i 7 2 SCIENCE PROGRESS 



have been considerably amplified and numerous illustrative cases, both experi- 

 mental and clinical, have been added. 



Although confessing at the outset that the primary cause of the symptom- 

 complex, which is known as Wound Shock, is still obscure, the author has none 

 the less rigidly adhered in his researches to the consideiation of the treatment of 

 the condition. A mass of evidence, both clinical and experimental, is brought 

 forward to show that the most important physical sign in Wound Shock is the 

 lowering of the blood pressure. The question of "acidosis" is discussed at some 

 length, but much of this section is of necessity somewhat technical and will be lost 

 on the average reader. The results obtained by the intravenous injections of acid 

 solutions are striking, but the author does not allow himself to be "side-tracked" 

 from his original purpose in order to follow up this subject. 



From the evidence which Prof. Bayliss brings forward it is clear : (i) that cases 

 of Wound Shock with a low blood pressure — and that includes the vast majority- 

 are greatly benefited by the intravenous injection of gum-saline ; (2) that the rise 

 of blood pressure so produced is permanent ; (3) that the only cases which fail to 

 react satisfactorily are those in which the condiiion has been present for so long a 

 period that the vaso-motor centres have become paralysed. That being the case, 

 it is rather disappointing to find that clinicians have not had correspondingly good 

 results in cases of Post-operative Shock treated by this method. 



As the reader follows the author's argument as to the rationale for the means 

 to be taken to restore the blood pressure to the normal, he will be apt to overlook 

 the brilliant character of the work, so logical and so, apparently, obvious is the 

 author's reasoning. 



The views and results of other workers are frequently given, and the references 

 to the literature included at the end of the book are as complete as they are 

 valuable. T. B. J. 



* 



The Statics of the Female Pelvic Viscera. By R. H. Paramore, M.D., 

 F.R.C.S. [Pp. xviii + 383, with 26 illustrations, including 23 plates.] 

 (London : H. K. Lewis & Co., 1918. Price \%s. net.) 



The main purpose of this work is to emphasise the practical functional importance 

 of the musculature of the pelvic floor. In the author's view, the pelvic viscera 

 are retained in place by the interaction of the downward pressure exerted, through 

 the abdominal to the pelvic viscera, by the diaphragm and the muscles of the 

 abdominal wall, on the one hand, and the muscles of the pelvic floor on the other. 

 Consequently, he does not rate the ligaments of Mackenrodt and the other 

 localised thickenings of the pelvic connective tissue as of primary importance for 

 the support of the pelvic viscera. The author strongly opposes the views recently 

 expressed by leading gynaecologists, notably by Fothergill, and does not hesitate 

 to break a lance with certain anatomists. The morphology of the levator ani 

 muscle is discussed in a very convincing manner, but the suggestion that partial 

 regression occurred " because the visceral pressure in the pelvis at some time 

 during evolution became too great for the muscles" (p. 350} is open to too many 

 objections to be considered satisfactory, as the author himself seems to suspect 



(P- 353). 



Unfortunately, there is a tendency to prolixity in the earlier chapters, and the 

 author's penchant for long sentences and parentheses may tend to prejudice the 

 unbiassed reader against the views brought forward, which are none the less 

 eminently sound and supported by evidence which opponents will have great 

 difficulty in controverting. 



