NEAT RE 
73 
THURSDAY, MAY 25, 1899. 
RECENT WORKS ON MEDICAL SCIENCE. 
t. The Administrative Control of Tuberculosis. Being 
the Harben Lectures delivered in 1898, before the 
Royal Institute of Public Health, by Sir Richard 
Thorne Thorne, K.C.B., F.R.S. Pp. 73. (London: 
Bailliére, Tindall, and Cox, 1899.) 
. Die Bedeutung der Retze fiir Pathologie und Therapie 
tm Lichte der Neuronlehre. Von Dr. A. Gold- 
scheider. Pp. 88. (Leipzig: Barth, 1898.) 
Twenty-seventh Annual Report of the Local Govern- 
ment Board, 1897-98. Supplement containing the 
Report of the Medical Officer for 1897-98. Pp. 331. 
(London : Her Majesty’s Stationery Office, 1898.) 
4. The Natural History of Digestion. By A. Lockhart 
Gillespie, M:Di; F-R-€.P., F.R.S. (Ed.) Pp. 427. 
“Contemporary Science Series.” (London: Walter 
Scott, Ltd., 1898.) 
. Diet and Food considered in Relation to Strength and 
Power of Endurance, Training and Athletics. By 
Alexander Haig, M.A. and M.D. (Oxon.), F.R.C.P. 
Five Illustrations. Pp. 86. (London: J. and A. 
Churchill, 1898.) , 
On Centenarians and the Duration of the Human 
ace. Byeteee.svouns, B.A., WoRTAUSoeePp, 145. 
(London: Charles and Edwin Layton, 1899.) 
rip HE subject-matter of the Harben Lectures, of 
which the book before us consists, is at the 
present time of special interest, not only to the medical 
profession, but to the general public. The country is 
now thoroughly roused to the importance of the control 
of tuberculosis, and although the measures considered in 
Sir R. Thorne Thorne’s book are intended primarily for 
sanitary officials, they should prove of extreme interest 
and importance to both the general practitioner and the 
agriculturist. 
In the first lecture, the author emphasises the fact that 
while of recent years the death-rate from pulmonary con- 
sumption has very greatly diminished, no corresponding 
diminution has been observed in the number of deaths 
due to tubercular lesions of the alimentary tract. The 
difference <etiologically between these two classes of 
cases consists mainly in the air being the source of 
infection in the former, and the food in the latter. 
The enormous improvement in the arrangement of 
wN 
us 
ue 
6. 
dwelling-houses and streets with regard to ventilation | 
facilities and drainage suffices to explain the diminu- 
tion in the phthisis death-rate. According to the author, 
the absence of improvement with regard to meat and 
milk supply goes far to account for the death-rate re- | 
maining stationary in tubercular disease of the digestive 
tract. The foods which, for the most part, are the sources 
of tubercular infection are meat and milk. So far as 
concerns meat, which is far the less important of the 
two, the author advises the establishment and exclusive 
use of public slaughter-houses under administrative | 
control. In these slaughter-houses experts could decide 
to what extent the flesh of tuberculous beasts was unfit 
NO. 1543, VOL. 60] 
for human food. It is interesting in this connection 
to note that beasts bred in confinement—z.e. with a 
diminished fresh air supply—are most frequently the 
subjects of tuberculosis, the disease in wild animals 
being very rare. 
The second lecture is practically devoted to the con- 
sideration of milk as a source of tubercular infection. 
The vast majority of cases of tabes mesenterica 
(tubercular disease of the intestines) occur at precisely 
that period of life which corresponds to the maximum 
milk consumption, viz. early childhood. The deaths 
under one year of age, returned as due to this cause, 
amounting to no less than 1'046 per million births. 
This, according to the author, is in great part due to the 
prevalence of tuberculosis among milch cows. In’ 
England and Wales there are 2,100,000 milch cows, and 
of these 525,000 are tuberculous. The rejection of al 
tuberculous cows is impracticable. The administrative 
control of cow-houses, especially with regard to the 
amount of cubic space per cow, would, according to the 
author, greatly lessen this appalling amount of disease. 
So long as the cow-house remains filthy, the burnished 
cleanliness of the dairy is unavailing. 
The third lecture discusses the gros and cons of the 
compulsory notification of phthisis, and is of less interest 
to the readers of NATURE, although of profound im- 
portance to the expert. 
The space at our command has only enabled us to 
touch upon a few of the many interesting points in these 
lectures. A thorough perusal of them will repay both 
the general and the special reader. 
2. This book is an interesting monograph devoted to the 
study of the importance of stimuli of various kinds in 
different disorders of the nervous system. The author’s 
contention is that the effect of the various stimuli, such, 
for instance, as massage, friction, electric stimulation, &c., 
which are now used very generally therapeutically, can 
be explained physiologically, and therefore that these 
methods must be regarded as part of the legitimate 
repértotre of the physician. 
The first chapter is devoted to the physiology of the 
subject. The author adopts the neuron theory of the 
nervous system, and goes a step further in that, according 
to him, each anatomical unit is also a unit physiologically. 
The unit of nerve activity he terms the neuron wave 
(Neuronschwelle). Chapter 11. treats of the pathological 
changes in the neuron waves. A relatively small part of 
the book is devoted to the explanation of how external 
stimuli, applied with a therapeutical object, act in certain 
cases of hypereesthesia and paralysis. The author 
thinks that the effect of external stimuli in these con- 
ditions is not entirely explained by merely assuming 
that they form the afferent impulse of a vascular reflex 
action, but that they also act by disturbing in one or 
other direction the equilibrium of the excitations 
(Erregungen) at the time existing in the nervous system. 
In conclusion, the author considers that the varied phe- 
nomena occurring as the result of so-called “suggestion” 
are all explicable upon this “physiological neuron ” 
hypothesis, and hence are robbed of any mysticism 
which, from a legitimate medical practice standpoint, 
seriously restricted the use of this method. 
The monograph is to the general physiological reader 
E 
