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Reviews of Books

The Clinical Application of AntibioticsVol. III. Chloramphenicol and the Tetracyclirbes. M. E.FLOREY, M.D. London : Oxford University Press. 1957.

Pp. 393. 84s.

BooKS about new drugs generally appear in two waves.First, rushed through like stop-press news, come smallhandbooks with simple dogmatic instructions about howthe new drugs should be given. Later the larger booksroll leisurely forward to summarise and evaluate experi-ence gained in ’the full exploration of the particulartreatment. Lady Florey’s new book belongs to this group,and it records in masterly manner the information nowavailable about chloramphenicol and the three tetra-cyclines, chlortetracycline (aureomycin), oxytetracycline(terramycin), and tetracycline (’ Achromycin ’). It isthus a continuation of her earlier work which began in1952 with penicillin ; and a fourth volume is promised ina few months on erythromycin, carbomycin, and otherantibiotics. Like the other members of the series, thisbook is compiled in the library from the publications ofother workers, rather than formed at the bedside from thewriter’s own personal experience. As such it enjoysadvantages as well as disadvantages : while guidance onany particular question is less authoritative and clear, itis more reliable and more free from error due to personalprejudice or mistake. It will be valuable chiefly to theexperienced clinician, who can use it to compare his ownimpressions with the findings of others, strengthening hisviews when they agree and warning him to reconsiderhis conclusions when they conflict.

This careful compilation of all the available information is aguide to considered judgment, and a guard against arbitraryimpressions based on scanty facts. The time is now ripe forsuch an evaluation of these antibiotics, for sufficient timehas elapsed since their introduction for their powers and

dangers to be assessed. Lady Florey takes each compound inturn and describes its properties, its administration, and itspossible toxic effects ; its use in the treatment of diseases dueto specific organisms is then discussed, and finally its thera-peutic use is considered by systems. Papers up to June, 1956,have been included, but more attention has been given to theearlier papers than to the later ones, which merely emphasiseresults already corroborated.

Considering the vast amount that has been publishedon this subject, the book is remarkably concise. Thereis an extensive bibliography of 42 pages and a good index.It will probably become the standard work of referencefor the clinical application of these antibiotics.

Sir George Buckston, BrowneJESSIE DOBSON, B.A., M.SC.: Sir CECIL WAKELEY, K.B.E.,D.SC., F.R.c.s. Edinburgh: E. & S.Livingstone. 1957.

Pp. 152. 25s.

THE name of Sir George Buckston Browne is familiarto British surgeons as that of a generous benefactor tothe Royal College of Surgeons. Few of them, however,know much about the man himself, or about thehard work and skill which earned him a substantialfortune. They will read with interest the account ofSir Cecil Wakeley, who was his close friend for fifteenyears.Buckston Browne was born in 1850 into a family which was

well-to-do but conducted on very austere lines. He was oftenunhappy at home, and at the age of 18 he left his birthplace,Manchester, and came to London to study medicine. He wasno dullard (he won a gold medal in chemistry) but he seemsto have been dogged by bad luck in examinations. He failedhis 1st M.B., qualified with the M.R.C.S. diploma, and wasrejected at a dial-fellowship

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practical." Curiously enoughhe never attempted either examination a second time, thoughthe lack of any higher qualification ensured from the outsetthat he would never obtain a hospital appointment.

Instead he served Sir Henry Thompson, the famous

urologist, as an assistant. In time he became a consultant

surgeon in his own right, and specialised in the same subject.How successful he was can be deduced from the fact that

though he came to London with an allowance of C3 a week to

cover all his expense!-!, before he died, at the age of 94, he hadendowed a research farm for the Royal College in the sum of£100,000. And this was only one of his many donations tosimilar bodies.

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In telling Buckston Browne’s story, the authors havemade abundant use of his personal memoranda, whichreveal him as a writer with an unusually vivid style,His descriptions of his early days at University CollegeHospital are reminiscent of those of a similarly giftedsurgeon, Sir Frederick Treves. And-because " B. B."had so many famous patients-in these pages are freshand unusual glimpses of such people as George Meredith,Manuel Garcia (the singer who invented the laryngoscope),and Horatio Bottomley.

This enjoyable book will appeal not only to those whowish to learn the secrets of success in private practice,but also to all who are interested in the memoirs of aman who lived through some of the most eventful yearsin the history of surgery.

PelvimetryHERBERT THOMS, M.D., emeritus professor of obstetricsand gynecology, Yale University School of Medicine.London : Cassell. 1957. Pp. 120. 37s. 6d.

THE greater part of this book deals with the develop-ment and morphology of the female pelvis. It is concisebut very readable, and the bibliography is adequate.Only a quarter of the text is concerned with radiologicalpelvimetry, and the only method described is thatevolved by the author during the past 25 years. It isunfortunate that Professor Thoms’s technique includes,and largely depends on, the supero-inferior radiograph ofthe pelvic inlet, which is known to entail a very large doseof radiation to both foetal and maternal gonads. MostBritish workers believe that a modified anterosuperiorview of the pelvic brim gives enough information with avery much smaller exposure.

Microdiffusion Analysis and Volumetric Error (4thed. London : Crosby Lockwood. 1957. Pp. 465. 42s.).—The exploration of new paths in biochemistry has been madepossible largely by the development of new techniques;and there are now a number of books each devoted to a

particular analytical technique, such as colorimetry, spectro-photometry, and ehromatography. Prof. E. J. Conway’sgreat contribution to microanalysis has been the techniqueof microdiffusion, and his textbook, first published in 1939,is now a well-established classic. The third edition was

published seven years ago and the book has now been broughtfully up to date. The new edition deals particularly with theestimation of blood-ammonium levels-much used latelyin the study of hepatic disease and especially hepatic coma.This development has probably contributed more than anyother to the acceptance of microdiffusion analysis as a routinelaboratory procedure. In addition to new applications of thetechnique, there have been improvements in the apparatusitself, and of particular note is the one in which the micro-diffusion unit is sealed without a fixative because the lidfits in a circular groove containing some of the fluid used toliberate the volatile substance.

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The Normal Child (2nd ed. London : J. & A. Churchill.1957. Pp. 356. 33s.).-This early second edition of Prof. R. S.Illingworth’s book is welcome evidence of interest both inchild health and hygiene and in that elusive concept "nor’mality." It now covers five years instead of three and hasnew sections on prevention of accidents, toys, play, the

nursery school, and the sick child. Many sections have beenrewritten and there has been some skilful pruning. For itsabundance of information, direct and bibliographical, and forthe soundness and sanity of its opinions and advice, we warmlyrecommend the book.

Advances in Radiobiology (Edinburgh : Oliver & Boyd.1957. Pp. 493. 77s. 6d.).-The 5th International Congressof Radiobiology was held in Stockholm in August, 19a6.The proceedings, edited by Prof. G. C. de Hevesy, Dr. A. G.Forssberg, and Dr. J. D. Abbatt, deal with the chemical,cytological, systemic, and genetic influences of radiation, withsections on the time factor and the distribution of isotopes intissues.