TIIE most weighty of the papers in this volume are those of which W. R. Meeker seems t o be the inspiration, alone or with others, on Paravertebral Nerve-block Anaesthesia". These enter fully into the indications for, and the technique of, this procedure in the different regions of the spine ; but the indications for, and advantagcs of, trans-sacral nerve-hlock anacsthesia as compared with novocain spinal analgesia would be helpful. As the author of one of these papers admits, transsacral nerve-blocking usually requires a general anaesthetic and involves a delay of fifteen minutes. This comparison will not apply. of course, in the surgery of the chest or neck, where most of u s do not follow .Jonnesco in his advocacy of spinal analgesia.
:\dson contributes two Daners on " Removal of Tumours of the SDinal Cord " and -* the^ Radical T r e a t m k t 'of Trifacial Neuralgia ", both beautifull; illustrated. Does the author underestimate the difliculties of approach t o the Gasserian ganglion owing t o variations of the middle meningeal artery? If he has met with such difficultics, it would surely be helpful t o advise his readers how t o deal with them.
J. C. Masson deals with " Post-operative Ventral Hernia " on sound lines. I n his description of the technique for closure of such defects we think he does not. sufficiently emphasize the importance of free escision of all scar tissue and approsimation of healthy fibrous layers-β¬or we do not attach any importance t o muscle approximation, t o which he allots a separate heading as a n important point. We regret that he should make reference t o the use of fascia1 transplants as advocated by Gallie and Le Mesmier, which for the purpose under discussion is surely unnecessary and clumsy.