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heparin. Plasma and a leucocyte cream were preparedfrom oxalated blood ; the plasma is applied to recipientareas and the cream painted on the deep surface of thegraft. This procedure had been adopted for battlewounds a few days after initial debridement when therewas no other means of closing a large skin defect. Aftergrafting, the limbs were immobilised but pressure dressingswere not applied.-Lieut.-Colonel BRICKER, USMC,doubted how far such a coagulum glue could replacesuture and pressure fixation of the graft. Certainlyitwas.a useful adjunct. Grafts should not be washed in salinebefore application because this removed natural adhesive.

PAPERS FROM THE LEEDS SCHOOLProf. A. DuRWARD described his researches into

Blood Supply of Nerves, which confirmed the importanceof the longitudinally disposed intraneural vessels whichfreely anastomose and convey blood for long distanceswithin nerves even after division of the many smallvasa nervorum which enter laterally.

Prof. M. J. STEWART, speaking on the characteristichistology of Benign Giant-celled Synovioma of TendonSheaths, said that the intracellular presence of haemo-siderin or lipoids was merely a demonstration of phago-cytosis by the polymorphous connective-tissue cellsof which the tumour was composed. ’The presence offoam cells did not justify the description of certain ofthese tumours as " xanthomas." In fact the " xanthic "reaction wherever seen was a local phagocytic responseby connective-tissue cells to the’chemical conditions oftheir surroundings.Mr. A. S. JOHNSTONE described the work of Batson of

Philadelphia on the Vertebral Venous System as a

Mechanism for the Spread of, Metastases and his owninvestigations along the same lines. There is a freer

connexion than is commonly recognised between the veinsof the prostate and those of the vertebral column, andthe vertebral venous system may provide a means forsome of the occasional spread from this and otherorgans, but it by no means accounts for the spread ofcancer by the classical means already accepted.

Dr. J. R. NUTTALL described the results of Treatmentof Osteo-Arthritis by Deep X-ray Therapy in 259 cases,of which 164 were followed up. There had been no.particular selection of cases for treatment. Threemonths after the completion of treatment 17 patientshad complete relief of pain, 90 had incomplete relief,and 57 received no benefit at all. Smaller joints seemedto show the best results. A second course of treatmentsometimes gives more relief than the first one.

Mr. L. N. PYRAH reviewed 10 cases of GeneralisedOsteitis Fibrosa, 6 of which had been admitted forspontaneous fracture. All of the patients were foundto have parathyroid tumours which he had removed.Reliance was placed entirely on blood-calcium andphosphorus estimation, except in one case in whichcalcium-balance experiments had been carried out. The’blood-calcium figures ranged from 12-5 to 20 mg. per100 c.cm. and the blood-phosphorus in every case waslow, usually 2-25 mg. per 100 c.cm. The plasma-phosphatase was raised in every case. These estima-tions should be done by a chemist who was constantlyperforming them ; errors in chemical technique some-times vitiated results.

Mr. REGINALD BROOMHEAD and his associates demon-strated a series of orthopaedic cases, including a groupof people who had been operated on for intractable meta-tarsalgia with good results ; the shaft and head of themetatarsal was denuded and after being osteotomisednear its base was rotated through 180°.

Reviews of Books

Principles and Practice of RehabilitationJOHN EISELE DAVIS, MA, sc D, Veterans AdministrationFacility, Perry Point, Md. (Barnes. Pp. 211.$3.)

Dr. Davis does less than his introduction promises ;instead of a usable psychology he proffers a diffusereview of many aspects, in which the treatment of peoplewith mental disorder occupies the largest place. Herefers copiously to the literature of industrial psychologyand rehabilitation in its various guises, and he saysnothing that is far-fetched or unacceptable even todoctors who believe their common sense to be almostvox Dei : but the lay-out of his book is too loosely knit,and the echoes of his earlier work, Principles and Practiceof Recreational Therapy for the Mentally Ill, are toonumerous for the average reader to find in it what itstitle suggests. Even on its own ground, the rehabilita-tion of people with neuroses, many of the difficultiesmet with in practice are slurred over, and the details ofmanagement, which are all-important, are subordinatedto discussion of general principles. It is plain that Dr.Davis’s experience has been chiefly with the insane,whereas psychiatrists who have been occupied with therehabilitation of the neurotic know how often in theirexperience the road winds uphill-more so than withpatients in a mental hospital, from whom, since less isexpected, a painful inch may seem a big gain, and whowhen they recover may do so completely, withoutpainful backslidings. If Dr. Davis were to compress hisbook and call it Rehabilitation of the Mentally Ill, it wouldbe a useful manual. Some psychiatrist or psychologistwill doubtless presently set about writing a good com-pendium of the psychological principles and practice ofrehabilitation in its wider and now customary sense ; hewill find Dr. Davis’s book a helpful storehouse.

Blood Groups and Transfusion

(3rd ed.) ALEXANDER S. WIENER, MD, New York.(Baillipre. Pp. 438. 41s.)

THIS book has been a standard work of reference since’the first edition appeared in 1935. The third is con-siderably larger and has been extensively revised. Twonew chapters have been added on the transfusion ofstored blood, plasma and serum, and the Rh factor.

The inclusion of the practical side of transfusion, andthe preparation of fluid and dried plasma and serumare perhaps out of place in a book which has become aclassic as a guide to the intricacies of the blood-groups,since there are other fuller works on these subjects.For the specialist they are sketchy, making littlereference to recent British work, while for the beginnerthey assume more than a passing familiarity with thesubject. Wiener’s name is associated with the discoveryand description of the Rh factor but the chapters onthis property of the red cell are disappointing, even ifone allows that an author of a book which deals with arapidly expanding field is always at a disadvantage.The book however maintains its high place as a standardwork of reference.

1943 Year Book of General Medicine

Editors: G. F. DICK, MD, and others. (Year BookPublishers; H. K. Lewis. Pp. 784. 198.)

SOMEWHERE between the catalogue of abstracts andthe review lies the province of the year book. If it istoo near to the former it loses its appeal to the generalreader ; if too near to the latter it provokes the experts.This book strikes the balance well : each contributoris an acknowledged expert in his own field, yet byassigning to him a whole field of medicine, instead oflimiting him to the particular patch which he hadcultivated, perspective is preserved. The result is abook which is both stimulating and comprehensive,and one which can be recommended to physicians ingeneral.

Illustrations of Regional Anatomy(5th ed.) E. B. JAMIESON, MDEDIN. (Livingstone.75s. the set of 7 sections.) }

TiTis fifth edition includes 319 plates comprised in7 sections. As the author rightly says : " The publishershave not grudged expense in adding colour." Colourhas indeed been added with an unstinting hand and thestudent who derives his knowledge of anatomy fromDr. Jamieson’s plates will acquire a truly vivid pictureof the ideal structure of the human body. It is to behoped that after the delightful study of purple mucousmembranes, emerald green fascias, vivid blue cartilages,orange glands, and golden teeth and eyes he will notfind the actual human body rather disappointing.