General and Plastic Surgery

CORRESPONDENCE much in this summary to interest a student of visual theory. For example, the variations among different subjects with normal color vision in the position of the spectral zone for pure yellow are plausibly accounted for by supposing the existence of an individually varying proportion of the number of receptors for red aand for green combined with a mass action giving more weight to the central impression of a fundamental color component when the number of its excited receptors is greater. Furthermore the perception by a congenitally yellow-blueblind observer (the famous case of Alrutz) of the short-wave end of the spectrum as "red with black spots" may be explained in the same way. Even the highly elaborated theory of Miiller does not seem to do quite as well on these points. D. B. Judd. GENERAL AND PLASTIC SURGERY. By J. Eastman Sheehan, M.D. 1st Edition, clothbound, 345 pages, 495 illustrations. New York and London, Paul B. Hoeber, Inc., 1945. Price $6.75. This book, which is the fifth in the career of the author, is not primarily a text for ophthalmologists but rather a treatise on general surgical techniques with an emphasis on war injuries. The first four chapters deal with the agents which produce war wounds, the nature of such wounds, wound excision, and the control of wound infection. The author points out that prior to World War II, reliance was placed chiefly on bactericidal action, but after the power of the sulfonamides to induce bacteriostasis was demonstrated, attention has centered on this later method. Some space is devoted to the use of sulfonamides and penicillin. Chapter five deals with the subject of burns and their treatment. It is

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encouraging to note that he recommends that the tannic-acid treatment be abandoned and the wound be treated as an open wound with special attention to the elimination of infection and replacement of lost skin as early as possible. The major portion of the text is devoted to the care of wounds, and an attempt has been made to cover the whole field of surgery. The section on wounds of the face includes wounds of the orbit, and the discussion on reparative procedures about the eyes is brief and incomplete. The chapter on tissue replacement demonstrates the different types of skin flaps and classifies skin grafts on the basis of their thickness. Some attention is devoted to the Padgett dermatome, and there is a discussion of plasma and white-cell fixation of grafts and the use of other materials for plastic repair. The last two chapters are devoted to the healing of wounds and elaboration on the details of surgery for repair of the nose, the mouth, facial contours, the eye, and the ear. The illustrations, which are numerous, consist chiefly of line drawings, and there is a tendency to oversimplification. The book is interesting and contains much informative material but it is not comprehensive enough to be classified as a complete reference book on modern operative methods. No one can be experienced and well informed in the whole field of surgery, and, in our present day of specialization, the need is for books which cover a small field thoroughly rather than those which cover the whole field inadequately. Irving Puntenney.

CORRESPONDENCE PRESBYOPIA ASSOCIATED WITH ALTERNATING SQUINT

Editor, American Journal of Ophthalmology: