this is true in the male subject, in whom this abnormality appears nearly twice as often as in the female. Deformity or change in position of the remaining kidney is rarely met with, only a more or less intense hypertrophy is usually present. Besides the kidney, all its vessels, and nearly always the foundation of the ureters are generally absent. Changes in the bladder are also very rare. Occasionally the suprarenal capsule of the same side is also absent. Abnormalities of the genital organs, which are more frequently found in the female, exist nearly without exception on the side of the absent kidney, and affect in the first instance the canals of exit, rarely the ovaries, which, however, may frequently be atrophic. Very rarely, and then only in the female, is the whole genital apparatus undeveloped. -Pediatrics, March 1st, 1897.

NEUROLOGY.

Heredity in Neuroses.-At a meeting of the Neurological Society of London, held January 14th, Savage considered the subject of heredity in neuroses. He traced the idea of heredity from the Darwinian to the Weismann periods, but he could not admit that there is no power of transmitting acquired capacities. He felt that misunderstanding had arisen from the idea of the direct transmission of fully-developed habits, whereas all that is transmitted is a capacity or previous disposition for developing these habits. In the transmission of instincts it was shown that some are transmitted but never developed. There may be, in fact, potential abilities which are never evoked because no stimulus is present. It is thus with some neuroses, which lie dormant until some special conditions rouse them into activity. There are also cases in which special forms of mental disorder occur only at certain ages.

The relation of heredity to the neuroses must be traced in various ways, one of the best being a study of the relation of the nervous disorders which often occur in the offspring of the insane and markedly neurotic. The lack of nerve power of various degrees is shown by defect of one or the other of the mental factors, which may give rise to various forms of idiocy or smaller degrees of mental weakness. Ordinary mania does not seem to have sufficiently definite basis for it to be transmissable. Melancholia, on the other hand, is especially associated with general

bodily ailment, and is often met with in generation after generation of certain families. The individuals in some families seem to die out in mind before body, and in some there seems to be a capacity for passing on a tendency of recurring melancholia, which in the end becomes chronic. Dementia in a different way is often associated with the old age of certain families.

What in some cases looks like direct heredity is after all the result of nervous instability, associated with dread and expectancy. This is well seen in some cases of puerperal insanity, and in the suicidal tendency recurring in certain families. Heredity is an important factor in the production of neuroses, but their transmission depends as much on the stimulus which evokes the symptoms as on the heredity, and it is this which is so important for the consideration of the physician. There is hope in changing the surrounding of the neurotic, and in thus breaking morbid habit or preventing its development.—Med. News.

The Effect of Diet Upon the Fits of Epilepsy. - Dr. Alexander Haig from his studies believes that the uric-acid fluctuation is the cause of the fits. By diet he reduces the intake and formation of uric acid, so that the largest quantity the patient is likely to get into his blood as the result of such fluctuation shall never, or only very rarely, be sufficient to affect the blood-pressure and the intra-cranial circulation to a serious extent. Epileptic wave of excretion runs very high, but only for a short time, and it is very difficult to keep the general level of uric-acid excretion so low that these waves shall not occasionally get high enough to do damage by raising the blood-pressure and affecting the intracranial circulation. Here flesh-food must be avoided entirely, and all soup and meat extracts regarded as poisonous; while tea, coffee and cocoa, and all other vegetable substances containing xanthin compounds, are to be regarded as containing uric acid, and used, if at all, only as the merest flavoring. From the facts mentioned in this paper, it is pretty clearly shown that the fits of epilepsy and convulsions in general have an extremely close relationship to the uric-acid headache (migraine), and like this are probably functional disorders due to altered circulation in the brain, such altered circulation being due to the contracted arterioles and high blood-pressure caused by uric acid. Since the headache is controlled with almost abso

lute certainty by a diet which frees the blood from the excess of uric acid, so it is hoped that it will be found that many fits will yield in the same way to well-directed treatment.-Brain.

The Johns Hopkins Hospital has opened a maternity ward.

The American Climatological Association.-The fourteenth annual meeting will be held in Washington on May 4th, 5th and 6th, under the presidency of Dr. E. Fletcher Ingals of Chicago.

Meeting of the Missouri State Medical Association, May 18, 19 and 20.-Present prospects are that the meeting of the Missouri State Association this year is going to prove very satisfactory. The committees have all gotten to work early which is a good indication. The Committee on Scientific Communications is already in receipt of titles in numbers and character sufficient to insure the programme scientifically attractive. The Executive Committee is enabled to announce the following programme, the details of which only remain to be completed. All the first, the second and the third day until noon will be devoted to the scientific programme. On the evening of the first day the association will as a body attend a session of the Illinois Society in East St. Louis. On the evening of the second day the Illinois Society will attend as a body a session of the Missouri Association, after which there will be a banquet and reception. On the third day both bodies will adjourn and join in a steamboat excursion on the river.

Short Papers for the Missouri State Meeting. The Programme Committee of the Missouri State Medical Association this year beg to announce that short papers must be the rule. The papers are numerous and the time short. They, therefore, ask writers to make a special effort to condense their communications. A paper of ten or fifteen minutes always makes a better impression than one of twenty or thirty. A great deal can be said in ten minutes, generally more than in twenty.

The committee hope to have a programme characterized by short, strong papers. There is already on the list a number of five and ten-minute papers, which we can promise will be good productions.

Book Reviews.

By J.

Royal

Genito-Urinary Surgery and Venereal Diseases. WILLIAM WHITE, M.D., and EDWARD MARTIN, M. D. 8vo., pp. 1061. Illustrated with Two Hundred and Fortythree Engravings and Seven Colored Plates. [London and Philadelphia: J. B. Lippincott Company. 1897.

This is one of the series of valuable treatises which have emanated from the press of the Lippincotts. The work is a truly valuable one from every point of view, and the illustrations which are found in the text are of a superior character. Dr. White has long held a high position among syphilologists, and his opinions are in the main correct. We desire to once more enter our protest to the term of hereditary syphilis, as that of "prenatal" is more correct; and so far as the term genital" is concerned, it is simply out of the question, meaning nothing in regard to the form under consideration.

"con

The treatment which is advocated seems to us rather a restricted one. When we consider that Maurine has devoted nearly 1,500 pages to this subject alone, a few pages seem rather inadequate to cover the subject. In prenatal syphilis he recommends grey powder in doses from to grains thrice daily. He could certainly give more. In the hypodermic treatment he fails to mention one of the best as well as most rapidly-acting mercurials the cyanide. We have noticed throughout his therapeutics that he employs rather light doses, which is well enough when a strong impression has been made, but which have a tendency otherwise to produce a toxic action before a therapeutic one has been accomplished.

In speaking of excision of the chancre as a means of abating syphilis, he takes no decided stand. He looks upon excision as a possibility merely, and states that it succeeds in but a small proportion of cases. He very sensibly states in regard to the constitutional treatment of a syphilitic, or rather supposed syphilitic, that mercury should not be given till the diognosis of syphilis is assured by the appearance of secondary symptoms.

We can heartily commend the descriptions of the various phases of syphilis, and the numerous illustrations added for the purposes of elucidating the text. Dr. White has certainly furnished us with a very valuable contribution on the subject.

Dr. Martin, who is without doubt the author of the part devoted to genito-urinary surgery and diseases, has acquitted himself most admirably. He has covered the subject well and thoroughly; but his very thoroughness in the fullness of prescriptions for the treatment of gonorrhea is evidence which still remains to prove how little we really know of the therapeutics of

this common and distressing malady. The many vaunted cures for gonorrhea, and the many injurious methods of treatment for stricture, are merely evidences of the impotence of medical men to cope with these troubles.

The book before us is magnificently gotten up, and is quite thorough in the manner in which the subjects it treats of are handled. It is a good, reliable work for the practitioner, and one upon which he can rely. We are sorry that urethral chancroid is not mentioned, but as it is a rather unusual venereal trouble its absence will scarcely be noticed. We desire to congratulate both the authors and the publishers upon the successful completion and issuance of this valuable work. O-D.

The International Medical Annual and Practitioner's Index. A Work of Reference for Medical Practitioners, English and American. 8vo., pp. 724. Fifteenth Year. 1897. [New York and Chicago: E. B. Treat. 1897. Price, $2.75. Treat's Annual is an institution, and one which has acquired a large circulation in the medical profession. It is a most admirably constructed book, which gives a condensed, but wellwritten, by the most competent authority. Thus, in the present edition, we have given a review of new remedies and of therapeutic progress, by William Murrell, M. D., F. R.C. P. Part II., devoted to new treatment, is contributed to by the entire staff of collaborators, which includes such men as Dr. Armour Hanson, on leprosy; Mr. Cantlic, on oriental diseases; Drs. Unna, Norman Walker, and W. S. Gottheil, on skin diseases; Mr. Herbert W. Allingham, on rectal diseases; Mr. Harry Fenwick, on urinary surgery; Graeme M. Hammond, on neurology; Dr. David Hardie, of Brisbane, New Zealand, on Australian diseases; Dr. Thomas More Madden, on obstetrics; Dr. George E. de Schulinitz, on ophthalmology; Dr. Sonnenburg, on stricture of the rectum; and a host of other most competent authority on other subjects.

One of the valuable articles in this volume is that on insanity, which is profusely illustrated and well written, with commentaries on the recent advances made in this branch of neurology, written by Dr. James Shaw. Diabetes insipidus, by Professor R. Saunsby, is illustrated by two magnificent ophthalmoscopic illustrations of the fundus. Space forbids our entering into a critical review of the various subjects entered into, as it would necessitate the writing of an entire volume.

Suffice it to say, that the work is a most complete review of the progress made in medicine and surgery during the year 1896, and the articles are profusely illustrated with well-executed engravings and fine half-tone and colored plates.

No physician who aspires to be at all progressive can afford to omit this work from his library, as he will find it continually of the highest value in making reference and in obtaining approved and successful modes of treatment.