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Reviews and Notices of Books.HISTORY OF THE GREAT WAR.

Medical Services General History. Vol. II. ByMajor-General Sir W. G. MACPHERSON, K.C.M.G.,C.B., LL.D. London: H.M. Stationery Office.1923. Pp. 510. 21s.THE second of four volumes on the General History

of the Medical Services, forming part of the officialmedical history of the war, is exclusively the work ofSir William Macpherson, as was the first volume onthe general history published two years ago. 1 Thereremain two volumes of general history, which havebeen prepared, though some time will elapse beforethey can be published. These will close the seriesapart from the volume on Statistics, which is beingundertaken by the Ministry of Pensions. Thepresent volume deals with the medical services ofthe British Expeditionary Force in France andBelgium down to the Battle of Loos, and has beencompiled entirely from war diaries, including diariesof the administrative medical services, and fromofficial despatches. At the outset of the campaign,without carefully prepared schemes and organisa-tion, so as to ensure the rapid collection andevacuation of the wounded, confusion and delaywere inevitable, and here the importance of adminis-tration in the employment of the medical services iin war is emphasised. During the earlier opera-tions, while the work of organisation was goingon, the field medical units of divisions were most inevidence; for until the Expeditionary Force hadbeen formed into armies, each with casualty clearingstations and motor ambulance convoys allotted toit, it was difficult to carry out schemes for methodi-cally receiving and evacuating sick and wounded. Butin the succeeding years the casualty clearing stationsbecame the chief centres of the medical work withthe field armies, and " when put to the practical testof war " fully justified their description in the fieldservice regulations as " the pivot on which the wholesystem of collecting and evacuating sick and woundedturned." Hence the chapters on the later battlesemphasise more the strategical employment andwork of those units than the tactical employment ofthe field ambulances, which were acting underdivisional control along normal lines.The volume contains a number of illustrations and

many carefully prepared charts and plans. Six largemaps, unbound, are included in a pocket of the cover.It is understood that separate histories of the MedicalServices of the Dominion Contingents are in course ofpreparation.

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TEXT-BOOK OF CLINICAL PERIODONTIA.

By PAUL R. STILLMAN, D.D.S., and J. 0. MCCALL,A.B., D.D.S. New York: Macmillan Co. 1922.With 79 Illustrations. Pp. 240. 16s.FOR the benefit of the English reader unversed in

the newer developments of dental terminology inAmerica it may be as well to state that by " peri-odontia" is meant the branch of dentistry concernedwith the treatment of "

periodontoclasia." Thelatter term can be translated into the familiar wordspyorrhoea alveolaris. While we may agree with theauthors that this phrase is pathologically inaccurate,it is doubtful whether it can be replaced at this stage.Many strange words, indeed, appear in this book,such as

" apoxesis " (the operation of scaling theteeth) and " ula " (the gum), and the authors find itnecessary to devote a whole chapter to nomenclature.We deplore this invention of new and unnecessarywords when others exist with the sanction of longusage. It darkens counsel and may, as Voltairereminded us, conceal a poverty of thought. ,

In a book concerned with so elusive a disease aspyorrhoea, the chapters on aetiology are those likely

1 See THE LANCET, 1921, ii., 1286; and also Oct. 20th,1923, p. 893.

to be first examined. The authors put forward somenew hypotheses of considerable interest. They dividethe aetiological factors into two-primary or inaugurat-ing, and secondary or non-inaugurating. These twoco-exist in a kind of symbiosis ; neither alone can

, cause pyorrhoea. The primary causes are, according,

to the authors, almost entirely mechanical; thesecondary causes are of various kinds, of whichbacterial infection is only one receiving compara-tively brief mention. Among primary causes theauthors lay great stress on traumatic occlusion as

; an important factor in the production of pyorrhoea.Since this view was first put forward by P. R. Stillman,

this book represents an authoritative account of histheory. The conception depends on the hypothesisthat there is a normal occlusion of standard type ;Stillman, following E. H. Angle, assumes a rigid andfixed type which may be considered the same for allcases. The orthodontist concerned with the correctionof irregularities of the teeth is familiar with thishypothesis, but its application to the aetiology ofpyorrhoea is a newer development. Such a view doesnot appear to allow any margin for biological variation.Traumatic occlusion as an aetiological factor inpyorrhoea seems therefore somewhat speculative.Gross deviations from normal occlusion often existin pyorrhoeic mouths, though not invariably, and mayundoubtedly predispose’to pyorrhoea by favouringthe impaction of food. But Stillman goes muchbeyond this and considers that very slight deviationsfrom the hypothetical normal can cause pyorrhoea.According to his argument, the impact of masticationon teeth not correctly aligned injures the periodontalmembrane to such an extent that bacterial infectionsupervenes. Stillman advises that pyorrhoea shouldbe treated by correcting the mal-occlusion, and thisby grinding the surfaces of the teeth, so as to producethe same series of inclined planes which exist innormal occlusion. No very convincing proofs are

offered in support of the theory, but it is claimed thatthis form of treatment is highly successful. Since theusual routine of scaling and medication is also carriedout, it might reasonably be argued that improvementresults rather from the last-named treatment.

There may be a wholesome kernel of truth in thistheory, but the husk of conjecture seems dispropor-tionally large, and we doubt if the obscurity surround-ing the causation of pyorrhoea is much lightened bythe theory propounded in this book.

SURGERY.Elements of Surgical Diagnosis. Sixth edition.By E. P. GouLD, M.D., F.R.C.S., AssistantSurgeon, Middlesex Hospital; Surgeon to theBolingbroke Hospital. London: Cassell and Co.1923. Pp. 739. 12s. 6d.

Tins is a new and revised edition of a well-knownmanual. It maintains the standard of former editions.It is eminently readable, has a good index, and is ofa handy size. It is likely to remain popular with thestudent beginning the study of clinical surgery.

A Text-book of Mi.nor Surgery. Fifth edition. ByE. M. FooTE, A.M., M.D., Visiting Surgeon, St..Toseph’s Hospital ; Consulting Surgeon, Randall’sIsland Hospitals and Schools ; Clinical Professorof Surgery, New York Polyclinic Medical Schooland Hospital. London: D. Appleton and Co.1923. Pp. 845. 35s.

IN the preface to this book Mr. Foote points outthat in the past few years many new ideas in thediagnosis and treatment of disease have beenannounced and tested. Some of them, like theWassermann test of the blood and the intravenousinjection of preparations of arsenic in the treatment ofsyphilis, have affected all branches of medicine.Others are purely surgical in character, and it is thesewhich have been incorporated in the fifth edition ofthis popular text-book. The excellence of illustrationsalone would account for this popularity, and the

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general get-up of the book is attractive. The sectionon blood transfusion needs to be rewritten entirely.Direct blood transfusion from one patient to anothercannot be ranked as a minor surgical procedure,and, moreover, it is not justifiable, in view of the othersimpler and more reliable methods. In most otherrespects the book is adequate for its purpose, which isto apply to the less serious everyday problems ofsurgical practice the new knowledge which thediscoveries of the last 20 years have revealed.

Orthopaedic Surgery. Seventh edition, thoroughlyrevised. By ROYAL WHITMAN, M.D., M.R.C.S.,F.A.C.S., Surgeon to the Hospital for the

Ruptured and Crippled, New York, &c. With877 engravings. London : Henry Kimpton. 1924.Pp. xii. + 993. 42s.Dr. Royal Whitman seems rightly determined to

keep his treatise on Orthopaedic Surgery up to date,for he has this year brought out a seventh edition.We noticed the sixth edition in THE LANCET (1919,ii., 19), and it is therefore only necessary now tonote the changes which have been made in the newedition of this well-known work. In the first place,a few of the old illustrations have been omitted, buta number of new ones have been added, so that thereare now 877 instead of 767. The additional figuresare distributed throughout the book, but the principalchanges are to be found in the chapters on the treat-ment of the deformities following upon anteriorpoliomyelitis in which operations of tendon trans-plantation are fully illustrated. The operation ofarthrodesis of the foot and ankle, which is so wellknown under the author’s name, is illustrated by somenew photographs. The section on the treatment offracture of the neck of the femur in adults is expandedand transferred, without reason assigned, to the

chapter on Collateral Orthopaedic Surgery, whichtakes the place occupied in the sixth edition by thaton Military Orthopaedic Surgery. Under this newchapter heading are included the treatment offractures, operations of reconstruction or arthrodesisof the hip-joint, and some of the subjects whichwere formerly included in Military Orthopaedics.

It is unnecessary to say much about a book whichhas become so well known, but we may hazard theopinion that this standard treatise has been broughtso thoroughly up to date as to make it one of themost complete works on orthopaedic surgery in theEnglish language.

McNALLY’s SANITARY HANDBOOK FOR INDIA.Sixth edition. Rewritten by Major A. J. H.RussELL, M.A., M.D., Director of Public Health,Madras. Madras: Government Press. Pp. 472.R.4.8.THE appearance of this well-known handbook, now

revised and rewritten by Major Russell, affordsuseful evidence of advance in Indian sanitation, andits contents incidentally throw much light on Britishsanitary problems. The book is well written, read-able, and we heartily commend its perusal to publichealth students in this and other countries desiringto view the chief problems of public sanitation froman Eastern standpoint.The subjects are dealt with on similar lines to

those followed in other text-books on public health.The information given under certain headings is ele-mentary, as befits a book for consumption by Easternstudents ; but the main principles are clearly statedin the light of recent research, and we have failed todiscover any error of fact or inference, except possiblythe remarks on page 357 on the prevention of syphilis ;here it is definitely stated that the inspection andtreatment under the Contagious Diseases Acts inthis country were definitely beneficial, and an opinionis expressed that regulation of prostitutes by law hasbeen of obvious benefit in many European states.Both of these statements are highly debatable.The chapter on foods is very full, and includes a

section giving a useful summary of our knowledgeon accessory food substances. The importance ofmilk as a food is stressed, as in India it forms the soleanimal food of Brahmins and some other castes.The Indian cow gives only about a quarter of the milkyielded by an English cow, the difference probablybeing due in the main to the deficiency and poorquality of the food supplied to the Indian cow.

Raw milk is very rarely used in India; but that theapparently small amount of non-pulmonary tuber-culosis in India is not thus explained is indicatedby the statement on page 355 that in Madras Presi-dency it is very rare to find a tuberculous animal ina slaughter-house.

Parasitic diseases are very prevalent, especiallyankylostomiasis. Special investigations in the lastthree or four years have shown that the infection-rateof the population varies from 99 per cent. in wetdistricts to between 30 and 40 per cent. in dry dis-tricts. It is almost universal in the coolie classesworking on tea and coffee estates. We note a usefulpractical point in protecting coolies who will notwear boots against hookworm disease-viz., to makeeach man, before going to work, step into a vessel con-taining tar, so that the legs are coated with tar up tothe knees. Apparently no instances of dermatitis havebeen recorded. The difficulty of protecting nativesagainst this disease, even in cities, may be appre-.ciated from the statement that in Madras city 20 tonsof faecal matter are estimated to be deposited dailyin unauthorised places all over the town, and thereallowed to remain. Ingenious use is made of ancientIndian teaching on various topics, as that Vishnulaid down a heavy fine for the pollution of drinkingwater. So in advising against immature marriagesorthodox Indians are commended to observe theteaching of the seer who stated that a young manshould not marry until he becomes a grihastha-thatis, when he is about 24 years old.The student or health officer who reads through

this sanitary handbook will be impressed by itsmastery of the essential principles of hygiene andpublic health, and by the excellent manner of pre-sentation and discussion of each subject.

INDUSTRIAL OPHTHALMOLOGY.

L’hygiene de l’ceil et le travail industriel.Problems of Industrial Illumination. Geneva IInternational Labour Office of the League ofNations. 1923. Pp. 160. Fr.3 (Swiss).THE subjects dealt with in this useful brochure are

as follows : The comparison of various sources ofnatural and artificial light, the minimum amount oflight required for various employments, and themethods whereby it can be measured ; ocular fatigueand its prophylaxis in different employments, its bear-ing on progressive myopia and on miners’ nystagmus ; ;industrial accidents due to deficient illumination ; andlastly, a comparison of the regulations in force indifferent countries whose object is the minimising ofocular fatigue in industrial employment. This volumeaffords a useful summary of the present stage ofknowledge and practice in all these subjects. Itsvalue is enhanced by a bibliography containing a listof papers on these subjects by English, American,French, German, and Swiss writers.

CHEMISTRY.

Systematic Organic Chemistry. Modern Methods ofPreparation and Estimation. By WILLIAM M.CU&bgr;IMING, B.Sc., F.I.C., 1. VANCE HOPPER, B.Sc.,A.R.C.Sc.L, F.I.C.; and T. SHERLOCK WHEELER,B.Sc., A.R.C.Sc.L, A.I.C. London : Constableand Co., Ltd. 1923. Pp. 535. 25s.A CRITICISM which may justly be levelled at the

majority of books dealing with practical organicchemistry is that they have been written with acomplete disregard for any considerations of practicalimportance in technical production. To meet thiscriticism the present authors, all of whom have had

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both academic and industrial experience, haveemphasised the necessity for considering the cost ofthe process and materials employed in the productionof any given compound and have further introducedseveral manufacturing methods on a laboratory scale.They have, moreover, very wisely included a fewoperations involving the use of

" oleum " in view ofthe industrial importance of this material.The book opens with a useful chapter containing

cautions with regard to the dangers of fire, poison,and accidents, and simple methods of dealing withthe latter and other general advice to students ; thesecond chapter deals at some length with a varietyof apparatus which should be contained in a well-equipped laboratory. The second part of the book isdivided into 30 chapters dealing with the actualpreparation of specific compounds. The arrangementhere adopted is novel and has much to recommendit; the general principle has been to divide the prepara-tions and the headings of linking of carbon to carbon orhydrogen, sulphur, nitrogen, &c., each group beingfurther systematically subdivided. Part III., composedof ten chapters, deals with quantitative measurementsand estimations of groups, &c., while Part IV. is devotedto the preparation of a number of inorganic compoundsrequired for the production of some of the organiccompounds described in Part II. The authors have.kept before them the intention of showing the studentthe close connexion between the lecture-room and thelaboratory by accompanying each new reactionmentioned by a practical experiment to illustrateit, and have thus compiled a valuable book con-taining a large variety of organic preparations.The practical instructions are throughout clear andintelligible and references to original literature are

repeatedly given. The book should be welcomed byteachers and students as a valuable addition to thepractical text-books of organic chemistry.

Kurzes Lehrbuch der Chemie in Natur und "TV issen-schaft. By Prof. CARL OPPENHEIMER, Ph.D.,M.D. Leipzig: Georg Thieme. 1923. Pp. ix. +258 + 862. 29s.THERE is nowadays hardly a branch of pure or

applied science which does not, sooner or later,require the assistance of chemistry for the furtherelucidation of its problems, but unfortunately not allworkers have chemical equipment requisite for furtherprogress. It thus happens that there exists a largebody of what may be described as chemical amateurswho, through force of circumstances, have acquiredan interest in chemistry when it is too late to takeup a complete study. For these a book such asProf. Oppenheimer’s may supply a want, since itattempts to compress into one volume the whole sub-ject of chemistry in potted form. The introduction togeneral chemistry has been entrusted to Prof. JohannMatula, who deals ably with a wide range of subjectswhich include, among others, radio-activity, atomicstructure, X ray spectra, colloids, valency, coördina-tion numbers, thermodynamics, electro-chemistry,&c., the whole being treated in an up-to-date andreadily intelligible manner. The second part, devotedto inorganic chemistry and covering 318 pages, is byProf. Oppenheimer himself, and by skilful inter-spersion of a number of facts of practical or of physio- ’logical interest he has invested the subject with an Iinterest not commonly encountered in a text-book ofinorganic chemistry. The perusal of this section

might well be recommended to those who would liketo see inorganic chemistry cut out of the syllabusof medical students. The third part, on organicchemistry, is in some ways perhaps the least satis-

factory of the three ; the author has here attemptedan almost impossible task, and the subject istreated in too sketchy a manner to serve the needsof students.As a book of reference for biologists and others the

work may be recommended on the whole, since itcontains a wealth of up-to-date biochemical informa-tion which has not yet been incorporated in text-books

e on biochemistry. It is stated in the preface that thef book is addressed to biologists, pharmacists, medicali men, and agriculturists, as well as to technical chemists1 who wish to obtain information upon subjects in. which they are not themselves specialists ; but thev author furthermore claims that it should be of use tof any educated person wishing to obtain an insight into

the workshop of the chemist. Whether it is possible5 to write a text-book appealing to such a heterogeneous, type of audience remains doubtful, but there can be1 no doubt that the compilation is a very readable one.

New Inventions.PORTABLE LIGHTING APPARATUS FOR

OPHTHALMIC WORK.

SOME years ago, when commencing refraction workin schools scattered over the area of the county ofDurham, I was forced to evolve a source of light thatwould be sufficient, reliable, and easily portable.Through the kindness of my friend, Dr. A. C. Norman,my attention was drawn to the desirability of usingelectric light supplied by an accumulator. I havegradually improved on the original, and the improvedinstrument is shown in the illustration. A polished

metal spring head-band, with an eight candle-powerfrosted lamp at its centre, is placed across the child’shead from occiput to forehead. This lamp isconnected by eight feet of flex, with a four-voltaccumulator which stands on the floor near the child.A threaded screw placed near the lamp makes orbreaks the contact. The accumulator will givesufficient output for 100 average refractions. Theeight candle-power lamp gives ample light. If it bedesired to use the light for direct examination of thefundus or for inspection of the cornea, the metal bandis lifted off the head, and thus one is able to hold thelight in any position. Apart from its portability,the light when on the head has the advantage ofmoving as the patient moves-a considerable advan-tage where a restless child is concerned. At theDurham County Hospital I use this same lamp for allpurposes, and I obtain current by attaching theterminals to a pantostat. Oculists who may be calledupon to see private patients in houses where the lightis not too accessible and where the electric ophthalmo-scope does not give sufficiently intense illumination,will find this portable apparatus of considerableservice.

Messrs. F. Davidson and Co., 29, Great Portland-street, London, W. 1, supply sets to medical men.

ARTHUR T. PATERSON, M.D., F.R.C.S.E., D.P.H.Durham.