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in other types of bone surgery, since the blade is alwayssharp and is not blunted by cutting bone or steel. No

special sterilising precautions are necessary.The saw is made by Chas. F. Thackray Ltd., 10 Park

Street, Leeds.D. C. BODENHAMM.B. Brist., F.B.C.S.E.

Plastic Surgeon,Frenchay Hospital,

Bristol

Reviews of Books

Hamey the StrangerJOHN J. KEEVIL. London : Bles. 1952. Pp. 192. 21s.

THE Royal College of Physicians of London owes muchto Baldwin Hamey, son of the subject of this book ;for he was one of its chief benefactors. He and hisfather were both confirmed letter-writers; and theirletters, mostly in Latin, are in the archives of the collegeand the University of Leiden. Dr. Keevil, formerlibrary keeper of the college, has drawn on these lettersin compiling this biography.Baldwin Hamey the elder-Hamey the Stranger-was

born at Bruges in 1568, the year in which Roman CatholicSpain sentenced to death, as heretics, all the inhabitantsof the Netherlands. Things became so bad that in 1584,or soon after, the Hamey family migrated to Leiden, whereBaldwin received his university education, first in philosophyand letters, and later in medicine. Through the influence ofhis teacher, Joannes Heurnius, he was appointed, two yearsafter qualifying, as physician to the Czar of Russia ; andfound himself plunged into a world of murder and intrigue,where the vast figures of Czar Fedor, Boris Godunow, and therest of the Godunow family moved in a drama much largerthan life. Elizabethan England, to which Hamey soon

fled with his promised wife, Sarah Oeils, must have seemedtame in comparison ; and indeed the book partakes of theanticlimax. His graphic account of the Essex rebellion,and his own courage in various plague, smallpox, and typhusepidemics, stand out ; but much space has to be given,unfortunately, to his struggle to persuade the college toexamine him and give him an English diploma. It wasachieved at last, but not without some undeserved humilia-tion for him. His son Baldwin, whose life is to form the

subject of a second volume, The Stranger’s Son, became M.D.of both Leiden and Oxford, as well as a fellow of the

college.This first tale is well told and worth reading, and

we look forward to the second.

Surgery of the Chest .

A Handbook of Operative Surgery. JULIAN JOH11TSON,M.D., D.sc., professor of surgery, school of medicine andgraduate school of medicine, University of Pennsylvania.CHARLES K. KIRBY, M.D., associate professor of surgery,school of medicine, University of Pennsylvania. Chicago :Year Book Publishers. London : Interscience Publishers.1952. Pp. 387. 68s.

, THE authors set out to provide an atlas of thoracicoperations, and have adopted the general pattern of apage of illustrations to a page of text. The book isstraightforward and easy to read and understand, sincethe illustrations are clear and precise. For anyone likelyto become interested in thoracic work it gives a very goodidea of the scope of the subject.Almost every routine thoracic operation is described briefly

and illustrated from the technical aspect, and the reader isgiven the choice of studying the operation of lobectomy inthe supine, lateral, and prone positions, with special referenceto the important anatomy of the lung root. In addition, suchunhappy incidents as haemorrhage from the aorta are con-sidered, with the appropriate method for dealing with them.There is little to criticise, though it is strange that an elaborateplastic form of treatment should be described for cardiospasmin preference to the more simple Heller’s type which is hardlymentioned. These clear descriptions and the apparent sixn-plicity of modern heart operations should not, however,encourage the inexperienced surgeon to embark on them,thinking they are necessarily easy.There is an attractive lack of pretension about this

well-produced and well-illustrated book.

Microbial Growth and its Inhibition

First International Symposium on Chemical Micro-biology. World Health Organisation Monograph SeriesNo. 10. Geneva: World Health Organisation. 1952.

Pp. 285. 15s.

IN June, 1951, an international symposium was heldin Rome on chemical microbiology, with particularreference to antibiotics and the various problems con-cerned with their inhibition of bacterial growth. It wasorganised by the Instituto Superiore di Sanita incollaboration with the Council for the Coordination ofInternational Congresses of Medical Sciences and theWorld Health Organisation. The papers, read byleading specialists, have now been published in bookform.

They cover a wide range, including the origin and nature ofdrug-resistance in bacteria, vitamin-B-group substances inbacterial metabolism, the liberation of nucleic acid whencells are heated, penicillin-fermentation, the chemistry ofterramycin, antibiotics against fungi and antibiotics as

stimulants of animal growth, the biological standardisationof antibiotic preparations, the lag-phase in bacterial growth,and similar subjects. The papers are mostly short reviewsof subjects in which the authors were particularly interested,but the references are chosen with discrimination.

Each of the articles thus presents the consideredopinion of a well-known authority. They are lucidand easy to read, and so should stimulate those workingon chemical microbiology, and inform those notconversant with this field of research.

Refresher Course for General Practitioners

By various authors ; reprinted from the British MedicalJournal. London : British Medical Association. 1952.Pp. 486. 25s.

Tms volume is a " first collection " of articles whichappeared in the British Medical Journal under theirpresent title between October, 1949, and December, 1950.Their publication in book form should be welcome tomany practitioners, whether or not they read them asthey came out. The authors, drawn from many hospitalsand teaching centres in London, the provinces, andbeyond, have maintained a remarkably high level notonly in the content but in the presentation of theirmatter. The articles are informed, readable and to thepoint, and well calculated either to supplement thereader’s knowledge of the subject or to stimulate himto consider it afresh. They are illustrated where necessarywith diagrams and photographs, well reproduced. Thesubjects of the 55 articles, though all relevant to generalpractice, cover no defined field and are arranged in-nological order. This makes for easy reading, but therandom selection limits the usefulness of the book forreference.

Metabolism of Protein Constituents in the MammalianBody

S. J. BACH, PH.D., F.R.I.C., department of physiology,University of Bristol. Oxford : Clarendon Press. 1952.Pp. 272. 40s.

IN this book Dr. Bach has confined himself to a reviewof our knowledge of some aspects of the metabolismof alanine, glycine, serine, threonine, valine, leucine,isoleucine, methionine, cysteine, and cystine. Thereare sections on the formation and reactions in vivo ofhaem pigments, bile pigments, porphyrins, uric acid,glutathione, and other metabolites ; and an interestingaccount of cystinuria is included. The nutritionalvalue and use of these amino-acids for glycogenformation are considered, and there is an exhaustiveaccount (about 53 pages) of "biological methylation."On this subject Dr. Bach is evidently a scholar, and hisreview-including as it does references to pathologicalconsequences, in man and other species, of deficienciesin methylating processes-could hardly be bettered.

In other respects. the book is less satisfactory, for in spiteof the many references to original papers the treatment ofsome subjects is scrappy and inadequate. Thus the accountof conjugated bile acids is inaccurate, and would not do fora student’s textbook ; and Dr. Bach does not mention therecent work of Friedman and Byers on the excretion of

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uric acid by dalmatian dogs. Again his references to detoxica-tion do not include any to the work, or to the comprehensivereview, of R. T. Williams. It is disturbing to find majordeficiencies of this kind in a learned monograph.

Nevertheless, the book does contain some valuablesurveys, especially of recent work with isotopes, and itshould be useful to the biochemist and the (appro-priately critical) advanced student.

Pr6cis de MycologieM. LANGERON, Chef de la Section de Mycologie del’Institut de Parasitologie de la Faculte de Medecine deParis. 2nd ed. Revised and enlarged by R. VANBREU-SEGHEM. Paris: Masson. 1952. Pp. 701. For. 5400.

Tms book, when first published in 1945, proved sopopular with microbiologists, and particularly withmedical mycologists, that the edition was quicklyexhausted. Work on the second edition, which beganimmediately, was interrupted by the death of Dr.Langeron in 1950, and it was eventually completed by hisformer pupil, Dr. Vanbreuseghem.The new book is in three sections : general mycology,

technique, and medical mycology. The section on generalmycology, representing the entire original book except forthe descriptions of technical methods and a chapter on fungusdiseases, has largely been rewritten with many additions ;but it retains all those features which made the first editionso valuable. Descriptions of mycological technique, scatteredthroughout the text in the first edition, have been collectedtogether in a comprehensive section on laboratory methods.The section on fungus diseases by Dr. Vanbreuseghem isentirely new and replaces the single chapter on mycosesin the first edition. In it the diseases are arranged in

alphabetical order and the descriptions follow the plan adoptedby nearly all textbooks on medical mycology. This section,which makes the book more attractive to the general medicalreader, could with advantage be expanded in a future edition.

A.nurie bei Chromoproteinurie (Hamolyseniere, Crush-Niere)HANS U. ZOLLINGER. Stuttgart : Georg Thieme. 1952.

Pp. 138. DM. 14.70.THE author of this monograph has been interested

for many years in the problem of the pathogenesis ofthe renal lesion associated with myolysis or withhaemolysis, primarily from the viewpoint of thepathologist.In this study, however, he includes a good account of the

clinical aspects of this syndrome, dealing briefly with thesigns and symptoms and the mechanism involved in theirproduction, the course, and the prognosis. The sectionon treatment is not so well balanced, dealing mainly withparavertebral block and decapsulation-therapeutic measuresnow largely abandoned. High-calorie, low-nitrogen diet ismentioned very briefly but without reference to Borst:avoidance of overhydration and electrolyte intolerance isstressed and there is a brief mention of dialysis methods.

It is, however, the sections dealing with the anatomy andpathogenesis of hsemoglobinuric or myoglobinuric nephrosisthat the interested reader will find of most value ; hereProfessor Zollinger speaks as an expert. He has surveyedin detail 55 cases of this condition coming to necropsy inZurich in ten years (from roughly 17,000 necropsies). Theyinclude groups with haemolysis due to mismatched trans-fusion, bad conservation of blood, or sensitisation ; post-transfusion cases associated with pregnancy, operation, orinfection ; a group due to exogenous haemolytic agents suchas chlorate and soap ; a group with muscle necrosis due tocrush, carbon monoxide poisoning, or electrical accidents ;one case of burns ; and a final group of miscellaneous cases.Illustrative case-histories are given. The pathologicalfindings are given in considerable detail and are well illustrated.A full discussion of pathogenesis reviewing the blockage,ischsemic, and toxic theories leads the author to the con-clusion that this is a syndrome of multiple factors. Thereare 486 references, most of which are recent ; and, unlikemany monographs with large bibliographies, the referencesare used critically.

This will be standard reading on the subject for along time.

After-Treatment (4th ed. London. Oxford: BlackwellScientific Publications. 1952. Pp. 338. 30s.).-Mr. H. J. B.Atkins has thoroughly revised this popular book on the careof patients after operations, which ho designed for generalpractitioners, house-officers, ward sisters, and dressers.Methods in surgery change quickly and are often ephemeral;but this book successfully reflects current views and practice,and the author has used discretion, judgment, and experiencein presenting his subject. He has deliberately excluded all

descriptions of technique-for such things as spinal puncture,the making of plasters, and so on-holding that these practicalprocedures can only be learnt at the bedside. Though thereis much to be said for this point of view, it is neverthelesshelpful for a resident to be able to refresh his mind with theimportant practical details and pitfalls of these small opera-tions. He will need a small practical book to supplement thisexcellent guide to after-treatment.

Child Health. The Practitioner Handbooks (2nd ed.London: Eyre & Spottiswoode. 1952. Pp. 264. 218.).-This, like the first edition, consists of 22 chapters, each writtenby a different authority, and covers many subjects not dealtwith in textbooks of psediatrics or public health. There is asection on feeding, and a good chapter on the control ofcommon fevers, by Dr. C. M. Smith; but in general the bookaims to give an account of the public-health services availablein this country, rather than guidance to the practitioner onthe application by himself of preventive medicine. For thisedition Prof. Alan Moncrieff and Dr. W’. A. R. Thomson, theeditors have revised all the chapters. No new subjects havebeen added, however, and it is disappointing to find nomention of the problems of homeless children, which havearoused much interest recently, and which led to the ChildrenAct of 1948. Nevertheless, this is the most up-to-date bookon the subject of child health in this country, and it willcontinue to be a valuable guide to all concerned with themedical care of children.

New Dictionary of Psychology (London : Vision Press& Peter Owen. 1952. Pp. 364. 35s.).-He is a brave manwho sets out to define psychological terms ; so many writersuse them with different meanings. This compilation byPhilip Lawrence Harriman is useful but far from complete,and too many not so important American psychologists arelisted at the expense of other nationalities. One American islisted merely because he was the first that ever burst intoprint in U.S.A. with Mental Hygiene as the title of a book;Lord Kelvin appears as

" William Thomson Kelvin " insteadof "William Thomson"; and Napoleon is included for

opposing phrenology. Moreover some of the definitions soundwholly incorrect to English ears ; but this may be due toAmerican usage, for this book has been made and printed inAmerica and had an English title-page stuck on to it. Butthere can be no such excuse for the statement that lapsu8calami is a " psychoanalytic term referring to the unconsciouswish for a disaster."

Permeability of Natural Membranes (2nd ed. Cam-

bridge : University Press. 1952. Pp. 365. 30s.).-The firstedition of the book was sold out within a year and it hasbeen accepted as a standard work in its own field. Since 1943,however, there has been a considerable shift of emphasis inour whole way of thinking about the distribution of ions andother substances across natural membranes; the propertiesof the membranes themselves are less emphasised, and moreimportance is attached to active processes of ion extrusionwhich are linked to cell metabolism. Moreover, active cellprocesses probably prevent any formal thermodynamicequilibrium of the type treated in chapter ill. It is obviousfrom their candid preface to the new edition that Mr. HughDavson, D.sc., and Prof. J. F. Danielli, D.sc., the authors,recognise the need for a more complete revision than theyhave in fact been able to make : " reprinting of this bookwith a few minor additions " is an accurate description ofwhat has been done. The minor additions " consist of aparagraph at the end of most of the chapters, giving referencesto work up to 1950. The book remains an authoritativesummary of the older work in this field, but we hope that theauthors will notbe content to leave it at that, but will proceedto a full discussion of the subject, with a critical survey of theresults <of’ jsotope studies and the effect of cell metabolism onthe distribution of ions.