THE CURE OF HAEMORRHOIDS, VARICOSE VEINS AND ULCERATION, AND ALLIED CONDITIONS: BY MODERN METHODS OF INJECTION AND

BANDAGING.?By Stuart McAusland, B.A.

(Lond.), M.D., Ch.B. (Liv.). 1933. John Bale, Sons and Danlelsson Ltd., London. Pp. 63, with

11 plates. Price, 3s. 6d. net

This modest work is intended to be a guide to the general practitioner in the art of non-operative treat-

ment of varicose conditions and as sucn it fulfils its

object very well. The descriptions of technique are

clear, the necessary instruments are illustrated and the contra-indications for this form of treatment are very carefully explained. For haemorrhoids the author prefers the almond-oil-carbolic mixture on the grounds of the absence of sloughing, the reduced number of

injections necessary and the absence of haemorrhage and post-operative discomfort. The reviewer, having f

some experience of this technique, can entirely agree in his preference. In a thousand cases the author has had only one ischio-rectal abscess and two thromboses. It is often erroneously supposed that injection causes thrombosis and so obliterates the piles, but its real action is to set up an aseptic inflammation. For varicose veins Ihe author prefers quinine urethane and gets 85 per cent of permanent cures, though he discusses the use of the other solutions. He prefers to start above and work down, which is contrary to the usual practice. The question of whether recurrences are

recanalizations of obliterated veins or varicosities of fresh veins has lately been the subject of discussion; the author favours the latter opinion and thinks they are mostly due to neglect of after-treatment. Some brief notes on injection treatment of other conditions conclude a very practical little manual.

W. L. H.