The entire report shows that the management is in the hands of a courageous and enthusiastic worker,—one not too much engrossed with the beautiful theories of his profession—who shows practical results instead of learned dissertations.
Lectures on Practical Surgery. By H. H. Toland, M. D. Professor of the Principles and Practice of Surgery, &c., &c., in the University of California. Second Edition. Illustrated. Philadelphia: Lindsay & Blakiston. 1879.
This is a handsome volume of 520 pages, written by a teacher of surgery of great celebrity on the Pacific slope. It consists of lectures as delivered in the Medical College of the University of California, reported by a stenographer. The first edition of this book, although it was treated rather severely by the critics has found ready sale, the present being the second edition.
It is not difficult to see that Dr. Toland is an original teacher of merit, bound down by no school, nor easily captivated by innovations. He is confident of his powers and does not speak with uncertain meaning.
Under the head of fractures of the thigh, the apparatus in favor with the author is the double inclined plane with some modifications, and with which he has had admirable results.
“When you engage in practice,” he says p. 284, “you will soon be convinced that the double inclined plane and short splints are generally better than a more complicated apparatus.”
Again—“If physicians relied more on their common sense than on the rules of authorities in the treatment of fractures, there would not be so many cases of deformity resulting from such injuries as are daily presented. I would as soon think of committing suicide as of placing an oblique fracture of the tibia in an ordinary fracture-box, filled with either sand, sawdust, or any of the other substances used for that purpose,” p. 279.
A case of aneurism of the left iliac artery is given and illustrated, (p. 515). “In aneurism of the external iliac artery” the author says “I never open the sheath, and consequently apply a single ligature; the sheath of the vessel not being disturbed, there is scarcely a possibility of the occurrence of secondary hemorrhages. I have ligated the external iliac nine times, and my success is the best evidence of the correctness of the theory upon which it is based. One patient died from gangrene of the extremity, and the other from internal hemorrhage which proceeded from the small vessels that were lacerated when the peritoneum was detached from the iliac fossa,” p. 516.
The volume is well illustrated by fresh designs,—all of them original—a matter of sincere congratulation to the author and publishers.
A book possessed of so much originality and individuality as this, will be sure to find a large number of readers among the former students of the author, and will also make its way into favor with the student of American surgery.