the 

 various organs of the body is probably unsurpassed by 

 any other morbific agency. Two articles upon diabetes 

 mellitus and insipidus, respectively, are written by Dr. 

 Bertrand Dawson. The article on gout is by Dr. Luff. 

 In writing a short article presumably for students one 



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