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Reviews and Notices of Books.Studies in Cancei- and Allied Sll,bJects: The Study

of Experimental Cancer.A Review by WILLIAM H. WoGLOM, M.D., Assistant Pro-fessor, Columbia University. Conducted under the GeorgeCrocker Special Research Fund at Columbia University.Vol. 1. New York : Columbia University Press. 1913.

Pp. 288. Price$5.

VOLUME II., dealing with the Pathology of Cancer,conducted under the Crocker Research Fund, wasreviewed in THE LANCET of April 26th, 1913. InVolume I., which has been recently issued, we havea. summary of the more recent experimentalinvestigations of cancer. No attempt is made to

give a critical precis at this time, since muchof the work is so new, and ideas regarding thedisease are so chaotic, says Dr. Woglom, that evalua-tion is well-nigh impossible. The author, however,ends on a more optimistic note, for, he says, " newerconceptions of malignant growth encourage the hopethat at some time, far in the future though it maybe, the dream of effectual interference with inces-santly proliferating cells will become an actuality."Chemical studies have been omitted because a

number of excellent reviews are in existence, andalso because investigation in this field has thus faryielded but little of practical importance, while thebacteriological side has been neglected, because itsdiscussion would amount to little more than a listof micro-organisms.Having delimited his theme the author deals

in succession with the following : A brief historicalreview; attempts to produce tumours; the earlierobservations on the transmissibility of cancer; thetransplanted tumour resistance; hypersuscepti-bility ; the spontaneous tumour; tumours of a

nature still undecided; and therapeutics.From the earliest days in medicine cancer has

been recognized to some extent as an incurable andfatal disease. Though the literature of experi-mental cancer seems to be a tangle of conflictingstatements, there are a few threads which theauthor has endeavoured to disentangle and followthrough. The mass of detail with appropriate refer-ences cited by Dr. Woglom is so vast that we mustcontent ourselves with a brief summary of someof the main findings which may be regarded, hethinks, as " probably reliable," having received thesupport of a majority of those engaged incancer research. It is to be remembered thatthere are mice and mice, and that what mayhappen in two groups of ten mice may not,and often does not, occur in a third series. Thegreatest amount of attention has been bestowed onmouse cancer, and the author expresses the ,viewthat there can be scarcely any doubt that the

neoplasms of the mouse are entirely comparable tothose of man. Malignant growths have been foundin all classes of animals from fishes to mammalswith one exception-viz., that no certain instancehas yet been reported among the reptiles. Thereis some evidence to show that in mice there is an

hereditary influence at work making mice of recentcancerous ancestry more prone to develop cancerthan those in which the taint is more remote.Almost any spontaneous new growth in mice canbe transplanted into other mice, and the propaga-tion generally becomes easier in succeeding genera-tions. Moreover, cancer is moxe readily transplant-able into the animal in which it arose spontaneously

than into any other. In addition, an animalcannot be immunised in any manner yet atcommand against the inoculation of its own

primary tumour. These and other observationsmilitate strongly against any parasitic theory ofcancer. After a portion of a tumour is introducedinto another host, the proliferation of the tumouris an example, not of an infection, but of a trans-plantation. The parenchymal cells of the result-ing growth are derived, not from the elements ofthe new host, but from those of the transferredgraft. These transplanted cells are nourished andsupported by connective tissue and blood-vesselsof the new organism.A fact of prime importance in relation to all so-

called cures of cancer is this, that propagabletumours are subject to fluctuations in growthenergy. Indeed, they may grow progressively ordisappear spontaneously. Under most favourableconditions the proliferative power of the cancer cellfalls far short of that possessed by bacteria, andperhaps also of the cells of the developing embryo.Mice in which tumours have undergone partial orcomplete absorption are refractory to subsequenttransplantation, either of the same or anothergrowth. Immunity once induced cannot be trans-ferred passively to other animals. There is a certainamount of evidence to show that natural resistance

may be the outcome of hereditary transmission,but none to show that acquired immunity can betransferred. This brief summary, condensed fromthat of the author, postulates the present positionof the question. Indeed, Dr. Woglom, after hismost comprehensive survey and mature delibera-tion on the vast amount of detail he has passed inreview, says: "It must be frankly confessed thatso far, at least, the study of cancer, instead of

affording an understanding of the nature of thedisease, has but opened up new problems which wereformerly not even conceived."We express our grateful thanks to the author for

his luminous summary of the present position ofthe question of experimental cancer.

Vaccine and Seoum Therapy, including a Study ofinfections, Theo’ries of Immunity, SpecificDiagnosis, and Chemotherapy.

By EDWIN HENRYScHORER, B.S., M.D., Dr.P.H., AssistantRockefeller Institute for Medical Research, New YorkCity, &c. Second revised edition. London: HenryKimpton ; Glasgow : Alexander Stenhouse. 1913. Pp. 300.Price 12s. 6d. net.

THIS book proceeds on the usual lines of text-books on its subject. The first chapter deals withthe general features of infectious disease, and thesecond with the different theories which have been

put forward to explain the phenomena of immunity.The third chapter is devoted to specific diagnosis,including identification of organisms, agglutina-tion, fixation of complement, opsonic determina-tions, and so forth, some empirical tests such as thecobra venom reaction being also mentioned, andsome account given of inclusion bodies and filtrableviruses. The fourth chapter deals with specificmethods of treatment by means of vaccines andserums, some account being given of the mode ofpreparing and standardising the latter and of thephenomena of serum disease. A few pages alsoare devoted to the use of leucocytic extract andnormal serum. The fifth, last, and longest chaptercontains an account of the practical application ofthe methods already described to the individual

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infections, while an appendix is added on diagnosis,treatment, and prophylaxis of syphilis and malaria.There are a few illustrations, chiefly of temperaturecharts and apparatus.The treatment of the subject throughout is

adequate and the material is brought well up todate. In places the style seems unduly con-

densed, and we could have spared the briefaccounts of the clinical features of some of theaffections, which are not of much value, in orderto have more detail on essential points. Thusthe statement that " the only harm that can bedone by careful tuberculin therapy exists whenthere are complicating diseases. Of these thereare few of importance " - with no indicationas to which are important-is not illuminating.Again, the assertion that all forms of tuberculin" produce good results in all types and forms oftuberculosis" is a wild overstatement, due prob-ably merely to condensed or careless writing. Theauthor has seen no marked good effects from the useof phylacogens. The author should make up hismind whether he wishes to call the organism ofsyphilis treponema or spirocheeta and adhere

throughout to one or other term. By the way,the phrase " two treponema " cannot be correct,though it may be a matter of individual preferencewhether the plural used is the English treponemasor the Grsecolatin treponemata. It is fervently tobe hoped that Noguchi’s atrocities of nomenclaturehere adopted, sp. microdentium and macrodentium,will not survive.

The Poisonolf,S Terrestrial Snakes of our BritishIndia Dominions (including Ceylon) and Howto Recognise Them, with Symptoms of SnakePoisoning and Treatment.

By Major F. WALL, I.M.S,, C.M.Z.S. Third edition.Bombay: Natural History Society. 1913. Pp. 149. PriceRs.3.

THE practical nature of the author’s aim, partlyindicated in the title, accounts for the neglect ofthe marine snakes in the volume before us. WhileMajor Wall has not absolutely ignored the variedforms which frequent the seas that wash the shoresof India and Ceylon, there is enough to be saidabout the numerous poisonous terrestrial snakesto justify any curtailment at the expense of theirless important marine allies. The author enu-

merates 40 species of vipers and venomous colu-brines as inhabitants of the political regions definedin his title, and to each species devotes a sufficienttechnical description and general notes upon appear-ance and habits. It should be easy enough for anyoneof intelligence to identify a given species after imastering the clear directions devoted in an earlierchapter to the principal characters of scales andso forth, used in the differentiation of species fromspecies and of genus from genus. These directionsare accompanied by plain outline drawings of thehead and tail of most of the marked types, whichalmost render a prolonged attention to the text

unnecessary, so descriptive are they to the eye.The zoological part of the book occupies 66 pages,

the rest being devoted to snake poisoning and thesymptoms and remedies thereof. In a condensed

practical treatise of this sort disquisitions uponzoological matters of wider interest must not belooked for. The author has, however, devotedquite as much care to the preparation of the purelyscientific side as to the more purely practical of hishandbook. His statements of fact are trustwormy,and he has not ignored contemporary literature.

The classification used is that crystallised by Dr.Boulenger into his British Museum catalogue of

snakes, and only external characters are tabulatedby Major Wall. For practical purposes this can stillbe done; but it is a little difficult to be sure whetherit will be possible in the case of new forms whichmay turn up.We are not at all surprised that this excellent

manual has reached a third edition. Seeing howlittle in the way of records of new snakes has.occurred since 1908, when the manual was firstpublished, and having regard also to the energeticstudy on the part of herpetologists of manycountries, it is not perhaps likely that the list

displayed by Major Wall will be materially increased.This reflection gives us additional confidence inrecommending the work.

Compendiic7z of Regional Diagnosis in A,ù’ectio/î.’;of the Brain and Spinal Cord.

By ROBERT BiNG, Privat-docent for Neurology in the Uni-versity of Basle. Translated by F. S. ARNOLD, M.B.,B.Ch.Oxon. Second edition, revised and enlarged, with73 illustrations. London: Rebman. 1913. Pp. 222.Price 10s. 6d. net.

WE have already favourably reviewed both theGerman and the English editions of this book. Wenow extend a welcome to the second Englishedition. A considerable number of emendations

’

and additions have been found necessary; there isnew material in the sections on the motor cortex,extracerebellar tumours, aphasia, apraxia, thepituitary and the pineal glands, &c. Some newillustrations are supplied, and a few of the old havebeen improved. In this new edition we considerthat the needs of the student and the practitionerwho is not a professed neurologist have beencatered for in generous fashion.

Zur Psychopathologie des AlltagslebeJls.(Uber Vergessen, Versprechen, Vergreifen, Aberglaube undIrrtum.) By Professor Dr. SIGMUND FREUD, Vienna.Fourth, enlarged edition. Berlin: S. Karger. 1913.

Pp. 198. Price 5 marks.

Professor Freud, as is well known to all workers inmodern psychology, sees in everyday life innumer-able instances of passion lurking behind triflingoccurrences and incidents, instances of concealed orrepressed mental processes behind the slips of thetongue, the mistakes, the forgetfulness, the mis-conceptions, to which all are more or less subject.That behind some apparently accidental and paltryoccurrences repressed motives are at work is a

truism which any introspective individual mayreadily discover for himself. Not infrequently theanalysis of such incidents is psychologically veryinstructive, and the debt which psychology owes tothe author is augmented by the critical and un-flinching dissection of the human mind revealed inthe book under consideration

Nevertheless, after re-reading this fourth edition,it is the duty of the critic to call attention to theauthor’s tendency to overrate the significance ofmuch of his material. The " will to believe "itself requires vigorous repression if we are to besaved from some of the exuberant interpretations.which he would offer us. Thus we are told thatthe common experience of moving from one sideto the other in front of an individual on the side-walk, who makes the same movements so that pro-g.Pe8sWll is for the moment at a standstill, "seelIeAbsichten umter der Maske der UngeschicMiehkei

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verfolgt." When Professor Freud " accidentally "knocks a little marble statuette off his table thereis a hidden meaning in the incident; the examina-tion of such instances has convinced him that it isnever the result of an accident. If, however, a

domestic does the same, " so wird man an eine

psychologische Erklarung hierfur gewiss nicht inerster Linie denken." Why " gewiss nicht " ?These, and sundry other instances that might bequoted from the book, put a strain on the reader’swillingness to endeavour to understand the author’sargument. Much of what is offered by ProfessorFreud as explanatory is merely conjectural if not

purely fantastic. The saving grace of commonsense might, in some cases at least, find a simplerinterpretation than that imagined by the ingenioussubtlety of which Professor Freud is a master.

Handbuch de-z. Vergleichenden Physiologie.Herausgegeben von HANS WINTERSTEIN. Lieferung 37.Band III. Physiologie des EnergÙ3n:eohsels. Erste Halfte.Jena : Gustav Fischer. 1913. Pp. 1133-1294. PriceJena: Gustav Fischer. 1913. Pp. 1133-1294. Price5marks.

Professor Biedermann brings to a close his long,laborious, and elaborate account of the physiologyof the supporting and skeletal substances of thebody with a fascinating account of the architectureof bone. Histology and architecture are considered,especially from the functional point of view, with athoroughness and wealth of detail which leavenothing to be desired. The chemistry and develop-ment of bone conclude the articJe.

R. F. Fuchs, of Breslau, deals with the colour

changes and the chromatic cutaneous functions ofanimals, a subject which attracted the attention ofAristotle himself. Beginning with the inverte-brates, the chromatophores in the lower forms arefirst considered, then those of the mollusca, exclud-ing the cephalopoda. To the colour changes andchromatophores of the cephalopoda alone nearly 100pages, well illustrated, are given. This is by farthe most comprehensive review that we know of ona fascinating subject. In the final pages the author

begins his exposition of the colour changes in

arthropoda.

LIBRARY TABLE.

The Principles of Evolution. By JOSEPH McCnBELondon and Glasgow: Collins, Sons, and Co., Limited1913. Pp. 264. Price ls. net.-Mr. Joseph McCabe hasa remarkable gift for dealing with a large subject ina small space. He gives in this little book a reallygood all-round description of the many variousthings connoted by the word

"

evolution." He

explains what it is, and what effect its doctrineshave had, not only in every conceivable field ofstudy, but also on the thoughts, lives, and socialbehaviour of us all. He has to a great extentreturned to first principles in narrating the factsand in dealing with the natural agencies of evolu-tion, its range, and the various particular problemswhich at present engage attention. The chapteron natural selection is a clear exposition of twowords of constant occurrence in newspapers andconversation, and very frequently misapplied. Mr.McCabe is the author of books describing theheavens and the earth on evolutionary lines, andto some extent this volume of the National Libraryis used as a supplement to previous writings. Werecommend the book cordially. It is extra-

ordinarily comprehensive, considering its size, and

it is properly dogmatic-by which we mean to saythat the need is recognised, if a book is to be smallwhile its subject is almost indefinitely large, ofsaying certain things in a downright way withoutmarshalling all the evidence for or against theirtruth.

The Practical 3medicine Series. Vol. IV.

Gynecology. Edited by E. C. DUDLEY, A.M., M.D.,Professor of Gynaecology, Northwestern UniversityMedical School; and H. M. STOWE, M.D., Associatein Gynaecology, Northwestern University MedicalSchool. Series 1913. Chicago : The Year BookPublishers. Pp. 230. Price 1.35 dollars.-This isone of a series of ten volumes issued at about

monthly intervals and covering the entire fieldof medicine and surgery. They are publishedprimarily for the general practitioner, and give avery complete résumé of the work done in the

particular branch of medicine concerned. After

chapters devoted to general principles, such asanaesthesia and operative technique and kindredsubjects, the various infections and allied disordersof the genital organs are considered. In the same

way a general survey is given of all the most recentpapers in connexion with malformations and

tumours, traumatisms, displacements and disordersof menstruation, and sterility. The value of thebook is enhanced by the notes and annotationscontributed by the editors, and the whole containsa great deal of valuable and interesting informationon the recent progress of gynsecology.

Alimeyztary Toxcemia : Its Sources, Consequences,and Treatment. A Discussion opened by W. HALEWHITE, M.D., F. W. ANDREWES, M.D., VAUGHANHARLEY, M.D., ROBERT SAUNDBY, M.D., Sir W.ARBUTHNOT LANE, M.S., and J. F. COLYER, M.R.C.S.,L.D.S. London, New York, Calcutta, and Bombay :Longmans, Green, and Co. 1913. Pp. 380. Price,cloth, 4s. 6d. net.-The discussion on alimen-

tary toxæmia at a series of special meetings ofFellows of the Royal Society of Medicine betweenMarch 10th and May 7th, 1913, was so fully reportedin our columns at the time, Dr. Hale White’s openingand closing addresses, together with the papers ofProfessor W. E. Dixon and Sir James Goodhart,being published in full, and an editorial reviewappended to the whole, that it is unnecessary hereto say more than this reprint from the Proceedingsof the Royal Society of Medicine is almost a text-book on the subject. The index will prove of par-ticular service to those in search of information onthis increasingly important topic.

Obstetric Aphorisms. For the Use of Studentscommencing Midwifery Practice. Eleventh edition.

By JOSEPH GRIFFITHS SwAYNE, M.D. Revised andedited by WALTER CARLESS SwAYNE, M.D., B.S.

Lond., M.D., Ch.B. Bristol. London: J. and A.Churchill. 1913. Pp. 216. Price 3s. 6d. net.-Theeditor, in response to many requests from friends,has come to the conclusion that there is still a

place which a new edition of this work can fill withadvantage, and therefore has revised and broughtit up to date. The original form of the work hasbeen retained as far as possible, but Dr. W. C.

Swayne has endeavoured in his revision to retainthe results of the immense practical experience andsound judgment of the author, even at the expenseof modernity. This little book has no doubt proveduseful to many hundreds of students since its first

appearance some 20 years ago. In its modern dressit should be as helpful to present generations ofstudents as it was to their predecessors.