Book Reviews. Therapeutics of the Circulation. By LAUDER BRUNTON, M. D., etc. (Philadelphia: P. Blakiston's Son & Co., 1908.) This volume of 280 pages consists of eight lectures delivered in the spring of 1905 in the physiological laboratory of the University of London, under whose auspices they are published. Naturally, some rewriting has been necessary to adapt these lectures to readers rather than hearers, but it is inconceivable that there should have been any loss and that in the present form they are less capable of being understood. While illustrations and diagrams have taken the place of the actual experiments, there are so many of these and the explanations are so clear that it seems probable that in the present form it is even easier to follow and understand as one can digest the various points advanced more at leisure. This is possible largely due to Dr. Brunton's delightful style which makes this book extremely pleasant reading. The separation into lectures makes a somewhat artificial division of the subject, which appears to be a slight defect, and while it may be desirable to preserve the lectures in the original form so far as possible, it would have been better perhaps to have adhered to a division by subheads rather than have these come in various irregular positions of the lectures. After a very brief introduction the author takes up the Physiology of the Circulation, Pathology of the Circulation, Valvular Diseases of the Heart, Method of Treatment in Cardiac Disease and Treatment of Cardiac Diseases. In order to bring the subject up to date there are several appendices treating of matters not included in the lectures. The book is a valuable contribution and gives in a compact, readable form a summary of all that should be known in reference to the circulation by every medical man, whether he be student, practitioner or specialist. Dr. Brunton deserves the thanks of all who read his book for making of what might be a task almost a recreation. W. R. D. Philadelphia General Hospital Reports. Volume VIII, 1908. Edited by HERMAN B. ALLYN, M. D. (Philadelphia: Printed by Dunlap Printing Company, 1909.) This is a well-printed volume of 272 pages containing 41 papers, including the report of the resident physician, of the superintendent of the training school for nurses, an account of the founders' week reunion and a list of the members of the medical board. Eight of the papers are especially of neurological interest and are: Tabes Associated with Trophic Changes Suggesting Acromegaly, by F. X. Dercum; A Study of the Refraction in the Morally Deficient White Male Adolescent, by Chas A. Oliver and Jay C. Knipe; Clinical Report of a Case of Herpes Zoster Ophthalmicus Involving the First Division of the Left Fifth Nerve, by Chas. A. Oliver; The Symptom Complex of Occlusion of the Posterior Inferior Cerebellar Artery-Two Cases with Necropsy, by Wm. G. Spiller; A Case of Epileptic Automatism, in which there were also Hallucinations and Other Mental Phenomena, by Chas. S. Potts; Roentgenology in Neurology, by Mihran K. Kassabian; Pseudo-bulbar Palsy, by J. H. Lloyd; Hydrotherapy—Methods of Application, with Results-as Used in the Philadelphia Hospital for the Insane, by Walter G. Bowers. It is needless to say that all of the papers are of interest, although some are quite brief, and the last-named paper might have been expanded without diminishing our interest in it. In contrast with the last volume, this leaves nothing to be desired in mechanical details. W. R. D. (New York: The Neurological and Mental Diagnosis. A Manual of Methods. By L. PIERCE This little book by two well-known authors gives excellent methods of neurological and mental diagnosis and is very valuable. The descriptions given are clear and the apparatus required is simple and easily obtained. Neurological methods of diagnosis occupy about one-third of the book, the other two-thirds being given to mental diagnosis. The latter portion consequently goes more into detail and is of increased value because of the preceding presentation of neurological methods. The phenomena of the various forms of insanity are analyzed and the methods of psychological investigation are given. The new terminology of Kraepelin is carefully explained. A glossary of terms used in psychiatry is also given. The book is well adapted to the use of students of medicine. Handbook for Attendants on the Insane. Fifth edition, revised and enlarged. (Chicago: W. T. Keener & Co., 1909.) This handbook, which is published by authority of the British MedicoPsychological Association, has been known for some time, but in the present edition it has quite outgrown itself and is now more than double the size of the fourth edition, which was a volume of 158 pages. It now contains 390 pages. In the five editions 33,000 copies have been printed. Perhaps one reason why this book has been so popular is its comprehensiveness, containing as it does in sections or chapters the amount of the various subjects which pupils are often required to glean from larger text-books or the notes taken from a lecturer. The eleven sections in order are entitled: Anatomy and Physiology; General Hygiene and Causation of Disease; Accidents, Emergencies, First Aid; General Symptomatology of Bodily Disease, with a Brief Description of the Commoner Forms of Disease of Each System; The Nursing of Bodily Diseases; The Nervous System; Mind in Health; The Mind in Disease; General Care and Nursing of the Insane; Diseases of the Nervous System; General Duties of an Attendant. This is a radical change from the last edition, which contained but five chapters. In its present form it seems that this handbook has gained greatly and must prove more convenient to both pupil and teacher than former additions. A noteworthy addition is the greatly increased space given to the anatomy and physiology of the nervous system, an increase of 36 pages. Another improvement is the omission of the questions which formerly were at the end of each chapter and which had but little value except for selfquizzing. In its present form this book is a great improvement over the former edition and will certainly prove valuable in asylum training schools. W. R. D. Genito-Urinary Diseases and Syphilis. By HENRY H. MORTON, M. D., Clinical Professor of Genito-Urinary Diseases in the Long Island College Hospital; Genito-Urinary Surgeon to the Long Island and Kings County Hospital, etc. Illustrated. Second edition. Revised and enlarged. (Philadelphia: F. A. Davis Company, 1908.) This book has the virtue of brevity and for this reason will be of use to students who desire much information in a compact form. The ground is covered with a fair degree of thoroughness; in certain places however (as, for example, in the chapter on prostatic hypertrophy) the treatment is entirely too sketchy and the modern advances, which in the case of the prostate have been marked, are passed over with bare mention. The illustrations are very much below par. Abstracts and Extracts. Contribution to the Study of the Blood Pressure in General Paresis. By A. SCHMIERGELD. New York Medical Journal, Vol. XC, p. 402, Aug. 28, 1909. The author briefly reviews the opinions of Craig, Pilcz, Walton, and Bravetta, and explains that their different results are easily explained by the fact that blood pressure depends upon so many factors that in comparing it in different individuals it must not only be observed under the same conditions, but also many times in the same individual. His results, which were obtained from patients in the Manhattan State Hospital at Ward's Island, N. Y., are very briefly stated and are summed up as follows: 1. To estimate the blood pressure of an individual it is necessary to measure it several times. 2. The blood pressure in general paresis is very variable. 3. In the majority of cases, however, it seems lower than in normal individuals. 4. There exists no relationship between the mood of the paretic and the arterial tension; elated paretics can have a high pressure and depressed paretics a low one. W. R. D. Observations on the Blood Pressure and Vascular Disease in the Female Insane. By JOHN TURNER. Journal of Mental Science, Vol. LV, p. 418, July, 1909. The author, who is senior assistant medical officer at the Essex County Asylum, makes an examination of his accumulated observations of blood pressure to determine: "whether its routine determination is worth while; whether from it any fairly trustworthy conclusions can be drawn as to the condition of the circulatory apparatus during life, or as to the prognosis, not only with reference to the mental disorder, but as to the prospects of the duration of life, or whether the time spent in this direction might not more profitably be otherwise employed; and further to ascertain whether the results obtained tally with those of previous workers." He first discusses a number of papers on this method of observation and states that he used Martin's modification of the Riva-Rocci instrument, the observations being made daily for a week between 10 and II a. m. He then takes up the blood pressure in different forms of insanity, the relation between coagulation rate and blood pressure, the correlation of blood pressure observations and post-mortem and microscopical exami nation of cases, and the factors which control blood pressure. A number of tables are inserted and the conclusions are as follows: I. There is no definite relation between pressure and exalted or depressed emotional states, but the very general occurrence of higher pressures with the first few readings on consecutive days in any individual case suggests that there is some nervous condition at work which has the effect of interfering with the pressure. 2. The only condition revealed by collating a number of sphygmomanometer observations which has a constant relation to height of pressure is advancing age. 3. From pressure observations alone only a very rough opinion can be educed as to the structural alterations of the circulatory mechanism. 4. Height of pressure and slow coagulation rate are generally associated, but this is a rule to which there are many exceptions. 5. The high percentage of the smaller blood-vessels, especially renal, which present microscopically structural changes, points to the great importance of vascular lesions in the histogenesis of insanity. 6. Evidence in the form of free gland cells in the blood stream is recorded, which lends support to H. Batty Shaw's view that in some cases heightened blood pressure may be due to the entrance of kidney substance into the circulation. In view of the fact that vascular changes are so frequently met with in the insane, the author believes that the routine record of the blood pressure in conjunction with histological examination of the blood-vessels is likely to result in a better understanding of the factors which control the circulatory mechanism, and if only for this reason is a measure which fully justifies the time it occupies. W. R. D. Psychasthenia. By A. H. RING. Boston Medical and Surgical Journal, Vol. CLXI, p. 185, August 5, 1909. This is a very good digest in which the author briefly discusses the history, symptom complex, clinical picture, diagnosis, and treatment of psychasthenia. His conclusions follow: 1. Janet, who coined the word psychasthenia, intends to include under the term, obsessions, manias of doubt, tics, agitations, phobias and the deliria of contact, states of anxiousness, neurasthenias and bizarre sensations of strangeness and depersonalization. These he would group together into a grand psychosis similar to hysteria and epilepsy. 2. Psychasthenia is at base a disturbance of the feelings, the will and perception, and may range from mere eccentricities in the superficially normal through mild depression to melancholia and dementia. 3. Two types: (1) those in which the disturbance shows itself principally in motor fatigue and (2) those in whom the principal affection is in the sensory motor and emotional sphere, the latter offering the less favorable prognosis. 4. Phobias result from an unhealthy, prolonged feeling tone of depressing ideas and may be conscious or subconscious. |