Textbook of Pathology

There are few full-length textbooks of pathology by British authors, and the appearance of a new one is therefore in any case an important event. If its merits as the student's principal guide in this subject make a wide appeal it is something which does not happen more than two or three times in a generation, and the new work by Dible and Davie certainly will appeal. The purpose of studying pathology has never been better expressed than in their preface, and the authors' aim of enabling the student to envisage the processes underlying the clinical manifestations of disease has been admirably followed out. A novel and commendable feature is the interpolation between the sections on general and regional pathology of another entitled " Special Infections," in which infective disease is classified aetiologically. Chapters on diphtheria and anthrax, as contrasted types of bacterial infection, are followed by ten others, among the subjects of which tuberculosis, virus diseases, and infections by the pyogenic cocci are obvious choices in view of their characteristic nature and the variety of tissues which they may involve. Others have not so clear a claim to description here, and the section might well have included a chapter on the special features of infection by protozoa. Both here and elsewhere in the book the characters of the micro-organisms concerned are fully described, as are the mechanisms by which the body resists infection: indeed, for most purposes, except that of technique, this work will, incidentally, almost serve as a textbook of bacteriology. Just as there is much to commend, there is not a little to criticize. Among matters of fact are a diagram of the renal arterial system (Fig. 27) which is anatomically incorrect, and the devastating suggestion that chronic phthisis predisposes to squamous-celled cancer of the lung. The whole subject of lung cancer is dealt with in only nineteen lines. There is much that is highly unorthodox, if not positively untrue, in the chapters on arterial disease: atheroma is not usually believed to occasion cardiac hypertrophy, as is deliberately asserted on page 566, nor, as stated on the following page, is it "the common cause of senile gangrene of the extremities"; this is a consequence to be ascribed more exclusively to Monckeberg's sclerosis, which is described later. The doctrine that atheroma can result from raised blood pressure is also highly disputable, and its repetition by an examinee might well be detrimental to him. In describing tumours of bone the authors appear to accept the term "osteogenic" as correctly describing growths in which bone is formed, whereas it should be restricted to those of osteoblastic origin. In contrast to the usual clearness of the teaching is the highly abstruse argument which opens the chapter on diseases of the reticuloendothelial system; the authors' natural desire to define their own opinion on a debatable subject has here made that subject too difficult for the ordinary reader. The book is easily readable, but picturesque language is rather forced in some places, and misspelt words are unduly frequent: "pacchymeningitis" occurs repeatedly, as does " empyrical," which has evidently exchanged a letter with "saprophite." To set against these faults there are many chapters of outstanding merit, among which those on diseases of the alimentary tract, on tuberculosis, and on the causation of tumours are particularly successful. The historical data introduced into the text often add greatly to its interest. Illustration is lavish; a few drawings are overemphatic of essential features (for example, Fig. 215), but the photographs used reach a very high standard of excellence. The book is assured of a wide popularity.