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Reviews of Books

Early Recognition of DiseaseEditors : Sir HENEAGE OGILVIE, K.B.E., F.R.C.S.W. A. R. THOMSON, M.D. London : Eyre & Spottiswoodefor the Practitioner. 1949. Pp. 134. 10s. 6d.

IT is’ difficult to think of a more ambitious title, andcertainly not easy-to think of a more important subject.Clearly, the distinguished authors who have contributedthe 15 short chapters of this book have not altogetherenjoyed their task. Despite the editorial preface pointingto the mass of new data about the recognition of diseasein its early stages, much of the information they offeris already to be found in the -standard textbooks.Indeed this is as it’ should be. Also they are sometimeshandicapped by the brevity of their articles, havingto steer between a few pious-and perhaps well-known-generalisations on the one hand and a few particularexamples of disease on the other. The conclusion tothe chapter on malignant disease-that -every practi-tioner should be in a perpetual state of watchfulness-is an example of the first course, while the passages oncoarctation of the aorta are an example of the second.These, however, are minor criticisms, and many of theseclear and authoritative chapters could hardly be bettered.It is perhaps invidious to single out particularly helpfulsubjects among those chosen, but practitioners willcertainly read with gratitude the chapter on the principlesof neurological diagnosis and -those on cardiac andrespiratory diseases.

Elementary AnesthesiaW. N. KEMP, M.D., C.M., consultant anesthetist, Children’sHospital, Vancouver, B.C. London : Bailliere, Tindall,and Cox. 1948. Pp. 289. 27s. 6d.

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To the growing list of good textbooks on anaestheticsis added one more, this time from Canada. Dr. Kemppresents a compressed, and in the main orthodox,restatement of the principles and techniques of generaland local anaesthesia. He received his training both inthe United States and in Great Britain, and these twoinfluences are clearly seen. His preference for tabulatingthe various points he makes may give the misleadingimpression that the book is intended for examinationstudents ; but it is in fact an expression of Dr. Kemp’spersonal opinions-and firmly held ones, too. The usualsubjects are covered, but many of the chapter headingsare novel-for example, Pharmacodynamic Considera-tions, Anesthesia adapted to the Patient’s Handicaps,Adapting Anesthesia to Surgical Requirements. Achapter on anaesthesia for non-surgical conditions is alsoincluded. The section on status lymphaticus resuscitatesthe condition in all its one-time glory. Though anauthority in this country recently suggested that " statusflat-foot " might be an alternative name for this condition,Dr. Kemp’s views must be carefully considered, for hemakes out a case for the retention of the term to explainclinical observations in his locality. Postgraduatestudents and practising anaesthetists will glean muchinformation and many new ideas from this useful andwell-illustrated book.

Biological Reactions caused by Electric Currents andby X rays

J. Tn. VAN DER WEBFF, M.D., D.SC. Amsterdam andLondon : Elsevier Publishing Company. 1948. Pp. 203.30s.

Dr. Van der Werff aims at unifying biological effectsobtained experimentally by physiologists on the onehand and radiologists on the other. Those in the formercategory are the nerve-muscle interplay, while those inthe latter are the chief effects of X rays and radiumon the living cell. The main thesis is that in all livingorganisms important parts are continuously being brokendown (dissimilation) and being built up (assimilation).The author assumes for simplicity that assimilation isproportional to the store of building material available,while the rate of dissimilation is proportional to theamount of the substance undergoing this process. Anelectric current or a beam of radiation is thought tochange the dissimilation coefficient proportionately, andthis puts into operation a change in the assimilation in

such a way as to restore the original equilibrium. Thebulk of the work lies in an attempt to represent theobserved effects in terms of the differential equationsdeveloped from these premises. From the selectedexamples Dr. Van der Werff can claim that the mathe-matical curves often fit very well the charts of theexperimentalists, and he is doing a service by attemptingto unify what often appears so diverse.

Cancer of the Uterine CervixFRITHIOF TRUELSEN. London: H. K. Lewis. 1949.

Pp. 440. 50s.

IN the course of his report on 2918 cases of cancer ofthe cervix, treated at the Radium Centre, Copenhagen,from 1922 to 1939, Dr. Truelsen throws light on many

questions of symptomatology and the effects and resultsof radiotherapy. The arrangement of his book is familiar :,

an account of the development of radiotherapy is followedby a chapter on technique, with a short general descrip-tion of methods used in various major clinics. Thematerial is then discussed at length and provides dataabout age-distribution, age-morbidity, marital and socialstatus, and the number of pregnancies. The symptoms.and duration of the disease before attendance at hospitalare described and there is a useful section on tumourmorphology and type. The description of the techniqueused at the Copenhagen centre is hardly full enough ;the references to milligramme or millicurie hours, andto X-ray treatment (described in terms of total dose onsummated fields, this dose being measured in air), makeit difficult to find the dose actually delivered to thetumour-bearing cervix. Physical calculations are givenand isodose curves are shown which are approximatelythose which would be expected from a line of radium ;but the X-ray isodoses are not given, so combined dosagecannot be assessed. The rest of the book is a detailedanalysis of the excellent results obtained in this centre,and a description of complications and their treatment.A chapter on the terminal stage and cause of death is-particularly useful. The author has done a service togynaecologists and radiotherapists engaged in the treat-ment of cancer of the cervix by putting this valuablematerial at their disposal.

Dizionario Inglese-Italiano per le Scienze Mediche-(Turin : Minerva Medica. 1949. Pp. 565. 2400 lire).-Dr.Ruggero Marconi and Elena Zino have compiled an English-Italian dictionary of some 45,000 terms used in medicine,surgery, and pharmacology. All the common terms are given,and their search for uncommon words has also been fairlyexhaustive. They usually, but not always, prefer American-spelling to English ; they even outdo the Americans with"

edipism," which Dorland spells " oedipism " (but they donot mention Œdipus or Edipus). Nevertheless this work iswelcome, being the only dictionary of its kind.

Absorption Spectrophotometry (3rd ed. London: Hilger& Watts. 1949. Pp. 196. 26s.).-This edition, revised by a.new author, Mr. G. F. Lothian, describes instruments used for-measuring absorption of light in the ultraviolet, visible, andinfra-red regions of the spectrum, and the principles on whichthey are based. Some examples of the practical use of thesemethods are included, but this is essentially a book for thosewho wish to acquire a knowledge of the theory and design ofsuch instruments.

Clinical Orthoptics (London : Henry Kimpton. 1949.Pp. 475. 40s.).-Textbooks on orthoptics now make theirappearance with increasing frequency, and three or four newones are published each year. This one is written by MissMary Everist Kramer, orthoptic supervisor in the GeorgeWashington University Hospital, as a reference book for

students-presumably orthoptic students-and for doctors,to enable them to apply orthoptic principles to the treatmentof their squinting patients. It follows the familiar lines ofanatomy, neurology, physiology, optics, and orthoptics ; buta number of statements will cause English readers somesurprise, while others are difficult to understand. The writingis repetitive and somewhat involved, the author preferringthe long word to the short. Until the science of orthopticshas grown older and more stable it would be safer for text-books to be written by ophthalmologists, except perhaps forthe chapters on instruments. There is much useful informationin this book but also much that may mislead.