the knife was to be abated, and a new era of cure, without destruction of function, was to follow.

Tait, by his wonderful work, had thrown a glamour around the operations indicated that led hosts to follow his guidance. Keith, wise and always conservative, and probably equally as successful as Tait, upheld the promise that the surgeon was the rescuer of the diseased womb. So that when Apostoli began his crusade against the knife and offered his method to the medical world, it was so brilliant in promises that it soon had its followers eager and enthusiastic-denouncing the surgical work and offering the apparently harmless and certain substitute. Time has failed to justify these promises. Under the application of electricity tumors shrivelled, hemorrhages ceased, pain was allayed, and health seemed about to start afresh. The ease of mind was rudely disturbed when the growths began to reappear and grow with a rapidity that had not before been their characteristic, or if the treatment has been carried too far, degeneration ensued, and the surgeon had to come in to save a life that was threatened with death by sepsis.

In a word, the field for the service of this agent has been contracted, and while it will have its useful sphere of action, it cannot replace, even under the guidance of the most intelligent of those who use it, the surgeon's skill and his procedure. This is true for one reason, if no other, that there remains an element of doubt most frequently in the diagnosis of these fibroids, which a laparotomy alone can dissipate. It comes within the knowledge of the writer to speak confidently on this subject. Four medical men, two of whom are among the best equipped gynecologists in this country, had agreed, after careful examination, that a patient had a subperitoneal fibroid, that it involved the right side of the uterus, and was forcing that organ by its weight down into the pelvis, a part of which space the tumor occupied and in which it was fixed. The bladder was apparently involved in the adhesions that had followed several attacks of peritonitis. A salpingitis had come in to complicate matters, and affairs were in the state that electrolysis promised to give relief. Under advice, the interested parties accepted laparotomy as one of two alternatives, and it revealed a tumor, probably fibroid, which had its origin in the broad ligament, and which involved the ovary of the right side. Adhesion had formed, including the lower portion of the omentum, and fastening the

pelvic walls.

But it had been twisted away from its connection with the ligament, a hæmatoma remaining to mark its point of former attachment, and was living precariously upon the blood supply gained from its adhesions, and liable to degeneration and decay at any moment. The ovary was a moderately enlarged sac with thick leathery walls, enclosing a semi-solid substance resembling a broken-down blood-clot, and the evidences of the attacks of peritonitis were everywhere displayed. Happily the operation was done, and electricity was not sought after. The result of the removal of the tumor is that the patient is now practically cured, and the abnormal growth is no longer a source of danger or thought. If laparotomy and the removal of the uterus and its appendages have been too frequently done, it is a proposition at least unproven. That electricity can cure, as it is claimed for it, is still less a demonstration. If there is to be a wise conservatism ruling in this matter, let us have less of the words of enthusiasts and more of the deeds of earnest workers. Let the field for this new agent be fenced in to its proper bounds, lest in the mad rush after new discoveries true wisdom is lost and life suffer from the unwise displacement of wellknown methods for promises of a questionable value.

G. G. T.

PUBLIC SCHOOLS IN NORTH CAROLINA.

Through the courtesy of Major S. M. Finger, Superintendent of Public Instruction, we have received his biennial report to the Governor.

Education is a matter that vitally concerns the medical profession in our State, and while Major Finger and his little army of teachers are striving with great labor and patience to educate the children of the State in the fundamentals, the Board of Medical Examiners stands at the threshold of the profession demanding certain requirements before young men may enter upon the career of the physician. They, with wearisome labor of body and mind, and with means so inadequate in most parts of the State as to provoke a smile of derision at its futility, leading the children with all faithfulness through the dreary mazes of the rudiments, we

stand at the portals of a sacred calling testing the acquirements attained: they educating from below, we commanding from above, all working to the common end of lifting the population to a higher plane, thereby rendering to the State the very highest service. possible.

As we run through this report and see how pitiable is the condition of some counties, we cannot but urge upon the Legislature to do something worthy of our great State in its coming session. Teachers have shown their worthiness by working patiently on small pay, doing faithfully the task set before them and more, and it is not wise that their hope of better things should be so long delayed that they lose courage.

The negro problem is the point of greatest difficulty, and we will arrive at a clear solution as soon as we get white teachers in every school of colored children. Very, very, few negroes are fit to be teachers, and this has been clearly demonstrated by an experiment, costly in time and money. But very, very, few white people are willing to teach negroes, and how to make these divergent ideas meet is the difficulty. They probably will not in the present generation, but those to come may be wiser, and broader, and more self-possessed than we. The negro has come to stay, and while we are masters of the situation, and will be as long as we retain the manhood of the Anglo-Saxon blood, let our mastery be a wise one, and let us manifest it by taking the matter of negro education in our hands. We pay for it, we have the brains to shape it, and let us make it a means of strength in the body politic. We have tried the policy of employing the blind to lead the blind, let us not think it strange that they have fallen in the ditch, but let us take them out and place them in the way of light.

HAS GYNECOLOGY COME TO THIS?-We find in A. E. Foote's Catalogue the following: "Set Gynecological Instruments, etc., German silver speculum, large forceps, dilators, probes, pessaries, etc., 14 pieces cost over $25; our price $2.50." Where will the lumber room of the future be located for the reception of obsolete pessaries and speculums? Would the Army Museum be large enough?

REVIEWS AND BOOK NOTICES.

POST-MORTEMS. What to Look For and How to Make Them. By A. H. Newth, London. Edited with numerous notes and additions by F. W. Owen, M.D., formerly Demonstrator of Anatomy, Detroit College of Medicine. Cloth, 12mo.; postpaid, $1.00. The Illustrated Medical Journal Co., Publishers, Detroit, Mich. This little book is just what the general practitioner needs to aid him in his infrequent work of post-mortem examinations. It is in the form of a convenient remembrancer to the doctor who has not time or opportunity to consult the larger works, and it will serve to make suggestions in the dead-house that he can work out more fully when he returns to his library. It can be carried conveniently in the overcoat pocket, and will stay open at any desired place when laid flat on the table.

The pathological conditions to be sought after and interpreted are clear, and the suggestions for note-taking for medico-legal purposes are good. Size of the book 4x74 inches; pages 136.

A SURGICAL HAND-BOOK: For the Use of Practitioners and Students. By Francis M. Caird, M.B., F.R.C.S. (Ed.), and Chas W. Cathcart, M.B., F.R.C.S. (Eng. and Ed.) With numerous illustrations. Philadelphia: P. Blakiston, Son & Co., 1012 Walnut St., 1890.

"has any

It is seldom these days that the title of "hand-book reference to the size of the volume, but this little volume well deserves the name. As one glances over the pages at the minuteness and fulness of the information compressed in the 262 pages the older surgeon could hardly help feeling greatly the whole subject of treating emergencies and the minor details of surgical practice has been advanced of late years. Such a book in the haversack of a Confederate medical officer would have been a serviceable acquisition.

Some of the subjects treated are: "Treatment of Patients Before and After Operations," "Anesthetics General and Local," "Antiseptics and Wound Treatment," "Arrest of Hæmorrhage," "Shock and Wound Fever," "Emergency Cases," "Tracheotomy

and Minor Surgical Operations," "On Bandaging," "On Fractures," "Dislocations, Sprains and Bruises," "Extemporary Appliances and Civil Ambulance Work," "Massage," "Surgical Applications of Electricity," "Joint Fixation and Fixed Apparatus," "The Urine," "The Syphon and Its Uses," "Plaster Casting," and "Post-Mortem Examination."

The chapter on post-mortem examinations might easily have been omitted, having no proper place in such a treatise, and not being elaborate enough to answer a practical purpose.

Young surgeons will also find this book useful in the hints it gives about instruction to nurses and ambulance corps, its size making it a convenient hand-book, and its correctness, so far as we are able to judge by our examination, warranting the statement that it is reliable.

EPILEPSY. Its Pathology and Treatment. Being an Essay to which was Awarded a Prize of 4,000 Francs by the Academie Royale de Médécine de Belgique, December 31, 1889. By Hobart Amory Hare, M.D., B.Sc. [Price $1.25.]

This essay is one of absorbing interest because of the careful manner the whole subject has been presented. It is instructive because all of the best material that has accumulated upon the subject of epilepsy has been placed under contribution. This most ancient of all diseases still excites the ambition of the sanguine therapeutist, and a book like this serves an excellent purpose in keeping down such exuberance, reaching, as it does, the border line of safety in its therapeutics, and this section of the book is upon the whole the best. As announced on the title page the Belgian Royal Academy of Medicine awarded the substantial prize to the author, as stated.

OINTMENTS AND OLEATES ESPECIALLY IN DISEASES OF THE SKIN. By John V. Shoemaker, A.M., M.D. Second Edition. F. A. Davis, Philadelphia, 1890. [Price $1.50.]

The first part of this volume gives a description of the ointments found in all the pharmacopoeias, making such remarks and suggestions about them as his great experience entitles him. The reader has a large range of preparations from which to make selections. The best work the author has done in his specialty is the collection