648 REVIEWS AND NOTICES OF BOOKS.-NEW INVENTIONS.

illustrations. London : Charles Griffin and Co., Limited.1916. Pp. 364. Price 8s. 6d. net.-We noticed the sixteenthedition of this excellent handbook less than two years ago.Two pages, 327A and 327B, have now been interpolated in theappendix on Antiseptics in Time of War, describing Lister’scurative antiseptic method in compound fracture, and theapplication of hypochlorous acid in the form of eupad andeusol to septic wounds. If the subject of antiseptics in wartime had to be included at all we could have wished it to bemore comprehensive in character. It is somewhat astonish-ing to find that the authors have so little to say on thesubject of war surgery in what purports to be an up-to-datesurgical handbook-there is, for example, no word concern-ing either tetanus or gas gangrene-but it is quite likelythat the pressure of duties brought about by the war hastaken from them all chances of the leisure necessary tocollate the wealth of information that now is on record. Theprophylactic injection of antitetanic serum is not evenmentioned. The remainder of the book is unaltered. ’

The Eyes of Our Children. By N. BISHOP HARMAN,M.A., M.B. Cantab. The Care of the Teeth. By ARTHUR T.PITTS, M.R.C.S., L. R. C. P. Lond., L. D. S. The Health of theChild. By O. HILDESHEIM, M.D., B. Ch. Oxon. The Healthofth6 Skin. By GEORGE PERNET, M. D. Paris. The Care of theBody. By FRANeIS CAVANAGH, M.D. The Prevention ofthe Common Gold. By OLIVER K. WILLIAMSON, M.A., M.D.Cantab. London : Methuen and Co. Price ls. each.-Theselittle volumes of Methuen’s Health Series, the first six to

appear, have been written with the object of giving thegeneral public information which, if carefully applied, wouldadd greatly to their health and happiness. Each book iscomplete in itself and deals, as will be seen from the titles,with a particular region of the body or a particular group ofindividuals. The appearance of the two volumes concerningchildren is appropriate at a time when special stress is beinglaid upon the preservation of child-life. Mr. Bishop Harman’sbook, in which instruction is given in an attractive manner,should be read by school teachers as well as by parents.The same applies to Mr. Pitts’s book, for it is during schoollife that much preventive work may be done in safeguardingthe teeth. The pernicious use of the "dummy" is graphicallypictured on p. 70 by the reproduction of a photographshowing the resulting deformity. Dr. Hildesheim dealsmore with the health of the child in general and thehygienic measures essential to maintaining it. Dr. Pernet’slittle treatise may help in restricting the harmful use ofcosmetics among the young girls to whom munition work hassuddenly brought a liberal supply of pocket-money. Dr.

Cavamagh gives much information which young workers

especially might lay to heart with profit. In the last volumeDr. Williamson deals with a subject of perennial interest,though he does not claim to do more than lay down a codeof life which will fortify the body against the common cold.Each book of the series is written in clear and non-technical

language.lftrench and English DictionM’Y. Compiled by JOHN

BELLOWS. Revised and enlarged by WILLIAM BELLOWS.London : Longmans, Green, and Co. 1916. Library edition,cloth, pp. 689. Price 5s. net. Pocket edition, leather, pp. 606.Price 9s. net.—The third edition of this admirable dictionaryhas made its appearance and will receive the same heartywelcome that has been accorded its predecessors. With allstudents of French Bellows’s dictionary has been popular fromthe day of its first appearance in 1872 through all its editionsand enlargements, for the scope of the work is very large,while the convenient size of issue makes the inclusivecharacter remarkable. From the beginning the late JohnBellows, the projector of the work, made the inclusion oftechnical renderings a special feature of the dictionary, andin continuing and developing these points his son, Mr.William Bellows, the present editor of the dictionary, hasbeen industrious and energetic. Introductory notes acknow-ledge the good offices of many cooperators, among whom maybe mentioned Professor G. Bonet-Mauray, whose practical helpin the revision of the work has been extensive, M. AugusteMarrot and M. Gustav Friteau, professor of English atthe Lycee Hoche, Brussels, the last two names figuringalso on the title-page as collaborators with the editor. Themanner in which in this dictionary the genders are dis-tinguished, the indications for pronunciation and for theemployment of liaison in French, as well as the brief

grammatical schemes, are all alike useful, and we commendthe book to the use of all our readers.

New Inventions.AN IMPROVED BONE-DRILL.

THE accompanying illustrations represent a bone-drillwhich has been made for me from a design made by Dr.

w ..

G. Ramsey Phillips. As shownin Fig. 1, the drill is fittedinto a chuck connected to atoothed wheel which is rotatedby a chain stretched on a bow.Fig. 2 shows the drill in use.The great advantage of theinstrument consists in the easewith whicheven thehardest bonecan be drilledwith the least

possible exer-tion, especi-allv in awk-ward positions in which the drive is not ,

direct. I have used this drill in a large ’

number of cases of bone-plating and havefound it greatly superior to any other

design. It is easily cleaned and the whole can be boiledfor sterilisation.

Messrs. Allen and Hanburys, Limited, Wigmore-street,W., are the manufacturers.

R. H. JOCELYN SwAN, M.S. Lond., F R.C.S.Wimpole-stre6t, W.

-

A MONOMOIIVE RHEOTOME.

THE above title is the name given by an American firm to anew interrupter of medical electricity currents. The apparatusis a kind of clockwork that moves a drum over which arefixed metallic teeth or pins. A movable lever is fitted overthe drum and inits different posi-tions the lever

passes over 2, 4, 8,12, 20, or 40 ofthose teeth or pinsand gives 20, 40,80, 120, 200, or

400 interruptionsin the minute.This apparatusweighs about 4lb.,is quite portable,and free from theinconvenience of

having to providewater or mercuryas in nearly allother kinds of in-

terrupters. The eweakest part is the spring which has not a uniformmovement. After having been wound up the numberof interruptions agrees with the number indicated uponthe apparatus, but after some 15 or 20 minutes thenumber is reduced by half and it is necessary to re-wind it ormove the lever to the next intersection. The feeling to thepatient and the muscular contractions are about the sameas with the metronome, and it is quite sufficient for ordinarymedical work. The apparatus is manufactured by Mr. A. E.Dean, of Leigh-place, Holborn, London, the cost being lessthan öB3.

649THE FUTURE OF THE WAR CRIPPLE.

THE LANCET.

LONDON: SATURDAY, OCTOBER 7, 1916.

The Future of the War Cripple.THE problem of converting the fighting man

who has been crippled in this war by sea or by landinto a useful citizen again is one of appallingmagnitude. It is not merely the numbers to bedealt with which constitute the difficulty, butthe manysided nature of the problem, whichcannot be effectively dealt with unless the severalaspects are adequately studied. To do thiswithout omission and without overlapping is a

task which may well claim continuous atten-tion from highly trained intellects. To us thedifficulties appear to group themselves under threeheads-administrative, material, and personal.With the first we are not, as medical men, veryintimately engaged. But here one difficulty is bothmedical and crucial, and concerns the point atwhich the cripple shall pass from the militaryorganisation into the civilian. So long as heremains in the Services he is the object of care ofthe hospital, the convalescent home, or the com-mand dep6t. As soon as a Medical Board hasdecided that he is no longer physically fit for war

service the cripple becomes a civilian entitled to apension, and under the care of the Statutory Com-mittee who pays him the pension. At this pointthe difficulty arises. The fact of his metamorphosisfrom soldier to civilian does not imply the desir-ability of any change in the cripple’s treatment.On the contrary, it is of the utmost importance thatthe treatment should be continuous. It might con-ceivably be possible to duplicate all the appliancesat present in use at command depots and con-valescent homes-the baths, the mechanical appa-ratus, the workshops, and so forth-but it wouldunquestionably be impossible to obtain a duplica-tion of the skilled medical staff to supervise thetreatment. It is therefore an urgent administra-tive necessity that the treatment of the war crippleas soldier and as civilian should form a consistentwhole. The Disablement Sub-Committee of theWar Pensions &c. Statutory Committee has takenthis view and has asked for opportunity to press itupon the Secretary of State for War. The medical

profession is also taking action, and the proposal ofthe Committee of Reference of the English RoyalColleges to extend its purview to these matterswas noted in our last issue and is one which we

heartily welcome.The second group of difficulties which we see in

dealing with the problem of the war cripple ismaterial, and concerns the means of restoration.The old experience of the man who practised withhis artificial arm or leg for an hour or two and then ’,threw it away, or wore it only for show, is not likely ’

to be repeated under present conditions, but theartificial limb still leaves much to be desired. Dr.C. W. HUTT, in an article which appears elsewhere

in this issue, devotes a section to consideringartificial appliances for the one-armed. He recordsthe frequent French experience of the workman

provided with a carefully devised implement, whoplaces his artificial appliance on the table and worksaway with his sound arm and stump. The orthopaedicstaffs of our war hospitals are keenly alive to thissituation, and scarcely a week passes without someimprovement being introduced in the manufactureor the application of artificial limbs. The type ofartificial arm hitherto in ordinary use is by nomeans as serviceable for all kinds of mechanical

application as a simpler apparatus less resemblingthe real arm, but imitating with exactitude one ormore of the actual movements essential to the par-ticular work in hand. Such apparatus are now beingdevised not only in our own but also in enemycountries, as the pages of the most recent numbersof the military supplement of the MMc66t’Medizinische Wochenschrift abundantly testify.With a further aspect of this question, the pro-vision of suitable occupations for men of variouskinds and degrees of disability, Dr. HUTT also

deals, and his paper may serve especially to directattention to the intricacy of the adaptation neces-sitated. It is clear from his very interesting storythat France is well to the front in this matter.

The third group of difficulties in regard to thefuture of the war cripple centres in many casesround the man himself. Nor is this to be wonderedat. After the stress and strain of warfare, the mono-tony and confinement of illness and convalescence,the prolonged period of military discipline, the

crippled soldier would be less than human if, ondischarge from the Army, he did not sometimes

prefer to draw his pension and to lead an

existence free from exertion and ambition, ratherthan laboriously train himself for a new and perhapsuncongenial form of livelihood. From such a

natural inertia has arisen the classical picture ofthe idle and drunken old soldier of bye-gone times.One potent factor in this melancholy directionhas been the fear that any resumption of wage-earning capacity might imply a reduction in thepension to which the crippled soldier is entitled.Sir FREDERICK MILNER, whose work in theinterests of the soldiers who have suffered for

their country has been unceasing and wonderfullyefficient, has rendered a public service in establish-ing the principle that no soldier shall forfeit anypart of the pension allotted to him through makinghimself a useful citizen, and it is possible that asimilar position ought to obtain in France, whereone of the Directors of Instruction has put it onrecord that of 2000 men under his direction, only350 were willing to learn a trade and to becomeself-supporting. We have more than once calledattention to the part which the Local StatutoryCommittees under the War Pensions Act may play.By means of personal care and interest in eachindividual case they should be able to achieveresults comparable up to a point to those obtain-able by army discipline. We hope that this may beso. Much depends on the work of these LocalCommittees. In large measure the future of thewar cripple as a useful citizen is in their hands.