849

Reviews and Notices of Books.THE LAw RELATING TO LUNACY.

By Sir HENRY STUDDY THEOBALD, K.C., M.A.,Hon. Fellow of Wadham College, Oxford; latelya Master in Lunacy. London : Stevens and Sons.1924. Pp. 890..82 10s.WELL-ESTABLISHED legal text-books renovated in

successive editions cover so much of the ground overwhich lawyers have to travel in the practice of theirprofession that it must demand no little courage onthe part of the author to become, as it were, thefounder of a new one. The courage of Sir H. S.Theobald, handicapped by blindness, needs no

comment, but rather the recollection that his qualifica-tion for his task is derived from 15 years’ experienceas a Master in Lunacy, following upon many yearsof practice at the Bar. His example will long beremembered. The work he has compiled, shorterby about 150 pages than the monumental " Arch-bold," contains all that is essential for the lawyer’sguidance in studying any but the most abstrusepoints in connexion with lunacy law and practice,and he has found space for the introduction ofinteresting references to the history of his subject.Medical practitioners, however large their liabilitiesmay appear to bulk at the present date, are chieflyconcerned with lunatics as patients, after certificationhas taken place, and they will find all that they needknow as to the legal position of lunatics clearly setout and explained in chapters on the care andtreatment of the insane, including one entitledMiscellaneous Provisions. If they care to glance atthe non-essential pages of the book they may beinterested to trace the origin briefly outlined of theRoyal prerogative now exercised by the LordChancellor, and having its probable source in rightsover the property of the mentally defective summarilytaken from the feudal lords by Edward I., or theycan study the evolution of legal patronage in a

chapter on the Masters in Lunacy, the office heldfrom 1907.to 1922 by the author. It is not more than65 years ago that Master Winslow was said to have" had peculiar views as to the proper destinationof committees’ balances in which the Lord Chancellordid not concur. Master Winslow resigned." Hissuccessor, too, was unfortunate. Sidney Herbertwrote to Mr. Gladstone, "Poor Thesiger has gotinto a dreadful mess in appointing his son-in-law(little Higgins) a Master in Lunacy." Master Higgins,who held office for two months only, was a clerk inthe Colonial Office, whose legal qualifications wereconfined to his having married the Lord Chancellor’sdaughter ! However, Sir Henry Theobald is charitablein his observations on the exercise of patronage which’ savoured of excessive zeal in the service of relativesor friends," and observes that outside critics rarelyknow all the conditions of what may seem at firstsight to be a political job. " Even Lord Chancellors,"he suggests, " deserve the benefit of the doubt."One of the best known names among those of formermasters, to students of Victorian literature, was,of course, Samuel Warren, author of " Ten Thousanda I ear " and " The Diary of a Late Physician." " Ithas been said," writes Sir Henry Theobald, " that hedrew a good deal of the latter book from the contentsof affidavits in lunacy. Unfortunately for the storythe book was published before he became a master."

DER AMYOSTATISCHE SYMPTOMENKOMPLEX.By Dr. A. BOSTROEffI, Privatdozent for Psychiatryand Neurology in the University of Leipzig.Berlin : Julius Springer. 1923. Pp. 205. 7s. 6d.A RECENT edition to the excellent series of mono-

graphs in neurology and psychiatry edited by Profs.0. Foerster and K. Wilmanns is devoted to a con-sideration of the syndrome called by Strumpell" amyostatic," a term indicating sufficiently a

44 muscular astasia "-i.e., involuntary movements-with the corollary, variation in muscular tonicity.Dr. Bostroem, accordingly, is concerned with athe-tosis, chorea, and what he designates the " Parkinson-W estphal-StrÜillpell- Wilsonsche Krankheitsgrappe "in a somewhat omnibus fashion. Characterised bymuch erudition and a due appreciation of the con-tributions of others, this monograph is suggestiveand thought-provoking in its main outlines, thoughits division of the amyostatic complex into the threegroups of chorea, athetosis, and the above-mentioneddisease class is obviously open to criticism. Further,some of the author’s statements in reference to whathe calls, briefly, " Parkinson-Wilson " are misleadingif not erroneous-e.g., he holds that " involuntaryspontaneous movements " are wanting in thatgroup-a curious reading of the facts. The viewthat associated movements do not occur in the sameclass of case is also misleading if, as appears, theimplication is that they are present or increased inthe others, and that this may be used as a means ofdifferentiation.

LE CERVEAU ET LA PENSEE.

By HENRI PIERON, Professor at the Institute ofPsychology of the University of Paris. Paris :Felix Alcan. 1923. Pp. 326. Fr.10.THE age-old problem of the interrelation of brain

and mind is approached afresh by Prof. Pieron insuccinct and readable fashion. Undeterred by thetrend apparent in certain quarters towards a com-plete cleavage between mind and its organ, he pleadsfor a closer approximation of physiology and psycho-logy, pointing out with truth how frequently theexponent of the latter science is unfamiliar with thedata of neuro-physiology and the rich material ofthe neurologist. He would have a dynamic psycho-logy taking its place in the comity of the sciences,collecting and examining objectively the finest andmost delicate reactions of cerebral activity. Chainsof neurones form without question the " functionalcircuits " of thought, and within them exist systema-tised " groups " suggesting the reality of " centres "of a psychological order. The application of physio-logical method can illuminate not a few processescommonly called " mental " ; this is particularlythe case with the phenomena of speech. Prof.Pieron reaches no special conclusion, and studiouslyavoids any type of special pleading ; but no readerof unbiased mind will fail to appreciate the forceof his contention, that the activities of the humanmind should be investigated from the physiologicalside no less than from the psychological.

THE UNSTABLE CHILD.An Interpretation of Psychopathy as a Source ofUnbalanced Behaviour in Abnormal and Trouble-some Children. By FLORENCE MATEER, A.M.,Ph.D., Psycho-clinician in the Ohio Bureau ofJuvenile Research. London and New York:D. Appleton and Co. 1924. Pp. 471. 10s. 6d.

Dr. Mateer has passed beyond the optimisticassurance that a diagnostic classification or a mentalage test, of which the Simon-Binet stands as a type,is more than a reliable means of systematising observa-tion. The problem of the psychopathic child is differentfrom that of the feeble-minded, for educational or socialcrises occur in individuals whose mental age may beequal to or above the physical age. This book is anaccount of the work done and difficulties met in theBureau to which the author is attached, and it rousesan uncomfortable feeling that in this country suchwork is almost non-existent. The author holds outthe promise that, however great may be the needs anddifficulties, the psychopathic child has potentialitiesand will repay care as no feeble-minded can. But thiscare involves more than correctional treatment carriedout without understanding of the condition. Of suchtreatment she writes : " We check his reactions, addanother load of fear, worry, shame, resentment, more

850

inferiority, and new grievances against all in authority.... It is only the elasticity and resiliency of the childmind which keeps any of them from a re-enforced andmore extreme type of behaviour."The subject is handled on broad lines. It indicates

the scope of the book when Dr. Mateer presentsevidence that congenital syphilitics show a recognis-able type of psychopathy peculiar to themselves,while she takes full advantage of whatever modernpsychological methods have to offer in the study ofindividual cases. There is a pleasing modesty through-out the writing; the author makes no attempt todisguise the many perplexities, and yet offers plentyof useful material and observation.

ST. ELIZABETH’S HOSPITAL.

Clinics and Collected Papers of St. Elizabeth’sHospital, Richmond, Virginia. Yo!. 1., contributedby the Staff. London : Henry Kimpton. 1923.Pp. 560. 37s. 6d.

THIS book contains 66 papers written by the staff-of a small hospital which only includes six medicalmembers. It therefore represents a large output fromindividuals. A feature is the collection of articles onthe management of the hospital. A great deal ofthought has obviously been given to this side of thesubject, an example which might well be followed bymany nursing homes in this country. Only a few ofthe scientific papers have appeared elsewhere. Theycover a very wide range of subjects, and a breadth ofview runs through them which is undoubtedly relatedto the fact that extreme specialisation, such as

has occurred in some hospitals. does not exist atSt. Elizabeth’s. The book is well illustrated andrepays perusal.

JUNIOR REGIONAL GEOGRAPHIES.

Book III. The Regions of the -World. By ,Yo H.BARKER, B.Sc., F.R.G.S.; and LEONARD BROOKS,M.A., F.R.G.S. London : University of LondonPress. 1924. Pp. 272. 2s. 9d.

THIS is the third of a useful series which, whencompleted, will form a general regional study of theworld as a whole. All practised teachers agree thatbefore attempting to impart detailed knowledge ofcontinents and regions, their pupils should obtainsome general notion of the world in which thesecontinents are set. This volume gives a very goodidea of the world as a living unit, and will be of usenot only to the young pupil but also to the adultwhose grasp of the relations and interrelations of theworld is not as fresh as it was ; indeed, quite advancedworkers along special lines will find here useful infor-mation when they come to think of their subjectsinternationally-and this is the spirit in which manypathological problems must now be approached.Chapters on the industrial regions of Europe and ofNorth America are especially valuable. Nearly onehundred well-chosen illustrations enhance the text.

INTERNAL DERANGEMENTS OF THE KNEE-JOINT.

By A. G. TiMBRELL FISHER, M.C., F.R.C.S. Eng.,Surgeon (with Charge of Out-patients), Seamen’s(Dreadnought) Hospital, Greenwich ; Assistant,Surgical Unit, University College Hospital, London.London: H. K. Lewis and Co., Ltd. 1924. With80 illustrations. Pp. xii. + 144. 12s. 6d.

IN this monograph the author has presented hissubject after a critical re-investigation of the funda-mental, anatomical, and pathological principles whichunderlie the lesions grouped under the heading ofinternal derangements of the knee. The first part dealswith the pathology and surgery of the semilunarcartilages and constitutes a safe and sound essay initself. In the second part other varieties of internalderangement are considered, and in this section is

incorporated much of the valuable original workrecently carried out by the author in connexion with

the pathology of loose bodies, and the pathogenesisof osteoarthritis.The monograph deserves high commendation.

To the author’s own exceptional knowledge of theanatomy and pathology of the whole subject is added-in the form of foot-notes scattered throughout thebook-a wealth of clinical experience derived fromSir Robert Jones. Sir Arthur Keith writes a foreword.

JOURNALS.JOURNAL OF PHYSIOLOGY. Edited bv J. N.

LANGLEY, Sc.D., LL.D., F.]R.S. Vol. LVIII., N0;..4 and 5. Cambridge University Press, March, 1924.Pp. 259-372. 10s.-Chelonian Respiration (Tortoise),by Thomas Lumsden. The author finds that the-respiratory centres in this animal are the gaspingcentre at the apex of the calamus scriptorius, theexpiratory centre just above this, and the apneusticcentre above the level of the fourth ventricle. Thereis no evidence of the existence of a pneumotaxic centre,and the vagi do not appear to have any tonic-regulatingeffect on the respiration. Moreover, the respiratoryneeds of the tortoise are so slight that under ordinaryconditions a single inspiration may last for twoto three hours. The respiratory rhythm is morepowerfully affected by variations in the temperatureof the cells composing the respiratory centres than byvariations in the activity of the general metabolicprocesses or in the gases respired. When, however, thetemperature is constant, the amount of C02 in theblood appears to be the chief factor in the regulation ofnormal respiration.-G. V. Anrep and H. N. Kahndeal with the metabolism of the process of recon-struction of the submaxillary gland in the dog. Theyfind that the recovery of an exhausted gland undernormal conditions is a slow process ; it takes threedays for the gland to recover completely after a largesecretion. Paralysis of the secretory fibres of thechorda tympani by atropine does not influence therate of recovery. The recovery of the gland afterextirpation of the superior cervical ganglion isaccelerated. The experiments do not support thetheory that the sympathetic nerve has any ’’ trophic’"influence on the submaxillary gland under normalconditions.-The Mutual Influence of SecretoryStimuli in the Submaxillary Gland of the Cat, byE. E. Goldenberg. In anaesthetised cats, twosuccessive stimuli were applied to the gland itself, toits nerves, chorda, and sympathetic, with variation ofthe length of the interval of stimulation. Augmentedsecretion can be obtained by successive stimulation ofthe same or of the two secretory nerves, and anaugmented vaso-motor effect-dilator or constrictor-can also be obtained by two successive stimulations ofthe same nerve.-P. M. Jurist and B. A. Rabinovitchfind that the excitability of both sympathetic secretoryand vaso-motor fibres of the submaxillary gland of thecat after section of the nerve in the neck is lost in from41 to 48 hours.-The Nerve Fibre Constitution of theNerves of the Eye, by M. Nakanishi. In the cat andsheep most of the post-ganglionic ciliary nerve fibres.are somewhat larger (3-6-4-5) than the pre-ganglionicfibres (about 3). The nerves entering the ocularmuscles have fibres of all sizes from 3,u. to 17,u. Therelative number of the fibres of different size is not verydifferent, but the 3-d, fibres are rather fewer thaneither the 6—5—10’5/ or 11—17 fibres. The relativenumber of medium-sized fibres is greater than in theanterior roots of the spinal nerves. The greater partof the non-myelinated fibres of the sixth nerve run tothe retractor bulbi ; all the nerves entering thestriated muscles have a few non-myelinated fibres;non-myelinated fibres also run to the eye by the longciliary nerves ; most of the non-myelinated fibres canbe traced to blood-vessels.-Variations in the Sensi-bility to Pressure Pain Caused by Nerve Stimulationin Man, by R. C. Shawe.-The Effect of Insulin on theOxygen and Carbon Dioxide Tensions in Air betweenthe Skin and the Muscles, by J. Argyll Campbell andH. W. Dudley. Atmospheric air was injected underthe skin of an unancpsthetised rabbit and left there imtil