Reviews of Books

825

merely to the depletion of susceptibles by the initial epidemic wave. If transmission of the kurugenic agent is becoming less common, or if the agent now induces immunity rather than initiating the kurugenic process, then we can expect a continued fairly rapid decline in the number of kuru cases. Otherwise, in the endemic situation, the further decrease in kuru incidence may depend mainly on genetic mechanisms, and it will

be due

be slower than has hitherto been observed. The nature of the kurugenic agent is still unknown. Although a kuru-like syndrome has been transmitted to chimpanzees,8 the agent has yet to be fully characterised. The theory that the kurugenic process may be initiated during the female reproductive span does not necessarily imply that females first meet the agent at that time of life. Nevertheless, the question of sexual transmission ought

Reviews of Books Pathology

of the

Kidney

ROBERT H. HEPTINSTALL, M.D., associate professor of pathology, Johns Hopkins University School of Medicine, and pathologist to Johns Hopkins Hospital, Baltimore, Maryland. London: J. & A. Churchill. Boston: Little, Brown. 1966. Pp. 836.

E10;$28.50. MUCH of renal pathology has been controversial and speculative, partly because past descriptions based on necropsy findings often represented late stages and processes common to various conditions. Newer methods of study-especially serial renal biopsy-combined with new functional data have disclosed early and intermediate processes and patterns. This has not abolished controversy but has raised it to a higher level of understanding. Dr. Heptinstall, well known as a renal pathologist, draws together the old and the new in a critical and constructive fashion; ideas and classifications are revised and imperfections in knowledge are pointed out. Most space is sensibly given to the more common diseases of the kidney. Dr. J. M. Kissane contributes two excellent chapters on development and congenital malformations, and the chapter on renal transplantation by Prof. K. A. Porter is masterly. The numerous illustrations are of high quality, and each chapter has a good bibliography particularly useful for the specialist. Altogether, this is an excellent work, one of the best on renal pathology in the English language. It should become a standard source for the general pathologist. By British standards the price is high, and this will limit its private sale; but all medical libraries will want to have copies.

Cancer In the Cape Division, South Africa A Demographic and Medical Study. J. MUIR GRIEVE, M.B., D.M.R.E., F.-.R., scientific director, International Cancer Centre Project, Neyyoor, South Africa. London, New York, Toronto: 510-.,$17-60 Oxford University Press. 1967. Pp. 90.

(U.S.A.);$18-50 (Canada). THIS is an account of the incidence and types of cancer in the various racial groups, as defined by legislation, of the Cape Division, and as such should present interesting and important material. That it fails to do so is due to the style and format and to the inadequacy of the discussion. The material presented is very incomplete, but 27 tables, more detailed than any other in the text, are available at cost on application to the author ". While some of these tables are of interest only to statistical devotees, they include those giving such basic data as the primary cancers by site and age for the six population groups considered and the observed crude annual cancer incidence-rates for these populations by site and age and for the sexes. The survey was made in 1956-59, the foreword is dated December, 1965, and book has appeared in 1967. Of the 61 references (which include many dealing with racial origins and problems of South Africa), only 6 are to publications later than 1963. Nonetheless, behind the inadequately "

seriously considered.1920 There is a significant tendency for successive wives of Fore men to die from kuru,12 14 but the significance of this, even in lowincidence areas, needs to be assessed carefully. to

be

I thank the director of public health for permission to publish this paper, Sir Macfarlane Burnet, Dr. David Danks, and Dr. R. W. Hornabrook for helpful comments and criticism and Dr. 1. R. Mackay, Prof. R. J. Walsh, and Dr. I. Maddocks for reviewing a much earlier draft of this paper. The Department of District Administration, Okapa, made census returns available. Dr. Michael Alpers provided some early kuru statistics. Prof. J. H. Bennett and Dr. R. M. Glasse and Mrs. Shirley Glasse have provided copies of their genealogies for reference. Kuru Research

Office,

Department of Public Health, Okapa, Eastern Highlands, New Guinea 19. 20.

J. D. MATHEWS M.B.,

B.SC.

Melb.

McGill, H. 1964. Unpublished. Danks, D. 1966. Unpublished.

presented material, the often confusing and ill-arranged tables, and the turgid inchoate writing are interesting observations which will make this required reading for cancer demographers. Comparisons are made with the U.S. white and non-white populations and with the Norwegian urban and rural populations. The Bantu population is small and composed mainly of migrant males. Leukaemia in Bantu children is apparently rare. (No mention is made of Burkitt’s lymphoma, though this has been seen in Cape Town). Breast carcinoma is more anaplastic in coloured and Bantu females. Bantu colonic cancers are chiefly right-sided. Colonic cancer is less common in all communities than in Britain or the U.S.A., but lung in males both amongst coloured and whites is more than in the U.S.A. Skin and lip cancer are major problems of the whites. Once again it can be seen how differences in the incidence of cancer of all types are determined by environmental factors. cancer

common

Pulmonary and Bronchial Vascular Systems Their Reactions under Controlled Conditions of Ventilation and Circulation. I. DE BURGH DALY,C.B.E.,inM.A., M.D., F.R.C.P.,ofof the F.R.S., formerly University professor of physiology oftheAgricultural Birmingham andofInstitute Edinburgh,ofandAnimaldirector Research Council Babraham, Physiology, the CATHERINE head

HEBB, Research Cambridge, Council Institute of physiology, Agricultural

of M.A., PH.D., departof Research Council Institute of Animal Physiology, Babraham. London: Edward Arnold. 1966. Pp. 432. 90s. ment

THIS latest monograph of the Physiological Society is devoted to the thesis that the capacity and resistance of the lung vessels are actively controlled by both nervous and humoral agencies. The book begins with sections on the structure of the lung, its blood-vessels, and their innervation. These are followed by a chapter on criteria for the demonstration of primary pulmonary vasomotor responses. The remainder of the book brings together a great deal of experimental work on the active responses of the lung bloodvessels to various stimuli, much of it from the authors’ own work. The responses to hypoxia and hypercapnia and to drugs-particularly acetylcholine and the catechol aminesare discussed, and there is a chapter on pulmonary vascular reflexes. An appendix describes experimental procedures, particularly those concerned with perfusion of the isolated lung. The authors present a strong case for neurohumoral control, and the discussion is critical and thorough. Relatively few of the references are to work published after 1961. This is particularly unfortunate because of the important advances of the past five years, such as the recognition of the major effect of alveolar pressure on pulmonary blood-flow in some circumstances, and the effect of gravity on the lung. It is a pity, too, that the discussion of the influence of mechanical factors on blood-flow is brief and somewhat superficial since, in practice, these factors often dominate the pressure-flow relations of the lung. But the central theme-active neurohumoral control of the pulmonary circulation-should earn this book a place in every medical-school library. p3

826 Inheritance of Drinking Behavior A Study on Intelligence, Personality, and Use of Alcohol of Adult Twins. Alcohol Research in the Northern Countries: vol. XIV. JUHA PARTANEN, KETTIL BRUUN, TOUKO MARKKANEN. Helsinki: Finnish Foundation for Alcohol Studies. 1966. Pp. 159. Hard cover: Sw. kr.28;$5.50. Soft cover: Sw. kr.23;$4.50.

THIS volume contains an interesting and critical report on twin study concerning the inheritance of use of alcoholic beverages. 902 male twins, aged 28-37 years, from all parts of Finland were investigated in an attempt to evaluate the relative importance of hereditary and environmental influences. The main questions which the authors set out to answer were the extent to which hereditary influences determine whether an individual drinks or abstains from alcoholic beverages; and, in the case of the drinker, the extent to which such influences determine his drinking habits and his possible addiction to alcohol. Briefly, this study shows that hereditary factors to some extent influence drinking habits (i.e., whether, how often, and how much one drinks); but these factors seem to have no bearing on the development of social complications of drinking or on the development of addictive symptoms. The authors point out that twin studies, even if carried out under ideal circumstances, are subject to many uncertainties, and stress the particular circumstances which characterise drinking habits and attitudes in Finland: a relatively low overall level of consumption with relatively heavy drinking on special occasions, and the orientation of Finnish society towards extensive social control. The authors conclude that, because other countries may chose other criteria of " alcoholism ", the results may not necessarily hold good outside Finland. a

Hormones and Connective Tissue Editor: GUSTAV ASBOE-HANSEN, M.D., professor of dermatology and venereology, University of Copenhagen. Copenhagen: Munksgaard. 1966. Pp. 431. Dan. Kr. 103.

TWENTY authors, all affiliated to the University of Copencontribute the seventeen chapters of this book. Most of these are usefully critical, and it is salutary to read that " the differences in effect between the numerous cortisone analogues that have been produced have been of commercial rather than scientific importance. They have contributed nothing to the understanding of the basic mechanism of the cortisone effect ". How important is an understanding of this basic mechanism can be inferred from the series of calamities described by Dr. Lis Zachariae in her chapter on Side Effects and Erroneous Indications for Clinical Use. Other contributions include one by Dr. Henrik Poulsen on Thyrotrophic and Thyroid Hormone Control of the Inner Ear with Special Reference to Myxoedema and Meniere’s Disease; this must surely be the best account of this important, if somewhat esoteric, subject. The book is well produced, in remarkably good English. Illustrations are adequate, and several are in colour. In all, this is a valuable addition to the literature of both endocrinology and connectivetissue pathology.

hagen,

Peripheral Arterial Disease Vol. IV in the Series Major Problems in Clinical Surgery. WILEY F. BARKER, M.D., professor of surgery, University of California, Los Angeles, School of Medicine. London and Philadelphia: W. B. Saunders. 1966. Pp. 229. 59s. 6d.;$8.50.

THE scope of this attractive new book is smaller than its title might suggest. Its main theme is occlusive disease of the lower extremities-a subject on which the author has made important personal contributions. It is perhaps a pity that so much space is taken up by descriptions of operative detail-an arrangement which lowers the level of analysis so well set in the earlier physiological and rheological sections. The selection of nearly 400 references ranges far wider than the subject of the text. This book is noteworthy for the many bright gems of wise comment which should bring encouragement and warning at the proper times to the new vascular surgeon, and which tell of long and close experience to the old hand.

Tumors of Endocrine Glands and Secondary Sex Organs AGNES B. RussFmLD, Children’s Cancer Research Foundation and the department of pathology, Harvard Medical School, at the Children’s Hospital, Boston. Washington, D.C.: U.S. Department of Health, Education and Welfare, Public Health Service. 1966. Pp. 148.$3 (cloth).

THIS is a book for the cancer research-worker rather than the general reader. It includes a considerable amount of information on the production and effects of tumours of endocrine and secondary sex organs in animals. Deliberately, no reference is made to man; and attention is drawn to clear species differences in the induction and effects of these neoplasms and the danger of extrapolation of knowledge from one species to another. It is hoped, however, that a study of the metabolism and enzymology of these tumours in animals may make it possible to predict the behaviour of some human

neoplasms by histochemistry of surgical or biopsy specimens. The volume brings together much information formerly obtainable only by painstaking search. Osler’s Textbook Revisited

Reprint of Selected Sections with Commentaries. Editors: A. McGEHEE HARVEY, professor of medicine, and chairman, department of medicine; VICTOR A. McKusICK, professor of medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. New York:Appleton-Century-Crofts. 1967. Pp. 361.$6.75. FROM September, 1890, to January, 1892, Sir William Osler devoted much of his time to writing the Principles and Practice of Medicine. He was then professor of medicine and physicianin-chief at the newly opened Johns Hopkins University and Hospital. The book played a leading role in the training of at least two generations of physicians and had an influence far beyond the direct one on medical practice. It was a landmark in medical literature. It had high literary quality. Reprinting it in part is of itself valuable and most interesting. Here 17 sections have been reproduced photographically from the 1909 edition, the last one he wrote unaided. Each is followed by an admirable commentary by a contemporary expert, in clearly different type, evaluating Osler’s presentation and surveying developments in subsequent years. It is good to read again the historical resume with which Osler introduced most sections, reflecting his great interest in, and sense for, history. These, together with the new commentaries, make an effective history of each disease. All sections show that, at the level of clinical and pathological description of the natural history of disease, the text was wonderfully accurate. Nothing substantial has been added since Osler’s 7th edition in 1909. What has been added to our understanding is mainly in the realms of aetiology, pathogenesis, and treatment. This revisitation is a fascinating experience. The commentaries show over and over again what a genius William Osler was.

New Editions

Carleton’s Histological Technique.-4th ed. Revised and rewritten by R. A. B. Drury and E. A. Wallington. London, New York, Toronto: Oxford University Press. 1967. Pp. 432. 60s.;$13.75;

$10.50 (Canada).

Tropical Diseases-2nd ed. By Frederick J. Wright and James P. Baird. (Supplement to The Principles and Practice of Medicine, 8th ed. edited by Sir Stanley Davidson.) Edinburgh: E. & S. Livingstone. Baltimore: Williams & Wilkins Co. Toronto: Macmillan Company of Canada. 1967. Pp. 176. 10s. 6d.;$1.90 (Canada). Fundamentals of Immunology-4th ed. By William C. Boyd. London: John Wiley & Sons. New York: Interscience Publishers. 1966. Pp. 773. E6;$14.95. An Outline of Bacteriology and Immunity.-3rd ed. Hare. London: Longmans. 1967. Pp. 472. 50s.

By Ronald

An Atlas of Bone-Marrow Pathology.-3rd ed. By M. C. G. Israels. London: William Heinemann. 1966. Pp. 84. 50s.