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of non-magnetic foreign bodies present in theanterior chamber. The method was to make a

small incision opposite the perforating injury, 3 mm.in width, so as to admit a repositor. Then the pro-lapsed iris was dealt with. If any portion of irisremained entangled in the wound, the repositor couldbe passed through the eye so as to disengage it. Withregard to the treatment of large perforating wounds,especially those which perforated the sclera, he thought,contrary to Mr. Pooley’s view, that it was unnecessaryand dangerous to insert scleral sutures, because ofthe likelihood of loss of vitreous. When a seriousinjury was followed by a gaping wound, a good plan i

was to make an incision round the conjunctiva, thendraw the conjunctiva over the wound, and so close it.He discussed the technique of removing magneticforeign bodies by means of the electro-magnet.

Mr. M. H. WHITING pointed out the advantages ofthe Haab magnet over the Mellinger for the extractionof magnetic substances from the eye. The horse-collar of the latter instrument, its smaller power com-pared with that of the Haab, as well as the difficultyof preventing it touching the eye when being used, wereamong the factors mentioned.

Mr. ELMORE BREWERTON said his practice when heencountered prolapse of iris was to make an incisionless than 90° from the wound before dealing withthe prolapsed iris.

Mr. T. HABRISON BUTLER said he had been usingthe Mellinger magnet for 15 years and had not seenthe disadvantages from it which Mr. Whiting men-tioned. With regard to sympathetic ophthalmitis, heconsidered that by removing the exciting eye in theearly days many eyes would be saved. But it wasnecessary to keep careful watch with the slit-lamp.If the latter showed commencing danger he at onceinstituted the treatment as for actual ophthalmia.This had resulted in the saving of several eyes.The PRESIDENT said that while it was true that an

eye could safely be retained a fortnight or so withoutrisk of sympathetic ophthalmia, he recently had acase in which that complication ensued ten daysafter an apparently trivial injury, accompanied bykeratitis punctata, so that the eye had to be excised.

Mr. CLEGG and Mr. POOLEY replied.Clinical Cases.

Mr. J. D. M. CARDELL showed and carefully describeda case of Kruckenberg’s spindles in a single womanaged 30. By means of the slit-lamp Miss Ida Mannfound that the pigment was in the posterior layers ofthe cornea ; it seemed to consist of a multitude ofclosely-set brown rings. Thomson and Ballantyneregarded the condition as congenital.

Mr. POOLEY showed two cases of punctured woundof the cornea, in association with his remarks in thediscussion of that subject.

Reviews and Notices of Books.HANDBOOK OF DISEASES OF THE THROAT, NOSE, AND

EAR.Edited by A. DENKER (Halle) and 0. KAHLER(Freiburg). Vol. I., Diseases of the Air-passagesand Mouth: Anatomy, Development, Physiology,Methods of Examination. Berlin : Julius Springer;Munich : J. F. Bergmann. 1925. Pp. 1068.M.84.

THIS volume is the first of a great work which, whencomplete, is to consist of nine volumes. Of thesethe first five will deal with the upper air-passages, thenext three with the ear, and the last with the thyroidand thymus glands and external structures of theneck. No fewer than 120 authors are concerned inthis work, of whom 21 contribute to the presentvolume. This, consisting as it does largely of the I’spade-work preliminary to the actual description ofdiseases and their treatment, is perhaps less intrinsic-ally interesting to the practising laryngologist, but itpresents an extremely thorough foundation for whatis to follow. Even the comparative anatomy of thenares, fauces, and larynx, as well as their embryology, Iis described and illustrated, that of the nares beingparticularly good. In the section on physiology the Iphysical characteristics of odorous substances, and theconditions which influence their absorption, are wellexplained by Prof. Zwaardemaker, of Utrecht, who,indeed, covers the whole subject of olfaction, ofwhich he has made a special study. Similarly, Prof.Skramlik, of Freiburg, deals at length with the senseof taste. The chapters on methods of examinationare likewise full of detail, but here a certain narrow-ness of outlook becomes apparent. Under anteriorrhinoscopy only one speculum, Hartmann’s, is advised Iand illustrated ; of bronchoscopic methods, distalillumination is dismissed in five lines as unsatisfactory,and Chevalier Jackson is not mentioned, except inthe list of references at the end of the chapter. Indeed,the workers of other countries receive throughoutscant recognition. The book is provided with a goodindex, a detailed table of contents, and a long list ofreferences at the end of each chapter. There are 709illustrations, all good, and some of them, notably thephotomicrographs, are beautiful examples of colourprinting. As a work of reference this volume will beof great value to specialists.

THE MIND IN HEALTH AND DISEASE. An Introduction to the Mind in Health and Disease.’ For Students and General Practitioners interested

in Mental Work. By T. WADDELOW SMITH,F.R.C.S., Deputy Medical Superintendent of the

! City Mental Hospital, Nottingham. London:BaiIlière, Tindall and Oox. 1925. Pp. 235. 10s. 6d.IN setting out to write an introduction of this

kind Dr. Waddelow Smith has undertaken a difficulttask. Such a book must of necessity be elementary,but even so, the author surely underrates the equip-ment of his readers, who are presumed to be medical

men and students, in a passage such as the following,from the anatomical description of the centralnervous system :-

" The membranes ... are continued all over the cerebralhemispheres and have between them and the nerve cells of

the hemispheres a layer of cerebro-spinal fluid, so we findthe little nerve cells, all over the surface of the brain andalso at its base and in its substance, are bathed by thisnourishing fluid by means of the layer just described andthe ventricles."In the section dealing with mental disorders

the author has a considerable experience of mentalwork behind him, and there are many practical hintswhich should be valuable to the beginner. But herethe purely Freudian definition and interpretation ofthe morbid phenomena is to be deplored. It ishardly a generally accepted view, for example, that theanxiety neurosis is " characterised by the failure ofthe individual properly to adjust his or her somaticand psychic sexuality." In an introduction to whatwill be of practical utility it is very important thatthe reader should be guided aright, and we do notfeel that this book can be wholly recommended asa help in difficulties. ____

Old and New Viewpoints in Psychology. ByKNIGHT DUNLAP, Professor of ExperimentalPsychology in the Johns Hopkins University.London : Henry Kimpton. 1925. Pp. 166. 10s. 6d.THERE is a growing number of practitioners and

laymen to whom psychology is an extremely interest-ing side-line. It may require a great deal of patience,as well as previous knowledge, to read appreciativelyan exhaustive text-book, and many readers are

content to derive their knowledge from small synopsesof more or less doubtful authority. Prof. KnightDunlap’s book is a very good example of this" popular " class of work on psychology, while itcarries exceptional weight, for the author is well

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known as a conscientious teacher. The five articleswere originally delivered as lectures; those on

mental measurements and present-day schools of

psychology are dull, but give an impartial surveyof recent progress in both these subjects. The

psychology of the comic is a good piece of constructivereasoning on a subject of universal appeal, and thearticle on spiritualism is less speculative and carriesa sober warning with it. The last, on the reading ofcharacter from external signs, is frankly negative.On the whole, the book shows the defects of anyrandom collection of articles or lectures. It lacksvitality and coherence, besides which the writeris too dogmatic for such a controversial subject.

THE EMOTIONS.

Experimental Investigations into the Emotional Lifeof the Child Compared with that of the Adult. ByHELGA ENG, Oslo. Translated by GEORGE H.MORRISON, M.B. Edin. London: HumphreyMilford, Oxford University Press. 1925. Pp. 243.21s.A LARGE amount of work has already been done in

measuring the physical concomitants of emotion, andin the book before us Miss Eng sets out to answerthe question whether psychical experiences of a

definite character are accompanied by definite changesin the volume-pulse curve and in the respiratory curve,and, secondly, whether such changes in children mightindicate a feature peculiar to the child’s emotionallife. Using the kymograph, the pneumograph, andthe plethysmograph, the author finds that the emotionsdealt with in the experiments can be arranged in threepairs, each pair showing opposite expression changeson the recording instruments ; attention and activity,displeasure and pleasure, depression and excitementare thus opposed, the first mentioned in each pairbeing marked by a fall in the volume curve, decreasein pulse height, retarded pulse, and retarded respira-tion, whilst the second shows opposite changes. Inexperiments on the effect of stimuli no difference wasfound between children and adults, but a phenomenon,which at first sight might be expected to vitiate theexperiments, proved to be of interest. The spontaneousemotional state of the subject, as revealed by intro-spection, often found expression in the curves, and itis here that age differences became manifest, forspontaneous emotions were, in the case of children,mostly related to sensory impressions, whilst in adultsthey were more often connected with events of greaterpersonal psychical content; moreover, in thesespontaneous emotions, pleasure is more notable inthe child and displeasure in the adult. The authorconcludes with an expression of the opinion that thephysiological processes concerned are " definitelydependent on the psychical processes, and not theother way round." About half the book is taken upby tabular records of experiments, and nine platesare devoted to reproductions of actual tracings. Todescribe laboratory investigations of physiologicalreactions as an investigation of the emotional life ofthe child may disappoint those readers who regardthat emotional life as made up largely of personalproblems and the inter-play of instinctive tendencies.But to say so is in no way to belittle the value of thisrecord of conscientious work. The translator hasdone his part well, and the book will interest all whoare concerned with youthful behaviour.

PHYSICAL SIGNS.Perkussion und Auskultation. By Dr. B:ERMANNVIERORDT, Professor of Medicine at the Universityof Tubingen. Berlin and Vienna : Urban andSchwarzenberg. Pp. 95. M.2.THE author of this little book has succeeded in con-

densing his information so well that practically all thestudent may require to know about percussion andauscultation (as far as they can be acquired from abook) is to be found in these 95 pages. Other partsof the body besides the chest are dealt with as far as i

their examination by percussion and auscultation isconcerned, and the reader is taught how to dis-tinguish between ascites and an ovarian cyst, andhow to percuss such organs as the kidneys when they.are displaced from their normal site. A book likethis is useful to the busy practitioner who, without it,is apt to fall into slipshod ways and to simplifyhis technique to the vanishing-point. Under suchcircumstances a small book, which will slip intoan overcoat pocket, may jog its wearer’s memory,reminding him of those diagnostic methods from thepractice of which, owing to pressure of time and wantof contact with his fellow practitioners, he has lapsed.

TUBERCULOSIS.

Diagnostik und Therapie der Knochen- und Gelenk-tuberkulose. Second edition. By Dr. EUGENKtscr3. Leipzig: F. C. W. Vogel. 1925. With6 tables and 367 illustrations and charts. Pp. 296.M.20 ; bound, M.23.

Trir,s profusely illustrated work comes from theHohenlychen Institute for Surgical Tuberculosis,attached to the University Surgical Hospital of Berlinunder the direction of Prof. A. Bier. Hohenlychenmay be said to be to Germany what Alton is toEngland ; and, like its English counterpart, Hohen-lychen is a standing demonstration of the fact thatheliotherapy is not a monopoly of the Alpine andsub-Alpine levels. It is an institution where a greatvariety of therapeutic measures serve the patients’needs. Hohenlychen makes considerable use of treat-ment by passive congestion, and those who haveabandoned this form of treatment in surgical tuber-culosis may wonder if the success of hyperaemia atHohenlychen may not be due to the many otherremedies provided there. The guiding principles ofHohenlychen are that surgical tuberculosis is a diseasefor conservative treatment, that success can beachieved at any altitude, and that only in exceptionalcases should the surgeon resort to the knife. Thebook is divided into -two parts, general and special.The former deals with the physiology of pigmentation,the experimental foundation of the combined treat-ment with sunlight and hyperaemia, the actions ofvarious forms of artificial light, and the techniqueof their administration. Information is given as tothe action of iodine taken by the mouth in associationwith passive hyperaemia, and as to the improvementto be effected in the general condition of debilitatedpatients by the intravenous injection of the blood ofmammals other than man. In the special part, anaccount is given of the disease as it affects each struc-ture, and a whole chapter is devoted to a study ofthe re-absorption of tuberculous sequestra. The bookis a valuable summary of modern German teaching.

Contributions to the Study of Tuberculosis by theResearch Department, National Jewish Hospitalfor Consumptives. Denver, Colorado. 1924.THIS large volume, which is the fifth of the series,

is a collection of the papers published by authorsassociated with the Research Department of theNational Jewish Hospital for Consumptives. Theearlier papers deal with the problems of tuberculosisin a more or less general manner. Several papers onresearch follow, and the last seven contributions areclinical. Most of the papers published in this volumehave already appeared in some American or Englishjournal, but the volume will serve the useful purposeof showing the patrons of the hospital the veryconsiderable output of the Research Department.

Recovery Pecord,for Use in Tvbprculosi’l. Secondedition. By GERALD B. WEBB, M.D., and CHARLEST. RYDER, M.D. New York : Paul B. Hoeber,Inc. 1925. Pp. 79.$2.THE first half of this book contains hints on how to

recover from tuberculosis, and the second half containscharts on which the patient is invited to record his

812

temperature, pulse, weight, general notes, and questionsfor his physician. On each page, above and belowthe chart, there is a proverb intended to give thereader a hint as to how to think and live. Both theadvice given in the first half of this book and theproverbs quoted in the second half show that theauthors attach more importance to rest than toany other factor in recovery from tuberculosis. Tothe advocates of exercise as a method for treatingtuberculosis is addressed the following quotation fromTrudeau : " I know I have hurt nobody by rest, butI am quite sure I often have by allowing them toexercise." Solly is quoted as having said : " Thewise have four times as good a chance to recover asthe foolish." This is surely an over-estimate of thefool’s chance.

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Tubere2zZosis Its Prevention and Treatment. ByJ. LAIRD, L.R.C.S. & P.I. Second edition. Bristol:John Wright and Sons, Ltd. 1925. Pp. 130.5.?. 6d.THE chief feature of this little book is its advocacy

of calcium in the prevention and cure of tuberculosis.Calcium, it would seem, is the key to the problem,not only of tuberculosis, but also of such diseases ascancer. In the first instance its influence is beneficial,in the second it is detrimental, for " cancer is chieflya disease of advanced life, when the salts of calciumare in excess in the system, and may act as the pre-disposing cause of the disease." Medical readers maydoubt whether the solution to complex problems canbe so simple as the author thinks.

VETERINARY DIAGNOSIS AND TREATMENT.By G. E. JORGENSON, A.B., M.D., N.D.V., formerState Veterinarian of Iowa ; Consulting Patho-logist and Associate Editor, North AmericanVeterinarian. London and New York : D.Appleton and Co. 1925. Pp. 441. 12s. 6d.THE author is evidently well informed and always

gives a reason for the conclusions he forms and thetreatment he adopts. This somewhat uncommonpractice should appeal to readers who wish to berational. He gives 132 case reports of wide range ;his treatments seem to have brought about a highproportion of recoveries. Case 8 (fibrinous pneumoniain a horse) and Case 10 (pneumonia in a cow) seemto have been treated, contrary to orthodox practice,by purgatives. However useful in bronchitis theyshould be given cautiously in serious pneumonia.It is somewhat surprising to learn that the authorhas never heard of epilepsy in swine ; convulsions,falling, and foaming at the mouth are common, andalthough they may not be signs of true epilepsy theyare certainly epileptical. We do not agree that thediagnosis of caecal impaction is easy, and the actionof drugs is modified by the fact that the caecum is acul-de-sac undisturbed by the flow in the main tube.Impaction of the colon often follows impaction ofthe caecum. It is impossible to commend the autopsyof the cow with anthrax (p. 282 et seq.), for which thetwo cases that developed later may well have beenresponsible.

There is much sound reasoning in this book, andit is well produced. We prefer the author’s descriptionof its objects to the publisher’s statement that it is" a standard practical guide for all farmers." Farmers

would remain uninterested in the sino-auricular nodeof Keith and Flack, polynuclear neutrophiles, andbasophiles.

JOURNALS.QUARTERLY JOURNAL OF EXPERIMENTAL PHYSIO-

LOGY. Vol. XV., No. 2.-Corpus Luteum Extractsand Ovulation in the Rabbit, by Walter P. Kennedy.It is now a generally accepted theory that at least ’one of the functions of the corpus luteum is the ,!prevention of ovulation so as to maintain the rhythm _;of the oestrous cycle and to avoid superfoetation inpregnancy. There is a considerable amount of clinical 1

evidence that extracts of corpus luteum exert a i

specific action on the functional activity of the E

ovary. Extracts were made from a powdered desic-cated product and shaken up with the requiredamount of saline, or fresh extracts were made fromcorpora lutea dissected out from fresh cow ovaries.The injections were given in the marginal vein ofthe ear or in one of its larger branches. The generalpicture of the histological findings was one of degene-ration and inhibition of the cyclical changes. Thegeneral results are that a substance or substancescan be extracted in the cold from the corpus luteumof the cow in the fresh or desiccated state, whichinhibits ovulation in the rabbit if injected intra-venously in sufficient dosage.-The Significance ofthe Elastic Tissue in the Human Foetus, by EvelynE. Hewer. The wide distribution and early appear-ance of tissue with a great affinity for elastin stainsindicates that this type of tissue plays an importantpart in the functional development of many organs;its appearance is in certain cases correlated with thetime at which functioning of the organ begins.-The Action of Pituitary Extract on Urinary Secre-tion, by Nicholas S. Craig. Ox pituitary (posteriorlobe) was used. The author found that in anaesthetisedanimals, intravenous administration of the extractproduced a definite diuresis. Continuous intravenousadministration of pituitary extract in 0*9 per cent.saline solution produces the same result. In un-aesthetised dogs pituitary extract administered sub-cutaneously controls the diuresis which normallywould result from the administration of water ornormal saline by the mouth. If concentrated salinesolution is used diuresis results. The author alsodeals with the action of pituitary on the absorption offluid from the alimentary canal and on the blood com-position. There are further studies on the pituitaryby Launcelot T. Hogben on the "Avine DepressorResponse," who finds that the substance present inpituitary extracts causing a powerful depressorresponse in the bird is a specific property of thefresh gland substance ; it does not belong to thecategory of capillary poisons common to extractsof many tissues, and has no connexion with thehistamine-like substance responsible for the secondaryfall in carnivora, and seems pre-eminently associatedwith the pars nervosa; it is present in the pituitaryof fishes, amphibia, reptiles, birds, and mammals.Another paper by the same author and Gavin R. DeBeer deals with Localisation and Phyletic Distri-bution of Active Materials in the Pituitary.-TheReactions of the Pupil in the Chloralosed Animal,by R. J. S. M’Dowall. The author observed that if ananimal such as a cat be anaesthetised with chloralosethe pupil remains of normal size, but is extremelysensitive and rapid in its reactions. The reactionsof the pupil give not only an indication of the stateof the autonomic nervous system of the animal, butthey may be utilised as an index of sensation, notonly from areas supplied by the spinal nerves, butalso from those supplied by the autonomic nervoussystem, and as a means of tracing out the paths ofafferent impulses in the sympathetic nervous system.-R. J. S. M’Dowall and B. L. Worsnop describe newmethods of demonstrating changes in the tone of thearterioles.-W. G. Millar records observations on thehaematocrite method of measuring the volume oferythrocytes, showing that the speed of centrifuginghas an important bearing on the accuracy of measur-ing the volume of erythrocytes by the hsematocrite.—A. D. Macdonald, in describing the action of pituitaryextracts on intestinal muscle, throws doubt on thecommonly held view that the pituitary gland con-tains a general stimulant of plain muscle-fibres.

SOMERSET’S MENTAL DEFECTIVES.-Sandhill Park,Bishop’s Lydeard, formerly the seat of Sir W. P. Lethbridge,was last week opened as a home for the mental defectives ofthe county of Somerset. The house, built in 1720 by SirThomas Lethbridge, and about 150 acres were bought forjB16,000, and the building has been adapted by Sir GeorgeOatley, the architect of the new extensions of BristolUniversity. There is at present accommodation for119 patients, but the estate is ultimately to be developed intoa farm colony for the feeble-minded.