786 



SCIENCE. 



[N. S. Vol. XVIII. No. 4C8. 



" 1. There is a rapid accumulation of CO, 

 in the pleuraj after death, which fact rules out 

 the majority of analyses yet published. 



" 2. The presence of a purulent exudate is 

 an important element in determining the com- 

 position of the gas. 



" 3. This post-mortem accumulation of CO^ 

 may explain the high tension of the gas, 

 which hisses from the chest on the autopsy 

 table. 



" 4. The method of diagnosing an open 

 fistula proposed by Leconte and Demarquay 

 seems to be valid." 



Preceding authors have largely, if not alto- 

 gether, failed to recognize the fact that the 

 composition of the gas found in the pleura in 

 pneumothorax is, in part at least, dependent 

 upon the character of the microorganisms con- 

 tained in the accompanying exudate. We 

 know that certain bacteria consume oxygen 

 and give off carbonic acid gas, while still 

 others break up proteid material and elaborate 

 H,S and possibly (]S[H,)2S. It is not, there- 

 fore, surprising that there has been much 

 diversity of statement concerning the composi- 

 tion of the gas in pneumothorax. " Our author 

 certainly makes it clear that these variations 

 are to be expected. 



The second paper is entitled ' Clinical Ob- 

 servations on Blood Pressure.' This is always 

 an interesting subject to both the physiologist 

 and the clinician. The instrument used in 

 these observations was a modified Eiva-Rocci 

 sphygmomanometer, which gives very satisfac- 

 tory results. The experiments made upon the 

 effects of anesthesia upon blood pressure con- 

 firm the views now quite universally held by 

 the best surgeons in this country ; that is, that 

 chloroform, on account of its depressing ac- 

 tion, and the consequent low blood pressure, is 

 a much more dangerous anesthetic for surgical 

 operations than ether. The authors of' this 

 paper, Cook and Briggs, bring out the fact, 

 so well known to obstetricians, that the de- 

 pressing action of chloroform is not manifest 

 when this anesthetic is used in labor. The 

 most interesting part of this paper, to your 

 reviewer, at least, is that which deals with 

 the effects of strychnin and digitalin in cases 

 of shock. Most clinicians of wide experience 



have become very positively convinced that 

 strychnin, especially, is valuable in shock, but 

 this has recently been denied by Crile, whose 

 most interesting and valuable work upon this 

 subject demands respect. Crile holds that the 

 employment of strychnin in shock is irrational 

 because, according to him, in this condition 

 the vaso-motor center is completely exhausted, 

 and no good is to be secured by ' flogging the 

 tired horse to death.' Notwithstanding the 

 conclusion reached by Crile, the majority of 

 clinicians thinic that they have had in their 

 experience ample and frequently repeated evi- 

 dence of the value of strychnin in shock, and 

 it is gratifying to know that Cook and Briggs 

 in the paper now under review have shown 

 that in eight out of ten cases of shock under 

 central stimulation with strychnin, digitalin 

 or cocain, positive improvement has been 

 secured. It is only fair to state that this 

 difference between Crile and other clinicians 

 is largely a matter of words. Crile recognizes 

 as ' shock ' only those cases in which strychnin 

 does no good, and he designates by the term 

 ' collapse ' other cases in which central stimu- 

 lation is of value; but inasmuch as no one, 

 not even the operator himself, can distinguish 

 between the two in many instances, the 

 clinician will undoubtedly continue to use 

 strychnin in shock, and in doing this will be 

 justified by the experimental observations 

 recorded in the article now under considera- 

 tion. 



The third paper in this volume is entitled 

 ' The Value of Tuberculin in Surgical Diag- 

 nosis,' and is presented by Dr. Tinker. While 

 this article is of value, inasmuch as it eon- 

 firms the fimdings of a number of others who 

 have investigated the subject, it can not be 

 said to furnish us with anything new. The 

 author concludes that tuberculin, properly em- 

 ployed, is a valuable agent, and, we may say, 

 the most valuable agent in our possession in 

 the diagnosis of latent tuberculosis, and is 

 harmless. V. C. Vaughan. 



SCIENTIFIC JOURNALS AND ARTICLES. 



The Psychological Review will hereafter be 

 edited by Professor J. Mark Baldwin, of the 

 Johns Hopkins University, and Professor H. 



