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A SIMPLE DEVICE FOR EXTERNAL COOLING
844
good index and comprehensive bibliographies to each section. The book is obviously the fruit of a lifetime’s experience in the mainstream of neuroradiology.
a
Pulmonary Tuberculosis VISWANATHAN, B.A., M.D., M.R.C.P., T.D.D., F.C.C.P., V.P. University of Delhi. London: Asia Publishing House. 1966. Pp. 150. 40s.
R.
Chest Institute,
THE value of a book on pulmonary tuberculosis can be quickly judged by reading the sections on chemotherapy and prevention-for these are the most important. Here chemotherapy gets 12 pages and prevention 10. The description of chemotherapy gives prominence to the scheme proposed by W. S. Russell and G. Middlebrook, even though this relies on laboratory investigations which are unlikely to be available to most physicians who will read the book. Moreover, such schemes of chemotherapy are completely inapplicable in mass treatment and have no place at all in India and many other countries-including Great Britain. In this section, as elsewhere in the book, there is a strange mixture of old and new. Artificial pneumothorax is given 3 pages: the Medical Research Council’s trial of B.C.G. vaccine is not mentioned. There is little cohesion within the various sections. The volume contains much sound teaching, but also much that is irrelevant The inexperienced will be confused and the or outdated. experienced irritated.
Gastroscopic Photography ROBERT S. NELSON, M.D., internist and chief, gastroenterology section, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston, Texas. London: Lloyd-Luke. 1966. Pp. 122. 73s.
RECORDING of gastroscopic appearances by colour photography with adequate detail and faithful reproduction of colour
New Inventions A SIMPLE DEVICE FOR EXTERNAL COOLING HYPOTHERMIA by external cooling is still a promising technique in surgery and medicine 11; and my own experience2 and that of others 34 shows that deep hypothermia by external cooling is possible and practical. It is generally agreed that the most effective method for external cooling and rewarming is 1. Swan, H. Chicago Med. 1962, 65, 9. 2. Sun, S., Gunbuz, N., Birkadesler, F. New Istanb. Contr. clin. Sci. 1964, 7, 201. 3. Ishikawa, Y., Okamura, H. Arch. klin. Chir. 1958, 289, 232. 4. Spohn, K., Kolb, K., Heinzel, J., Kratzert, R., Wenz, W. ibid. 1959, 292, 898.
has become possible only in the past few years. The author’s purpose is to review the various methods, to illustrate them, and to show the diagnostic application. The first section is devoted to the technique of gastroscopy. The second describes the development of gastric photography and gives details of the author’s method using the ’Eder 400 ’ controllable-tip gastroscope with a large tungsten lamp and’Miranda’ reflex camera. The third and final section illustrates, very beautifully, examples of gastric lesions from the author’s collection. A large appendix gives details of cases illustrated, often with a record of the accompanying radiological investigation. Throughout the book Dr. Nelson stresses the complementary value of gastroscopic and radiological investigation in the diagnosis of gastric disorders. This work is clearly written and well illustrated. It will be of value to all who are interested in the diagnosis of gastric lesions, whether they are gastroscopists or not. New Editions
Principles and Practice of Medicine.-8th ed. Edited by Sir Stanley Davidson. Edinburgh: E. & S. Livingstone. 1966. Pp. 1342, The
40s.
of Medical Microbiology.-7th ed. L. Melnick. and Edward A. Adelberg. Scientific Publications. 1966. Pp. 492. 50s. Review
By Ernest Jawetz,
Joseph
Oxford: Blackwell
Handicapped Children.-2nd ed. By J. D. Kershaw. London: William Heinemann Medical Books. 1966. Pp. 3C4. 32s. The Metabolic Basis of Inherited Disease.-2nd ed. Edited by John B. Stanbury, James B. Wyngaarden, and Donald S. Fredrickson. New York and London: McGraw-Hill. 1966. Pp. 1434. E14.
Hypnosis of Man and Animals.-2nd ed. By Ferenc András Volgyesi. Revised in collaboration with the author by Gerhard Klumbies. London: Baillière, Tindall & Cassell. 1966. Pp. 216. 75s.
the immersion technique. But this method has its own disadvantages : it is difficult to transfer the patient to and from the tub, and moving the patient under deep ether anesthesia can produce a fall in blood-pressure and lead to ventricular fibrillation. It is also very difficult, especially in critical cases, to keep the monitoring devices (e.g., electrocardiograph and electrothermometer) and infusion sets in place. Okamura et al. have designed a special operating-table with tub, but I feel this to be an extravagance for a clinic which handles only a few cases a year. Essex-Lopresti and Eatwell6 designed an inflatable tub but this needs special care. For the last six years I have been using a simple deviceconsisting of a plastic sheet which is mounted by two rigid head and foot frames and four adjustable sticks-which can be used on any ordinary operating-table (see figure). This plastic pool can be set up very easily and quickly, and it contains only a
little water. The
cooling water can
be mixed by vibrating the sheet from outside by hand. This device has an extra advantage; the patient’s head can be kept out of the water by pillowing it from beneath the plastic sheet. If there is an emergency (e,g,, a ventricular fibrillation) during the cooling phase the necessary manipulation can be started immediately, and the water can be poured out in only a few seconds. This device is easy to use in any hospital ward for patients with high fever and head
injuries. Department Anæsthesiology, SADI SUN University of Istanbul, M.D. Istanbul Istanbul, Turkey 5. Okamura, H., Yonezawa, T., Seta, K., Nitu, K., Wako, H. ibid. 1961, 297, 593. 6. Essex-Lopresti, M., Eatwell, K. Lancet, of
Plastic sheet (a) in position in
use as a
cooling device and (b)
not
in
use,
with frames removed.
1962, ii, 1033.
good index and comprehensive bibliographies to each section. The book is obviously the fruit of a lifetime’s experience in the mainstream of neuroradiology.
a
Pulmonary Tuberculosis VISWANATHAN, B.A., M.D., M.R.C.P., T.D.D., F.C.C.P., V.P. University of Delhi. London: Asia Publishing House. 1966. Pp. 150. 40s.
R.
Chest Institute,
THE value of a book on pulmonary tuberculosis can be quickly judged by reading the sections on chemotherapy and prevention-for these are the most important. Here chemotherapy gets 12 pages and prevention 10. The description of chemotherapy gives prominence to the scheme proposed by W. S. Russell and G. Middlebrook, even though this relies on laboratory investigations which are unlikely to be available to most physicians who will read the book. Moreover, such schemes of chemotherapy are completely inapplicable in mass treatment and have no place at all in India and many other countries-including Great Britain. In this section, as elsewhere in the book, there is a strange mixture of old and new. Artificial pneumothorax is given 3 pages: the Medical Research Council’s trial of B.C.G. vaccine is not mentioned. There is little cohesion within the various sections. The volume contains much sound teaching, but also much that is irrelevant The inexperienced will be confused and the or outdated. experienced irritated.
Gastroscopic Photography ROBERT S. NELSON, M.D., internist and chief, gastroenterology section, University of Texas M.D. Anderson Hospital and Tumor Institute, Houston, Texas. London: Lloyd-Luke. 1966. Pp. 122. 73s.
RECORDING of gastroscopic appearances by colour photography with adequate detail and faithful reproduction of colour
New Inventions A SIMPLE DEVICE FOR EXTERNAL COOLING HYPOTHERMIA by external cooling is still a promising technique in surgery and medicine 11; and my own experience2 and that of others 34 shows that deep hypothermia by external cooling is possible and practical. It is generally agreed that the most effective method for external cooling and rewarming is 1. Swan, H. Chicago Med. 1962, 65, 9. 2. Sun, S., Gunbuz, N., Birkadesler, F. New Istanb. Contr. clin. Sci. 1964, 7, 201. 3. Ishikawa, Y., Okamura, H. Arch. klin. Chir. 1958, 289, 232. 4. Spohn, K., Kolb, K., Heinzel, J., Kratzert, R., Wenz, W. ibid. 1959, 292, 898.
has become possible only in the past few years. The author’s purpose is to review the various methods, to illustrate them, and to show the diagnostic application. The first section is devoted to the technique of gastroscopy. The second describes the development of gastric photography and gives details of the author’s method using the ’Eder 400 ’ controllable-tip gastroscope with a large tungsten lamp and’Miranda’ reflex camera. The third and final section illustrates, very beautifully, examples of gastric lesions from the author’s collection. A large appendix gives details of cases illustrated, often with a record of the accompanying radiological investigation. Throughout the book Dr. Nelson stresses the complementary value of gastroscopic and radiological investigation in the diagnosis of gastric disorders. This work is clearly written and well illustrated. It will be of value to all who are interested in the diagnosis of gastric lesions, whether they are gastroscopists or not. New Editions
Principles and Practice of Medicine.-8th ed. Edited by Sir Stanley Davidson. Edinburgh: E. & S. Livingstone. 1966. Pp. 1342, The
40s.
of Medical Microbiology.-7th ed. L. Melnick. and Edward A. Adelberg. Scientific Publications. 1966. Pp. 492. 50s. Review
By Ernest Jawetz,
Joseph
Oxford: Blackwell
Handicapped Children.-2nd ed. By J. D. Kershaw. London: William Heinemann Medical Books. 1966. Pp. 3C4. 32s. The Metabolic Basis of Inherited Disease.-2nd ed. Edited by John B. Stanbury, James B. Wyngaarden, and Donald S. Fredrickson. New York and London: McGraw-Hill. 1966. Pp. 1434. E14.
Hypnosis of Man and Animals.-2nd ed. By Ferenc András Volgyesi. Revised in collaboration with the author by Gerhard Klumbies. London: Baillière, Tindall & Cassell. 1966. Pp. 216. 75s.
the immersion technique. But this method has its own disadvantages : it is difficult to transfer the patient to and from the tub, and moving the patient under deep ether anesthesia can produce a fall in blood-pressure and lead to ventricular fibrillation. It is also very difficult, especially in critical cases, to keep the monitoring devices (e.g., electrocardiograph and electrothermometer) and infusion sets in place. Okamura et al. have designed a special operating-table with tub, but I feel this to be an extravagance for a clinic which handles only a few cases a year. Essex-Lopresti and Eatwell6 designed an inflatable tub but this needs special care. For the last six years I have been using a simple deviceconsisting of a plastic sheet which is mounted by two rigid head and foot frames and four adjustable sticks-which can be used on any ordinary operating-table (see figure). This plastic pool can be set up very easily and quickly, and it contains only a
little water. The
cooling water can
be mixed by vibrating the sheet from outside by hand. This device has an extra advantage; the patient’s head can be kept out of the water by pillowing it from beneath the plastic sheet. If there is an emergency (e,g,, a ventricular fibrillation) during the cooling phase the necessary manipulation can be started immediately, and the water can be poured out in only a few seconds. This device is easy to use in any hospital ward for patients with high fever and head
injuries. Department Anæsthesiology, SADI SUN University of Istanbul, M.D. Istanbul Istanbul, Turkey 5. Okamura, H., Yonezawa, T., Seta, K., Nitu, K., Wako, H. ibid. 1961, 297, 593. 6. Essex-Lopresti, M., Eatwell, K. Lancet, of
Plastic sheet (a) in position in
use as a
cooling device and (b)
not
in
use,
with frames removed.
1962, ii, 1033.