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CANNULA INTRODUCER
1364 far from complete. Much of the book is spent in describing what structures are found in higher animals and then illustrating that it is not often that comparable structures are found in bacteria. This information is useful in underlining the dangers of transferring theories based on experimental data from bacteria to the interpretation of function in higher organisms. There are many quotations from research papers, but the author’s opinions of them are rarely apparent. The book is a handsome but expensive way of presenting what amounts to very few facts and little interpretation.
Home Truths for Home Doctors MICHAEL P. WINSTANLEY. 238. 18s.
London: Frederick Muller.
1963.
Pp.
To give one’s own patient medical advice that is accurate, unambiguous, hard to misinterpret or misuse, and likely to do good is never easy but not impossible. To do the same for unknown readers of a book is exceedingly difficult and perhaps not possible at all. Dr. Winstanley has clearly tried to inculcate common sense, to explode myths and to present useful truths about health and impaired health to ordinary folk, intending to both them and their doctors. In many respects he has succeeded, but in many others the reader-patient’s doctor, if he has time, is likely to find himself disagreeing with or having to modify what has been read." Does halfa mental worker really need a mental hobby ? Will a minute " thermometer register accurately in a minute ? Is the greasy-skinned patient with acne really well advised to abandon soap ? Is it obvious that a wound should be kept well coveredif, for instance, it is a grazed knee ? Is it true that tonsils perform no useful function and that if they are deemed to be infected " nothing but good is likely to follow their removal " -at 5 years old ? And is it well to present to patients the " doubtfully valid concept of stress diseases " ? all on it how literally the reader interprets Perhaps depends what he reads. The book’s general attitude is sane and healthy.
help
Results of
Surgery
for
Peptic Ulcer
Editors: R. W. POSTLETHWAIT, M.D.; JAMES C. THOROUGHMAN, M.D. Philadelphia and London: W. B. Saunders. 1963. Pp. 308. 56s.
THIS
monograph presents a commendable study by a group of surgeons aiming to assess treatment of peptic ulcer (here used as a compendium term for gastricand duodenal ulcers) and its complications in the light of real facts. The work is based on a planned investigation with punch cards compiled from a formidable protocol. The outcome is a book packed with information and comparative statistics. It will be enhanced when a prospective survey, limited to duodenal ulcer and now being undertaken by surgeons in 19 hospitals, has been completed. This book gives an example of intelligent, planned clinical research. Immunity to Protozoa (Symposium of the British Society for Immunology. Oxford: Blackwell Scientific Publications. 1963. Pp. 359. 70s.).-Many doctors connect the development of immunity to infection with the response to bacteria, and possibly viruses, hardly including protozoa in their list of antigens. Yet Koch and Celli studied immunity against malaria as far back as 1900, though admittedly Celli did not succeed in his attempt to demonstrate antimalarial activity in the serum of patients recovering from this disease. Perhaps the recent work on gamma-globulin in protozoal diseases has contributed greatly to the wider acceptance of protozoal immunity as a phenomenon open to scientific study. Not since W. H. Taliaferro published in 1930 his Immunology of Parasitic Infections has there been a volume, such as this, devoted entirely to the immunity against protozoa: it is an account of a symposium of 28 experts, edited by Prof. P. C. C. Garnham, Dr. A. E. Pierce, and Dr. I. Roitt. An introductory section has contributions from Garnham and Taliaferro, and the rest of the book is divided into two sections-on immunity to blood and to tissue protozoa. As R. R. A. Coombs points out in a foreword, protozoal diseases differ from bacterial and virus infections in the resourcefulness with which the larger pathogens outwit the
defences of the host. The trypanosomes often change their antigenic properties and leishmania live successfully in the " very arsenals of the immune responses ". On the other hand, man has, for example, protected himself by developing the malaria-" fast " sickle-cell haemoglobin. This book is a fascinating account of the battle of man and of some animals against their protozoal diseases.
Choosing Toys for Children (London: Tavistock Publications. 1963. Pp. 127. 12s. 6d.).-Anyone who has to buy toys for children will value this book by Stan Hegeler, for it contains sensible lists of suitable toys divided according to the price of the toy and the age of the child. These lists contain many useful suggestions for parents and others; and there is a comprehensive and original list of toys suitable for sick children of different ages. It follows a short but excellent chapter on play for sick children. Most of the book is devoted to showing the practical importance of toys rather than to theoretical discussion of the nature and purpose of children’s play. The emphasis throughout is on simple toys that children like at different ages, and there is also a brief and fascinating history of toys. Altogether a useful book, and one which should solve for ever the problem of what to buy for a particular child. Parasitism (St. Lucia, Queensland: University of Queensland Press. 1963. Pp. 145. 35As.).-This book by Prof. J. F. A. Sprent, which we reviewed on Nov. 30, is published in this country by Bailliere, Tindall & Cox at 22s. 6d.
New Inventions CANNULA INTRODUCER IN haemodialysis the establishment of a bypass entails the cannulation of small arteries, such as the radial or anterior tibial, and as large a cannula as the artery will take is needed to obtain a good flow of blood. In introducing the cannula the intima may be stripped and the vessel wall may be torn, especially if there is atherosclerosis. To avoid these complications, and to make the procedure easier and more expeditious, a small introducer was designed. The introducer is made of stainless steel, and consists of two tapering curved blades held together by a light spring-loaded
handle resembling a Thudichum nasal speculum. The blades are introduced for about 0-5 cm. into the artery (depending on the diameter of the vessel) through an arterotomy incision, and the cannula is then inserted between the blades (see figure). The spring handle holds the blades apart and dilates the bloodvessel walls. The introducer is then pulled out between the cannula and the arterial wall. I am indebted to Messrs. Chas. F. Leeds. for makine the instrument. Renal Research Unit and Department of Urology, General Infirmary,
Leeds,
1
Thackray Ltd.,
Park Street,
MILES Fox Manc., P.R.C.S.
CH.M.
Home Truths for Home Doctors MICHAEL P. WINSTANLEY. 238. 18s.
London: Frederick Muller.
1963.
Pp.
To give one’s own patient medical advice that is accurate, unambiguous, hard to misinterpret or misuse, and likely to do good is never easy but not impossible. To do the same for unknown readers of a book is exceedingly difficult and perhaps not possible at all. Dr. Winstanley has clearly tried to inculcate common sense, to explode myths and to present useful truths about health and impaired health to ordinary folk, intending to both them and their doctors. In many respects he has succeeded, but in many others the reader-patient’s doctor, if he has time, is likely to find himself disagreeing with or having to modify what has been read." Does halfa mental worker really need a mental hobby ? Will a minute " thermometer register accurately in a minute ? Is the greasy-skinned patient with acne really well advised to abandon soap ? Is it obvious that a wound should be kept well coveredif, for instance, it is a grazed knee ? Is it true that tonsils perform no useful function and that if they are deemed to be infected " nothing but good is likely to follow their removal " -at 5 years old ? And is it well to present to patients the " doubtfully valid concept of stress diseases " ? all on it how literally the reader interprets Perhaps depends what he reads. The book’s general attitude is sane and healthy.
help
Results of
Surgery
for
Peptic Ulcer
Editors: R. W. POSTLETHWAIT, M.D.; JAMES C. THOROUGHMAN, M.D. Philadelphia and London: W. B. Saunders. 1963. Pp. 308. 56s.
THIS
monograph presents a commendable study by a group of surgeons aiming to assess treatment of peptic ulcer (here used as a compendium term for gastricand duodenal ulcers) and its complications in the light of real facts. The work is based on a planned investigation with punch cards compiled from a formidable protocol. The outcome is a book packed with information and comparative statistics. It will be enhanced when a prospective survey, limited to duodenal ulcer and now being undertaken by surgeons in 19 hospitals, has been completed. This book gives an example of intelligent, planned clinical research. Immunity to Protozoa (Symposium of the British Society for Immunology. Oxford: Blackwell Scientific Publications. 1963. Pp. 359. 70s.).-Many doctors connect the development of immunity to infection with the response to bacteria, and possibly viruses, hardly including protozoa in their list of antigens. Yet Koch and Celli studied immunity against malaria as far back as 1900, though admittedly Celli did not succeed in his attempt to demonstrate antimalarial activity in the serum of patients recovering from this disease. Perhaps the recent work on gamma-globulin in protozoal diseases has contributed greatly to the wider acceptance of protozoal immunity as a phenomenon open to scientific study. Not since W. H. Taliaferro published in 1930 his Immunology of Parasitic Infections has there been a volume, such as this, devoted entirely to the immunity against protozoa: it is an account of a symposium of 28 experts, edited by Prof. P. C. C. Garnham, Dr. A. E. Pierce, and Dr. I. Roitt. An introductory section has contributions from Garnham and Taliaferro, and the rest of the book is divided into two sections-on immunity to blood and to tissue protozoa. As R. R. A. Coombs points out in a foreword, protozoal diseases differ from bacterial and virus infections in the resourcefulness with which the larger pathogens outwit the
defences of the host. The trypanosomes often change their antigenic properties and leishmania live successfully in the " very arsenals of the immune responses ". On the other hand, man has, for example, protected himself by developing the malaria-" fast " sickle-cell haemoglobin. This book is a fascinating account of the battle of man and of some animals against their protozoal diseases.
Choosing Toys for Children (London: Tavistock Publications. 1963. Pp. 127. 12s. 6d.).-Anyone who has to buy toys for children will value this book by Stan Hegeler, for it contains sensible lists of suitable toys divided according to the price of the toy and the age of the child. These lists contain many useful suggestions for parents and others; and there is a comprehensive and original list of toys suitable for sick children of different ages. It follows a short but excellent chapter on play for sick children. Most of the book is devoted to showing the practical importance of toys rather than to theoretical discussion of the nature and purpose of children’s play. The emphasis throughout is on simple toys that children like at different ages, and there is also a brief and fascinating history of toys. Altogether a useful book, and one which should solve for ever the problem of what to buy for a particular child. Parasitism (St. Lucia, Queensland: University of Queensland Press. 1963. Pp. 145. 35As.).-This book by Prof. J. F. A. Sprent, which we reviewed on Nov. 30, is published in this country by Bailliere, Tindall & Cox at 22s. 6d.
New Inventions CANNULA INTRODUCER IN haemodialysis the establishment of a bypass entails the cannulation of small arteries, such as the radial or anterior tibial, and as large a cannula as the artery will take is needed to obtain a good flow of blood. In introducing the cannula the intima may be stripped and the vessel wall may be torn, especially if there is atherosclerosis. To avoid these complications, and to make the procedure easier and more expeditious, a small introducer was designed. The introducer is made of stainless steel, and consists of two tapering curved blades held together by a light spring-loaded
handle resembling a Thudichum nasal speculum. The blades are introduced for about 0-5 cm. into the artery (depending on the diameter of the vessel) through an arterotomy incision, and the cannula is then inserted between the blades (see figure). The spring handle holds the blades apart and dilates the bloodvessel walls. The introducer is then pulled out between the cannula and the arterial wall. I am indebted to Messrs. Chas. F. Leeds. for makine the instrument. Renal Research Unit and Department of Urology, General Infirmary,
Leeds,
1
Thackray Ltd.,
Park Street,
MILES Fox Manc., P.R.C.S.
CH.M.