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diet and fluids taken in hospital : she still takes the mist.alba every morning, and attends the antenatal clinic

weekly. If improvement is only temporary or not ade-quate, labour is induced by the bougie method.

At the Walton Hospital, Liverpool, between October,1932, and October, 1933, the method had been applied,Mr. Chisnall said, to 39 cases of pre-eclampsia, definedas a disorder of pregnancy associated with albuminuria,cedema, and hypertension, without evidence of

previous nephritis. Among them were 28 primi-gravidae. Medical treatment sufficed in 36 cases,but in the other 3 (all primigravidae) labour wasinduced because improvement was not maintained.

The treatment in favourable cases was followed

by reduction of blood pressure to normal figures,disappearance of cedema, diminution of albumin.uria, and cessation of symptoms. In all cases a

healthy live child was born ; in 36 the motherwas cured, and in 3 the symptoms recurred afterpartial relief. Despite the restricted fluid intake aprogressive increase in the daily volume of urineoccurred, lasting from 4 to 10 days, after whichthe volume remained steady. This was equal to thevolume of fluid which could be allowed withoutstorage occurring. If the intake went beyond thisfigure the symptoms tended to recur.

REVIEWS AND NOTICES OF BOOKS

Recent Advances in MedicineClinical, Laboratory, Therapeutic. Seventh edition.By G. E. BEAUMONT, D.M., F.R.C.P., and E. C.DODDS, M.V.O., M.D., F.R.C.P. London : J. andA. Churchill. 1934. Pp. 485. 12s. 6d.

THE great success which this book has achievedduring its ten years of life has been well deserved.A number of notable additions appear in the presentissue. The first chapter now includes an admirablereview of the present position of the sex homones-to the elucidation of which Prof. Dodds has largely con-tributed-and the vitamins, and ends with an accountof the parathyroids and their relation to calciummetabolism. In the chapter on the kidneys theurea-clearance test is fully described, and a goodaccount is given of the ketogenic diet in the treat.ment of urinary infections. The chapter on thestomach shows little alteration-a fair comment onthe lack of progress made in the treatment of

digestive disorders. A few additional illustrations areincluded in the account of the electrocardiograph,but the space allotted to this important branch ofcardiology is still perhaps rather too small. Some

help in the actual handling of the apparatus mightbe appreciated by readers who are well served withdetail in the very full account of basal metabolismdeterminations. In the next edition a short sectionon radiography of the heart might also be includedwith advantage. The conclusion reached on sano-

crysin in the treatment of pulmonary tuberculosisis that its value is doubtful, the immediate andultimate results of its use being often disappointing.A number of changes are found in the laboratorymethods of blood and urine examinations, which,as in previous editions, are given in enough detailto be of practical service.

" Recent Advances in Medicine " is now a standardwork, which will continue to attract grateful readersin ever larger numbers.

A Diabetic ManualFifth edition. By ELLIOTT P. JOSLIN, M.D.,Clinical Professor of Medicine, Harvard MedicalSchool; Consulting Physician, Boston City Hospital.London : Henry Kimpton. 1934. Pp. 224.10s. 6d.

IN its fifth edition this well-known manual hasbeen considerably altered and greatly improved. Thestatistical data and charts supplied show the greatimprovement which has taken place in the treatmentof diabetes, even as compared with the early andmiddle Banting period. Dr. Joslin does not advocatethe extreme high carbohydrate-low fat diet, containing

250-350 g. of carbohydrate and 50 g. of fat, but usesa moderate one of 150 g. of carbohydrate and 90 to100 g. of fat. The book offers useful hints on thecontrol of the blood-sugar in difficult cases, and thetreatment of coma is fully discussed. Dr. Joslinstresses the importance of the care of the feet, becausethe incidence of gangrene of the foot is still muchtoo high. For the treatment of corns, the cooperationof a skilled chiropodist should be enlisted. The

prevention of athlete’s foot (ringworm of the toes)seems to require special precautions. The increasingincidence of diabetes among elderly persons, especiallywomen, is disturbing. Dr. Joslin makes a strong pleafor the avoidance of obesity, which he thinks is a

prominent factor in its production.The photographs of diabetic patients running,

jumping, and the many sketches, provide an

encouraging indication of the success of modernmethods and make the book attractive to read.

Healthy ChildhoodBy HAROLD C. STUART, M.D., Assistant Professorof Pediatrics and Child Hygiene, Medical Schooland School of Public Health, Harvard University;Associate Physician, Children’s Hospital, Boston,Massachusetts. London and New York : D.Appleton-Century Company Inc. 1933. Pp. 393.8s. 6d.THE convention in 1930 of the White House

Conference on Child Health and Protection byPresident Hoover was an event which marked therecognition of the imperative call for a wider under-standing of the physical and mental needs of child-hood, and it is perhaps significant that the wholemachinery of the conference was put in motion duringa period of national crisis. It will be some consider-able time before it will be at all possible to evaluatethe work of the conference and before much of thedata gathered by subcommittees can be generallyassimilated. The " Children’s Charter" (which Dr.Stuart quotes in full) may perhaps seem at firstsight too idealistic and nebulous to serve as a workingbasis for investigation and research, but such a

simple statement of the aims of the conference is

definitely enlightening. The Century ChildhoodLibrary has been published with the object of render-ing much of the material of the conference reportsavailable to parents, and in this work Dr. Stuart,who was himself vice-chairman of the committeeon the growth and development of the child in themedical section of the conference, has given a résuméof the physiology and development of the normalchild, and of the aspects of preventive medicineconcerned with the preservation of child health.Some indication of the scope of the book is given by

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the chapter concerned with the prevention of infectiousdiseases, in which the author describes the use ofdiphtheria toxin-antitoxin, the limitations of theDick test, the employment not only of convalescentserum but of placental extracts in the preventionof measles, and refers to (though he does not recom-mend) the use of B C G. Whilst his treatment of thesubject has necessitated the use of a considerablenumber of technical terms, Dr. Stuart has been

singularly successful in presenting it in a form whichshould be perfectly clear to the educated layman.It is possible that even some of the medical professionmay find in it a gentle reminder that they mustpolish their armour if they are not to be caughtnapping by their patients’ parents !

Marriage and ParenthoodIssued by the Marriage and Parenthood Com-mittee of the Society of Friends. London : FriendsBook Centre. 1934. Pp. 16. 3d.

THIS excellent little brochure contains four chaptersentitled The Engagement, Marriage, Parenthood, andThe Home. The author, whoever he is, deservescongratulation on the vision he has displayed in relat-ing the new outlook of marriage and parenthood withthe religious values in the perspective of which theQuaker believes all human aspirations should beviewed. From the spate of books, pamphlets, andleaflets dealing with the problems of human repro-duction, this little document stands out by reasonof its breadth, its understanding, and its sobriety.Doctors are often consulted by anxious parents asto what advice should be given to young people whoare contemplating matrimony. They may even bepuzzled to know what advice to give to their ownchildren when in this predicament. This brochure isrecommended, not as a source of information onphysiological problems, but as a gentle reminder that,over and above the knowledge of sex psychologyand physiology which so preoccupy us to-day, asuccessful and durable marriage makes spiritualdemands which it is well to recognise beforehand.

A Text-book of the Practice of MedicineFourth edition. By Various Authors. Edited byFREDERICK W. PRICE, M.D., F.R.S. Edin., Con-sulting Physician to the Royal Northern Hospital;Senior Physician to National Hospital for Diseasesof the Heart. London : Humphrey Milford,Oxford University Press. 1933. Pp. 1995. 36s.

IN the fourth edition of this popular work manyarticles have been largely rewritten, and the sectionson the diseases of the spleen, blood, and lymphaticsystem entirely so. Amongst recent methods oftreatment now included are the use of Felton’s serumin pneumonia, of insulin and glucose in heart disease,and of the compound mercurial diuretics ; a verybrief reference without details is given to the ketogenicdiet in coliform bacillus infections. A full accountof idiopathic hypochromic anaemia is now supplied,and brief notes on the filtrable viruses, agranulocytosis,Simmonds’s disease, amongst over 50 new subjectsmentioned. Of the 13 new illustrations, which

hardly come up to the standard of the text, five areorthodiagrams of the heart and two electro-cardiograms. It was not easy to find any accountof how an orthodiagram is taken or of the normalmeasurements of the heart as estimated by thismeans. The electrocardiograms are excellent andtheir interpretation clear and concise. It is interesting

to note the reversion in this edition to the old namesof Graves’s disease and Hodgkin’s disease in place ofhyperthyroidism and lymphadenoma.

Dr. Price and his distinguished contributors maybe assured that this edition is likely further toenhance the well-deserved reputation of their work.

The British Journal of SurgeryTHE April issue (Vol. XXI., No. 84) contains the

following papers : A Contribution to the Study ofPulmonary Lobectomy, by A. Graham Bryce(Manchester). An experimental investigation intoremoval of a lobe of the lung in the cat by the three-stage operation of producing adhesions, ligaturing thepedicle, and excision of the gangrenous lobe.-Multiple Carcinoma of the Colon, with Four OriginalCases, by A. J. Cokkinis (London). The growthsare regarded as being all of primary origin ; theirrelationship to multiple adenomata is discussed, andtheir clinical significance is emphasised.-Some Experi-mental Observations bearing on the Etiology ofMegacolon, by Harold Burrows (London). Injectionsof crystalline silica into the mesentery of the caecumhas been followed by cæcal enlargement. It issuggested that persistent irritation of the sympatheticnerve-supply is the cause.-The Pathology of AcuteStrangulation of the Intestine, by Robt. L. Holt(Manchester). An experimental investigation todetermine the parts played by perforation andperitonitis, by absorption of toxins, by withdrawalof blood from circulation, and by dehydration, indeath from strangulation of the intestine.—Neuro-surgery in the Treatment of Diseases of the Peri-pheral Blood-vessels, by D. J. MacMyn (Mayo Clinic).An outline of the views held and the treatmentemployed at the Mayo Clinic in certain vasculardiseases, particularly in thrombo-angiitis obliteransand Raynaud’s disease.-The Selenide Treatment ofCancer, by A. T. Todd (Bristol). An account oftreatment by a combination of injection of a colloidalselenide preparation with X-radiation : the results in155 cases of inoperable cancer (see p. 963).-BilharziaDisease in England : the Cystoscopic Appearancesof the Bilharzia Bladder Before and After Intra-venous Injections of Sodium Antimony Tartrate,by J B. Christopherson and R. Ogier Ward (London). ).- Spindle-celled Mesenteric Tumours, with Remarkson Similar Retroperitoneal Tumours, by H. A.Phillips (Melbourne). A discussion of the origin,pathology, and classification, with an account of sixpersonal cases.-Observations on Pleural Absorption,by R. C. Brock (London). Observations on thefactors influencing the absorption of fluid from theintact and inflamed pleura in rabbits, with a discussionof the clinical bearing of the results.-The Plan of theVisceral Nerves in the Lumbar and Sacral Outflowsof the Autonomic Nervous System, by Hugh C.Trumble (Manchester). A description of the auto-nomic nervous system based on the work of Langleyand Anderson together with numerous dissectionsmade by the author. A less chaotic nomenclaturethan that current in recent literature is suggested.-Malignant Adenoma of the Prostate with secondarygrowths in the vertebral column simulating Pott’sDisease, by W. E. Carnegie Dickson and T. R. Hill(London). The primary growth was very small.The bony metastases were completely osteoclastic,and the main symptoms were due to rapid involve-ment of the spinal cord.-Primary Carcinoma of theLiver : with report of a case successfully treated byPartial Hepatectomy, by A. Lawrence Abel (London).A comprehensive description of the disease as itappears in the literature, followed by a description ofthe treatment and pathology of a case.The issue also contains accounts of some rare and

obscure cases.

THE TEACHING OF SPEECH.-Tlle price of Mr.Sibley Haycock’s book, reviewed in our last issue(p. 902) is 7s. 6d. post free.