BMJ (Clinical Research Edition)
Second edition, revised. (Pp. 403; illustrated. 25s.) London: William Heinemann. 1945. This small book, now in a second revised edition, contains a good deal of valuable information. The general arrangement is on the usual lines. It will be noted that the point of view tends to reflect the approach and experience of the Viennese and French schools, particularly the former, and the result is that a good many opinions held in this country and in the United States do not find expression. The
... s do not accept the theory of circus movement as an explanation of auricular fibrillation and flutter, but regard it as not yet established. They are inclined to hold reserved opinions on the interpretation of the curves of bundle-branch block. They prefer to speak of a common or a rare type, and not to accept the new terminology which locates the more common lesion on the left side of the septum. They doubt whether reduplication of the first sound is ever caused by asynchronous contraction of the ventricles. They hold that the curves showing wide, notched mitral deflections in the ventricular complex are due to arborization block; these are thought to indicate widespread severe lesions in the ventricles, and they believe that the differentiation from the local lesion of bundle-branch block is important. There is a full discussion of chest leads, and a clear account of the various technical difficulties and discrepancies which cause confusion at the, moment. Scherf and Boyd prefer to use C R2 and C R4, but are cautious, for they regard the value of chest leads as exaggerated. This book is well worth study, and even if the conclusions are not acceptable the discussion is full, fair, and stimulating. The illustrations for the most part are clear, though some are faint and indistinct, with an obsolete method of time-marking. INTRAVENOUS THERAPY Intravenous Therapy. By K. V. Thakkar, L.M.&S. Second edition; revised and enlarged. (Pp. 349; illustrated. Rs. 8/8.) To be obtained from the KothariABook Depot, Parel, Bombay, 12. This book begins with a description of apparatus, methods, and dangers of intravenous injection, and then follow chapters on arsenical therapy, blood transfusions, intravenous drip, intravenous anaesthesia, and intravenous injection of drugs. The book serves a useful purpose by gathering together a good deal of scattered information, but it is not up to the standard of English and American textbooks. The typography is clear but there are many misprints. The laudatory forewords to the book and the inclusion of advertisements of proprietary remedies are out of keeping with a scientific monograph. Many of the details about sterilization of syringes and transfusion of blood are not up to date. Apparatus is figured which went out of use in this country ten years ago, and homologous serum jaundice is not mentioned. The second half of the book is essentially a compendium of details of most of the drugs which have ever been given intravenously. Some of this information is of purely historical interest, and much of it is presented uncritically. There can be little excuse to-day for treating Graves's disease by the intravenous injection of 5 c.cm. of 2% solution of sodium fluoride on alternate days. It is true that the Extra Pharmacopoeia mentions the treatment of paralytic ileus by the intravenous injection of 10 grammes of choline chloride in 180 c.cm. of normal saline, very slowly, but we would like to know how slowly; certainly it should not be more than 1 c.cm. a minute. It is not true that iron does not produce toxic effects when given intramuscularly. These, however, are minor blemishes. A more serious fault is the lack of any general consideration of the pharmacological principles of intravenous therapy and the effects on concentration and rate of excretion when drugs are given in this way. In many Eastern countries it is customary for an inclusive fee to be paid for a consultation and an injection, but custom can hardly be the basis for a scientific monograph. SURGERY OF THE CHEST Surgical Disorders of the Chest. Diagnosis and Treatment.