Februabt 19, 1909] 



SCIENCE 



299 



been- put to good use. His observations and 

 conclusions have therefore great value. 



While the book is, as he says, designed for 

 the general practitioner, one of the best writ- 

 ten and strongest portions is Part VI., sec- 

 tion I., in which he deals with Prophylaxis. 

 Under this general head we find discussed 

 Notification and Registration, Education for 

 the Consumptive and the Public, the giving 

 of Material Aid, and Administrative Control. 

 These chapters are well adapted for general 

 reading, and we wish that the educated public, 

 and especially those charged with the making 

 and administration of our laws', could be 

 forced to study them. A single quotation 

 only can be given: 



Society, which sometimes encompasses the regu- 

 lar and legitimate practitioner of medicine with 

 embarrassing restrictions, yet permits the unsus- 

 pecting invalid to become the non-defensive prey 

 of ignorant and unscrupulous charlatans. While 

 many forms of quackery have been overlooked, 

 and the advertisement and sale of patent medi- 

 cines containing alcohol and various narcotics have 

 been permitted, the state, by virtue of its failure 

 to enact repressive legislation or to enforce exist- 

 ing laws, has become indirectly responsible for the 

 lack of public health. 



At present interest is again turned to the 

 relation between bovine and human tubercu- 

 losis. Dr. Bonney's conclusions are in the 

 main sound and practical. While admitting 

 the danger to man from cattle, he says: . . . 

 " among individuals a greater virulence at- 

 taches to the bacillus of human origin than 

 to the bovine." This statement is incorrect. 

 If it means that the consumptive man is the 

 chief source of danger to man, we will agree 

 with it, but no one has ever shown that the 

 human bacillus is more virulent for man than 

 the bovine germ, and there is good reason to 

 believe that the contrary is true. 



The discussion of staining is meager, and 

 no mention is made of the non-acid-fast forms 

 of the tubercle bacillus, a most important 

 matter pointed out by E. Klebs, Much, 

 Michaelides, Herman and others. What he 

 says against waiting to make a diagnosis until 

 tubercle bacilli are found in the sputum is 

 eminently sound. Much valuable time is lost. 



and many lives sacrificed by this wide-spread, 

 but most pernicious, practise. 



The methods given for isolation of cultures 

 are incorrect. 



The sections of the book which will prob- 

 ably most interest the practitioner are those 

 on diagnosis, symptomatology, complications 

 and treatment. These occupy the major por- 

 tion of the book, and are illustrated by many 

 excellent and well-chosen cuts. 



The classification of cases is not in accord- 

 ance with the modem trend, and no mention 

 is made of the classification advised by the 

 National Association. 



The subject-matter in these sections is very 

 full and contains a vast amount of practical 



Sixty X-ray photographs are given, most of 

 them excellent. Dr. Bonney properly re- 

 gards the X-ray as a valuable aid to diag- 

 nosis. He considers the " legitimate scope of 

 the subcutaneous tuberculin test to be ex- 

 tremely limited," though he says it is " not 

 only harmless, but has a high diagnostic 

 value" when intelligently employed. While 

 recognizing the care necessary in the use of 

 tuberculin, we believe its use should be ex- 

 tended, and in view of what he says, it is 

 illogical to limit its use as he does. 



Dr. Bonney is an advocate of the most pro- 

 nounced type of the climatic treatment of 

 tuberculosis. For him the ideal climate is 

 found in Colorado, especially in Denver and 

 Colorado Springs. Even in those features 

 which apparently detract from the perfect 

 ensemble, he finds " concealed " desirable 

 features. It would be hard to imagine a more 

 marked contrast than his description of Colo- 

 rado and the Adirondacks. The latter he 

 says have a comparatively small number of 

 sunny days, moderate humidity, and an 

 abundance of clouds, fog, snow and rain, yet 

 admits that they have a " well-deserved repu- 

 tation as a place of sojourn for pulmonary 

 invalids." Prom his description certainly no 

 more unsuitable climate could be found, yet 

 we know that the results obtained there are 

 among the best in any part of the world. 



His reiterated advice concerning " regard 

 for infinite detail " in the treatment of tuber- 



