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1195 Reviews of Books Operative Surgery Vols. 1 and 2. Editors : CHARLES RoB, M.c., M.CHIR., professor of surgery, St. Mary’s Hospital ; RODNEY SMITH, M.S., surgeon, St. George’s Hospital. London : Butter- worth. 1956. Pp.543. £5 10s. per volume. THE birth of a new work on operative surgery will be noted with mixed feelings. This work represents an attempt to present operative technique visually, on the supposition that surgeons learn technique by watch- ing masters in their field. The editors have relied on illustrations with a modicum of description, each opera- tion being described primarily by illustrations at each stage ; and many have been invited to contribute, in order to ensure that the work is authoritative. The editors rightly remark that the techniques described may not always represent common practice. Vol. 1 includes an introduction to general methods, followed by the surgery of trauma, and then by surgery of the abdomen which is completed in vol. 2. On the whole this new approach is fairly successful ; but operative technique involves movement which cannot always be depicted by " stills," and one is forced to the conclusion that, failing a film, technique is often best conveyed by words. The anatomical and diagrammatic illustrations are mostly good, but those showing the human figure or recognisable parts such as the face are unsuccessful. There are to be eight volumes in all, each at £5 10s. The index is to cost £2. The Social Problem of Mental Deficiency N. O’CONNOR, M.A., PH.D., J. TIZARD, M.A., B.LITT., PH.D., Medical Research Council, Social Psychiatry Research Unit, Maudsley Hospital, London. London and New York : Pergamon Press. Pp. 182. 30s. THIS modest volume contains a wealth of information and must be regarded as indispensable to any student or practitioner interested in the problem. The data are derived mostly from studies by the authors and their colleagues. Their objectivity is a welcome relief from the subjective observation and opinion as to the limita- tions of defectives which have long dominated the literature on the subject. Dr. O’Connor and Dr. Tizard point out that rather more than half the patients at present under care in mental-deficiency hospitals are feeble-minded and had that a majority of these could be trained, thus releasing urgently needed beds for idiots and other defectives. This optimism is based on their own success in placing defectives from institutions in gainful occupations-a success much greater than that expected by many of their colleagues and, at one stage, by these workers themselves.’ Their argument for a new approach to feeble-minded- ness cannot fail to impress the reader. They advocate the final abandonment of the system of isolation, which has been gradually falling into disrepute. They show the limited validity of predictions based on assessment of psychological qualities, and suggest that the only method of assessing whether a feeble-minded person’s mental abilities fit him for a simple job is to let him try it. They suggest that the immense amount of work done on intelligence-testing has led to relative neglect of problems of learning and training. This comprehensive study of the relation of the com- munity to the mental defective, the first of its kind in this country, marks an epoch in the understanding of mental retardation and the training of the backward. Endogenous Uveitis . - ALAN C. WooDS, M.D., professor emeritus of ophthal- mology, Johns Hopkins University School of Medicine. s London : Bailliere, Tindall, & Cox. 1956. Pp. 303. 100s. Prof. Alan C. Woods has done much valuable work on uveitis. It was his influence that led to the general adoption of the terms " non-granulomatous " and ’’ granulomatous " uveitis, which have replaced older less explicit terms such as ’’ acute " and " chronic." This book is the culmination of many years’ study which, particularly in the past ten years, has revolutionised our attitude to the atiology and treatment of uveitis. Except for the effective though blindfold alleviation of non- granulomatous uveitis with cortisone, most ophthalmologists have felt painfully unhappy in their management of uveitis. Investigation has usually been confined to perfunctory sero- logical and radiological examinations which were almost always negative. Treatment has been non-specific and moderately effective in non-granulomatous uveitis (which is usually self-limiting) but has been dismally ineffective in the granulomatous form, which often leads to blindness. Pro- fessor Woods not only summarises clearly the massive reported data but gives explicit directions on methods of investigation and treatment which have been worked out in his own practice. , There is no mention of non-granulomatous uveitis in anky- losing spondylitis, which is much commoner in this country than uveitis in rheumatoid arthritis, which is mentioned. Professor Woods’s interest has always been chiefly in the bacterial allergies, and, while he admits that non-granulo- matous uveitis can theoretically be caused by food sensitivities, he states that " no evidence has as yet been brought forward which indicates that any food or drug sensitivity is related to uveal inflammation." This is not so. Well-substantiated cases of this sort have been reported, and possibly non- bacterial allergy may account for some of the 25% of non- granulomatous cases in which Professor Woods was unable to demonstrate a cause. Medical Physiology 10th ed. Edited by PHILIP BARD, professor of physiology, Johns Hopkins University. London : Henry Kimpton. 1956. Pp. 1421. ;f5 5s. THIS book is the lineal descendant of the late J. J. R. Macleod’s Physiology and Biocheynistry in Modern Medicine. The valuable section on the circulation was prepared six years ago by the late H. C. Bazett, but other contributions arrived years later. While the section on the cardiovascular system contains much that is commendable, occasionally the reader may be startled. For example, very few today would accept the calculated figure of 1300 ml. for the normal capacity of the human pulmonary vascular bed. Balance has obviously been difficult to maintain : the 33-page chapter on blood volume is far too long and somewhat tendentious ; much of this space might have been devoted more profitably to the physiology of blood formation, which gets no more than 2 pages. The section on respiration by Carl Schmidt is detailed and excellent, though the most interesting parts are mainly in small print. Renal physiology is well discussed on a historical basis by Gregerson and Cizek. Endocrinology and neurology should be primarily presented to medical students as clinical sciences ; but unfortunately this has not been done. The excellent reference list occupies 100 pages. This work is too long and too complex for students, who would readily lose their way in a welter of detail. But as a compendium of monographs it can be read with great interest and profit by critically minded medical and physiological investigators. Misleading or inadequate data are few and scattered compared with the immense volume of useful, provocative, and thoughtful commentary. : Christian Essays in Psychiatry Edited by PHILIP MAIRET. London : S. C. M. Press. 1956. Pp. 187. 15s. ATTEMPTS to fuse, or to reconcile, religion and psych- iatry have been made sporadically in this country and, to a rather greater extent, in North America. Always sincere and often well informed on both sides of the matter, the authors of these eirenicons have nevertheless lacked the intellectual force to grasp, and examine the central issues. Welcome as the present volume is, it exhibits the same defect. The ten contributors have dealt fairly enough with the topics entrusted to them and what they say is well expressed, sound, interesting, and reassuring to those who feared that medical psychology and religion were still poles apart. But the problems of suffering, of the nature and power of prayer, of doubt in matters of faith, of the kinship and the difference
