Douglas of the Pouch

this invaluable summary of the present position of chronic bronchitis. Their clear description of bronchitic disability underlines the thousands of personal tragedies produced by this preventable disease. " He awaits winter with apprehension and fog with dread. Though the end may not yet be near, his life may no longer be worth living because of an illness which he once passed off as ' only a smoker's cough.' " The facts about the distribution of chronic bronchitis in different countries, classes, and districts, and the facts incriminating air-pollution and cigarette-smoking, are well illustrated by clear diagrams, which will be found very helpful for teaching purposes. They stress the importance of early diagnosis before irreversible damage has been done. To give antibiotics and cough medicine instead of stopping the patient from smoking and looking into other environmental factors is indeed not enough. Perhaps the most valuable section is that covering the practical social management of the disabled bronchitic. Details of how to attempt to resettle him are given though the difficulties are not minimized. At present only a handful of all the severe bronchitics have been found sheltered employment. Much can be done in the last stages of the disease when the patient is house-bound and lonely and the burden on the relatives becomes too heavy. How to do it is clearly explained. A challenge is given to the chest clinics. to do what they have so successfully achieved for tuberculosis. This practical pamphlet should be in every medical ward and chest clinic, and on every general practitioner's desk. KEITH BALL.