Diabetes: Its Pathologic Physiology

1913 Journal of the American Medical Association (JAMA)  
ities due to anterior poliomyelitis. Twelve pages are devoted to apparatus, and 253 to the surgery of paralysis. The book is abundantly illustrated from the author's extensive material, and his views are clearly and forcibly expressed. Many Americans will disagree with certain of his opinions, as, for instance, that a transplanted tendon should almost invariably be attached to the paralyzed tendon whose function it is to assume (Lange and his followers holding that attachments to periosteum or
more » ... one are more logical and successful); or, again, that neuroplasty should be performed in suitable cases six months after the onset of the paralysis; or that arthrodesis of the ankle may properly be performed in children as young as 8 years. The author also believes thnt, partition of function is possible; thnt, for exuniple, the giistrocueinius muy be split longitudinally into two separate muscles, either of which will bo capable of acting as a dorsal flexor of the loot if properly attached, while the. other hull' remains a plantar Ilev.nr. Thirty-two pages nre devoted to nerve transplantation, with the conclusion that ns yet the results are too uncertain im its employment in any but exceptional cuses. Artificial silk ligaments, boiled in corrosive sublimate, as used exten¬ sively by Lange und many others, are not advocated by Vulpius with any degree of wurnith. His criticism of Whitman's operation for pes calcaneocavus is not competent, since ankylosis is neither produced nor desired in this operation. It is perhaps to be regretted (hut the actual operative technic of some of the author's procedures is not shown in grenier detail by photograph or diagram nnd by more minute description. The book is well produced, und is tobe recommended highly to those Interested in this kind of surgery, Diet and Hygiene in Diseases of the Skin. The average practitioner is fairly well prepared to treat diseases of the skin with up-to-date methods so far as applications go. The important theme in medicine to-day is prevention, and many an obstinate skin affection can be eradicated only by the removal of some underlying systemic condition partly through medicine and oftener through diet and hygiene. As a treatise on this subject, Dr. Bulkley's book will be welcomed. It is clear, sane, helpful. It represents his careful observation, study and deduction. The details of special diet and the tables will be cf practical service, and the bibliography will aid those who wish to read further. Diabetes: Its Pathologic Physiology. This is a contribution t te theor o diabete fro the chemical and experimental side which aims to put clearly before the reader the source of the sugar of the blood and the manner in which it is produced and destroyed. The methods of chemical analysis are well described and the action of the nervous system, of the ductless glands and particularly the process of glycogenesis, are described. The probable cause of hyperglycemia and the occurrence and explanation of the formation of sugar from fats and proteins (glyconeogenesis) are discussed. While the book is excellent in its sphere, it must be noted that no discussion of the symptoms or treatmen of diabetes is attempted. The Medical Diseases of Children. This is an interesting presentation, in rather condensed form, of information on the medical side of the diseases of children. In a brief work for easy and frequent consultation, one would particularly desire helpful suggestions in the way of management and treatment. In this respect one is liable o be disappoined th the vo ume It s well printed and abundantly illustrated, but poorly bound. is n most difficult injury to successfully (rent, the promised surgeon at no lime assumed personal charge of the case. Instead, a young physician in his employ, who had been in practice but three years, attempted to set the bone and adjust und maintain a Eodgen splint in proper position. It was not enough that the promised surgeon dropped into the plaintiffs room frequently while she was confined in bed and inquired us to how she felt, ¡nul on several occasions luid hold of the rope passing from the ceiling by which the plain¬ tiff's foot wns suspended, und on one occasion passed his hand over the plaint ill's hip in near proximity to the frac¬ tured bone. There can be no doubt that there nre under¬ takings in which one porty contracts for the personal serv¬ ices of another for his skill, knowledge nnd experience. When, therefore, it appears the contract stipulates that the serv¬ ices shull be rendered by some particular person, possessing peculiar knowledge nnd skill with respect to the undertaking, because Of the peculiar knowledge, skill und experience of such person, it Implies the services are to be personally ren¬ dered and that the performance muy not be delegated to another. It was competent for the jury to find that the contract required the defendant to furnish the plaintiff with the personal services of the promised Burgeon, und not his inexperienced nssislnnt.. in ¡in endeavor to bring the ends of the fractured femur in apposition, adjusting the llodgen splint nnd the subsequent treatment thereabout. Nor does the court, ngrce with the contention that though the promised surgeon did not personally perform the duties, in compliance with the obligation which the defendant assumed in the contract, the plaintiff wns nevertheless pre¬ cluded from a right of recovery us for a breach because she accepted the services of his assistant us and for compliance therewith. In those cases where such principle properly obtuins there always appears the element of voluntary acceptance. Every precept of natural justice repelled the suggestion that the fuels here in judgment invited the appli¬ cation of that principle, to the end of denying the right of recovery us u conclusion of law. It may have been proper enough to submit, this theory to a jury for a finding thereon to the effect that the defendant hud discharged the contract, if it be found that plaintiff hud voluntarily, accepted the services of the assistant, instead of the promised surgeon, ns u full compliance therewith. But no such issue was framed in the ense by instructions, und it is certain that the court may not deolare such a result as a conclusion of law. It appeared that the plaintiff was on her back, confined in a hospital of the defendant's choosing, with a fracture of the lemur, and her limb suspended in u sling attached to the ceiling. The proof was that she suffered intense pain through-Downloaded From: http://jama.jamanetwork.com/ by a Simon Fraser University User on 06/17/2015
doi:10.1001/jama.1913.04340220054031 fatcat:sakschvs3zeenl7575bgfy24iq