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REVIEWS OF BOOKS

A Mirror for Surgeons ] 1

By Sir D’ARCY PowER, F.R.C.S., consulting tsurgeon and archivist to St. Bartholomew’sHospital, London. Boston: Little, Brown andCo. 1939. Pp. 230. 11s. I

IN this attractive anthology Sir D’Arcy Power haschosen twenty-two surgeons, from Master John ofArderne in the fourteenth century to Macewen and

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Halsted. He gives longish extracts from the classical .

contributions of each author on subjects which they .

made specially their own-Colles on Colles’s fracture,Ambroise Pare on treatment of the wounded, Paget onosteitis deformans, Jonathan Hutchinson on the teethin hereditary syphilis, and so on. He honours each ofthese hero spirits " with a short cameo of apprecia-tion by way of introduction to each chapter. To thedoctor, whether he be surgeon, physician or Jack of alltrades, this companionable book can be recommendedfor the bedside; and it will afford the medical studenta happy introduction to the history of surgery interms of great personalities. It leaves the readerhankering after a second helping.

Textbook of Public Health

(10th ed.) By W. M. FRAZER, M.D., D.P.H.,barrister-at-law ; medical officer of health, City andPort of Liverpool ; and C. 0. STALLYBRASS, M.D.,D.P.H., deputy medical officer of health. Edin-burgh : E. and S. Livingstone. 1940. Pp. 04. 21s.

THE ideal textbook of public health has to cover inreasonable space a range of subjects from meteorologyto mental hygiene and present their scientific, legis-lative and administrative aspects in a readable form;a heavy task and perhaps an impossible one. Dr.Frazer and Dr. Stallybrass have overcome many ofthe difficulties, but like most other writers they havelaid too little stress on administration and haveviewed the subject too much from the aspect of acounty borough. A student would not fully appreciatethe peculiar relationship existing between the countymedical officer of health and the M.O.H.’s in themunicipal boroughs and urban and rural districts

throughout his county, which has resulted from environ-mental hygiene and personal hygiene being largelyadministered by different authorities. Failure tomake this clear has even led the authors themselvesinto one or two errors. They say, for example, that"public vaccinators are appointed by the sanitaryauthorities upon whom lies the obligation of con-

trolling an epidemic of smallpox," which is, of course,not true in counties. .

This edition contains valuable additions, of whichthe section on the medical aspects of civil air defencedeserves mention. The book is very readable and thestudent, before or after qualification, will not find itheavy going.Viruses and Virus Diseases

Lane Medical Tectitres. By THOams M. RIVERS,M.D., Sc.D., director, Hospital of the RockefellerInstitute for Medical Research, New York City.London: Humphrey Milford, Oxford UniversityPress. 1939. Pp. 133. 14s. 6d.

IT is obviously impossible to deal adequately, as thetitle of these lectures might suggest, with the wholeenormous field of viruses in less than a hundred andfifty pages, and Dr. Rivers has wisely confined hisattention to selected topics. In the first lecture hedescribes the discovery of a new virus disease in man-lymphoeytic choriomeningitis-and the steps which

were necessary to make certain that the virus wasreally a human pathogen. In the second he discussesthe characteristic pathological changes induced byviruses. The third deals with the serological andimmunological phenomena associated with virusdiseases, and the last two with the nature of virusagents and the methods so far evolved of preventingand treating virus diseases.

Dr. Rivers adheres to his belief that viruses repre-sent a heterogeneous co’llection of diverse agents, someof them minute parasitic organisms, others forms oflife more or less unfamiliar to us, while still othersmay be fabrications of their host cells aided by auto-catalysis. He attributes similarities in the clinical andpathological pictures of virus maladies to the characterof the reactions arising in infected cells rather than tosimilarity in the nature of the inciting agents them-selves. In discussing the interference phenomenonin certain animal virus infections, he does not mentionits common association with the viruses of plants.Apart, in fact, from their relationship to crystallineand paracrystalline proteins, he pays little attention tothe important questions raised by plant viruses, butthese have been adequately dealt with elsewhere.Many of the photomicrographs are unworthy of thestimulating text.

Courmont : Precis d’hygiene(5th ed.) Revised by A. RocHAix. Paris : MaiSsonet Cie. 1940. Pp. 1001.$2-75.THIS edition of Jules Courmont’s textbook has been

almost entirely rewritten, though Professor Rochaixof Lyons has kept to the general layout adopted byhis distinguished predecessor. French hygiene wasborn of medicine, English and American hygiene ofsanitation and of this each countrv’s textbooks bearevidence to this day. The French are behind theBritish and Americans in biometrics, but at least equalto them in parasitology, so it is not surprising thatthe best parts of Courmont are the chapters on

parasitic diseases and the least good those on vitalstatistics. English readers will be surprised to learnthat scarlet fever in England is frequent and vervsevere and that in London several thousands of deathsfrom it occur annually. Scarlet fever had ceased to besevere in England before Courmont wrote the firstedition of his textbook in 1913.

The Electrocardiogram and X-Ray Configurationof the Heart

By ARTHUR M. MASTER, M.D., F.A.C.P., associatein medicine and chief, cardiographic laboratory,Mt. Sinai Hospital, New York. London : HenryKimpton. 1939. Pp. 222. 30s.

THE greatest value of the cardiogram today is inthe diagnosis of acute and chronic damage to the myo-cardium, but there are many other conditions whichalter the size, shape and position of the heart, and atthe same time the form of the cardiogram. It is withthe object of collecting and emphasising these that Dr.Master’s book has been written, and their recognitionis important for the effects of some physiological pro-cesses are not unlike those of disease. He first con-siders the influence on the cardiogram of age, bodyposition, respiration, body habitus, and pregnancy.He then passes to conditions which lead to hyper-trophy of one or other ventricle, and the cardiogramsof axis-deviation. The cardiographic patterns in theadvanced stages of these cannot be sharply differen-tiated from those of muscle damage, and in practicethey often merge one into the other. He also dis-

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cusses congenital heart disease, chest deformities anddiseases of the lungs and pleura. The greater part ofthe book is taken up with radiograms and cardio-grams, all of a high standard, and arranged side byside so that the relation of the tracing to the cardiacconfiguration is easily seen. The book makes access-ible much useful information on an aspect ofcardiography sometimes neglected.The Rise of EmbryologyBy ARTHUR WILLIAM MEYER, emeritus professor ofanatomy, Stanford University. London: HumphreyMilford, Oxford University Press. 1940. Pp. 367.36s.

THIS book does not greatly overlap Dr. JosephNeedham’s " History of Embryology," published in

1934, for the authors have treated the subject fromrather different points of view. Needham made a

general historical survey of the subject as a whole,but Professor Meyer follows the story of such concretefactors in progress as the development of lenses andmore refined optical apparatus, the study of sections,the influence of the " mule " upon ideas of inheritance,and such outstanding contributions to knowledge asthe discovery of the spermatozoon and of the humanovum. He opens his study by discussing the sexualknowledge of primitive man. The ignorance of certainprimitive peoples of any connexion between the sexualact and reproduction is perhaps accepted by Pro-fessor Meyer somewhat uncritically. Malinowski’sstatements concerning the ignorance of the Trobriandislanders in this regard have not gone unchallenged.As for the Australian aboriginal, it is becoming moreand more recognised that although he has manycurious legends upon the subject he is by no meansunsophisticated. A completely alien inquirer mightreturn from this country with strange stories concern-ing gooseberry bushes or parsley beds or even ofstorks or the doctor’s black bag. What the nativetells the white inquirer is not always what the nativeknows or even believes.One of the most interesting chapters is that on

early visual and other technical aids. The rise ofthe modern compound microscope from the " fleaglass," involving as it does the history of the telescopeand spectacles, is well told and constitutes a fascin-ating story of discovery. The book is amply illus-trated with 97 photographic reproductions ofportraits, plates and instruments, of which the seriesof early optical apparatus is particularly valuable.The only criticism that can be made of this attractivebook is that the easy sequence of its reading is some-times interfered with by the insertion of over-longquotations.Localisations viscerales et aspects chirurgicaux des

brucelloses

By R. MiCHEL-BECHET, with the assistance ofR. PuiG and P. CHARVET. Paris : Masson et Cie.1939. Pp. 168.$1.15.THE study of medicine has almost invariably passed

from the epidemic to the endemic, from the clinicallytypical to the clinically atypical, from overt diseaseto latent infection. Once the obvious manifestationsof an infecting organism, of a nutritional deficiency,of a chemical poison, or of some other agent havebeen recognised, there is a tendency to imagine thatour knowledge is complete; and it is usually not forsome time-admittedly shorter now than formerly-that attention becomes directed to the less obvioussubclinical and latent manifestations. The brucellainfections are a case in point. First of all undulantfever was recognised clinically. Then, as the causativeorganism was discovered, continued fever without the

characteristic pyrexial undulations was shown to beof essentially the same nature. ]’.10re recently" influenza " attacks, lasting perhaps for only threeor four days, have often been traced to brucellainfection. Long-standing disability leading to neuras-thenia has been found to be sometimes due to thesame cause; while here and there the most unexpectedconditions have been demonstrably caused by brucella.The authors of this book set out to describe thelocalised lesions, both medical and surgical, to whichthis group of organisms may give rise. Many physi-cians will he already acquainted with the nervous,hepatic and pulmonary disturbances which may bemet with in undulant fever; but there will be fewsurgeons who realise the variety of bone and jointlesions for which brucella may be responsible. Thisorganism must be remembered as a possible cause ofboth acute and chronic bone disease. To the ortho-

psedic surgeon, in particular, the knowledge thatalmost every form of tuberculous arthritis and osteitismay be simulated by brucella infection is of egiisider-able importance, since the prognosis and treatmentof the disease must he affected bv it. How far theauthors’ conclusions are applicable to this country,where only the abortus variety of brucella is found,is doubtful, but it is to be hoped that orthopabdicsurgeons after reading this book will test the blood-serum of their patients as a routine, and so find outthe real frequency of brucella infection in bone andjoint disease in Great Britain.

TROLLEY FOR CASE-NOTES

A TROLLEY designed to carry case-notes is illustratedin the accompanying figure. The front view showscompartments for eighteen sets of notes. A similararrangement atthe back of the

trolley pro-vides a furthereighteen com-

partments.The shelves areset at a slopeso that thenotes do nottend to fallout. The over-all dimensionsare : -. width 36in., depth 18in., and height,including cas-

tors, 39 in.The top formsa useful table

. on which X-ray folders

f can be kept.,

The trolley hasproved usefulin huts where no provision can be convenientlymade for keeping the notes at each patient’. bedside.

" .. , At the present time no textbooks are availablewhich adequately portray the application of anatomy andphysiology to the health of the individual person or

describe its methods of’ diagnosis. The opportunity towrite such a textbook is open to some one who can describeaccurately and convincingly the signs, symptoms andmanifestations of health in the well person and the inter.pretation of the relation of these to the structures and thefunctions of the body.... A golden opportunityawaits the man who undertakes this task."-Dr. E.STANLEY RYERSON in an address to the Association ofAmerican Colleges, October 1939.