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AN IMPROVED TOURNIQUET.
374 some of the latter, taken from other sources, have been reduced more than is consistent with clearness. In Fig. 67 by some oversight the ascending sensory pathway appears to be innocent of all connexion with the optic thalamus. In Fig. 95 we are certainly under the impression that the rolandic fissure has been indicated too far forward on the skull, and scarcely corresponds with the description given in the text. We hope that some time Fig. 169 will be replaced by a more typical photograph of achondroplasia, In looking through the book we noted some statements to which exception will be taken, but no text-book can escape criticism unless its value is decreased by its colourlessness, and none of the points in question are such as to invalidate the general impression of the usefulness of this convenient and practical handbook.
indeed, though
Reviews
and
Notices of Books.
1. Nerve Wounds :: Symptomatology of Peripheral Nerve Lesinns Caused by War Wounds. By J. TINEL, Ancien Chef de Clinique et de Laboratoire de la Salpêtrière. Preface by Professor DEJERINE. Authorised translation by FRED RoTHWELL, B.A. Revised and edited by CECIL A. JOLL, M.B., M.S., F.R.C S., Assistant London : Bailliere, Surgeon, Royal Free Hospital, &c. Tindall, and Cox. 1917. Pp. 317. Price 15s. net. 2. Diagnostia Symptoms in Nervous Diseases. By EDWARD LIVINGSTON HUNT, M.D., Assistant Professor of Clinical Neurology, Medical Department of Columbia University, New York, &c. Second edition, revised. London and of Using Tuberculin in the Treatment of Philadelphia : W. B. Saunders Company. 1917. Pp. 292. I A Rational Method Pulmonary Tuberculosis. By JOHN R. GILLESPIE, M.A,, Price$2 net. M.D. Belf., Tuberculosis Medical Officer, Co. Down. 3. A Manual of Nervous Diseases. By IRVING G. SPEAR, Belfast: Graham and Heslip. 1918. Pp. 37. Price M.D., Professor of Neurology at the University of 2s. 6d. net. illustrations. London Baltimore. 172 With Maryland, Dr. Gillespie discusses the rival methods of Wright and 1917. and Philadelphia : W. B. Saunders Company. Koch, concluding that the former has proved disappointing Pp. 660. Price$2.75 net. when tried in pulmonary cases because (1) it fails to control 1. WHEN we referred to the original French edition in the temperature, and (2) owing to the disturbing effect of our columns we expressed our view that this monograph auto-inoculations the optimum does not remain constant, of best on the Nerve Wounds was one the on subject but varies in a way that cannot be calculated. He then that the war medical literature of any country has proadds :duced. To-day we go further, and say it is the best, withBut after we have raised the patient’s antitoxin to such that we have seen. out exception, of all The methodical amount that auto-inoculations have become negligible , arrangement of the various peripheral lesion groups, their an these objections no longer hold good; and then, in my the of the different features sub-varieties, distinguishing the best results are obtained by lengthening the degrees of peripheral nerve involvement, are all described opinion, interval between the doses so as to approximate to Wright’s in a fashion that is the acme of lucidity, while the anatomical method. drawings and the clinical phot graphs are by themselves His own practice has been based on this assumption, and sufficient to ensure the success of the volume. For he gives an analysis of the results, from which the reader neurologist and neurological surgeon it is indispensable ; skilled in statistical deduction be able to draw his indeed, for the physician and surgeon generally we can own conclusions. Dr. Gillespiemayhas certainly made a recommend it without reserve. thoughtful and logical contribution to tuberculin therapy. 2. We reviewed this book on Diagnostic Symptoms in Nervous Diseases favourably on its first appearance, at the
I
indicating what appeared to us the disadvantage compilations and suggesting that the desire to be concise was responsible for an occasionally misleading brevity. In particular, we remarked that spinal localisation was scarcely assigned that space which its importance requires. It is gratifying, therefore, in this second edition to find a whole new chapter on that topic, together with same
time
of such
other evidence of a desire to increase the usefulness of the work. We still feel that the author is sometimes not lucid in two lines when he might have been in three. Thus (p. 184) : "To obtain the Schaefer reflex pinch the Achilles. There results pain." As it stands, this statement is unintelligible, for we cannot suppose he means that pain on pinching a tendon is a reflex in the sense that plantar flexion is a reflex. Yet it is under this heading that the above cryptic remark is placed. Again, he rightly regards the ataxic gait as "wholly different"from the cerebellar gait, but in both of his two lists of diseases in which these differing gaits are found Friedreich’s disease occurs. A word might be said, also, on the author’s apparently distinctive use of the terms " conditionand "disease." He tracts as a condition," regards a lesion of the pyramidal but spastic paraplegia as a " disease." Apparently, also, brain tumour is both a condition and a disease. Such obscurity of meaning is regrettable, or, rather, such failure to express clearly what is to the author no doubt quite clear. In spite of these blemishes we think the new edition is distinctly better than the first, and regard it as a good compendium of neurological symptomatology from a diagnostic point of view. 3 Professor Spear’s Manual of Nervous Diseases contains a great deal of useful neurological information in a comparatively small bulk. From the view-point of the student it is concise and readable, with an up-to-date presentation of the facts of neurology as a whole, and a commendable It contains rather more absence of debatable matter. anatomy and physiology in proportion to the rest of the material than many more pretentious text-books, but probably this is rather an advantage than otherwise. The majority of the illustrations and diagrams are very good
New Inventions. AN IMPROVED
TOURNIQUET.
THIS is a modification of Petit’s well-known tourniquet. It possesses the following new features. The pad is separated from the band, so that when the requisite amount of pressure is applied mere is a space on either side of the pad by which complete constriction of the limb is avoided. A counter pull enables the band to be applied easily and accu. rately. An im.
proved fastening provides a simple method of
"
fixing the band and of releasing the band and pad, It has been in use for over two years,
reportsof its
and I have received such encouraging efficiency that I have been induced to bring it to the notice of the medical profes’-ion. It is made by Mr. J. H. of New Bond-street, London, who has carried out every detail to my satisfaction, and from whom it may be obtained. HEATON C. HOWARD, M.R.C S.Eng., L.R.C.P.Lond.
Montague,
the
THE Crediton Board of Guardians have increased
the salaries of their district medical officers by 10 per Clutton (Somerset) Board by one-third.
cent.;
indeed, though
Reviews
and
Notices of Books.
1. Nerve Wounds :: Symptomatology of Peripheral Nerve Lesinns Caused by War Wounds. By J. TINEL, Ancien Chef de Clinique et de Laboratoire de la Salpêtrière. Preface by Professor DEJERINE. Authorised translation by FRED RoTHWELL, B.A. Revised and edited by CECIL A. JOLL, M.B., M.S., F.R.C S., Assistant London : Bailliere, Surgeon, Royal Free Hospital, &c. Tindall, and Cox. 1917. Pp. 317. Price 15s. net. 2. Diagnostia Symptoms in Nervous Diseases. By EDWARD LIVINGSTON HUNT, M.D., Assistant Professor of Clinical Neurology, Medical Department of Columbia University, New York, &c. Second edition, revised. London and of Using Tuberculin in the Treatment of Philadelphia : W. B. Saunders Company. 1917. Pp. 292. I A Rational Method Pulmonary Tuberculosis. By JOHN R. GILLESPIE, M.A,, Price$2 net. M.D. Belf., Tuberculosis Medical Officer, Co. Down. 3. A Manual of Nervous Diseases. By IRVING G. SPEAR, Belfast: Graham and Heslip. 1918. Pp. 37. Price M.D., Professor of Neurology at the University of 2s. 6d. net. illustrations. London Baltimore. 172 With Maryland, Dr. Gillespie discusses the rival methods of Wright and 1917. and Philadelphia : W. B. Saunders Company. Koch, concluding that the former has proved disappointing Pp. 660. Price$2.75 net. when tried in pulmonary cases because (1) it fails to control 1. WHEN we referred to the original French edition in the temperature, and (2) owing to the disturbing effect of our columns we expressed our view that this monograph auto-inoculations the optimum does not remain constant, of best on the Nerve Wounds was one the on subject but varies in a way that cannot be calculated. He then that the war medical literature of any country has proadds :duced. To-day we go further, and say it is the best, withBut after we have raised the patient’s antitoxin to such that we have seen. out exception, of all The methodical amount that auto-inoculations have become negligible , arrangement of the various peripheral lesion groups, their an these objections no longer hold good; and then, in my the of the different features sub-varieties, distinguishing the best results are obtained by lengthening the degrees of peripheral nerve involvement, are all described opinion, interval between the doses so as to approximate to Wright’s in a fashion that is the acme of lucidity, while the anatomical method. drawings and the clinical phot graphs are by themselves His own practice has been based on this assumption, and sufficient to ensure the success of the volume. For he gives an analysis of the results, from which the reader neurologist and neurological surgeon it is indispensable ; skilled in statistical deduction be able to draw his indeed, for the physician and surgeon generally we can own conclusions. Dr. Gillespiemayhas certainly made a recommend it without reserve. thoughtful and logical contribution to tuberculin therapy. 2. We reviewed this book on Diagnostic Symptoms in Nervous Diseases favourably on its first appearance, at the
I
indicating what appeared to us the disadvantage compilations and suggesting that the desire to be concise was responsible for an occasionally misleading brevity. In particular, we remarked that spinal localisation was scarcely assigned that space which its importance requires. It is gratifying, therefore, in this second edition to find a whole new chapter on that topic, together with same
time
of such
other evidence of a desire to increase the usefulness of the work. We still feel that the author is sometimes not lucid in two lines when he might have been in three. Thus (p. 184) : "To obtain the Schaefer reflex pinch the Achilles. There results pain." As it stands, this statement is unintelligible, for we cannot suppose he means that pain on pinching a tendon is a reflex in the sense that plantar flexion is a reflex. Yet it is under this heading that the above cryptic remark is placed. Again, he rightly regards the ataxic gait as "wholly different"from the cerebellar gait, but in both of his two lists of diseases in which these differing gaits are found Friedreich’s disease occurs. A word might be said, also, on the author’s apparently distinctive use of the terms " conditionand "disease." He tracts as a condition," regards a lesion of the pyramidal but spastic paraplegia as a " disease." Apparently, also, brain tumour is both a condition and a disease. Such obscurity of meaning is regrettable, or, rather, such failure to express clearly what is to the author no doubt quite clear. In spite of these blemishes we think the new edition is distinctly better than the first, and regard it as a good compendium of neurological symptomatology from a diagnostic point of view. 3 Professor Spear’s Manual of Nervous Diseases contains a great deal of useful neurological information in a comparatively small bulk. From the view-point of the student it is concise and readable, with an up-to-date presentation of the facts of neurology as a whole, and a commendable It contains rather more absence of debatable matter. anatomy and physiology in proportion to the rest of the material than many more pretentious text-books, but probably this is rather an advantage than otherwise. The majority of the illustrations and diagrams are very good
New Inventions. AN IMPROVED
TOURNIQUET.
THIS is a modification of Petit’s well-known tourniquet. It possesses the following new features. The pad is separated from the band, so that when the requisite amount of pressure is applied mere is a space on either side of the pad by which complete constriction of the limb is avoided. A counter pull enables the band to be applied easily and accu. rately. An im.
proved fastening provides a simple method of
"
fixing the band and of releasing the band and pad, It has been in use for over two years,
reportsof its
and I have received such encouraging efficiency that I have been induced to bring it to the notice of the medical profes’-ion. It is made by Mr. J. H. of New Bond-street, London, who has carried out every detail to my satisfaction, and from whom it may be obtained. HEATON C. HOWARD, M.R.C S.Eng., L.R.C.P.Lond.
Montague,
the
THE Crediton Board of Guardians have increased
the salaries of their district medical officers by 10 per Clutton (Somerset) Board by one-third.
cent.;