NATURE 



465 



THURSDAY, SEPTEMBER 16, 1897. 



A SYSTEM OF MEDICINE. 

 A System of Medicine. Edited by Thos. Clifford Allbutt, 

 M.A., M.D., F.R.S., &c., Regius Professor of Physic 

 in the University of Cambridge. Vol. ii. Pp. xiv + 

 1175 ; with T] illustrations, 6 charts, i map, and i plate. 

 (London: Macmillan and Co., Ltd., 1897.) 



THIS, the second volume of Prof. AUbutt's "System," 

 the first volume of which was reviewed in these 

 columns (Nature, August 20, 1896), has been delayed 

 somewhat in its appearance owing to a desire on the 

 part of the editor and the corresponding contributors to 

 profit by the results of the Vaccination Commission. 



The volume commences with the infective diseases 

 of chronic course, Dr. Sidney Martin contributing the 

 article on tuberculosis, Dr. Phineas Abraham on leprosy. 

 Dr. Acland on actinomycosis and Madura foot. Dr. 

 Martin discusses the setiology of tuberculosis and the 

 various lesions resulting from tubercular infection ; also 

 the varieties of experimental tuberculosis, immunity, and 

 the pathological diagnosis and the prognosis of the 

 disease. Dr. Abraham begins with an historical sketch, 

 and then passes on to the geographical distribution, 

 symptomatology, and pathology of leprosy. The value 

 of Dr. Acland's article on actinomycosis is enhanced by 

 an extensive bibliography which he has added. 



The second division of the book is devoted to 

 " Diseases of Uncertain Bacteriology," which are divided 

 into two main classes, "non-endemic" and "endemic or 

 topical." The non-endemic diseases comprise measles^ 

 rubella, scarlet fever, varicella, variola, mumps, whoop- 

 ing-cough, and syphilis. The articles on measles and 

 rubella are written by Dr. Dawson Williams, in the latter 

 of which a useful table is given of the differential dia- 

 gnosis of measles, rubella, and scarlet fever. Dr. Caiger 

 contributes the article on scarlet fever, and under its 

 pathology discusses critically the relation of Klein's 

 scarlatinal streptococcus to this disease. Dr. MacCombie 

 writes the monographs on chickenpox and smallpox. 

 Mumps and whooping-cough are ably treated by Dr. 

 Eustace Smith. Mr. Jonathan Hutchinson writes an 

 admirable medical essay on constitutional syphilis. The 

 author confesses that since 1866, when he wrote the 

 article upon this subject for Reynolds' system, he has 

 changed his views with regard to the power of mercury, 

 when begun early and continued regularly, to prevent the 

 occurrence of secondary symptoms ; he says, further, 

 that in his experience patients thus treated usually escape 

 the class of symptoms known as " reminders." With 

 regard to hereditary syphilis, it is of interest that in the 

 author's large experience he has only seen one, and that 

 ;i doubtful, case of the transmission of syphilis to the 

 third generation. A short article on the coexistence of 

 infectious diseases, by Dr. Caiger, concludes this division 

 of the work. 



The "endemic" " Diseases of Uncertain Bacteriology" 



begin with an essay by Sir Joseph Fayrer, on the climate 



and some of the fevers of India. The first part of 



this monograph will be exceedingly valuable to non- 



NO. 1455, VOL. 56] 



professional readers, especially in view of the increased 

 frequency of winter travelling in India, both for health 

 and pleasure. The part devoted to actual disease will 

 be equally useful to practitioners in India, and also to 

 those who practise amongst "old Indians" at home. A 

 valuable bibliography is appended. The articles on 

 dengue, beri-beri, and sleeping sickness are contributed 

 by Dr. Patrick Manson ; those on yellow fever and 

 dysentery by Dr. Andrew Davidson. Oriental sore, 

 verruga, and framboesia are treated by Surgeon-Major 

 Firth. 



The third main division of the work is devoted to 

 diseases communicable from animals to man ; this, again, 

 is subdivided into those of certain and uncertain bac- 

 teriology. The former comprises an article on glanders, 

 by Dr. Sims Woodhead, and one on anthrax, by Dr. J. 

 H. Bell. The second subdivision includes articles on 

 vaccinia, foot and mouth disease, rabies, and glandular 

 fever. The first part of the monograph on vaccinia is 

 contributed by Dr. Acland, and is entitled " Vaccinia in 

 Man — a Clinical Study." The second part treats of the 

 pathology of vaccinia, and is by Dr. Copeman. The 

 third part, " Vaccination as a branch of Prev^entive 

 Medicine," is by Mr. Ernest Hart. This monograph 

 provides the reader with a complete clinical account of 

 the results of the inoculation of uncontaminated vaccine 

 lymph in man, all that is at present known of the bac- 

 teriology, chemistry and morpKology of vaccine lymph, 

 and a discussion of the ethics of vaccination. 



The article on rabies is by Dr. Sims Woodhead. The 

 author discusses the bacteriology and treatment of the 

 disease at some length. The recent methods of treat- 

 ment, introduced by Tizzoni and Centanni, and Babes, are 

 discussed, and their advantages over the Pasteur method 

 ' indicated. The marked difference in the magnitude of 

 I the effect produced by antirabic serum according to the 

 I seat of inoculation is emphasised by the author. This 

 1 is of interest from a general point of view as showing 

 I that, although the rabic poison itself is in the highest 

 degree selective, i.e. wherever introduced, it selects the 

 cells of the central nervous system for the sphere of its 

 action, its antitoxine, although capable of neutralising its 

 effects on these cells, is to a much less degree truly 

 selective, since a much greater effect is produced by it 

 when it is injected into a nerve-sheath on the sub-dural 

 space, i.e. in situ. 



The next division of the work is devoted to diseases 

 due to protozoa, and includes articles on malarial fever, 

 hasmoglobinuric fever, and amcebic dysentery, by Drs. 

 Osier, Copeman and Lafleur respectively. 



The intoxications are next considered. Dr. Sidney 

 Martin contributes an article on poisoning by food — 

 ptomaine poisoning ; the author summarises the work 

 of Brieger on the ptomaines. He then describes the 

 Middlesborough epidemic of pleuropneumonia, which was 

 traced to the use of a certain " American bacon." The 

 frequency o{ pita's meat as the offending food stuff in this 

 connection is emphasised ; and Dr. Ballard's suggestion 

 that this is connected with the gelatine-producing 

 power of this variety of meat is supported ; gelatine being 

 an excellent nutrient medium for many bacteria. The 

 articles on grain poisoning, mushroom poisoning, opium 

 poisoning and other intoxications are from the pen of 



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