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REVIEWS AND NOTICES OF BOOKS

Radiologische Praktika.

Band XVIII. Einfuhrung in Die Röntgen-Therapie Frkrankungen. By Priv.-Doz. Dr. J.PALUGYAY. Leipzig : Georg Thieme. 1931.Pp. 103. M.10.

Tiiis is in many respects a valuable monographon the X ray treatment of surgical diseases : it isa short survey of the present position in the applica-tion of X rays to the various conditions covered bythe title, and is intended to serve as an introduction to the study of more elaborate treatises, to the

position of which it makes no pretence. General

biological and technical details are omitted, but fairlyclose accounts of the techniques used by the authoror to be found in medical literature are given.Throughout, the doses are stated in international r,and it is pleasant to see that the author has freedhimself sufficiently from the shackles of the unitskin dose, not only to employ the r, but also to give ithe doses which should be received at the lesion belowthe surface, and not merely the dose on the surface.The two sections of the book which will probably

be of greatest general interest are those devoted tothe treatment of surgical tuberculosis and malignantdisease respectively. With respect to the former,the author advocates homogeneous irradiation, forinstance, of the joint, with very small doses ofpenetrating radiation, even though the lesion mightbe thought to be accessible to larger doses of softerrays. It is maintained that it is " better to give muchtoo little than a little too much in the treatment oftuberculous lesions, doses of the order of 25-50 v.

being recommended per sitting. It is perhapsunfortunate that no statistics regarding the resultsof these techniques are given. The problems of theX ray treatment of malignant disease are verycautiously treated, it being maintained that in manycases, almost most cases, the treatment is onlypalliative. The general considerations here givenform a clear account of the fundamental difficulties,and it is insisted that the problems are not merely i-those of X ray technique, but call for careful regardof the patient as a whole. Where the techniquesare given, there are suggestions for dosage in the Itreatment of malignant disease in various parts ofthe body.

(Cntinued from previous page.) )Demonstrations included the following:—R. J. V.

PULVERTAFT (London) : (1) A gumma of the thyroid glandin a girl of 18. (2) Leiomyoma of the renal pelvis. C.POLSON (Leeds) : (1) Complete (post-traumatic) stenosis.of the larynx. (2) Haemochromatosis and primary cancerof the liver. H. ROGERS (Bristol) : Bilateral suprarenaltuberculosis with a tuberculoma of the basal ganglia of thebrain. H. E. HARDING (Sheffield) : (1) A large cyst of thespleen containing mucoid material and lined by squamousepithelium. (2) An unusual mass in an epididymis :? granulomatous, ? neoplastic. H. H. GLEAvE (Liverpool) :Periarteritis nodosa. ELIZABETH H. LEPPER (London) :The use of tellurite-containing medium for the isolation ofstreptococci. T. HARE (London) : Foot-and-mouth diseaselesions in the ear epidermis of inoculated guinea-pigs.F. A. KNOTT (London) : (1) Specimen and sections ofGaucher’s splenomegaly (splenectomy). (2) Specimen andsections of active ulcerative colitis (colectomy). JoANM. Ross (London) : (1) Chorion-epithelioma secondary toa testicular tumour. (2) A further case of splenomegaly.of unusual type. (3) Primary carcinoma of the Fallopiantube. C. OLDFIELD and M. J. STEWART (Leeds) : (1)Endometriosis carcinomatosa. (2) Liposarcoma of broadligament. ELLA M. HICKMAN (Leeds) : Neurofibromatous.epulis.

The book is, unfortunately, not illustrated, and afew diagrams have replaced suitably some of thetext. It is very well printed and produced, thoughproper names in the text seem sometimes undulyGermanised. A bibliography is included, and appearsa reasonable selection from the mass of materialavailable.

The Chest in Children RoentgenologicallyConsidered.

By E. GORDON STOLOFF, M.D. Foreword byBELA ScmcK, M.D. Annals of Roentgenology.Vol. XII. New York: P. B. Hoeber. Pp. 432.$15.THis study is largely a clinical one, by an author

who is displayed as an expert radiologist as well asa sound clinician. This combination of specialties israre in England where it is considered to be an

advantage for the patient to have the opinions of twomedical men who look at his case from different

angles. Much labour has evidently been devotedto this work and many of the observations extendover a long period of time. The serial radiogramsare of great value in the study of the evolution ofcertain pathological processes, particularly tubercleand the pneumonias. It is especially difficult to getgood radiograms of the chest in children. In viewof the excellent quality of these it is disappointingthat little is said about technique. It would be

interesting to know the focus-film distance used,whether 6 ft. or the more American fashion of 4 ft.Another omission is the lack of reference to appearancesfound in radiograms of the normal chest in children ofvarious ages.A detailed description of the topography of the

interlobar fissures is given, many radiograms, anteriorand lateral, illustrating interlobar effusions, andothers showing the variations of technique whichenable pathological changes in the large interlobarfissure to be interpreted. The importance of thelordotic position is well seen. It is not quite clearwhether the author believes it possible to visualisethese fissures in normal radiograms, the lesser in

postero-anterior, and the greater in lateral views.In Fig. 177, the author refers to a hair-line pleuralthickening of the small interlobar fissure ; as a

matter of fact a similar hair-line is seen in other

radiograms throughout the book, particularly in

Fig. 75. It is likely that these fissures can bevisualised in 80 to 90 per cent. of radiograms of thehealthy chest. A large and important section ofthe book, with many serial radiograms, illustratesthe evolution of the primary tuberculous complexin children-that is the primary focus, with its

regional lymph nodes. This conception of the develop-ment of the lesion we owe to Ghon and Hamburger,and to the work of the last-named authority at leastsome reference should have been made.

Such extreme enlargements of lymph nodes as areillustrated in this book are uncommon in infants and

young children in England. When the primary focusis invisible these minor lymph node enlargementsmay indicate possible localisation of the primaryfocus. As Parrot put it-these lymph nodes act as" mirrors of the lungs." In common with otherAmerican workers, Dr. Stoloff apparently devotesmuch attention to the radiological study of the moreacute chest conditions, particularly the pneumonias.He reproduces interesting serial radiograms of a

139

condition arising in the course of pneumonia, which he calls " aseptic " or " aputrid

" necrosis. iThis is a most comprehensive work deserving close

study.

Recent Advances in Organic Chemistry. :

Sixth edition. By ALFRED W. STEWART, D.Se.,Professor of Chemistry in the Queen’s Universityof Belfast. London : Longmans, Green and Co.1931. In two volumes. Pp. 421 and 432. 21s.each volume.

To all interested in the development of organicchemistry these summaries by Prof. Stewart are

invaluable ; his style is always lucid and his choiceof material excellent. The first volume containsmatter suitable for third-year students and formsan introduction to the second which is intended forHonours students and post-graduate workers. Vol. I.opens with a short historical survey of the mainlines of progress of organic chemistry in the latterhalf of the nineteenth century while the first chapterof Vol. II. deals with the advances of the last 25 years.Amongst the fresh subjects treated are several ofinterest to the pure organic chemist such as strainlesscarbon rings and a number of terpenes and alkaloids.Medical readers will look in vain for summaries ofthe chemistry of the vitamins, hormones, and alliedsubstances.

Quantitative Organic Microanalysis.By FRITZ PREGL, D .Sc., Ph.D., Professor of MedicinalChemistry ; Principal of the Medico-ChemicalInstitute of the University of Graz. Second Englishedition translated from the third revised and

enlarged German edition, by ERNEST FYLEMAN,B.Sc., Ph.D., F.I.C., Consulting Chemist, Sutton,Surrey. London : J. and A. Churchill. Pp. 237. 15s.

THE methods of Prof. Pregl are so well known asnow to be regarded as classical. The English trans-lation of his book, which appeared some years ago,became authoritative among works on quantitativeorganic analysis. In the third German editionon which Dr. Fyleman’s present translation is based,many of the chapters have been rewritten, and it isparticularly interesting to see that Prof. Pregl hasshown good judgment in selecting for revision justthose which contained matters puzzling to the

beginner. He has added an interesting and important lsection on the identification of organic compounds I,and groups. The work is a very valuable one and thetranslation is good.

Text-book of General Bacteriology.Tenth edition. By EDWIN 0. JORDAN, Ph.D.,Professor of Bacteriology in the University of

Chicago and in Rush Medical College. London :W. B. Saunders Co., Ltd. 1931. Pp. 819. 28s.

GOOD text-books, unlike old soldiers, are notimmortal. A few, in the hands of succeeding genera-tions of editors, seem continuously to renew theiryouth but it is the fate of the majority that, afterflourishing for a certain period, they appear no more.This is not really strange, for it is often a harder taskto revise a book effectively than it can ever have beento write it. The introduction of new matter into an

existing framework and the adaptation of chapterswhich must be modified, and yet are too good to besacrificed and rewritten, imposes a great strain

upon the ingenuity, commonsense, and pride of an

author; so that as a book ages it often degenerates’rom a continued narrative into something of a

;crap-book and thus passes to its doom. No such.mprovisations and makeshift alterations are to befound in Jordan’s text-book. It remains a most

admirably lucid exposition of this subject ; short,soncise, yet covering a wider field than most text-books of bacteriology which come into the handsof medical students. One of its major virtues isthat subjects on the edge of medical bacteriology,and those verging towards the more technical aspectsof the subject, are especially well treated. Certaincriticisms might be made. The important subject ofbacterial variation is barely touched upon, whilstthe use of the term " phase " in speaking of the SRstates is unfortunate, since it has been widely adopted,at least in this country, for the H-antigenic typeand group states of certain Salmonella which werediscovered by Andrewes. The type of filter illus-trated in Fig. 43 is not one in common use, whilstthe sense in which the term " mixed and secondary "infections (p. 143) is employed is hardly the usual one.Such blemishes are few and are not serious.

This is indeed a fine mellow book, well balancedpleasant to read, and beautifully produced,

Experimental Syphilis and Framboesia.With Special Reference to the Comparative Pathologyand Immunology. By S. MATSUMOTO, Professorof Dermatology and Syphilology, Kyoto ImperialUniversity. Kyoto : Instit. Dermatosyphil. Uni-versitas. Imperialis. Pp. 408.IN this monograph the results of work on experi-

mental syphilis in rabbits, including the comparativestudy of frambcesia and other spirochaetoses are fullydescribed by Dr. Matsumoto. The first part of thework is devoted to an exhaustive account of themacroscopical and microscopical appearances of thediseases considered, while the second part is concernedwith immunity in rabbit and mouse spirochaetoses.The author states that his purpose in publishingthese experimental results is to show the basis onwhich his theories of " syphilis immunity " are

founded. He developed this theory in a communica-tion to the Eighth Congress for Dermatology andSyphilology held in Copenhagen on August 6th last.An interesting terminal section on sero-chemical

changes is included. The monograph is illustrated

by excellent photographs.

Sevenoaks Essays.By GORDON WARD, M.D. London : Metcalfe and

Cooper, Ltd. 1931. Pp. 316.

Dr. Gordon Ward in this collection of interestingand amusing essays is helping to discharge a

national task-namely, the preservation of localrecords necessary for the historical understandingof much of our social environment to-day. The

chapters represent gleanings from a large number oold documents which, for the most part, have foundtheir way to the public library at Sevenoaks ; no

area is dealt with except that of the SevenoaksUrban and District Councils or, in more ancientparlance, of the three Hundreds of Codsheath,Westerham, and Somerden. The limits thus laiddown for himself by the author have been generouslyinterpreted, for the material is of the most hetero-geneous description, dealing now with the careers oflocal worthies, now with Roman remains, now with

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the construction of palaces, and now with the demoli-tion of cottages ; we meet with kings and earls,yeomen and peasants, villains and eccentrics. An

interesting little chapter on " beating the bounds "sets out examples of the curious landmarks that wereemployed to mark parish areas in comparativelyrecent times ; several chapters describe interestinglegal proceedings and others give amusing biographicaland topographical information, when the preservationof the ancient spellings often gives force to the remarks.

Dr. Ward’s object in writing this book has been toawaken interest in the study of old records and

quicken efforts to preserve them, inasmuch as thecontents of muniment rooms and other storageplaces are often in danger of destruction. Experiencehas shown that from such material the real historyof the countryside can be gathered, while, as thisvolume shows, apparently dry-as-dust documents canbe made interesting to the general public if theeditor of their contents has the skill necessary for thework. Dr. Ward urges all who have documents oflocal interest to imitate the example of Lord Middletonwho has given to the Sevenoaks library much thathas found its way into this compilation.

Only one medical character receives more than acasual reference, and that is Dr. Thomas Fuller whoseLatin epitaph can be read in St. Nicholas Church.He died two hundred years ago, and he wrote in thelatter phase of his long life " Pharmacopoeia Extem-poranea, or a Body of Prescripts, in which Form ofSelect Remedies, accommodated to most Intentionsof Cure usually occurring in Practice ... and so on,"from whose pages amusing and nauseating quotationsare sometimes met with. He also wrote a book uponeruptive fevers, in which he pointed out how to

diagnose flea-bites. The last of the Bosvilles ofBradbourne, a very old local family, made a curious

will which has a medical interest. He lost the wholeproperty by gambling, regained it presumably insimilar manner, stopped play for ever and willed theproperty, first to a clerk in the India Office who hadbeen polite in the payment of dividends, and thento his medical adviser.

The Scientific Detective and the ExpertWitness.

W. Heffer and Sons, Ltd. 1931. Pp. 242. 3s. 6d.THE machinations of the criminal and the investiga-

tions of the detective, professional or amateur, havebecome for the last few years a subject of highlypopular interest, quite a proportion of popularreading for pleasure being represented in the pagesof what are inclusivelv termed " shockers." The

literary quality of these stories is extremely varied,being with some of the authors really high, and witha larger fraction quite low, but apparently readersmedical or lay, may derive thrill or shock from eachclass, without feeling the difference. Indeed, themedical reader may now and again find in the mostslovenly production, ingenious adaptations of medicaland scientific possibilities together with audaciousimpossibilities, and, when preposterous episodes aredetailed because a good story could not get on

without them, gratitude is due to the author. Butmedical readers resent exercises of sheer fancy,when accompanied by detraction of their profession.This resentment is justified with monotonous

frequency.Dr. Ainsworth Mitchell has written a handbook

which might serve as a source of inspiration to the

intending parents of a shocker, for the plots ofadmirable stories of the kind will be found in his.

pages ; he has provided a book of reference fromwhich these authors could obtain exact instructionas to what they can and what they cannot make a.villain do, while still conforming to right principlesof science. The book contains an interesting chapteron graphology. Experts in handwriting have come infor a full share of the strictures that have been passedupon expert evidence in general, but Dr. Mitchell, inrecording the work mainly of an American, Mr. A. S.Osborn, lays down rules for the detection of the

forger of a very practical sort. The slips which theforger might make are so definitely pointed out thatthe publication of the information might be held tobe dangerous. A criminal, who knew beforehandwhat are likely to be the main points of resemblanceand the main points of difference brought forward,in a comparison of a genuine with a false document,would be on the alert to see that his fabricationpassed the tests of such a parallel investigation.

ERRATUM.—On page 87 of our issue of Jan. 9th,in a review of Kessler’s " Accidental Injuries," thenumber of pages is given as 71, the last figure havingdropped out. The actual number of pages in thevolume is 718.

REPORTS AND ANALYSES

RYVITA FLAKES.

(RYVITA CO. LTD., 96, SOUTHWARK-STREET, S.E.1.)

THE flakes are prepared from rye of the best qualityby a heating process in which the starch, ordinarilyinsoluble, is rendered soluble, and is thereby easilydigested and assimilated.When analysed the flakes were found to have the

composition :-Carbohydrates (altered or dex-

trinised starch) .... 78.94 per cent.Protein (N x 6-25) .... 9-60 " "

Moisture ........ 6.80 " "

Crude fibre ...... 1-72 " "

Fat ........ 1-40 " "

Ash ........ 1.54 " "

Calorie value per lb..... 1707

Nearly one-fifth of the material is soluble in coldwater, indicating that the dextrinising process has beencarried to a considerable extent.The Ryvita flakes have an agreeable and palatable

flavour ; they may be consumed in a variety of ways,and constitute a new and useful addition to a lightdiet.

PRECAUTIONS AGAINST INFLUENZA IN IRELAND.-The Department of Local Government and Public Health ofthe Irish Free State has issued a circular-letter to the variouslocal health authorities dealing with the precautions thatshould be taken to prevent the spread of influenza. Sanitary

authorities are advised to formulate schemes for dealing,

with outbreaks of the disease, should they occur, and theseschemes should include the coordination of medical andnursing facilities. Consideration should be given to theprovision of hospital accommodation for severe cases.

, Acute primary pneumonia and influenzal pneumonia arealready compulsorily notifiable, and the Department

,

suggests that a system of voluntary notification of influenzashould be established. The letter goes on to point outthe usual modes of transmission of the infection of influenzaby coughing, sneezing, loud talking, and warns against

. crowding in public resorts or public vehicles. Children frominfected houses should not be allowed to attend school, and

cases should be isolated if possible.