316 
account of the venous pulse he raises difficulties 
which are really due to the attempt to make a minute 
comparison between the results of two methods, one of 
which is accurate to one-thousandth of a second, and 
the other only to one-twentieth of a second. By the 
optical method we can obtain very accurate records of 
the intra-auricular pressure. These show small eleva- 
tions of pressure, one due to the contraction of the 
auricle, the second to the beginning of the ventricular 
systole and the sharp closure of the auriculo-ventricular 
valves, and the third to the accumulation of blood in 
the auricle during the continued contraction of the 
ventricle. A tracing of the venous pulse in the neck 
taken with a polygraph also shows three elevations 
which must have a similar causation. The middle one 
has been called the ‘ carotid pulse’ by Mackenzie, and 
was ascribed by him to the pulse in the carotid trans- 
mitted to or through the jugular vein. This extraneous 
element in the venous pulse may possibly be often 
present in the tracings taken by this method, but it is 
really of not much importance whether it is external or 
whether it is due to the propagation of the wave of 
pressure which occurs in the auricle at the beginning of 
systole. Within the limits of error of the apparatus the 
“ce? wave may serve to mark the beginning of the 
ventricular systole, since it occurs either at the very 
beginning or within two-hundredths of a second 
afterwards. 
In his description of ‘tone’ as applied to the heart, 
the author, in common with many clinicians and guided 
by the physiology of a few years ago, takes a view 
which I believe is erroneous. He describes tone as 
resistance to distension and therefore as a property 
which comes into play during diastole to prevent over- 
distension of the heart. Such a property would hinder 
rather than further the action of the heart pump. The 
filling of the heart is determined by the inflow. If the 
inflow increases, the rate of the heart (in the intact 
animal) increases pari passu so that this organ shall 
not be too distended. To prevent over-distension the 
strong fibrous sac of the pericardium is provided. It is 
important that the heart during diastole should present 
as little resistance as possible to distension, since any 
resistance would cause a rise of venous pressure and 
impede the circulation. If we examine the clinician’s 
idea of a heart with good tone, we find he is really speak- 
ing of a heart with good contractile power, z.e. one which 
contracts strongly and empties itself, or nearly so, at 
each beat. The ‘tone’ would be measured rather by 
the systolic volume than by the diastolic volume of the 
heart. The term, however, is so ambiguous and has 
given rise to so much confusion that it would be better 
not to employ it at all in connexion with the heart. 
There are certain other points which one might 
NO. 2784, VOL. 111] 
NATURE 

[Marct 10, 1923 
criticise, such as the part ascribed to the capillaries in ~ 
the maintenance of the normal resistance of the circula- 
tion, as well as the mechanism of the absorption of drugs 
administered subcutaneously. But it is on account of 
its point of view that Dr. Sainsbury’s book is useful 
and can be recommended to students. It might, indeed, — 
be set to senior students as a Subject of commentary 
and criticism from a physiological standpoint. If they 
could take the habit of mind of the author with them 
into the wards, their training in physiology would not 
have been in vain. E. H. STARLING. 

Normal and Abnormal Psychology. 
(1) Beyond the Pleasure Principle. By Dr. Sigm. 
Freud. Authorised translation from the Second 
German edition by C. J. M. Hubback. (The Inter- 
national Psycho-Analytical Library, No. 4.) Pp. 
v+go. (London: G. Allen and Unwin, Ltd., 
1922.) 6s. net. 
(2) Fundamental Conceptions of Psychoanalysis. By 
Dr. A. A. Brill. Pp. viit+344. (London: G. Allen 
and Unwin, Ltd., 1922.) 12s. 6d. net. 
(3) Studies in Psychoanalysis ; An Account of Twenty- 
seven Concrete Cases preceded by a Theoretical Ex- 
position. By C. Baudouin. Translated from the 
French by Eden and Cedar Paul. Pp. 352. (London : 
G. Allen and Unwin, Ltd., rg22.) res. 6d. net. 
(4) Medical Psychology and Psychical Research. By 
Dr. T. W. Mitchell. Pp. viit+244. (London: 
Methuen and Co., Ltd., 1922.) 7s. 6d. net. 
(5) The Measurement of Emotion. By W. Whateley 
Smith. (International Library of Psychology, Philo- 
sophy, and Scientific Method.) Pp. 184. (London: 
Kegan Paul and Co., Ltd.; New York: Harcourt, 
Brace and Co., Inc., 1922.) ros. 6d. net. 
(6) Remembering and Forgetting. By Prof. T. H. Pear. 
Pp., xii+242. (London: Methuen and Co., Ltd., 
1922.) 7s. 6d. net. 
(x) ROF. FREUD’S “Beyond the Pleasure 
Principle” is not a long essay; but it is 
exceedingly difficult to read, not only because of the 
style in which it is presented, but also on account of 
the philosophical ideas which the author attempts to 
express. It is packed full of observations, theories, 
and extensions of theories of great interest and 
originality. 
The reader -will not always, perhaps, be able to find 
himself in agreement with the argument ; but he will 
certainly be stimulated to think. Originally, Freud’s 
theory worked with fairly simple conceptions. The 
““ pleasure-principle ” emerged as a result of actual 
psychoanalytical practice. Any mental process 
aS 
a 
