REVIEWS 693 



In more detail, we may refer to the treatment of one of the common objects 

 of the post-mortem room, the " nutmeg liver," which occupies just one page 

 (pp. 456-7). In the first place, in discussing the aetiology, the assumption is 

 tacitly made that any condition within the thorax which obstructs the return of 

 blood to the right heart must necessarily raise the blood-pressure in the branches 

 of the hepatic vein within the liver, and consecutively the ultimate destruction 

 of liver-cells is attributed to pressure. No mention is made here of the 

 possibility, at least as much in accordance with the observed facts, that the liver- 

 cells are killed by an imperfect blood-supply due to slowing of the blood-stream, 

 though there is a passing reference to this effect on page 29. The cut surface of 

 the liver is said to "resemble that of a nutmeg," and the cells in the peripheral 

 zone of the lobules are described without qualification as being fatty. 

 Both these statements are frequently untrue : fortunately the ordinary student 

 will see "nutmeg livers" so often that he will probably be able to find this 

 out for himself. The picture given to illustrate the condition is extraordinarily 

 bad and we know of at least one intelligent student who was for some time in 

 doubt as to whether it represented a macroscopical or a microscopical view. 

 It is, in fact, macroscopical, and there is no illustration of the minute anatomy. 

 Contrasting with this, we find an equal space of one page (p. 502) devoted to 

 two illustrations of a growth of the pancreas of which — so says the text — only 

 two cases have been described, and which is of the smallest theoretical interest. 

 Nearly two pages with four illustrations are given up to the rare condition 

 blastomycetic dermatitis, which is of importance only as showing that this kind 

 of organism may be pathogenic in man. The whole pathology of the teeth is 

 finished off in a page and a quarter. 



From the student's point of view, perhaps the most serious drawback is the 

 imperfection of the illustrations. They are rather few in number, often ill- 

 chosen and in many cases the execution is not above criticism. In the section 

 on the eye, for example, there are six illustrations : two are bacteriological, two 

 histological (one of these is of a curiosity) and two are photographs of patients. 

 To illustrate the pathology of the skin, there are three plates and twenty-nine 

 figures in the text : nine figures illustrate parasites or histological sections, while 

 the plates and twenty text illustrations are given up to pictures of patients. 

 With the fullest appreciation of the range of knowledge which our science 

 embraces, we cannot allow that such illustrations are appropriate to a text-book on 

 pathology, especially when they are present to the exclusion of such pictures as 

 would assist the student to interpret the naked-eye appearances in terms of the 

 essential cellular changes which underlie them. There is, for example, a picturesque 

 plate of a negro with white spots, but nothing to show the histological changes 

 in any of the common forms of dermatitis. The pictures themselves would be 

 admirable in a clinical treatise on dermatology but they are altogether out of place 

 here. On a rough enumeration, just one-fifth of the 310 illustrations are essentially 

 clinical. This tendency culminates in a table (p. 905) of differential diagnosis of a 

 variety of diseases of the breast by their clinical signs and symptoms, and the only 

 illustration having reference to the important subject of mammary cancer is a 

 horrible plate showing a patient with " neglected carcinoma of heart." The con- 

 trast is very striking in this respect between the present volume and two text-books 

 of pathology published last year — Beattie and Dickson's Special Pathology and the 

 Lehrbach edited by Aschoff : in both of these the illustrations are conspicuously 

 good. 



Disappointment is apt to exasperate, and it is no doubt disappointment of the 



