THE AUTONOMIC NERVOUS SYSTEM

This is essentially a continuation of the great work on British Surgical Practice edited by the same authors and brings that work up to date. It consists of three sections: original articles, critical surveys, and abstracts. They are all of a very high order, and either describe or provide access to the latest achievements of surgery. The first article, by Rodney Maingot, is perhaps the most arresting. He describes in detail the injuries which may occur to the bile ducts and the results which may follow, often unfortunately as the result of surgical procedures. He explains how such mistakes may arise, and how they might have been prevented by a more accurate knowledge of the abnormalities which may occur and by more accurate technique. There follows an admirable account of the methods which have been evolved for the repair of such injuries, sometimes the most difficult problem with which a surgeon can be faced. The article by Poole-Wilson on injuries of the urethra and bladder, fortunately of less common occurrence, is clear and the result of wide experience. It will be welcomed by all who have to deal with these difficult conditions. That by Paul Brand, of Vellore, on reconstruction of the hand in leprosy, is of far wider appeal than to his own special field, and all who have to deal with the restoration of the functions of the hand after nerve injuries will appreciate the value of his work. Pelvic viscerectomy for advanced cancer is the subject of an article by Sir Stanford Cade, and is an example of the extraordinary lengths to which modem surgery can go. Such operations can, of course, be justified only in desperate cases and when undertaken by surgeons of quite exceptional skill and wide experience. But he shows that with these conditions they are fully justified and may give relief which can be obtained in no other way. The article by G. A. Hay and F. W. Spiers on the application of electronics to clinical practice shows how dependent the surgeon of the future may be on physical science. One only hopes that it will be his servant and not his master. After all, one can use a microscope quite effectively without knowing anything about spherical aberration. The critical surveys include several articles of value. Those on antibiotics and on blood transfusion show important progress in these fields. On carcinoma of the oesophagus Ross Robertson gives a full and well-illustrated account of what can be done with the resources of modern surgery. That many surgeons now question whether such operations are worth while in no way detracts from the value of the article. Norman Tanner gives an excellent account of the present position of carcinoma of the stomach and the encouraging results of modern technique. The abstracts furnish a brief account of progress in a large number of fields and afford ready access to the literature for those who desire to explore these subjects further, We would like to congratulate the editors on the high level of material, and the publishers on the standard of production maintained throughout the volume.