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A CATHETER INTRODUCER
1047
Reviews of Books
DISCUSSION
In view of the variation in plasma concentration, the mean values reported in a group of this size must be Anatomy considerably influenced by the choice of subject. In order Gray’s 32nd ed. Editors: T. B. JOHNSTON, M.D., professor emeritus of of information about the to obtain detailed plasma pattern anatomy, University of London; D. V. DAVIES, M.A., M.B., proconcentration throughout pregnancy, a large number of fessor of anatomy, St. Thomas’s Hospital Medical School, consecutive assays will have to be made in individual University of London; F. DAVIES, M.D., D.sc., F.R.C.s., professor of anatomy, University of Sheffield. London: Longmans, Green. subjects. Furthermore, it should be possible to study 1958. Pp. 1604. E66s. in concentrations as occur such acute changes plasma may has reached its 32nd edition and its centenary year. Gray before and during parturition and to investigate the renal on anatomy have been held to be better and still Other works clearance of the steroid. but none have won such popularity. Excellent texts be; may Comparison of these results with those obtained for on human anatomy have languished, and now linger on library plasma progesterone is limited by the fact that the pro- bookshelves in outdated editions. Some may have been ousted gesterone levels have not been studied in detail throughby their lusty rival, but this is not an adequate explanation, for out pregnancy. However, comparison of the amounts it ignores the differing needs of students of human anatomy. observed in late pregnancy indicates that the concentration The same approach and content cannot suit medical and dental of plasma pregnanediol is approximately five times that students, physiotherapists, postgraduates (general surgeons, dental surgeons, ophthalmologists, and many other specialists), of plasma progesterone. In fact, the pregnanediol concentration of peripheral venous blood is similar to that and professional anatomists. Most of these groups require a text, and obviously that entails subdivision of the reported for the progesterone content of placental venous special anatomical public ", but neither publishers nor authors care blood.8It will be important to determine the progesterto launch a work for so small an audience that it is unlikely to one/pregnanediol ratios under physiological and patho- pay its way, however excellent. Hence many who need a book logical conditions, and such information may indicate on human anatomy are still without a volume based on their whether a lack of effective progesterone concentration at needs: they must look for a compromise. the target organ is due to a low level of endogenous This may account in part for the success of the sumptuous secretion or to a disorder of intermediary metabolism. volume which has so far outgrown in size and price Henry We wish to record our indebtedness to the late Sir Charles Read; Gray’s relatively small book: it is a great compromise. Most to the consultant staff and sisters in charge of the antenatal departstudents acquire it, and are duly impressed by its magnificent ment of Queen Charlotte’s Maternity Hospital; and to the British air of erudition. But to read such a book, even once, is a task Empire Cancer Campaign for a grant from which part of the expenses few undertake. Yet a textbook ought to be something of a was defrayed. The work was done during the tenure of fellowships guide, philosopher, and friend ", and Gray’s austere pages from the Harmsworth Trust and the Royal College of Physicians of scarcely provide this. Students may remain uncertain, as indeed Edinburgh. G. N. DESHPANDE whether is a text or a work of of their teachers "
"
B.SC.
Harmsworth Research Fellow
IAN F. SOMMERVILLE The Endocrine Laboratory Unit, Chelsea Hospital for Women and The Institute of Obstetrics and Gynæcology, London, S.W.3
M.D., PH.D. Edin. Director of Endocrine Laboratory Unit; Freeland Barbour Fellow
New Inventions A CATHETER INTRODUCER THIS introducer has been designed to introduce the Malecot self-retaining catheter into the chest for empyema drainage, Compared with other types spontaneous pneumothorax, &c. of introducer, it is more easily manipulated and introduces the catheter more quickly, especially in emergency thoracic
work. The introducer will take all sizes of catheter commonly used and would prove useful in general genitourinary work. The method is to rotate the handle into the catheter, pass the long rod through the handle, and draw the two parts together. This action extends the catheter ready for the insertion. The long rod is then withdrawn and the .handle is removed by a rotating action. This instrument is manufactured by Chas. F. Thackray Ltd., Park Leeds. My thanks are due to Dr. T. M. Wilson, medical superintendent, and to Miss E. Sculthorpe, matron, for their kind permission to
Street,
publish this note. Thoracic Surgical Unit, Baguley Hospital, Manchester 8.
Zander, J.,
von
D. COWAN
S.R.N., B.T.A.
Münstermann, A.-M. Klin. Wschr. 1954, 32, 894.
many
are,
Gray
reference. The subtitle, Descriptive and Applied, gives a hint, and the text is mostly an able account of the arcana of human topography, with occasional reference to their application. But reference alone cannot be the intention; many sections are prefaced by introductory remarks which provide, indeed, the best reading. Some of these are well in line with recent work, not only in anatomy but in cognate studies. They blow into the stale atmosphere of structural detail an invigorating breath which may yet veer this august argosy of anatomy towards a livelier interpretation of the body. Gray is the product of an era of unhampered dissection and an ever-widening gulf between the pursuit of topographical detail and all that enlivens this lore with comprehension. Departure of so much into the hands of other specialists, though inevitable to progress, has left a hard core of gross topography, preserving at its worst no more than a customary link with surgery. But anatomists have never completely abandoned the proper ingredients of their subject; there have always been some disinclined to detached description. Unfortunately anatomical description can be separated from all that makes structure significant. Such teaching does harm, creating a narrow view of human anatomy, even among the most able clinicians, whose condemnation is wrongly based on unfortunate student experience. They will, nevertheless, find some agreement amongst anatomists of recent decades, for many would relinquish much detail for more understanding. The chief criticism of Gray is that it is unsuitable for beginners, who still form the largest element in its public. The amount of information is too great, the style of description too dry a wine for young palates. It does not stimulate the tyro to explore a new continent; it shows an old one where almost all apparently has been discovered. The wisdom in the general remarks is often neglected, being too far removed from the descriptive text. For those who return to anatomy this is less serious, though many are already settled in the groove of mere topographical study. They have, however, the advantage of clinical experience which enlivens the monstrous task of memorisation still expected of them in their examinations.
Reviews of Books
DISCUSSION
In view of the variation in plasma concentration, the mean values reported in a group of this size must be Anatomy considerably influenced by the choice of subject. In order Gray’s 32nd ed. Editors: T. B. JOHNSTON, M.D., professor emeritus of of information about the to obtain detailed plasma pattern anatomy, University of London; D. V. DAVIES, M.A., M.B., proconcentration throughout pregnancy, a large number of fessor of anatomy, St. Thomas’s Hospital Medical School, consecutive assays will have to be made in individual University of London; F. DAVIES, M.D., D.sc., F.R.C.s., professor of anatomy, University of Sheffield. London: Longmans, Green. subjects. Furthermore, it should be possible to study 1958. Pp. 1604. E66s. in concentrations as occur such acute changes plasma may has reached its 32nd edition and its centenary year. Gray before and during parturition and to investigate the renal on anatomy have been held to be better and still Other works clearance of the steroid. but none have won such popularity. Excellent texts be; may Comparison of these results with those obtained for on human anatomy have languished, and now linger on library plasma progesterone is limited by the fact that the pro- bookshelves in outdated editions. Some may have been ousted gesterone levels have not been studied in detail throughby their lusty rival, but this is not an adequate explanation, for out pregnancy. However, comparison of the amounts it ignores the differing needs of students of human anatomy. observed in late pregnancy indicates that the concentration The same approach and content cannot suit medical and dental of plasma pregnanediol is approximately five times that students, physiotherapists, postgraduates (general surgeons, dental surgeons, ophthalmologists, and many other specialists), of plasma progesterone. In fact, the pregnanediol concentration of peripheral venous blood is similar to that and professional anatomists. Most of these groups require a text, and obviously that entails subdivision of the reported for the progesterone content of placental venous special anatomical public ", but neither publishers nor authors care blood.8It will be important to determine the progesterto launch a work for so small an audience that it is unlikely to one/pregnanediol ratios under physiological and patho- pay its way, however excellent. Hence many who need a book logical conditions, and such information may indicate on human anatomy are still without a volume based on their whether a lack of effective progesterone concentration at needs: they must look for a compromise. the target organ is due to a low level of endogenous This may account in part for the success of the sumptuous secretion or to a disorder of intermediary metabolism. volume which has so far outgrown in size and price Henry We wish to record our indebtedness to the late Sir Charles Read; Gray’s relatively small book: it is a great compromise. Most to the consultant staff and sisters in charge of the antenatal departstudents acquire it, and are duly impressed by its magnificent ment of Queen Charlotte’s Maternity Hospital; and to the British air of erudition. But to read such a book, even once, is a task Empire Cancer Campaign for a grant from which part of the expenses few undertake. Yet a textbook ought to be something of a was defrayed. The work was done during the tenure of fellowships guide, philosopher, and friend ", and Gray’s austere pages from the Harmsworth Trust and the Royal College of Physicians of scarcely provide this. Students may remain uncertain, as indeed Edinburgh. G. N. DESHPANDE whether is a text or a work of of their teachers "
"
B.SC.
Harmsworth Research Fellow
IAN F. SOMMERVILLE The Endocrine Laboratory Unit, Chelsea Hospital for Women and The Institute of Obstetrics and Gynæcology, London, S.W.3
M.D., PH.D. Edin. Director of Endocrine Laboratory Unit; Freeland Barbour Fellow
New Inventions A CATHETER INTRODUCER THIS introducer has been designed to introduce the Malecot self-retaining catheter into the chest for empyema drainage, Compared with other types spontaneous pneumothorax, &c. of introducer, it is more easily manipulated and introduces the catheter more quickly, especially in emergency thoracic
work. The introducer will take all sizes of catheter commonly used and would prove useful in general genitourinary work. The method is to rotate the handle into the catheter, pass the long rod through the handle, and draw the two parts together. This action extends the catheter ready for the insertion. The long rod is then withdrawn and the .handle is removed by a rotating action. This instrument is manufactured by Chas. F. Thackray Ltd., Park Leeds. My thanks are due to Dr. T. M. Wilson, medical superintendent, and to Miss E. Sculthorpe, matron, for their kind permission to
Street,
publish this note. Thoracic Surgical Unit, Baguley Hospital, Manchester 8.
Zander, J.,
von
D. COWAN
S.R.N., B.T.A.
Münstermann, A.-M. Klin. Wschr. 1954, 32, 894.
many
are,
Gray
reference. The subtitle, Descriptive and Applied, gives a hint, and the text is mostly an able account of the arcana of human topography, with occasional reference to their application. But reference alone cannot be the intention; many sections are prefaced by introductory remarks which provide, indeed, the best reading. Some of these are well in line with recent work, not only in anatomy but in cognate studies. They blow into the stale atmosphere of structural detail an invigorating breath which may yet veer this august argosy of anatomy towards a livelier interpretation of the body. Gray is the product of an era of unhampered dissection and an ever-widening gulf between the pursuit of topographical detail and all that enlivens this lore with comprehension. Departure of so much into the hands of other specialists, though inevitable to progress, has left a hard core of gross topography, preserving at its worst no more than a customary link with surgery. But anatomists have never completely abandoned the proper ingredients of their subject; there have always been some disinclined to detached description. Unfortunately anatomical description can be separated from all that makes structure significant. Such teaching does harm, creating a narrow view of human anatomy, even among the most able clinicians, whose condemnation is wrongly based on unfortunate student experience. They will, nevertheless, find some agreement amongst anatomists of recent decades, for many would relinquish much detail for more understanding. The chief criticism of Gray is that it is unsuitable for beginners, who still form the largest element in its public. The amount of information is too great, the style of description too dry a wine for young palates. It does not stimulate the tyro to explore a new continent; it shows an old one where almost all apparently has been discovered. The wisdom in the general remarks is often neglected, being too far removed from the descriptive text. For those who return to anatomy this is less serious, though many are already settled in the groove of mere topographical study. They have, however, the advantage of clinical experience which enlivens the monstrous task of memorisation still expected of them in their examinations.