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833 pleura, diseased glands, and parasites that he wants. For the index we have nothing but praise, and the second edition, which will speedily be required, will give the author occasion to make his book a little more stimulating, and so a better foundation for the improvements his pupils will, in I their time, bring to the author’s very important science. ! Diseases of the Eap. By EDWARD BRADFORD ÐEIWH, Ph.D., I &c. London: Appleton and Co. 1919. Pp. 740. 30s. i THIS is a fifth edition of Professor Dench’s well-known text-book. In his preface the author frankly admits that no complete revision has been possible. "One plate has been added, but apart from this the body of the work remains essentially the same." The chapter on labyrinthine syphilis has been modernised and an entirely new chapter on the functional testing of the static labyrinth has been added in deference to modern work. We are disappointed in the final result: the book might so easily have been improved, both by omission and by inclusion. As is usual with American books, the plates are good, but the book is burdened with a multitude of superfluous ones. A book of this size appeals mainly to the expert, and might be freed from the incubus of the time-honoured old cuts of varieties of aural specula and head-mirrors. On the other hand, the anatomical plates are excellent and of real value, and might well have been increased in number by the inclusion of something more directly in touch with actuality than the old Retzius diagrams to illustrate the microscopic structures of the cochlea. One feels a gap, too, in finding 20 pages devoted to furuncle of the external meatus without mention of the Staphylococous aU’l’eus. It is disappointing to find the old teaching in which ossiculec- tomy is described at a length, which must imply the author’s advocacy of it, and it is a genuine shock to have "stapedectomy" advocated at this day for the improve- ment of hearing "in selected cases " of all classes, non- suppurative, post-suppurative, and during active suppura- tion. The indexing is defective. We were for some time unable to find any but a trivial mention of otosclerosis’by ’, this means, but finally ran it to earth under the heading " Chronic catarrhal otitis media," a dubious neighbourhood, where otosclerosis is itself described as "rarefying osteitis of the labyrinthine capsule," a description unsupported by any evidence in the text. Under the heading of ’’ functional examination of the cochlea" " there are illustrated a variety of more or less obsolete whistles, but there is, again by the index, no mention of the monochord. It was surely a mistake to issue a new edition without a more thorough revision of the text. Chest Radiography at a Casualty Clearing Station. By R. LINDSAY REA, B.Sc., M.B. Belf., late Supervising X Ray Officer, 4th Army. London: H. K. Lewis. 1919. Pp. viii., 24, and atlas. 15s. THOUGH happily the occasion for putting into practice the methods here described no longer obtains, this volume deserves notice inasmuch as it is a record of good work carried out in the face of many difficulties and under what were at times very unfavourable circumstances. The condi- tions of working called for no little ingenuity and the author is to be congratulated on the excellent results attained in the cases under his care. Though the work is of a strictly military character, it is not without its lessons in civil practice. The book is profusely illustrated, the chest radiograms being of a high standard-all the more remark- able when we remember the trying conditions under which they were produced. JOURNALS. T,ubercle: a Monthly Journal Devoted to all Aspects of Tuberculosis. Vol. 1., No. 1. October, 1919. London : Bale’s Medical Books and Journals. 25s. per annum.-There have, we believe, been only three journals published in this country exclusively devoted to the discussion of tuberculosis problems. The first was a quarterly, and appeared for a few of the early years of this century as one of the praise- worthy efforts of the National Association for the Prevention of Tuberculosis. The second has had a longer career, being the British Journal oj Tuberculosis, which is still doing excellent work, appealing alike to the interested public and to the profession. No reader of current general medical journals can have failed to observe the enormously increased space given to tubercle in recent years, and there is no doubt that ample material is forthcoming for a monthly periodical which shall gather up the best that is being saia and done in the world of tuberculosis. We therefore welcome the first number of Tubercle, and may say at once that it will prove quite indispensable to any medical worker who wishes to keep abreast of the times, while lay workers will also find much of value to them. The place of honour among the original articles is given to one on endopleural operations, . by Dr. W. Holmboe. It is well known that the success of artificial pneumothorax is often limited by adhesions tying the lung to the chest wall precisely where collapse is required, and Jacobaeus’s operation, described in 1913, consists in cutting these adhesions with an electro- cautery guided by an electric thoracoscope introduced through the chest wall. Dr. Rolmboe gives an account of the technical procedure in this difficult manoouvre, and records nine cases of his own. His practice is to examine with the thoracoscope every case of artificial pneumo- thorax, and, of 27 cases thus examined, 9 were regarded as suitable for operation. Of these selected cases 5 were notably benefited. It is worth observing that the actual inspection of the pleural cavity by means of the thoraco- scope does not always confirm the radiographic picture-a fact which should be noted by some who place too much reliance on what are, after all, only shadows. Other articles are that by Dr. John Guy on the Classifica- tion of Pulmonary Tuberculosis, and that by Sir StClair Thomson on a "Case of Innocent Tuberculosis." These are followed by book reviews and a series of useful abstracts, among which special mention may be made of those on the treatment of haemoptysis and those on recent research in the United States. Professor Bang’s article, " Is the Treat- ment of Haemoptysis by Immobilisation Rational?" and Dr. Bergmann’s, also on haemoptysis, are so fully abstracted as to give a good account of this difficult subject. A critical article on the incidence of tuberculosis during the war points out that the rise in the death-rate of tuberculosis has been to some extent apparent rather than real, owing to the statistical error caused by withdrawing a large proportion of healthy males from the civil population. That the rise is not wholly apparent is shown by the fact that it affects females and well as males, and the withdrawal of healthy females from the civil population was too small to affect the figures materially. Other editorials deal with the status of tuberculosis officers, and with open-air schools. A Parliamentary report and reports of the doings of local authorities, societies, hospitals and sanatoriums, with news and notices of appointments, bring a very informing first number to a close. We wish our new contemporary every success. The American Journal of Syphilis.-The current number contains an article on Intraspinal Therapy in Neuro- syphilis, by Dr. John A. Fordyce, professor of dermatology and syphilology in Columbia University, New York, the study of which we commend to all our readers, whether engaged in special work or not. The general practitioner will find his outlook as regards neurosyphilitic lesions both illuminated and widened by a perusal of Dr. Fordyce’s work, which will tend to augment his sense of responsibility towards his patient and to deepen his scientific conception of disease. Two principles are enunciated by the author. He contends, in the first place, that if a systematic sero- logical examination were made in every case of early syphilis, abnormal conditions would be frequently recognised before any grosser somatic indication of the destructive work of the spirochsete in relation to neural tissues. By prompt intraspinal therapy a serious lesion in later life might then be prevented. In the second place, the author is convinced that even in advanced cases where gross neural lesions are clearly manifested there is reason to believe that judicious intraspinal therapy, combined with the more ordinary method of treatment, may still produce useful results. And he is speaking of such conditions as paresis, tabes dorsalis, and optic atrophy. We hope that the author will supplement his present article in the near future. Medical Quarterly. Vol. I., No. 3, July, 1919. Department of Soldiers’ Civil Re-establishment, Canada.-This number adequately carries out the purpose for which the journal was established-to publish contributions relating to the medical and surgical aspects of the problem of the discharged soldier. Dr. Le Mesurier contributes a useful article on Orthopaedic and Prosthetic Appliances in the Late Treat- ment of War Disabilities. Figures illustrating modifica- tions of the heel of the boot for painful flat-foot and Whitman’s plates are included; also a figure of the meta- tarsal bar for use when there is pain on pressure on the sole over the heads of one or more metatarsal bones. The issue of the complicated metal arm with controlled elbow-joint, pronation and supination, and controlled finger movement has been discontinued, as most of the men supplied would not wear it. The Dorrance and the Bowler hook have been found to be very satisfactory. Dr. Le Mesurier considers
