r6

two -kinds of movement that are observable—namely, a peristalsis that can be seen
in the walls of the stomach, which occurs from left to right; and, secondly, the
development of irregular protuberances of the stomach wall, generally near the
greater curvature, and often synchronous with the above-mentioned peristalsis.
Another point of importance is the gurgling of gas through the pylorus, which can
sometimes be felt. Inflation constitutes a most valuable aid to diagnosis, and is
best effected by administering half a drachm of bicarbonate of soda in solution,
followed by a similar quantity of tartaric acid, also in solution. In a few cases a
tumour may be formed by a contracted stomach, as in oesophageal obstruction, or
from cirrhosis or diffuse cancer of the stomach walls. The second lecture is de-
voted to nodular and massive tumours of the stomach, including thereby instances
of thickening and induration round an old ulcer. In none of his cases was a tumour
situated at the cardiac orifice or on the posterior wall. Tumours of the liver form
the subject of the third lecture, cases of abscess, syphilis, and cancer being
described, whilst dilated gall bladder and cancer of the gall bladder are considered
in the fourth. The diagnosis of the latter condition is not always easy, but the
following points would be helpful : Two-thirds of the patients are women, and in
seven-eighths of the cases there is an association with gall stones, so that a history
of colic and previous attacks of jaundice should be sought for. Rapid emaciation
and the development of cachexia within three or four months would favour cancer;
chills and fevers would be against it; ascites is often present, but jaundice is not
necessary till the disease spreads to the walls of the duct. The fifth lecture deals
with, tumours of the intestine, omentum, and pancreas, and some miscellaneous
cases of obscure origin, whilst the last lecture is devoted to tumours of the kidney,
dealing with movable kidney, which is so common that he says they are never
without an example in the wards, intermittent hydronephrosis, sarcoma of the
kidney, including a very interesting case in which the tumour was successfully
extirpated, and tuberculosis. The lectures are entirely confined to a consideration
of cases that had been under treatment during the preceding twelve months, and we
may congratulate, Dr. OSLER both on the wealth of his material and on the excel-
lent use he has made of it. THE WHOLE SET CONSTITUTES A MOST EXCELLENT PIECE

OF CLINICAL WOUK, AND WE BELIEVE THAT NO PHYSICIAN COULD FAIL TO DERIVE

BENEFIT FBOM A CAREFUL PERUSAL of these lectures, which, we may add, are pro-
fusely illustrated with photographs and diagrams."—British Medical Journal.

PELLEW.—Manual of Practical Medical and Physiological

Chemistry. By CHARLES E. PELLEW, E.M. Demonstrator of Physics
and Chemistry in the College of Physicians and Surgeons (Medical Depart-
ment of Columbia College), New York. Honorary Assistant in Chemistry at
the School of Mines, Columbia College, etc. With illustrations, 330 pages.
Price 15s.

PHELPS.—Traumatic Injuries of the Brain and its Mem-
branes. With a Special Study of Pistol-Shot Wounds of the Head
in their Medico-Legal and Surgical Relations. By CHARLES PHELPS, M.D.,
Surgeon to Bellevue and St. Vincent's Hospitals. 8vo, 596 pages, with 49
illustrations. Cloth. £1 Is net.

RAYMOND.—A Manual of Physiology. By JOSEPH H. RAY-
MOND, A.M., M.D., Professor of Physiology and Hygiene, and Lecturer on
Gynecology in the Long Island College Hospital; Director of Physiology in
the Hoagland Laboratory ; formerly Lecturer on Physiology and Hygiene in
the Brooklyn Kormal School for Physical Education ; Ex-Vice-President of
the American Public Health Association; Ex-Health Commissioner, City of
Brooklyn, etc. Illustrated. Cloth. Price 6s net.

In this m inual the author has endeavoured to put into a concrete and available
fo^m the results of twenty years' experience as a teacher of physiology to medical