Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens, Part 125

Author: Jacob Anthony Kimmell
Publication date: 1910
Publisher:
Number of Pages: 1189

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For unlocalizable lesions causing pressure symptoms he does a decompressive operation which is a modification of his osteoplastic flap operation. The objections to it are that the defect is made in a region protected only by scalp; and that it is as extensive, if not more extensive than an osteoplastic flap resection. Compared with this method the simple procedure conducted under the temporal muscle as described by Cushing would seem vastly superior; and we feel that Krause does not at all appreciate the advantages of this method. He does not make use of the method employed by Horsley.

The closure of his wounds is not done with sufficient care, and it would appear that this fact is largely responsible for the num- ber of cases of post-operative fungus or brain prolapse which appear in the volume. Undoubtedly the complication should be less frequent. He does not apparently suture the dural flap made at operation but simply lays it back over the cortex. This seems particularly bad especially if there is increased pressure; for the cortex immediately bulges through the dural defect and adhesions, if not a fungus, result. To conduct a second operation at some future date through a wound closed in this manner would indeed be difficult. The dura must be closed with the greatest care and if any opening is left in it, this should be under some protected region, as under the temporal muscle. Sometimes even the scalp is not sutured but simply held in place with dressings. As pre- viously stated he drains his wounds too frequently; he packs cystic cavities and those left after the extirpation of tumors-pro- cedures which in the presence of increased pressure tend to favor fungus formation.

In all his operations chloroform is used. The operator does not wear gloves. He believes that rapidity of technic, control of hemorrhage and asepsis are the essential factors for success.

As customary in works on brain surgery he devotes many pages (20) to cranio-cerebral topography. He appreciates the difficulty of recognizing the pre- and post-central gyri even when the cortex is exposed; yet he always marks the fisures of Sylvius and Ro- lando on the scalp the day before operation.

He considers brain puncture and believes it a definite aid in the diagnosis of intracranial lesions. He warns however against the dangers of this procedure. He himself has had several cases of bleeding and in some others an aggravation of symptoms already

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present. He mentions the possibility of causing hemorrhage into the ventricle and of encountering a vascular tumor such as an angioma. It would seem pretty definite that this procedure should be used only when the needle can be introduced under direct in- . spection.

He describes ventricular puncture, giving the various points of election for introducing the needle, but does not take up the in- dications or contraindications for this procedure. He gives the various methods for accomplishing permanent drainage of the ventricles. As a preliminary to exploration of the cerebellum in cases with extreme tension he does a ventricular puncture which is a very useful procedure.

The translation has been rightly estimated by the translator in his preface. His attempts to follow the German too closely have in many places been made at the expense of good English. The volume is elaborately illustrated with 24 colored plates, some of which are very good, others less well done and showing little de- tail. The other illustrations are as a whole poor. The print is large and legible with perhaps too frequent use of bold-faced type. The size of the volume is unnecessarily large. In scientific works, with few exceptions, it seems to us a mistake to publish a volume with such broad margins.

The Treatment of Syphilis with Salvarsan. By SANITÄTSRAT DR. WILHELM WECHSELMANN, of Berlin, with an Introduction by PROFESSOR DR. PAUL EHRLICH, of Frankfort-on-Main. Only Authorized Translation by ABR. L. WOLBARST, M. D., of New York. Price $5. (New York and London: Rebman Company. 1911.)

Wechselmann's experience with the use of salvarsan has been larger than that of any other physician, since he was one of the first chosen by Ehrlich to try the new remedy. In this work Wechselmann gives us the result of his studies of 1400 cases treated, and what he has to say is of importance to all physicians who are using this drug. The profesion at large is now pretty well acquainted with the value, danger, and other characteristics of the medicine, but here we have an as authoritative book on the entire subject as can be had up to the present time. With the lapse of a few years after the discovery of the drug new views may be held in regard to it, but at present this book can but serve as a most valuable guide to all students, for the author has con- sidered all the essential points in regard to the administration of salvarsan. It is well translated and the few illustrations excellent.

Cholera and Its Treatment. By LEONARD ROGERS, M. D., F. R. C. P., F. R. C. S., I. M. S., etc. Price, 4s. (London: Henry Frowde and Hodder & Stoughton, 1911.) Oxford Medical Pub- lications.

Dr. Rogers has had a large experience with cases of cholera in the Medical College Hospital at Calcutta, and he has written a valuable and interesting work on this disease. The six chapters cover the following ground: 1, History of Cholera Epidemics and Their Lesions; II, Epidemiology; III, Etiology and Prophylaxis; IV, Clinical Description; V, Morbid Anatomy and Pathology; VI, Treatment. As in this country few physicians ever have the opportunity to see a case of cholera, this book is not likely to have many readers; but the student of tropical diseases will find it a useful book to have in his library, and will give especial at- tention to the chapter on Treatment, in which the author sets forth the results of the simple means used by him and by which he has been able to distinctly lower the percentage of mortality in his wards. He advocates the use of infusions of salt solution to lower the concentration of the blood resulting from the fre- quent evacuations; and also the administration of permanganate of calcium to destroy the toxins produced in the body by the cholera germs. With a combination of these two methods his re-

sults have been most favorable, and they deserve to be forte: tried. . The author is modest in his claims as to the value of the treatment, which has at least one great merit, that it seems to do no harm, even if its importance prove less marked with ft: ther trial.

Manual of Human Embryology. Edited by FRANZ KETBEL &E. FRANKLIN P. MALL. In two volumes. Volume 1 with #: Illustrations. (Philadelphia and London: J. B. Lippines: Company, 1910.)

In the introduction to this volume the editors announce the intention of adhering strictly to human embryology, and of t: concealing the gaps which exist in the subject as is sometim- done. They assume rather the very praiseworthy attitude of = pecially pointing out these deficiencies, as in this way the p> will be sooner filled.

Comparative embryology is largely excluded and is only intre duced in the discussion of the early stages of development.

It is interesting to learn that this treatise on embryology which was projected by His and Keibel has been completed by Keile and Mall, one of His's most noted pupils.

This is the first manual of human Embryology to be written to: jointly by a number of authors, a method which has lately bes: frequently adopted in other books. Such books are subject to tw dangers: first, a lack of unity, and secondly, repetition. The= dangers have been avoided here however by very thorough ed" ing and supervision, proved also by the fact that a careful resi ing of the book has shown a remarkable absence of typographiz' or other errors. The advantage of a multiple authorship is : greater thoroughness and accuracy of discussion, each auth- being especially qualified for his task by his own researches.

The reason given for an exclusive human Embryology is th importance of the subject to the physician.

Keibel in his introduction considers the historical developmer" of Embryology, and one is pleased to note that great credit i: given to that remarkable genius von Baer and also to His w. laid a secure foundation for human Embryology and made pass- ble the great advances of the last 30 years. Keibel calls attentic: to the spirit of co-operation which is permeating the scientif: world, and acknowledges his indebtedness to many investigators. This spirit is part of a broader movement affecting education' institutions which no longer are rivals but rather coadjutor: This volume was published simultaneously in German and Eng lish, the English translation being made by McMurrich and the German by Keibel.

Keibel contributes articles on the germ cells, fertilization, seg- mentation, young ova and embryos up to the formation of the first primitive segment, germ layers and gastrulation and differentis tion of external form.

Grosser writes on the egg membranes, placenta and menstras- tion.

Mall's contribution includes the determination of the age o. human embryos and fetuses, the pathology of human ova and the development of the coelom and diaphragm; Pinkus discusses the development of the integument, Bardeen the development of the skeleton and connective tissues, and W. H. Lewis the development" of the muscular system.

Keibel's discusion is an excellent one. He accepts Waldeyer: view that at birth or shortly after all oogonia have become oocytes of the first order and so have before them only further growth and maturation. It is questionable whether the intre duction of the term " polocyte " for " polar globule" is desirable A fuller discussion of sex determination should be given. Keibel: statement that most observers now incline to the belief that sel is always determined in the ovum before fertilization is, in the opinion of the writer, not justified. There is considerable evt

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es: Attention is called to the desirability of examining the lucts in the hope of finding early embryos. Keibel critically ews the early embryos which have been described and thinks chert's ovum has been detrimental to the progress of Embry- ry because of the wrong impressions created.

1 the discussion of the formation of the germ layers he does reader a service by stating precisely what he means by gas- ation. He defines it broadly as follows: "Gastrulation is process by which the cells of the metazoan ovum are separated an upper and lower layer." Attention is called to the gap ch exists between Pfannensteil's embryos III and VI of the mentafel of Keibel and Elze. Embryos 3, 4, and 6 of His he iders abnormal.

rosser gives an excellent account of the method of placenta- and explains his classification of placentæ, which is based on extent of erosion of the decidua. According to his nomen- ire the human placenta is a placenta hemochorialis discoidalis ormis. This is the highest type and is not yet reached by the tropoid apes. His statement that the endometrium undergoes nsive degeneration in menstruation is, to say the least, mis- ing. He calls attention to the important fact that the pres- of furrows in the endometrium may be indicative of preg- 'y and that pathologists, bearing this in mind, may help ryologists to obtain early ova.

speaking of the increase in size of the uterus in pregnancy. rrect use is made of the terms Hypertrophy and Hyperplasia. 1 page 99 lymph nodes are spoken of as existing in the en- etrium; we think this should be "nodule," as lymph node Id be used as the equivalent of lymph gland.

termination of the age of human embryos and fetuses is dis- ed by Mall with his usual clearness and keen analysis. One is :what surprised at the statement, quoting Ravano, that ovula- occurs frequently during pregnancy. He emphasizes the ssity of a standardization of the corpora lutea as an aid to determination of the age of ova, and makes the important estion that surgeons might materially assist in this matter by ttine examination of normal ovaries in abdominal sections.

concludes that the balance of evidence is against the iert-His theory and in favor of fertilization occurring near ime of the last menstrual period. The crown-breech and 1-heel measurements are considered the best, corresponding ey do with the sitting and standing height of anthropolo-

the discussion of the pathology of the human ovum, Mall in- rates largely his studies already published. He has found 10 per cent of the ova of the first two months received by re pathological, and considers the causes secondary and en- nental rather than germinal. Changes in the chorion are in a very large percentage of pathological ova, and inflam- 1 of the decidua is regarded as a frequent cause. A classifi- of pathological ova is explained. He believes with mini that as abortions are frequently due to pathological 's in the ova, threatened abortions should rather be en- ed than prevented, for if retained the embryos may become irs.

onsiders that the evidence from various sources including Experimental Teratology indicates that the causes of mon- es are rather environmental than germinal and calls atten- the importance of treatment of the diseased endometrium e cases where monsters have been born, to prevent a repe- His statistics show that seven per cent of all pregnancies h pathological ova. This discusion is a valuable contribu- bur knowledge of the subject.

article on the development of the diaphragm and colom ts in a large measure his own researches in the subject.

Pinkus. His article includes the consideration of skin pigmenta- tion, dermal ridges and folds, metamerism of the skin, Mongolian spots, hair whorls, the ontogeny and phylogeny of the hair.

He concludes from the evidence, experimental and otherwise, that the melanin is formed in situ in the epidermis. The writer does not believe that the evidence is so conclusive on this point as Pinkus represents.

Perhaps the most elaborate and complete article in the book is the one by Bardeen on the development of the skeleton and con- nective tissues, occupying some 160 pages. It includes a discus- sion of the histogenesis of the connective tissues, and morpho- genesis of the skeletal system including variations and abnormali- ties in skeletal development. He divides for consideration the development of the cartilage bones into three stages, the blastemal, chondrogenous and osteogenous. This discussion is based largely on his own work and that of Lewis already published. He opposes Rosenberg's theory of the cephalic shifting of the ilium during ontogeny.

The article by W. H. Lewis on the development of the muscular system is an excellent discussion of the subject and is based largely on his own work. The subjects included are the histo- genesis of muscle, the segmentation of the mesoderm and the de- velopment of muscles in groups and individually. Contrary to the usual view of anatomists he finds no cephalic myotomes but de- rives the orbital muscles from a mass of mesoderm on the dorsal side of the optic stalk. Also, he fails to find occipital myotomes but believes that the tongue musculature develops from the mesoderm of the floor of the mouth. Futamura's description of the genesis of the face muscles is followed, deriving them from the hyoid arch.

The illustrations in this volume are numerous, but in some cases they are not so good as such an excellent text deserves. A considerable bibliography is appended to the sub-divisions of each article. No index is furnished.

This country is certainly to be congratulated on the excellent showing made by its anatomists, and Mall in particular is to be felicitated on the excellence of the volume. Anatomy in America is greatly indebted to the work, influence and high ideals of Mall. The second volume will be awaited with great interest.

The Medical Annual. A Year Book of Treatment and Practition- ers' Index. Twenty-ninth Year. Price 9/6. (Bristol: John Wright & Sons, Ltd. New York: E. B. Treat & Co., 1911.)

This is one of the best books in English covering the progress made in all branches of medicine during the past year. The articles are carefully prepared by physicians thoroughly acquainted with the subjects discussed by them. The majority of the con- tributors are English, but in the list are also the names of two Americans, one Canadian, two Germans, and a Frenchman. The work is supplied with an excellent table of contents, and many good illustrations. It contains also a valuable addition in a list of the principal medical works, and new editions published during 1910, and another of asylums and a trade directory which makes it of especial use to English practitioners; but for other practi- tioners as well it is an excellent annual.

Puerperal Infection. By ARNOLD W. W. LEA, M. D., F. R. C. S., Lecturer in Obstetrics and Gynecology, The University, Man- chester, England, etc. Price $9. (London: Henry Frowde and Hodder & Stoughton, 1910.) Oxford Medical Publications.

For a long time German monographs upon practical medical sub- jects have been available, but similar compilations are only be- ginning to appear in English. There is particular good fortune in having such an excellent one, as is here given, upon puerperal in- fection, for this is by far the most important complication with which the obstetrician meets.

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The author quotes statistics from the British Registrar General's office, which indicate "that one-half of all the deaths of women occurring in connection with child-birth are referable to infec- tion, while its remote results are a source of ill-health to a much larger number." We are shown that there has been only a slight diminution in the mortality from this disease during the past 40 years, and that in some parts of the United Kingdom there is even a tendency toward an increase. The total puerperal death rate was 5.9 per 1000 from 1851 to 1855; it still amounted to 4.2 per thousand between 1901 and 1906. In England and Wales alone from 3000 to 5000 women die annually from this largely prevent- able complication. Statistics further indicate that the incidence of infection is very much greater in country districts than in the cities where fairly good conditions would seem to prevail. How- ever, the author regards the whole situation as a grave reproach to our times, and in the prevailing conditions he has found su.fi- cient stimulus to prepare this volume of nearly 400 pages. ...

The monograph views the subject from every side, and in cx- haustiveness compares favorably with the article by Von Herff in Von Winckel's Handbuch. It must prove helpful to those w10 teach obstetrics, but will perhaps have an even greater value for the practitioner. Fully two-thirds of the book is devoted to cl'n- ical matters, and one-half of this section deals altogether with treatment. As might be expected, means of prevention are em- phasized as the most important feature in combatting infection, but curative measures are discussed at great length and their relative values carefully weighed. The recommendations made are unusually trustworthy. In the discussion of therapertic measures about which there is some diversity of opinion, the evidence of different advocates is impartially given, yet the author always frankly commits himself to one view; herein he displays clear reasoning and reaches sound conclusions.

The same judicial qualities are apparent in the first portion of the volume which deals with the bacteriological and pathological phases of puerperal infection. The more recent contributionis along these lines have been incorporated, and in many instances first hand information relative to disputed points is given. Thus, from his own investigations the author believes that streptococci may occasionally be found in the vagina during pregnancy. He has also observed that such organisms may possess hæmolytic properties.

The pathology is discussed at length, and the suggestions it affords as to treatment are indicated. The author agrees with those who find in the reaction of the endometrium a very good argument against curetting an infected uterus, for this operation usually does no more than remove nature's defense against the disease.

The one criticism which may be fairly offered pertains to the pathological illustrations: these do not reach the standard justi- fied by the text. The book is a valuable addition to the literature of infection, and will be welcome to those who are practising obstetrics.

Urgent Surgery. By FELIX LEJARS. Professeur Agrégé a ja Faculté de Medicine de Paris, etc. Translated from the sixth French edition by WILLIAM S. DICKIE, F. R. C. S., etc. Vol- ume II. Illustrated. (New York: William Wood & Company, 1910.) .

The second volume of this work is divided into four sections, dealing respectively with the genito-urinary organs, the rectum and anus, the strangulated hernia, and the extremities. Of the

first two of these sections it is perhaps sufficient comment to se that they exemplify the excellent characteristics of the work & # whole. That is, the subject is handled concisely and clearly. ; e with no tendency to a restriction to simple generalities, as mi- quite unusual conditions are discussed and typified by case report Logical subdivision of the subject matter into topics and pas graphs, with typographical arrangements to emphasize hestia and important conclusions, aids greatly in dispelling the iner;) bly forbidding effect of page after page of unvarying print. cz renders quick consultation of the book easy. The work is furt- distinguished from the usual uninspired recitation of comme places by the numerous ingenious bits of technique and the weby of striking clinical observations, which give so strong a note the writer's personalty and add so much to its practical value.

The part of the book devoted to the urgent surgery of heru demands more consideration than the above remarks, which is true of the work as a whole. This section really constitutes : monograph of authority, and a masterly treatment of emerges hernial surgery. It is the most comprehensive and ratkoca handling of this highly important phase familiar to the review: The unusual types of strangulation are ably discussed, and perusal of this book makes one feel far less likely to overlook : mistreat some of these quite obscure cases. The last part of #: book, dealing with the extremities, is likewise eminently ratkt and practical. The various subjects are presented with an att tude of healthy conservatism, of the sort that is not deterred fre recourse to seemingly radical measures when such measures a" in fact truly conservative.

There are certain points that strike one as noteworthy for shade of difference presented from the familiar American ri point. One misses any reference to the so-called Mayo closure c. umbilical herniae in a transverse direction. There is & decide: fondness displayed for more or less complicated apparatus in t} treatment of fractures. The author categorically condemns t. use of gauze in packing abscess cavities, using rubber tubes e! clusively. A number of conditions are included that many wix give no place to in a work on urgent surgery, such for instance the open treatment of certain fractures. This, however, is puret a matter of degree, since most surgery, excepting plastic az' other types of work where an optimum period is awaited. # urgent in the sense that the sooner it is done the better, even whz there is no imperative need of haste.

The book is properly and most admirably illustrated, most of the cuts being original. The translator deserves high appreciation for a rendition into English so pure and idiomatic that no flavor d the original French of the text is perceptible. HARVEY B. STOSL

A Text-Book of Surgical Anatomy. By WILLIAM FRANCIS CANA- BELL, M. D., Professor of Anatomy at the Long Island Colle: Hospital. Second edition revised. Illustrated. Price, $5 .?! net. (Philadelphia and London: W. B. Saunders Company. 1911.)

In the preface to this edition the author states "that only such additions have been made and errors corrected as to make the tes: more complete and exact. Several illustrations have been r: placed by others which more accurately elucidate the text." The merits of this work were noted by us (Johns Hopkins Hosp. Bull. Feb., 1909), and its success, as shown in the call for a new edition so soon, is a natural consequence of its qualities which make it valuable to students.

The Johns Hopkins Hospital Bulletins are issued monthly. They are printed by the LORD BALTIMORE PRESS, Baltimore. Subscriptions, a year (foreign postage, 50 centa), may be addressed to the publisher's, THE JOHNS HOPKINS PRESS, BALTIMORE; single copies will be sent " mall for twenty-five cents each. Single copies may also be procured from the BALTIMORE NEWS CO. Baltimore.

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Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens, Part 125

Author: Jacob Anthony Kimmell Publication date: 1910 Publisher: Number of Pages: 1189

Author: Jacob Anthony Kimmell
Publication date: 1910
Publisher:
Number of Pages: 1189