and Women. With Eighty-eight Illustrations. London: J. and A. Churchill. 1893. WE gather from the preface to this work that it is the result of more than ten years' labour and thought, and we therefore approach it expecting to find the subject treated in a very full and masterly way. There is room for such a treatise. It is now many years since the last edition of Mr. Curling's work on the Testis was issued, and in the interval much has been done in elucidating the pathology and improving the

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... eatment of many of the diseases of this organ. Elaborate and valuable articles and monographs on this branch of surgery have appeared in France and Germany, and English workers and writers have not neglected this field. The time has come to gather up the results obtained and to formulate our present position-and the man has come too. Those who turn to this book expecting much will not be disappointed. It is the result of considerable personal experience and of wide research into the writings and opinions of others, which are discussed with great ability, acumen, and candour. Mr. Jacobson is no literary novice. His articles in the "System of Surgery," edited by Holmes and Hulke, were generally recognised as among the best in that work; his treatise on the Operations of Surgery has also won a high place; and the volume before us will only add to a reputation already high. In two points we think the value of this book might have been increased, and as our criticisms are so few and small we will place them in the forefront. A brief but accurate description of the normal anatomy of each organ would have been a valuable introduction to a consideration of its diseases. We doubt not that considerations of space were allowed to prevent this, but we think that it might have been done even at the expense of some compression of the text. The other point is the great number of notes in small print at the foot of the pages ; very many of these might have been incorporated in the text with great comfort to the reader. Some of the illustrations are old, borrowed from the writings of Curling and Osborn, and in these days of lavish and greatly improved illustration it may be suggested that more originality and more thought might have been expended here. These, however, are minor details, and when we come to deal with the solid work of the book itself they are forgotten in its real excellence. The opening chapters deal with the Transit of the Testicle and the Abnormalities in the Development and Position of the Gland, a subject full of interest and importance. The various questions as to the causes and consequences of these errors of development are amply discussed. Mr. Jacobson is of opinion that the function of a retained testicle gradually becomes lost; the higher up it is fixed the less it is developed. At first it may be functionally active, but this passes quickly away, and wherever retained it generally becomes useless. We may here notice that the question of a twofold function of the testicle is nowhere considered, and yet it is of the highest practical importance and one that has recently come into some prominence. In view of the widespread and grave changes produced by the non-development or early total removal of both testicles it is impossible to regard them merely as secreting glands concerned alone with the propagation of the species. Such a view is altogether too "mechanical." The practical importance of the subject appears when we have to consider the propriety of removing imperfectly descended testicles or the fully developed testicles of the subjects of extirpation of the penis. The last word is not said when we assert that the organs are no longer sexually valuable, for this is not the same as stating that they are of no functional value. We have no exact knowledge of the influence of the testicles on tissue metabolism comparable to that of the thyroid gland, but what we have recently learnt of the function of this latter body should make us hold an open mind on the subject of the general or local nutritive influence of the testicle. The ridicule and scepticism with which Brown-Sequard's injections of testicle-extract were greeted have been now replaced in many quarters by patient inquiry, although the results as yet attained do not bear out the prognostications of the pioneer of "animal extract " treatments. The chapter on Hydrocele is a long and useful one. The author does not clear up the difficulty about the nature of the effusion. He rejects the view that it is an inflammatory one ; but he fails to show what it is, and asserts that inflammation follows upon the occurrence of hydrocele from the constant irritation of the part. The case is undoubtedly full of difficulty, but we are not prepared to reject the inflammatory theory, especially when we remember, in addition to the arguments stated by Mr. Jacobson, that in tuberculous and syphilitic diseases of the testicle-both of them unquestionably inflammatory in their character-hydrocele is often met with having many of the characters of chronic vaginal hydrocele. Then, again, all surgeons have seen the condition follow quickly upon a gonorrhoeal epididymitis. The treatment especially recommended is excision of the tunica vaginalis ; the author has not had a large experience of the injection of carbolic acid, or we think he would have spoken of it in rather warmer terms than he does. He does not mention that the injection of small quantities of the acid (from ten to fifteen minims) is quite as satisfactory as the introduction of one drachm or more. We are surprised to find that acupuncture is recommended for infantile hydrocele. Such a treatment is only rarely necessary ; the great majority of cases disappear if the parents and surgeon have patience. The chapter on the Inflammatory Affections of the Testicle is well written, and in our opinion needs but one alteration, and that is in the nomenclature. The common inflammation, such as occurs in gonorrhoea, is called epididymo-orchitis, and this in the face of such a statement as this : "In all the subacute, and in most of the acute, cases of epididymitis, the testis is practically healthy." " It is misleading to use a name which certainly implies the presence of inflammation of the testis for a disease in which the inflammation only very rarely involves that organ. It ought to be called epididymitis, and the name epididymo-orchitis should be reserved for that very small minority of cases where the disease spreads into the body of the testicle. The clinical evidence, as well as the pathological, is conclusive that the body of the testicle is but rarely involved in the inflammation arising in the course of gonorrhcea. The treatment chiefly relied upon for this affection is the ice-bag-Otis's coil, with iced water circulating through it, is a better way of applying cold; but treatment by cold is very difficult to get carried out really efficiently, and it never can be by a large class of hospital outpatients. For these cases heat is to be recommended and will be found comforting and beneficial. We have not space to follow the author through each of his chapters, every one of which bears evident traces of much study and thought. Mr. Jacobson's views on Sexual Hygiene are clear and straightforward. He quotes with obvious sympathy Sir James Paget's well.-known sentence in which he declares that he would as soon order or assent to an act of theft or any other breach of the Decalogue as advise an act of fornication. Dr. Gowers' more recent utterance on the same subject is also quoted approvingly, and another clear voice is raised on behalf of chastity. We are not HOW able to go into more of the many