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Reviews and Notices of Books.The Evol1btion of National Systems of Vocational Re-ed1wation Ifor Disabled Soldeers and Sailors. By DOUGLAS C.

McMURTRIE. Washington, U.S.A. : Federal Board forVocation Education. 1918. Bulletin No. 15 (Re-educationSeries No. 3). Pp. 265.As the title denotes, this report traces the evolution of the

systems of vocational re-education for disabled soldiers andsailors in the countries where such systems exist. The,material for the sections relating to France and Belgium hasbeen prepared by Miss G. G. Whiteside, to Great Britain byDr. J. 0. Faries, to Italy and Germany by Miss R. Underhill,.and to Austria by Mr. A. Gourvitch. In the introductionMr. McMurtrie emphasises the part played in the evolu-tion of these systems by the Belgian trade schools for

crippled victims of industrial accidents. The obvious

corollary, the extension of the facilities for disabledsoldiers to industrial cripples, has recently been suggestedin the British lay press. As Mr. McMurtrie points out,the dictates of national gratitude and national economycoincide as to the need for systems of re-education. Asthe result of a review of the various systems he has drawnvarious conclusions. He holds it to be axiomatic that aman should be given his course of training in a locality nearhis home. He is not in favour of compulsory re-education ;the unwilling pupil learns but little. " If a competentvisitor has been in touch with the man’s family duringhis absence at the front the members of the home circlecan be easily convinced of the wisdom of his re-

education ; this will make all the simpler persuasion ofthe man himself." The choice of a particular trademust meet with the full approval of the soldier

himself ; Mr. McMurtrie would allow the man, withinreasonable limitations, to change to another trade if thesubject prove definitely distasteful. To persuade him toundertake training the disabled man should be informed ofthe progress of men with similar physical handicaps, butthis information must be accurate and not relate to freaksuccesses. " It would seem inadvisable to train a man foran occupation which he can pursue only by means of

specialised apparatus adapted to individual motor limitationsimposed by his deformity. While a badly crippled man maybe taught to operate a lathe with special treadles his oppor-tunities for employment will be precarious." Many of thoseinterested in the problem will not agree with Mr. McMurtriein this conclusion, especially if State workhops be providedfor men with severely crippled arms. The American RedCross Society, however, appear to be more optimistic thanwe are as to the possibility of industrial firms providing workfor this class of man. An interesting commentary is that thetraining provided must be thorough; there would be an un-justified disturbance of the labour market and its wage-standards if a school thrusts into a trade, as professedlyskilled operatives, a crowd of under-trained men. As regardsemployment disabled soldiers must be considered as a specialclass. The transition from military to civilian life whichtake-! place on a man taking up his first job is a more radicalstep than the change made when the civilian employee goesfrom one position to another. For this reason Mr. McMurtrieadvocates the appointment of specially trained employmentofficers for placing and following up disabled men.The section on the work in Great Britain contains some

racy comments on our ways of doing things, but pays atribute to the system which has ultimately been evolved.Although the writers of the report do not make thecomment, we have something to learn from Germany inour treatment of one-armed men. In no less than 14 tradeschools, scattered over the various German states, specialcourses are held for one-armed men. After preliminaryinstruction of about six weeks in the ordinary acts of every-day life, and a course of left-handed writing, if necessary,the men take up trade training. Again, in the larger matterof simultaneous medical treatment and re-education we arebehind other countries. In Germany re-education isundertaken by civilian care committees working in

military hospitals. The section on France tells us thatthe schools which admit soldiers only when completelycured have considerable difficulty in obtaining pupils,while the schools at Montpellier and Bordeaux have

found their usefulness increased since they have beenlinked up with hospitals. Cooperation between hospitaland school has from the beginning been carried out success-fully at Saint Maurice, the Grand Palais, and MaisonBlanche. Dr. Kresser, head of the school at Maison Blanche,writes : ’’ The best recruiting agency for the schools is theexample of the man who works at a trade during the dayand who, on his return to his pavilion in the evening, tellshis companions what he has been doing and what he hasearned." " The excellent results obtained at the SouthAfrican Military Hospital, Richmond Park, show the valueof coincident medical treatment and vocational re-education.The percentage of disabled men who undertake training isextremely high-over 90. If the commanding officer of thehospital considers a man will not become fit for furthermilitary service no time is lost in commencing his re-educa-tion. The training does not stop when the man is dischargedfrom hospital ; he is accommodated at a hostel and con-tinues his course ; during this time the men continue to weartheir uniform and remain under military discipline.

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An appendix contains a comprehensive bibliography of thesubject. As a review of the systems of re-education thereport is unique ; it cannot fail to be of the greatest valueto the workers in the United States of America for whom itwas written.

Clinical Diagnosis: A Manual of Laboratory Methods. ByJAMES CAMPBELL TODD, Ph.B., M.D., Professor ofClinical Pathology, University of Colorado. Illustrated.Fourth edition, revised and reset. London and Phil-

I adelphia : W. B. Saunders Co. 1918. Pp. 687. 14s. ,

THIS work is a practical manual which treats of the moreimportant methods employed in the investigation of thoseproblems of diagnosis which are now customarily submittedto the clinical laboratory. In reviewing earlier editions otthe book 1 a favourable opinion was expressed as to itsmerits, and practical use of this work in the reviewer’s

laboratory has confirmed this opinion. The methods selectedare usually good and the directions clear and precise, whilethe deductions drawn from the results of the investigationsare judicious.A considerable number of additions and alterations have

been made in the present edition which have improved it andbrought it up to date without undue increase in size or price.On the other hand, some methods have been omitted and theseinclude Abderhalden’s protective ferment reaction to whichexception was taken in the review of the 1914 edition.

Important additions are to be found in the section on bloodexamination. These include the methods for recognisingblood by spectroscopic and chemical means, for thevital staining of blood cells and for testing the resist-ance of red cells. The methods used in the selection ofblood for the purposes of transfusion and for matchingbloods are now given, together with a short account of thetheoretical basis for these methods. The plan devised byBass and Johns for facilitating the search for malarial

parasites in the blood by concentration is described andrecommended. An illustration shows the satisfactory resultsobtained. In the examination of cerebro-spinal fluid twonew tests are proposed-Lange’s colloidal gold test andthe "mastic test"-for the purpose of distinguishingpathological changes in the central nervous system,especially those caused by syphilis. Changes and simpli-fications in the technique for carrying out the phenol-sulphone-phthalein test of the functional activity ofthe kidneys are described, and further details are givenas to the clinical interpretation and value of the test.There are many other additions, including Schick’s test forimmunity to diphtheria, Craig’s method for the complementdeviation test for tubercle, the estimation of urobilin infseoes, which is useful in the diagnosis of pernicious anaemia,and of amylase in faeces, useful in suspected pancreaticdisease.The illustrations have always been an important feature of

this book, and in the present edition there has been a markedimprovement effected by substitution for the less satisfactoryplates and figures of better ones and considerable additions ofnew figures, among which may be mentioned a representationof Curschmann’s spirals, as seen in the usual naked-eyeexamination of asthmatic sputum, and one of Entamtvba

gingivalis. The production of the book leaves little to bedesired.

1 THE LANCET, April 10th, 1915.