been warded off. I lately saw a case with Mr. Carter, of Leeds, in which a lady died after some three weeks of septic fever following small-pox, although we were easily able to keep the daily curves within or almost within the parallels of health. Her life was probably prolonged, but not saved. She became weaker, nervous tremors set in as usual, the breathing became more rapid, and she died of exhaustion in spite of unlimited food and alcohol. I saw a case very like it about year ago with Mr. W. Hall, of Leeds. We kept the temperature down as we pleased, but we could not flatter ourselves that the patient's state was materially lightened thereby. After a long fight her life was spared, but an enormous abscess or abscesses formed in the right shoulder and arm. This was a puerperal case. So that I cannot regard quinine as an indirect antipyretic by virtue of any power as a direct antiseptic, as I was once tempted to suppose. On the contrary, it checks the fever, while a fatal issue nevertheless seems to prove that the septic mischief may, and often does, continue unmoderated. It is almost unnecessary to state how far my experience is borne out by the well-known effects of quinine in intermittent fever properly so called. Once more: is quinine useful in moderating the average intensity of continued fevers having a definite course, such as typhus or typhoid? To use my former figure of speech, can we by quinine flatten the trajectory of such a disturbance; and if so, what do we gain by it? We might fairly hope to limit the injurious consequences of a prolonged pyrexia, such, for example, as the combustion of the heart. My own experience of the continued use of large doses of quinine in typhoid is full of contradictions. On the whole I have not a very cheerful view of our capabilities in this respect, and as a matter of practice, I have found myself neglecting to use quinine at all during the stages of ascent and of culmination, and reserving the drug for the time of flickering when the remittent oscillations of impending lysis enable me to act with certainty if required. But this question demands far more close work than I can pretend to have given it. If we can have the completed charts of at least one hundred cases of young and previously healthy adults, in which quinine has been given from the outset, we may get some more light. Even then we must remember how variously typhoid shows itself. Not

only does it prefer particular families, but it is much modified by the calmness or the irritability of the inherited nervous system. Some patients, again, lose the first sound of the heart more quickly at a given range of temperature than do others, and by large numbers of cases only can we hope to eliminate this source of error.

NOTE.-I do not discuss the question whether quinine acts or fails as an antipyretic in virtue of any relation to the nervous system, or in want of such virtue. I have always felt great hesitation in admitting that fever depends upon the nervous system in any essential way, and have always regarded the regulating centre as a very doubtful speculation. That the nervous system is largely influenced in fever, and that by its means the effects of fever may be more widely and rapidly felt, is tolerably certain, but all the elements of fever must be independent of any nervous system at all. If I may judge from the syllabus of Dr. Burdon-Sanderson's recent lectures, he is of like opinion with myself.



It is greatly to be regretted that the subject of vivisection should have entered upon the stage of clamorous discussion in the public journals, from which nothing but evil, at any rate for a long time to come, can possibly result. For those who cynically enjoy every fresh illustration of the fact that one silly person can do more harm in a day than ten wise men can repair in a year, there may be choice recreation in this onslaught of the pseudophilanthropists: but for anyone who desires that truth and common sense may prevail, there is nothing but weariness and disgust in the spectacle. Meanwhile, there is at least one duty which appears to us to be incumbent upon the conductors of all medical journals: namely, to protest in decided terms against the conduct of medical men who publicly put forward reckless statements against the practice of vivisection, and make hideous accusations against physiologists of the highest character and reputation, the said statements and accusations being such as will not bear a moment's calm inquiry. Mr. de Noe Walker is presumably a young man, and the temptation of occupying a large space in a public sensational discussion has probably been too much for his common sense as well as for his sense of justice and propriety. But nothing that can be urged in his excuse. forms any reason for permitting him to circulate statements which are in the highest degree incorrect and mischievous. We shall therefore make a direct answer to his principal allegations. In the first place we may notice his statement that vivisection has not been of any real service to physiology, but, so far as it has had any influence at all, has been deleterious

and misleading. To this one can only say that it is not possible to open any standard text-book of physiology, and turn to the exposition of any of the more important principles, without discovering that the first sound and sure information on the subject was obtained by means of experiment on living animals. The other charge by Mr. Walker which requires notice is far more serious. It amounts to the statement that the representative physiologists of Europe generally, and Professor Schiff in particular, are guilty of gratuitous cruelty to animals: and as regards Schiff, the statement is backed up by a story which, in its (doubtless unconscious) suggestio falsi, is more blameworthy than anything which we have ever seen stated by any person who has enjoyed a scientific education. The story is, that the man who purchases the skins of the defunct animals from Schiff's laboratory declares that nowadays these skins are so hacked that they are valueless; the inference being that the physiologist has performed repeated cutting operations on the animal during its life. It is needless to say that (as Mr. Ray Lankester has already pointed out in the Times) this hacking must have been the work of a careless dissector after the animal was dead: and that no such " hackings" are done on the live animals, as physiological experiments are made with but limited incisions, and for one definite purpose. And as regards the general charge of gratuitous cruelty to animals, we will simply take three of the most representative advanced physiologists now living, and inquire as to their practice. Schiff himself shall be one, Ludwig another, and BurdonSanderson a third. All practise vivisection: and concerning all of them, it happens to be known with absolute certainty that they are most scrupulous in avoiding any unnecessary pain to animals. It is with no little indignation that we perceive that the priceless services which the labours of such men have rendered to physiology during the last quarter of a century can be lightly spoken of, and even perverted into a distressing accusation before the public, by a medical man who, whatever his talents may be, has never won any title to speak in the name of modern physiology, or modern medicine.


A System of Midwifery, including the Diseases of Pregnancy and the Puerperal State. By WILLIAM LEISHMAN, M.D., Regius Professor of Midwifery in the University of Glasgow, &c. 8vo. pp. 831. Glasgow: Maclehose. London: Macmillan and Co. 1873.

A Manual of Midwifery, including the Pathology of Pregnancy and the Puerperal State. By KARL SCHRÖDER, Professor of Midwifery and Director of the Lying-in Institute in the University of Erlangen. Translated from the third German edition by CHARLES H. CARTER, M.D., B.Sc. Lond.

THE almost simultaneous appearance of these two important works (for to most Englishmen Schröder is now for the first time accessible) cannot fail to be of interest to our readers. Undoubtedly these text-books represent an advance, by many degrees, from the stand-point of the obstetrical treatises which were offered to the student of thirty years back. The improvement thus represented has been no single man's work; but among the many labourers none have been more assiduous or useful than the authors who are now under our notice.

The work of Professor Schröder has already received such a strong testimony of approval in the fact that two German editions have been disposed of in two years, that we need not discuss every part of it. Its English dress is quite satisfactory, the translation having been done with care and efficiency by Dr. Charles Carter, who is justified in speaking of his labour as "a very arduous undertaking," and who deserves thanks for everything except some slight clerical errors. Among the portions of this book which have more particularly attracted our attention, are naturally those devoted to the therapeutics of parturition and of the diseases of the puerperal state, especially puerperal fever. We have been very much struck with the condensed and yet perfectly intelligible form of the practical directions which Schröder gives respecting all points in the

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