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Reviews of Books

Chemistry of Lipids of Biochemical SignificanceJ. A. LovERN. London : Methuen. New York : John

Wiley. 1955. Pp. 132. 8s. 6d.

THIS monograph is a worthy successor to the previousone in the same series by Smedley Maclean, which

appeared twelve years ago. Four of the five chaptersare based upon a series of lectures given at the Universityof Aberdeen; the fifth (on the preparation and analysisof lipids), added since, is a valuable companion to them.The author deals first with the structure of lipids as isolated

and then with their physicochemical relations to the cell-

proteins. One chapter is devoted to the intermediary meta-bolism and dynamic turnover of the lipids in vivo, as revealedby the use of labelled isotopes, and the concluding chapterdeals with lipid function. This chapter is short and manywill wish that more space had been devoted to the functionof lipids in relation to cell structure and metabolism, and lessto their preparation and analysis. The term lipids includesthe sterols, triglycerides, and glycerophosphatides, and thelast group embraces a bewildering range of chemical com-pounds containing amino-acids, amines, aldehyde derivatives,carbohydrates, inositol, and other substances ; so the authorhas attempted to compress a great deal of information withina very small compass.

He has been successful in that he has produced a veryreadable and informative book with a sufficiency ofstructural formulae to allow anyone with a basic know-ledge of biochemistry to understand it. It will be justthe thing for advanced students and lecturers whosespecialty does not lie in this field, and it may also appealto the inner circle of lipoid chemists. References to theoriginal publications are plentiful but not exhaustive.

International Review of CytologyVol. in. Editors : G. H. BOURNE, London HospitalMedical College, and J. F. DANIELLI, zoology depart-ment, King’s College, London. New York : AcademicPress. 1954. Pp. 530.$9.50.

CYTOLOGY is here taken to include physiological aswell as morphological studies at the cellular level, andthe editors have ranged widely in their choice ofcontributors.

C, Waymouth shows how the exponents of tissue-culturetechnique, like their microbiological colleagues, are movingaway from complex media of uncertain composition to syn-thetic media susceptible of precise chemical definition. Itseems that metazoan cells can now be kept alive in totallysynthetic media for up to 70 days, though not without somediminution in viable-cell count. 0. Bucher appraises statis-tically the practicability of measuring volume-change innuclear populations, and I. Cornman follows him with a shortand admittedly discursive account of what is known aboutthe cellular pharmacology of urethane. M. Alfert, ina splendidly illustrated article, considers the nature of thegiant chromosomes, and R. A. Beatty deals with inconstancyof chromosome-number in the somatic cells of mammals.Two specially topical reviews deal with the biochemicalcharacteristics of cellular inclusions : A. L. Dounce coversthe metabolic activities of isolated nuclei, with which hehas worked extensively, and C. de Duve and J. Berthet givean outstandingly good account of the application of differentialcentrifugation to the separation of cellular components.T. Gastafson contributes a detailed essay on the inhibitoryeffect of lithium on the respiratory activity of that favouriteof chemical embryologists, the sea-urchin’s egg. In reviewingthe histochemical applications of the azo dyes Everson Pearseemphasises a number of guiding principles for histochemicalpractice generally. R. G. Williams gives a useful summary ofthe scope of techniques employing transparent chambers inrabbit ears and elsewhere, G. Asboe-Hansen writes on the mast-cell, and E. W. Dempsey and A. I. Lansing give a commend-ably brief report on what little is known about the molecularstructure of elastic tissue. In a final paper S.-O. Brattgardand H. Hyden discuss microchemical studies of single nerve-cells, and the extension of microspectrophotometry from thenow familiar ultraviolet region to that of the softer X rays.The papers go rather deeply into this great variety offields, but (in addition to professional cytologists)

experimental pathologists and others with biochemicaland histological leanings will find much profitable readingin them.

Babcock’s Principles and Practice of Surgery2nd ed. Editor : KARL C. JONAS, M.D., M.S., F.A.C.S.,F.I.C.S., instructor in surgery, Temple University Schoolof Medicine, Philadelphia. London : Henry Kimpton.1954. Pp. 1543. £6 15s.

Ten years ago Dr. W. W. Babcock’s Textbook of Surgerywas expanded, with the aid of thirty-seven collaborators,into the Principles and Practice of Surgery. It thenrepresented mainly the teaching at Temple University,Philadelphia. Many of the fifty-four contributors to thisnew edition practise and teach in Philadelphia, but it isan eclectic work. Dr. Jonas, as editor, has allowed histeam to present uncommon conditions together with thecommon in an endeavour to produce a comprehensivevolume. -

In some subjects the consequent condensation has led totabulation, particularly in the urological section. The thoracic,orthopaedic, and neurosurgical specialties are fully considered,while paediatric surgery has gained a section to itself.

Gynaecology is omitted, and so is otorhinolaryngology, thoughdescriptions of many of the conditions and procedures asso-ciated with this specialty are scattered through the sections.As a result of these gaps conditions such as ectopic pregnancyand otitis media are not described. But the work is in partsbroad in conception and even original, for there is a generalchapter on surgery during pregnancy preceded by anotheron surgery and diabetes ; while the last chapter not onlydescribes the mental state of the surgical patient but alsocontains some shrewd observations from a psychiatrist onthe personality of a surgeon. For English taste the sectionon anaesthesia is perhaps overweighted with spinal and

regional methods. Irradiation therapy is mentioned onlycursorily, and the lack of a detailed account of radioactiveisotopes and their uses is surprising. The description of

Trendelenburg’s test for varicose veins is mystifying. Illus-trations are profuse ; many are good, some indifferent, whilethe few colour plates are poor. _

Any textbook with this ambitious scope must haveweaknesses, and in this work their number is notexcessive. The cost of the book matches its weight.The Vitamins -

Chemistry, Physiology, Pathology. Vol. III. EditorsW. H. SEBRELL, jun., director, National Institutes ofHealth, Bethesda, Maryland; ROBERT S. HARRIS,professor of biochemistry of nutrition, MassachusettsInstitute of Technology, Cambridge. New York:Academic Press. London: Academic Books. 1954.Pp. 665.$15.00.

THE third and final volume in this new series ofreference works on the vitamins deals, in turn, withp-aminobenzoic acid, pteroylglutamic acid, vitamin B6,riboflavine, aneurine, the tocopherols, and miscellaneousgrowth factors such as lipoic acid and carnitine. As inearlier volumes, each section on each vitamin has beenwritten by an expert on the particular subject. Up tillnow most books about the vitamins either have dealtexhaustively with one vitamin or group of vitamins orhave surveyed the whole field generally. The presentseries, by giving a full and up-to-date account of all thevitamins, is a welcome addition. Even in a work of thissize not all relevant information can be included, butthe editors and contributors have succeeded in incorpor-ating all the main’ findings. Numerous references are

given to original papers, and each volume is well providedwith tables and illustrations.

Maxillofacial AnatomyHARRY H. SHAPIRO, D.M.D., assistant professor of ana-tomy, College of Physicians and Surgeons, ColumbiaUniversity. Philadelphia : J. B. Lippincott. London :Pitman Medical Publishing Co. 1954. Pp. 392. 96s.

THIS textbook is partly based on a smaller volume,Applied Anatomy of the Head and Neck, which Dr.Shapiro wrote eleven years ago. As the work of ananatomist and surgeon mainly concerned with dentaland oral surgery, its main appeal is likely to be to dentalsurgeons ; but it offers an original and clear approach

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to the complex anatomy of the facial skeleton andneighbouring tissues.The drawings are admirable, and many illustrate unusual

but important aspects which are rare in conventional textbooksof anatomy.’ Photographs and radiographs are also clearand helpful. The text is designed on a morphological ratherthan a regional basis, so the student may not always-find iteasy to form a composite picture of bony, vascular, neural,and muscular elements. Dr. Shapiro has also added " prac-tical applications " of anatomy, to show its usefulness in

practice, but these digressions are sometimes unworthy of therest of the book. It is not helpful to discuss burns in fourhundred words or cleft-lip in two pages. Some of the surgicaltechniques advocated are unlikely to win general approval.The book is beautifully produced and is a pleasure to

handle as well as to peruse.

Medicine, Magic and MythologyDr. JOHN PRE COPE. London: Heinemann MedicalBooks. 1954. Pp. 284. 42s.

THIS is an account of the evolution of pre-Hippocraticmedicine based on the study of anthropology and aknowledge of Ancient Greek. In it the author traces thedevelopment in men’s minds of, first, the appreciationthat disease as an entity exists and should be combated,then that it can be cured by magic, and then that it canbe cured by magic aided by material things such as plantand animal extracts. After this came the faint beginningsof experimental medicine, sometimes aided, sometimes

retarded, by the new systematised tales of magic-thosemythological tales that are the wonder and glory of theGreek mind. The text is broken up by numerous quota-tions in Greek (usually with an English translation)which make it rather difficult to read. But it will intereststudents of prehistoric medicine, especially if theyare anxious to brush up their Greek at the same time.

Textbook of Gynaecology (9th ed. London: A. & C.Black. 1954. Pp. 493. 40s.).-After three and a half yearsProf. James Young’s textbook is substantially the same:but advances in our knowledge of endocrinology, disorders ofmenstruation, prolapse of the uterus, and uterine and ovariantumours all find a place in the new edition. The printing, andsome of the illustrations, are beginning to look a trifle old-world, and a few of the photographs are too vague and foggyto serve their purpose.

Physical Signs in Clinical Surgery (12th ed. Bristol:John Wright & Sons. 1954. Pp. 456. 38s. 6d.).-In the hard-going days of 1949 this book appeared in four paper-coveredparts ; but now it is back between comely boards. llr.Hamilton Bailey has this time had the help of Mr. AllanClain, who has rearranged the text so as to include an instruc.tive chapter on the orbit, and has combined the chapters onthe spine and the sacro-iliac joints-structures which, indeed,are not easy to consider apart. Mr. Bailey himself has putsalt on the tails of some supplementary physical signs whichhad escaped him till now, and caged them in a final chapter.The illustrations are as good as ever-every one of them aclinical demonstration.

New Inventions

A CONSTANT INFUSION APPARATUS

MANY methods used today in clinical medicine-e.g.,in the estimation of renal clearance and of inulin space-require an apparatus capable of delivering fluids at aconstant rate. Most of these methods are based on theprinciple of a geared-down electric motor driving thepiston of a syringe forwards into the syringe barrel.1These methods have several disadvantages ; the initialexpense of the apparatus ; the variation of motor speedwith voltage changes in the mains electricity-supply;and the errors involved if it is necessary to refill thesyringe during an infusion.The apparatus described here is a modification of a

simple blood-transfusion unit. It has a capacity of

RATE OF FLOW OBTAINED DURING ESTIMATION OF SUCROSE SPACE

IN A PATIENT WITH ASCITES. USING APPARATUS DESCRIBED

250 ml. (or larger if required), needs no motor, and isinexpensive. It can be sterilised easily and is transport-able. It is particularly useful where the mains electricity-supply is either non-existent or of poor voltage stability ;it has been successfully used in a recent investigationin East Africa .2A constant head of liquid is maintained above a glass

capillary tube. For a capillary tube of a given diameterthe flow will depend on the head of liquid above thetube, and this is varied according to the flow required.

In our apparatus (see figure) the reservoir (R) consistsof a tube (32 x 4 cm.) of uniform bore and witha capacity of 250 ml. It is graduated at 2-ml. intervals.A ground-glass stopper (8) closes the reservoir at thetop. The lower end of R leads into a constant-headdevice (T) which maintains the liquid at the level E.At E a hole (diameter 0-5 cm.) is blown into the sideof a tube (A) 0-5 cm. in diameter leading from R ;P, a side-arm open to the atmosphere, has a smallsterile cotton-wool plug placed in its mouth.The lower end of T is joined by flexible tubing to the

ground-glass joint (G), the cone of which bears the

capillary tube (F). F has an internal diameter of

1. E.g., Last, C. E. Brit. med. J. 1945, i, 122.2. Heller, H., and Schnieden, H. Unpublished observations.

0-047 mm. (about the size of the stylet of a no. 20needle). The capillary tube need only be approximatelyof this size The capillary tube widens out into a tube(0) of bore 0-3 cm., and this is sealed into the chamber H,

which is similar to the drip-chamber of a normal blood-transfusion unit. ’Polythene’tubing 0-038 cm. in diameteris connected to the taperedlower end of H and can beinserted into the patient’s vein.Rubber tubing, which can beclosed by the gate-clamp (M),by-passes the capillary tube, sothat a rapid priming infusioncan be given, if required, intothe patient’s vein.

Before the apparatus is used,all air-bubbles must be removed.By reference to the reservoirlevel the total volume of liquidinfused may be read to 2 ml.For measurements of flow dur-ing a shorter period of time,the dripping-rate in H is meas-ured. The liquid drop volumeis previously determined bycalibration against the corre-

sponding fall in liquid level in R.The volume of solution infused

can thus be determinedto 0 -1 ml. In practice it

has been foundadvisable touse heparin-ised solutions.The approxi-mate rate ofinfusionrequired is ob-tained before

the polythene tubing is in the patient’s vein. The tubing.is then inserted, and the height of E above the capillarytube F is adjusted until the required rate is obtained.We wish to thank Mr. J. H. Burrow, B.sc., for his interest

and technical skill in making the prototypes of this apparatus.M. JOSEPHSB.SC. Brist.

HAROLD SCHNIEDENM.B. Brist.

Beaverbrook Research Fellow

Departments of Physical Chemistryand of Pharma cology, University

of Bristol