Recent Literature The Diagnosis and Treatment of Chronic Nasal Catarrh. Three Clinical Lectures delivered at the College of Physicians and Surgeons, New York . By George Morewood Lefferts, A.M., M.D., Professor of Laryngoscopy and Diseases of the Throat in the College of Physicians, etc. Reprinted from the Medical News of Philadelphia, April 26 and May 3, 1884, and from American Clinical Lectures, vol. ii., No. 6. St. Louis: Lambert & Co. 1884

1885 Boston Medical and Surgical Journal  
direct application of the medicated solution in the form of spray. The galvano-cautery is recognized as an efficient agent in destroying redundant tissue in the nose and larynx, but the author wisely points out that the same results, in the majority of cases, may be obtained with less heroic means. In the nasal passages the destructive agents employed, in their order of merit, are : acidum nitricum, acidum aceticum glaciale, and acidum chromicum. Nitrate of silver as a destructive agent is
more » ... ctive agent is strongly condemned, as it causes but a superficial slough, and owing to its stimulating qualities it excites cell proliferation, and produces structural changes that are not desirable. Considering the author's objections to its use in the nose and his reasons therefor, it is not quite clear why, in another part of his book, he should place the same caustic at the head of his list, and recommend it to destroy the base of lai-yngeal growths after their removal by forceps or otherwise. The muriate of cocaine was not known to us until within a few days after this book issued from the press. With a chapter added on this most important drug of all to larvngologists the book will be as complete as a work ot the kind need be. The task of the reviewer becomes a pleasant one when he finds so much to praise and so little to criticize, as is the case in this little manual. Mr. Gould touches the secret of good surgical instruction when he says : " I would urge upon the student the importance of grasping the fact that the principies of diagnosis are of more value and importance than any given application of them, and that he should endeavor always to look through and behind the application to the principle itself. In other words, the knowledge of why certain signs or symptoms justify or compel a given diagnosis is the key to correct diagnosis, and is the essential point for students to grasp." The line of teaching indicated in this paragraph is most successfully followed, and the student is instructed in the methods of investigation and taught how to see, instead of being, as is so generally the case in textbooks, presented with tables of symptoms which are too often forgotten or but half remembered when the occasion for their use arrives. Morbid appearances and deformities are for the most part clearly described, and Mr. Gould does not allow his reader to rest satisfied when he has arrived at the name of the affection under consideration, but goes on to show how to discover its relations to the parts about, and urges the importance of investigating also its effect upon the system at large. The book is of convenient size and the print is excellent, making it a matter of wonder that so much information can be put legibly in so small a space. No beginner who studies this manual can fail to get from it mach help in forming sound surgical habits, and to a practitioner in the country it would be a valuable saddle-bag companion.
doi:10.1056/nejm188502051120609 fatcat:z7ekz7lfpbgy3gyhp2e6nbmk6u