BOOK REVIEWS 551 



grade processes are treated in a masterly and deservedly extended 

 fashion. The section on Tumors, comprising approximately one-third 

 of the book, is a remarkable monograph which presents a summary of the 

 author's own extensive material basis on which his mature and deserv- 

 edly respected opinion is based. The treatment of this phase, impor- 

 tant as it is from a diagnostic standpoint, seems disproportionate for 

 the needs of beginning students of disease processes however valuable 

 it may be for the specialist. The second part dealing with Special 

 Pathologic Histology is on the other hand somewhat short for general 

 needs, and lays unusual emphasis on those rarer lesions which have 

 happened to attract the author. 



From the larger standpoint of pathology as a study of the natural 

 history of disease the book represents an unfortunately restricted atti- 

 tude. In studying disease we are of course interested in studying the 

 cause and progress as well as the result produced. In the infectious 

 diseases of known causation the entire course of the process can be fol- 

 lowed, particularly with the aid of animal experimentation. Much can 

 be learned concerning the progress of a disease if an approximately com- 

 plete set of lesions is gathered by the diligent collector at the autopsy 

 table, provided always that the successive stages be subsequently fitted 

 into their proper places. Much more rapidly and certainly can a 

 chronological series be prepared by injecting the specific microoorganism 

 into a suitable animal. To Mallory "recourse to animal experimen- 

 tation has often served to confuse a subject rather than to simplify and 

 clear it up." Experimentation unfortunately requires a certain type of 

 ingenuity and the power of inductive reasoning in addition to the de- 

 ductive reasoning required by the collector. The author has correctly 

 stated that from a study of lesions alone "we are in a position to read 

 the process (of disease) backward with some degree of certainty." It 

 is profitable that the life work of a group of individuals should center 

 in pathology as viewed from this essentially Chinese angle, but it is 

 inexcusable that the work of the growing majority who choose to follow 

 pathology forward rather than attempt to read it backward should not 

 at least be recognized. 



This failure to recognize the essentially dynamic functional view- 

 point of disease has led Mallory into numerous errors in treating of the 

 infectious diseases. Bacterial causation he recognizes in so far as bac- 

 teria may be fixed and stained, but failure to utilize or even absorb the 

 experimental viewpoint has led to numerous unlikely hypotheses. Prac- 

 tically all bacteria are stated to act by the production of a "toxin" of 

 greater or less strength as judged by the response of fixed cells; anti- 

 toxins are asserted to be formed in typhoid fever and indeed they are 

 said to be formed in the so-called "endothelial leucocytes." It is need- 

 less to state that there is no experimental evidence for a statement of 

 this sort. The very name of "endothelial leucocytes," for the de- 

 scription of which Mallory is properly appreciated, is probably inexact 

 if we are to accept their origin from connective tissue as shown by 

 Evans in his work with vital stains. For his insistence on the objec- 

 tivity of lesions we have only to thank Mallory, but it is unfortunate 

 that he has not employed his imagination in experunental verification 

 of his working hypotheses. 



F. P. Gay, 



