in a great many cases, entirely disappear. But this remedy is not very convenient in practice; the facilities for giving a hot bath to an adult being often unattainable. I should have mentioned that the water should be as hot as the patient can bear it, and it will be all the better to contain about a quart of table salt.

The remedy which I will next mention as being prompt and efficient is chloroform. I believe this powerful agent has been often recommended, and I have found it act like magic in a great many cases. I give a teaspoonful in a tablespoonful of thick simple syrup, in the commencement of the chill, and repeat the dose every half hour until relief is obtained. It is rarely necessary to give more than two doses until the patient is in a quiet, comfortable condition, very little fever and no subsequent chill supervening.

One of the following tonic prescriptions will be found an excellent substitute for quinine, choosing that one which is thought most likely to fulfill the indications presented in each individual case:

S.-A tablespoonful every 2 hours in the intermission.

Divid. in chart. No. xii.

S.-One powder every 3 hours in the apyrexia.

It is essentially necessary to premise the use of either of these tonics with an efficient antibilious cathartic, and this to be repeated pro re nata. To aid and assist the salutary action of these remedies, an occasional dose of the phosphoric or nitro-hydrochloric acid should be administered.

Substitutes for Quinine.

41

It will be noticed that all these tonics are to be given in the absence of fever; but there is one remedy besides the hot bath, which should be given in the hot or febrile stage, and this is the bisulphite of soda or magnesia. Twenty grains of either of these hyposulphites should be given every two hours during each febrile stage. The use of the tonics should be kept up for a considerable time after the disappearance of the disease, so as to fortify the system against a relapse or a recurrence of the fever.

I do not claim that the above medicines are superior, or even equal in efficiency to quinine, but in a great many cases where the latter is objectionable or inappropriate I can sincerely recommend to my medical brethren a recourse to the measures above indicated.

DECEMBER, 1867.

Reviews and Bibliographical Notices.

A PRACTICAL GUIDE TO THE STUDY OF DISEASES OF THE EYE: THEIR MEDICAL AND SURGICAL TREATMENT. By HENRY W. WILLIAMS, M.D. Second edition. Revised and enlarged. Boston: Ticknor & Fields. 1867. 12mo., pp. 422.

The great body of medical practitioners in the United States have received very little of systematic instruction in ophthalmology, and have enjoyed only the most meagre facilities for intelligently observing ophthalmic diseases. Some of our schools of medicine have lately recognized this great and crying deficiency, and have established chairs of ophthalmology either in connection with summer courses of lectures, or, in a few cases, in the regular winter session. Others still either wholly ignore the subject, or consign it to the Professor of Surgery, who summarily disposes of it in perhaps half a dozen lectures. The consequence is, that the great majority of even the better educated physicians and surgeons throughout our country bring to the diagnosis and treatment of eye diseases a degree of skill far less than they display in most other departments of practice, leaving the way open for the many and fearful abuses which attend the presumptuous meddling of ignorant and knavish pretenders to the name of oculist.

It is in recognition of this state of things, and in the hope in some degree to remedy it, that the first edition of the work now under consideration was prepared. "It has been the aim of the author," to quote the words of the preface, "to avoid encumbering his work and confusing the reader by the introduction of merely exceptional details,—by an account of every proposed but exploded mode of treatment, or by more than the most sparing use of the too learned technical designations which abound in ophthalmic literature; but he has endeavored to give clear and explicit descriptions of the usual forms of disease, so that the physician may be able to recognize, at once, their distinctive features, and to define the course of treatment best adapted, in a majority of cases, to remove the morbid condition. Some affec

tions, and certain phases of disease, of rare occurrence and trivial importance, are merely alluded to; enough being said, however, to enable the reader to detect their character, as exceptional cases, and to allow him to consult other works at his leisure, should he wish for complete information regarding them." That the promises made by the author in his preface are well fulfilled we gladly testify from a familiar acquaintance with the book in its two editions; and, while it is not in any sense either an encyclopædia of ophthalmology or a guide to ophthalmic literature, it is emphatically just what it pretends to be, viz., "a practical guide" to the general student of medicine, and especially to the busy practitioner who demands a book which shall be at once easily read and understood, and to which he may refer, as occasion requires, with confidence that he will find the needed information clearly and succinctly given, and with the sanction of the author's own opinion.

Of the great variety of subjects treated, we would especially call attention to the chapter on the examination of the eye, to the simple and comprehensive classification of the affections of the conjunctiva and cornea, and the judicious statement of the indications for treatment, to the chapters on lacrymal obstructions, on injuries of the eye, on affections of the iris, on cataract, and on glaucoma. The theory and use of the ophthalmoscope, the anomalies of refraction and accommodation, and especially, the relation of these to asthenopia and strabismus, as demonstrated by the recent investigations of DONDERS, are treated and illustrated with great clearness, and form a most interesting and important portion of the volume. Upon the treatment of iritis the views of the author are now well known, and have wrought a complete revolution in practice; and now, in this volume, he introduces to our notice a novelty even more striking in the application of a corneal suture in the operation for the extraction of cataract. In the treatment of lacrymal obstructions, the author adopts the now well-known and established method of BOWMAN, which he describes with rare good judgment; but we would gladly have seen, also, a notice of the excellent method of a distinguished American ophthalmologist, Prof. E. WILLIAMS, of Cincinnati, which under certain conditions, and in the treatment of certain forms of lacrymal disease, offers advantages not to be obtained by any other practice.

In conclusion we have only to repeat, that Dr. WILLIAMS' handbook is an eminently useful and practical one, and fully sustains the high reputation of its author. It is by far the best work of its kind in the English language, and we trust it will speedily find its way into the hands of as many of our physicians as are called upon to treat eye diseases in connection with general practice.

The book is admirably printed on tinted paper, and is abundantly illustrated by original and well-executed wood-cuts, and by a full series of test types, based on the "Letterpræven" of SNELLEN, which are now almost universally recognized as the standard.

J. G.

INJURIES OF THE EYE, ORBIT, AND EYELIDS: THEIR IMMEDIATE AND REMOTE EFFECTS. BY GEORGE Lawson, F.R.C.S., etc. American reprint. Philadelphia: Henry C. Lea. 1867. 8vo., pp. 408.

This book is a plain and careful resumé of the existing state of opinion and practice at the Royal London Ophthalmic Hospital, Moorfields. The immense number of patients treated annually at this hospital (18,953 new cases in the year 1866, of which no less than 883 were important injuries to the eye-ball), and the eminent ability and high reputation of its large corps of surgeons, combine to make it by far the best place in Europe for the observation and study of the very important class of cases which form the subject of the present work. Scarcely any of the affections of the eye demand so much of good judgment, and so thorough a knowledge of the general principles of ophthalmic surgery as traumatic cases, both on account of their infinite variety, and especially from the fact that the salvation of the eye often depends upon the judiciousness of the treatment adopted during the first days or hours after the receipt of the injury. A knowledge of the immediate effects of injuries of the eye and of their treatment, is therefore an essential part of the education of every physician; while in the diagnosis and treatment of their remoter consequences, there will generally be abundant time and opportunity for consultation, or reference of the case to an expert. This book, therefore, while it contains much which is important to the general practitioner, necessarily includes the discussion of nice points of treatment, operative and other, which can only be