537REVIEWS AND NOTICES OF BOOKS.

Reviews and Notices of Books.A Text-book af Pathology. With a Section on Post-

mortem Examinations and the Methods of Pre-

serving and Examining Diseased Tissues. By FRANCISDELAFIELD, M.D., LL.D., Emeritus Professor of thePractice of Medicine, College of Physicians and Surgeons,Columbia University, New York; and T. MITCHELL

PRUDDEN, M.D., LL.D., Professor of Pathology andDirector of the Department of Pathology, College ofPhysicians and Surgeons, Columbia University, NewYork. Eighth edition, with 13 full-page plates and650 illustrations in the text in black and colours.London: Bailliere, Tindall, and Cox. 1908. Pp. 1057.Price 25s. net.

IN reviewing some of the previous editions of this Text-

book of Pathology we have commended the general characterand scope of the work. This, the eighth edition, has beenconsiderably revised, and a great deal of recent work is

incorporated in the text. Dr. Delafield, the senior author,no longer shares in the preparation of the work, but Dr.Prudden has had the assistance of Professor Francis C.

Wood, who has revised the section on the blood, which wasoriginally contributed by Professor J. Ewing, and has writtenthe section on malaria. The chapter on the nervous systemin the part devoted to special pathology has been revised byProfessor F. R. Bailey. The arrangement of the mattersdealt with has been altered in this edition and the volume isnow divided into three parts, of which the first is devotedto general pathology; This part has been expanded and isa very readable and clear presentation of the subject. Thevarious pathological processes are carefully described andthe effects of animal and plant parasites are discussed. The

chapter devoted to the relations of micro-organisms to diseaseis worthy of special commendation. The problems of infectionand immunity are described in such a way as to be intelligibleand interesting, and, indeed, the chapter gives one of the

clearest presentations of the subject with which we are

acquainted. Ehrlich’s side-chain hypothesis and its develop-ments are clearly set forth and illustrated by useful

diagrams. The characters of the opsonins are also dealt within some detail. In considering the various infectious diseases,the nature and properties of the specifie infective agentsare described in so far as these are known and their

pathological effects are .carefully workedout. The chapterson malformations and on tumours are also worthy of note ;in the latter the biological problems involved in the growthof tumours are discussed and some of the most importanttheories in regard to the etiology of new growths in generalare outlined.The second part of the book is concerned with special

pathology and is divided into chapters, each dealing withone of the chief systems of the body. As a reference hand-book affording accounts of the principal lesions affecting thevarious systems and organs we have found this part mostsatisfactory. The chapter dealing with the respiratorysystem may be mentioned as being thorough and as beingmost copiously illustrated with reproductions of photographsof sections through the whole of one lung or parts of it ofalmost natural size. Some of the more obscure and rarerconditions are also referred to, in illustration of which maybe mentioned the various forms of chorion epithelioma, ofwhich a succinct and lucid account is presented.The third part deals with the method of making post-

mortem examinations and the methods of preserving andexamining pathological tissues. The directions given arepractical and the special methods of preparation suitable forthe various organs are indicated.The book is lavishly illustrated and the quality of the

illustrations is very good; they are such as are likely to be ofassistance in the post-mortem room and laboratory. The

book is well produced and the style in which it is written iseasy and clear. Dr. Prudden writes well and this, the eighthedition of the book, is one which we can cordially recommendas a useful and scientific presentation of the most importantfacts in regard to the pathology of disease.

A lext-book of Physiology for 1’medical Stzcdents and Physicians.By WILLIAM H. HOWELL, Ph.D., M.D., Professor of

Physiology in the Johns Hopkins University, Baltimore.Second edition. London and Philadelphia : W. B.Saunders Company. 1907. Pp. 939. Price 18s. net.

THERE is no fundamental change either in the arrange-ment or the scope’of this most excellent and up-to-date text-book of physiology, to our mind one of the best, mostreadable, suggestive, and withal critical of the modern text-books on this subject. Additions and changes have beenmade freely throughout the text, but these are so counter-balanced by elimination of such material as could be sparedthat the size of the book is practically unaltered, beingincreased by about 30 pages. A number of new figures havebeen introduced. The physiology of mind and nerve isdealt with tersely, yet sufficiently, in about 50 pages, and issupplemented by a generous amount of excellent illustrations-clear, well printed, and most useful.Many references to important memoirs are given in foot-

notes, but in Chapter II., which deals with muscle plasma,our knowledge of which begins with the investigations of

Kuhne, it might be useful to the junior student to know thedate of Kuhne’s work. Many other historical dates are

given, but this one is omitted. The term protein" isadopted throughout instead of ’’ proteid. " We are familiarwith the terms ° plain " and "smooth" " muscle, but to us"long striated," as applied to smooth muscle, is not so

familiar. We are getting used to the appearance in print offiber, carbon dioxid, centers, hoemoglobin, hemin, and so

on, but we prefer the English form. We are glad to seea paragraph on the uses of the inorganic salts in muscle,important as they are in maintaining osmotic pressure andthus controlling the exchange of water with the surroundinglymph, and for the study of normal structure and excitabilityof living muscular tissue. On p. 74 there is an interestingaccount, with a well-balanced criticism, on the uses of themyelin sheath of nerve fibres.An excellent presentment of the origin, inception, and

validity of the neuron doctrine is given in Section II., adoctrine which has been found both acceptable and helpful.Some physiologists and pathologists, such as Nissl and

Bethe, have attacked its most fundamental feature-viz.,that each neuron represents an independent anatomicalelement and contend that the neuro-fibrils pass throughnerve cells and form a I continuum " through which nerveimpulses pass without a break from cell to cell. For obviousreasons the author makes use of the neuron doctrine. The

complex facts of spinal physiology are admirably set forthand indeed the titles of some of the chapters, both here andin other sections-e.g., the one on the eye-are most sug-gestive. There is a very readable account of the recent

advances made by the physiologists in the United Stateswhich for the most part appear only in American journals.The chief advances will be found in the chapters devoted tothe nervous system. We would specially point out how theareas of the cortex cerebri, as defined and mapped out byFlechsig, both from an anatomical and functional point ofview, are brought into relation with pathological phenomena.Nor is the author neglectful of the contributions made to ourknowledge of the cortex cerebri by English observers. He

gives an account of the advances recently made on this

538 REVIEWS AND NOTICES OF BOOKS.

subject by Campbell and also by Bolton. The chapter on the’cerebellum is thoughtful and suggestive. Practically through-*out the author uses Langley’s term-autonomic-for the

sympathetic nervous system. Cardiac physiology is very

thoroughly done and we are glad to see incorporated theexcellent work of Dr. J. Mackenzie on pulsatile phenomena.In an appendix some of the physical processes which playsuch an important part in the explanation of physiologicalphenomena are tersely described.The work throughout is sound, accurate, philosophical,

.and thoroughly up to date, and should be read by studentspreparing for the higher examinations, while practitioners of’medicine will find in it an admirable survey of the present: state of physiology and its practical bearing on medicine.

due Geschichte der Ohrenheilk2c-nde. (The HistM’.1! of Otology. )By Professor ADAM POLITZER of Vienna. In Two Parts.Part I. : From its Earliest Commencement to the Middle,of the Nineteenth Century; with 31 full page portraits:and 19 figures in the text. Stuttgart: Ferdinand Enke.1907. Pp. 467. Price 20 Marks.

Professor Politzer’s researches take us back to the daysof the Egyptians, dating from ithe time of Notiz HereAx,and we gather from the book before us that there was aconsiderable amount of knowledge of diseases of the ear

amongst the practitioners of medicine in those days. From

Egypt he passes on to Babylonia and Assyria and Judea andwe see that in the Talmud one of the four celebrated

physicians, Manjume, who lived 280 A.D., describes runningfrom the ear as dangerous, with certain exceptions. Naturally’there is a considerable amount of information with regardao the earlier treatment of diseases of the ear derived’from India. Professor Politzer next proceeds to the

Græco-Roman period, dating from the time of Hippocrates,,460 B.C., all his quotations being supplied with references.Aristotle next comes under review and then the period’.from Aristotle to Galen, including the works of Celsus

-and others less well known. The Byzantine period, com-’mencing about 525 A.D., is next considered, and during this-period Alexander of Tralles appears to have had a greatreputation, as had Paul of Aegina and others. The author°then enters very fully into otology as known and practised; amongst the Arabians in those times, and goes on to

what is termed "Die Latinobarbaren " period, in which

comes a large number of names, mostly Italian, but all’ of men who appear to have contributed their mite to the

history of otology. After this we are brought to the period of the Renaissance where we find names better known -to us all, such as that of Andreas Vesalius, andProfessor Politzer reproduces a copy of the earliest picture ofthe malleus and incus, with a section through the organ ofhearing reproduced from Vesalius’s work, ’’ De CorporisHumahi Fabrica Libri Septem," 1543. Amongst othernames in this period we may mention those of Fallopius,Bartholomeo, Eustachio, who was born in 1510 and whose- careful dissections of the ear added so much new matter, and

Casserio whose name is so well known in connexion’ with anatomy. The last shows in his work, publishedIn 1600, the comparative anatomy of the ossicles, while-Felix Plater shortly afterwards gave a diagrammatic repre-sentation of the auditory organs, vessels, membranes,

. ossicles, and so on. In chronological order Professor Politzerproceeds to describe the progress of the science and art of

’ otology in the various countries in the same way in which h3’ described the sixteenth century, to which we have just: alluded, grouping the shining lights in their various nation-alities. We find the names of Englishmen appearing fore-most, among them that of Thomas Willis. Under Otology ofModern Times we find only J. B. Winslow and Elliott repre-senting Britain, Dutch and British being grouped together.It is interesting to learn that it was in the closing decades of

the eighteenth century that the first definite indications forthe operation of opening the mastoid were given, although ithad been already employed for over a hundred years.

It is impossible even to allude, however briefly, to all

the interesting information stored up in this first volume

of Professor Politzer’s exhaustive work, but it is one which

will be a fitting memorial of a useful life. It is a work

which will find its place in every library and we look forwardwith pleasure to seeing its completion.

A Study of the Human Blood-vessels in Health and -Disease., :By ARTHURA Supplement to " The Origin of disease." By ARTHURV. MEIGS, M.D., Physician to the Pennsylvania Hospital.With 103 original illustrations. London and Philadelphia:J. B. Lippincott Company. 1907. Pp. 136. Price 21s. net.A COMPREHENSIVE study of the histological features of the

human blood-vessels, both in health and in disease, shouldafford a great amount of valuable information. Dr. Meigs,who has been attached to a hospital where he has eitherpersonally conducted the necropsies on his own cases or hasdirected their performance, has also himself investigated bymicroscopical methods the materials obtained. He has

therefore enjoyed special opportunities for the investigationof the state of the blood-vessels in various abnormal con-ditions. Some years ago he collected his observations andhis deductions therefrom in his book entitled The Origin ofDisease." " When all the unsold copies of this book were

destroyed by fire in 1899, instead of preparing a new editionhe determined to elaborate his work on the blood-vessels,incorporating the results of later observations, and to publishit in the form of a new work to be in some sense a supple-ment to his former one.

In the introduction he claims that the human blood-vessels

have not been exhaustively studied either in respect of theiranatomy or of their diseases and that the descriptions intext-books are too frequently drawn from the appearancespresented by the blood-vessels in the lower animals. He

also states that too little attention is paid to the changesoccurring in the vessels as age advances, with the result thatthere is no standard to establish whether a vessel is of

normal appearance at a given age. The first chapter dealswith the normal histology of arteries and veins. In orderto avoid the shrinking which occurs during the pro-cesses involved in the preparation of sections for the

microscope Dr. Meigs inserts a rod of glass or other

rigid material within the lumen of the piece of vessel

which is being prepared and of such a size as to keepit distended without stretching. Sections from the same

vessel prepared without this precaution were also examinedfor purposes of comparison. He finds that the intima is of

very variable thickness at different parts of its circum-ference and that the fine layer of endothelium lining thearteries and veins is exceptional, which is a’ very heterodoxstatement in support of which he gives little direct evidence.The sections prepared from vessels which have had a rodinserted into them show that the fibres of the muscular coatsof arteries are arranged in regular concentric fashion andnot irregularly as they often appear to be in ordinarysections. Another point which is referred to is thatarterioles of good size and composed of three coats maybe accompanied by return vessels with a single coat whichare more like large capillaries than ordinary veins.The capillaries form the subject of the second chapter, in

which the extraordinary. opinion is propounded that theyare ephemeral and elusive," that they are nothingbut tubes hollowed out in the connective tissue with

which they are surrounded, and that if a capillarybecomes emptied, and remains so it forms " a string or

fibre of connective tissue." In support of this statement

the structure of the spleen is referred to, but Dr. Meigs’s

539REVIEWS AND NOTICES OF BOOKS.

contentions do not carry conviction, since he does not appearto have employed the silver nitrate method of demonstratingthe capillary endothelium. The third chapter deals withthe formation of new blood-vessels and it is suggested thatnew vessels may arise, not only by outgrowths from pre-existing vessels but also independently in a manner similarto that by which they originate in the embryo. Dr. Meigssuggests that the so-called giant cells found in tubercles are.abortive attempts to produce new blood-vessels and givessome drawings to illustrate his contention, which are, how-ever, far from convincing.

In the fourth chapter some observations are made upon- disease of the blood-vessels in general. A morbid degreeof thickening of the muscular coats of arteries is stated

to be very common and is regarded as a degenerative ratherthan as a compensatory change. A similar explanation is- offered for the hypertrophy of the heart which occurs in

’disease, which is not regarded by the author as necessarily- compensatory and beneficial. In regard to the intima

of blood-vessels, it is affirmed that a progressive thickeningoccurs as age advances, and that this may be of such adegree as to make the intima thicker than the other twocoats together. The cause of cerebral haemorrhage is attri-

buted to a chronic ulcerative process affecting the vesselwalls and not to rupture from increased pressure on theweakened walls.

Diseases of veins are next considered and various con-ditions of fibrosis and of endophlebitis are described.Disease of the radial arteries and veins is discussed andreceives special attention owing to the fact that theyare most frequently studied during life. Dr. Meigs findsthat one vessel may be normal and the other diseased,.and that the appearances presented in sections from

’closely adjacent parts of the same vessel may have widely’different characters. He also states that the radial veinsare very frequently diseased. The blood-vessels in inflam-

mation, in tuberculosis, and in syphilis are next the subjectof examination, and the general conclusions reached are

that these conditions all produce lesions which are in no

way specific and that syphilis does not cause disease of the’blood-vessels so frequently as some authorities believe. In

’regard to the blood-vessels of the heart, the statement is

made that the capillaries actually penetrate the muscular

fibres. The venous radicles accompanying small arterioles.are said to have the structure of large capillaries. The

blood-vessels of the lungs are described and the occurrenceof fibrosis in them is figured and described. Chapters arealso devoted to the blood-vessels in the liver, spleen,kidneys, brain, and spinal cord.The book is illustrated by 103 figures which have been

prepared by the camera lucida and etched directly upon themetal plates from which they were printed. They constitutethe most admirable feature of the book, as they are of

singular excellence. We must confess to being disappointedwith the letterpress, since Dr. Meigs so often expresses views’divergent from those at present current on grounds whichare anything but convincing. It is, however, only fair tostate that in the concluding paragraph of his book he prac-tically admits this. It is impossible not to admire the energyand persistence which the preparation of this volume must-have entailed.

Green’s Encyclopœdia and Dictionary of Medicine andSugery. Vo1. VII. NeriYn--Physiology (Tissues).London and Edinburgh: William Green and Sons.1908. Pp. 579. Price 15s.

,

Ix the reviews which have appeared in the columns ofTHE LANCET on the previous volumes of this work we have

explained its nature and scope. As will be seen from the

,title, the volume now before us carries the subject matter

from Neriin to Physiology, and we are informed in the

preface that it contains 1322 subject headings. Besides

containing important monographs on Nerves, Nose, Para-

lysis, Peritoneum, and so on (which have appeared in

the Encyclopaedia Medica "), it contains an article on

Pharmacology and the first half of a long paper on

Physiology. Numerous short contributions have like-

wise been added dealing with subjects of interest,such as the Ophthalmo-reaction and Opsonins. Contri-

butions on certain subjects, in the knowledge of which

there has been marked progress during recent years, havebeen revised-e.g., the article on Diseases of the Pancreas ;and new paragraphs have been added (under ° Parasites ")dealing with trypanosomes, with the spirochæta pallida,with piroplasma, and with cytorycetes. ,

The article on Pharmacology has been written by Dr. J.Stewart Fowler of Edinburgh. In considering the pharma-cological action and chemical constitution of drugs he makessome interesting observations on the theory of ions. He

points out that the view is now held that not the molecule ofa salt in a solution as a whole but the ions into which it isdissociated produce its effect. Certain salts, acids, and baseswhen dissolved in water form electrolytes and are split upinto positive ions and negative ions. The ions in solution

exert the same osmotic pressure as molecules, and when theyare comparatively inactive in other respects pharmacologicalresults depending solely on osmosis may occur. When the

action of the ions is potent, however, the effects of osmosismay be neglected. For instance, Dr. Fowler mentions thatthe hydroxides of the alkalies act as corrosives by reason ofthe OH ion, the K or Na ion being inert, but alcohol is notcorrosive because the OH is not dissociable into an ion. Again,cacodylic acid is not poisonous because it is not dissociable,and therefore none of the effects of the As ion are produced.,These facts constitute an interesting basis upon which toform an explanation of the action of certain drugs in thetreatment of disease.

The article on Physiology is written by Dr. D. Noel Patonof Glasgow. Part I. deals with the Tissues and the Neuro-muscular Mechanism. Part II. (Nutrition of the Tissues)will appear in Vol. VIII. Judging from the portion nowbefore us, an instructive and useful résumé of the knowledgewhich now exists with regard to physiology will be theresult. The article will be of value mainly for reference, asit does not pretend to take the place of any of the ordinarytext-books on the subject.

’

LIBRARY TABLE.

Essentials of Surgery: An Outline of Surgical Pathology,Diagnosis, and Ireatment, for Students and Practitioners. ByALWYNE T. COMPTON, F. R. C. S. Eng. Illustrated. London :

Henry Kimpton. 1908. Pp. 428. Price 4s. net.-There are

many books claiming to contain a resume of surgery and theyvary greatly in value ; but of all those which have come underour notice we have not seen one which more nearly approachesthe ideal than this. It is confessedly only an outline and itis not intended to replace the ordinary text-book, but it is

likely to prove useful to students and practitioners who wishto revise their knowledge and to have in a compact form themain facts and principles of surgery. Descriptions of majoroperations have been omitted, but we think that in a secondedition it might be well to give the main points of theseoperations. The printing is good and the employment ofheavy-faced type for important words and for headingsfacilitates reference.

Labyrinthciterung zond Gelaor. (Suppuration of the

Labyrinth and Heccring.) By Dr. HEINRICH HERZOG.

With eight tables and 28 photographs. Munich: J. F.

Lehmann. 1907. Pp. 133. Price 5 Marks.-This brochure is