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THE PAPERS by Lobel which appeared, one in 1949 1 and its successor in 1951, 2 on the use of vitamin A for the control of tinnitus and chronic progressive deafness stirred the hopes of patients and the enthusiasm of the press by reason of the outstandingly good results reported. Otologists in the main kept their fingers crossed. Soon reports by other investigators appeared, some favorable,* some unfavorable.† It was of personal importance to gain firsthand knowledge of the rights of the matter; wherefore the following investigation was undertaken. It was noticeable that in three of the six case reports in the second of Lobel's papers, the patients were given vitamin B complex intravenously, the preparation and dosage unspecified. In the other three cases, and in the text of this and of the first paper, no mention was made of the use of vitamin B complex or of any of

Although hallucinogenic drugs have been used for various purposes for centuries, serious medical studies of them began only about one century ago. In more recent years the use of compounds like D-lysergic acid diethylamide (LSD-25), as well as congeners and derivatives, has become the subject of scientific scrutiny. Of major interest to the practicing physician is the value of these compounds either as therapeutic agents or as adjuncts to psychotherapy. While the evaluation of the psychotherapeutic procedure itself is certainly not readily achieved statistically, the psychopharmacologic action of these drugs can be and has been determined by replicable techniques on man. More than 1,000 papers have appeared on the general aspect of the subject since 1943. Previous conferences have tried to integrate results and to clarify the value of these drugs. The present volume covers an extended conference of the Royal Medico-Psychological Association in 1961. Here are reported the papers

It is not without much reflection that I venture to bring before the Association a paper upon such an old subject as sea-sickness. This subject, however, which I have the honor to develop anew before this assembly, has recently become enriched both by new theories regarding. the nature and pathogenesis of sea-sickness and, what is still more practical, by new methods of treatment which bring into action medicinal agents not hitherto exhibited in this affection, and which are recognized to have beneficial and even curative effects. There is much in this matter that is new and important; the Academy of Medicine of Paris recently discussed it in one of their seances; and it may be profitable to briefly review it here, in order that we and our patients may be spared that atrocious suffering to which those who venture upon old Neptune's domain are exposed. The author of this paper

A recent review (Pronko et al. 15) of shock therapy in the United States since its introduction in 1937 until 1956 leads the authors to conclude that the era of shock therapy is fast drawing to a close. After 20 years of research, there are conflicting results as to the mode of action, therapeutic aim, and conditions for optimum therapeutic efficacy. In terms of scientific knowledge, the position is very little different now from that in 1937. With this in mind, the aim of the present paper is to review the literature on the therapeutic efficacy of the most commonly used of the shock therapies, electroshock or ECT. The literature on ECT is considerable; in the Psychological Abstracts from 1955-1960, there are references to over 200 papers on the topic. However, only a proportion of these are concerned with the therapeutic efficacy of ECT; the remainder can

To the Editor:— Dr. Collins' criticism of my definition of placebo is somewhat tangential to the main emphasis of my paper, which was on the etiological factors in the placebo effect and not on the definition. The basis for my definition was discussed extensively in another paper referred to in the article.1 Dr. Collins avoids the problem of proposing a formal definition. Hisimplieddefinition seems to be: "A placebo is what a somebody does to a somebody" which is thought by the latter to be helpful. This definition has several shortcomings: negative placebo effects, which may arise when the patient thinks the doctor isnothelping, cannot be included in his definition. I agree with Dr. Collins that the placebo should refer to therapies and that physician and patient, or their cultural and symbolic representatives, are essential to the definition. But a definition should include more than this

Buffalo, N. Y., July 26, 1897. To the Editor: —Your editorial in the Journal of July 3, entitled " The Late Meeting of the Ophthalmic Section of theAmerican Medical Association," must have attracted the attention of all your readers. The Association meeting was bo notable in all respects that there may be danger of losing sight of the great excellence of the work in the various Sections. It may not be out of place to emphasize once more the high estimate universally expressed of the work done in the Section on the Practice of Medicine. Knowing from experience how difficult it is to arrange a program satisfactory to all of a large body of physicians, the list of papers read and the discussions brought out are recalled not only with gratification but a certain amount of wonder. It ought not to be necessary to reiterate the titles of papers

1. By way of introduction, a brief sketch of the literature and history of tetany may not be inappropriate, since very few observations have been published or papers written in this country upon the disease in question. The recognition of tetany (though Steinheim is credited by Stewart, of Montreal, as the first to give a true clinical description of tetany in 1830) dates from the memoirs of Dance, published in 1831 in the Archives Generales de Medecine , and entitled, "Observations on a Form of Intermittent Tetanus." The attention of the French physicians of this period having been directed to the new malady, various papers and memoirs were contributed by them from 1832 to 1855, elucidating its characteristic symptoms and conditions so thoroughly that it may be fairly conceded that to their labors is due all our present knowledge of this disorder. Several names were proposed to be given to this

In April, 1889, I presented a paper before the Medical Society of the County of Broome, this State, entitled "The Use of Alcohol in Medicine." This paper was published in the New York Journal of Medicine , Sept. 28, 1889. At that time I took the position that our text-books on materia medica and therapeutics needed revision, since their statements relative to the effects of alcohol upon the human system had been proven by modern research and observation to be erroneous. In my article I made many quotations from our standard authors, a few of which I here repeat. "Alcohol is a useful food." "An important remedy in the various forms of pulmonary phthisis." (Bartholow.) "The early administration of the preparations containing alcohol furnishes our best means of counteracting the depressing action of disease in general" (Bidwell.) "Alcohol is the savings bank of the tissues. He who eats little and drinks

I have chosen for the subject of my brief paper "Conservative" or "Preservative Dentistry," and my only apology for presenting such a paper as this, is the hope that it may draw out some discussion, and do something toward clearing the minds of many general practitioners of medicine from fallacies, inherent from a lack of a proper appreciation of this subject and a prejudice which many of them must have obtained from the constant rantings and railings about the lamentable ignorance of the Doctor of Medicine, by some of the would-be lights of the dental specialty. I will be excused in the light of the above in making this paper deal largely in generalities; thinking by thus doing that the mind of the general practitioner may enlarge upon these generalities, and through them we may hope to enlighten the laity, who are, as a rule, willing to do anything which

So much has been written on this subject that a new paper may seem superfluous. The reasons which have impelled this paper are the following: 1. My desk is continually flooded with medicaments sent by manufacturing pharmacists, and delivered by detail men who talk quasi-scientifically, and just as glibly as they did when I began to practice twenty-five years ago. 2. In mingling with other physicians I find many such mixtures and new preparations used in practice, the only excuse being the recommendations contained in literature accompanying the preparations. 3. Many such preparations are used by physicians without any knowledge of their contents or action. There can be no doubt that this use of the preparations is attended by dangers which I hope to make plain. 4. With few exceptions the preparations sent about as samples are mixtures. Now, every intelligent physician knows that if our use of drugs is

In December, 1888, Dr. Simon Baruch read before the New York Academy of Medicine a paper (Archives of Paediatrics, April, 1889), in which he discussed "Nocturnal Enuresis in Chil dren, and its Treatment," bringing to the notice of the medical profession the great value of the alkaloid atropin in this affection, as evidenced by results obtained in quite a number of cases in which he had used it. But he added that since his cases had not been very long under observa tion, he could not predict the ultimate result to be obtained. Dr. Perry Watson, of Jersey City, read before the American Medical Association, at its last meeting, a paper in which he reported in detail thirty unselected cases of enuresis all cured or greatly benefited by this drug. Prompted or en couraged by such glowing accounts of the virtue of this drug, many of the profession resorted to

It is proper that I should offer to you some reasons for selecting so ordinary a disease as is chronic endocarditis as the subject for this paper. But the ordinary diseases are, after all the important ones, and often as we see them we never really know them well enough. Any fresh record of facts, any new way of grouping, or of looking at these facts must be of some little service. It is the object of this paper, therefore, not to give a systematic account of endocarditis, but to draw attention to some features of the disease; not to give a history of the views of other observers, but to state simply what I have put together from my case books and post-mortem records. Of the ordinary diseases few are more common than is chronic endocarditis. In few of them is there so great a variety in the severity

When honored by the American Medical Association with an invitation to become its guest and to contribute to its program, I cast about to consider in what way I could be of most use to those who might do me the further honor to read my paper when published. In my opinion, physiologists and physicians have stood too much apart. Although the American Physiological Society has held meetings for a great many years in the different great centers of the country, but few physicians ever attend those meetings or even read the reports of the papers presented, probably because they are usually published in periodicals other than medical. In most instances teachers of physiology to-day are not men in active medical practice, while many never were doctors, except academically. This has its advantages, but also some disadvantages. Physiology as such, even yet, it is to be feared, is only occasionally

(Read before the Section on Practice of Medicine and Materia Medica of the American Medical Association, May, 1884.) In the course of a somewhat extended experience with what is known as the "milk cure," it has occurred to me that the growing popularity of this form of treatment, demanded, at this time, some systematic consideration of the principles and practice on which its use is justified, as well as an outline of the class of cases in which it may be expected to be of advantage. It is now a little more than eighteen years since Dr. Philip Karell read his paper on the "milk Cure" before the Medical Society of St. Petersburgh. To this paper I must refer for a large number of interesting historical facts, of both ancient and modern date, bearing on this subject, beginning with Hippocrates and coming down to the date of the paper itself

Youngstown, Ohio, Dec. 24, 1894. To the Editor: —During the past year you have published four papers on typhoid fever, which I had read before the Mississippi Valley Medical, theAmerican Medicaland the Mahoning County Medical Societies. Those papers were all written for one object,—to prove that typhoid fever can be aborted—a difficult enough task surely; without wasting much time in giving details of a treatment which I did not suppose many would care to try until very conclusive evidence of its efficacy had been presented, but although, some physicians have secured most brilliant results from the treatment by relying on these published directions as their only guide, I fully recognize their inadequacy and have always intended to write a treatise on the abortive treatment of typhoid fever, as soon as there seemed to be a demand for it. Since the publication of my first paper in February last

REVIEW OF LITERATURE. The question of the relationship existing between pelvic diseases in women and insanity is one which has occupied the attention of the profession many years, more particularly since 1857, when Loiseau presented a thesis on the subject, "Sympathetic Insanity," which caused considerable discussion, and also since the paper by Hergt, in 1870, on the subject, "Women's Diseases and Disturbances of the Mind." Although from that time to the present the subject has been discussed to some extent in medical societies and through medical journals, even yet great difference of opinion exists among gynecologists and alienists. When I read a paper before the Nebraska State Medical Society in 1898 on the subject, "Relations of Insanity and Pelvic Diseases in Women," there was little sympathy expressed by the members of the society and my conclusions then given, which more extensive experience has served to confirm, were not received with

Reading, Mass., Dec. 26, 1905. To the Editor: —InThe Journal, Dec. 23, 1905, in the discussion of Dr. Pressey's paper, page 1944, a statement is made by Dr. Crothers so extreme that it seems to me worthy of some adverse comment in addition to that which it received from the members who criticised it on the spot. He says that from some studies which he made five years ago and which have since been fully confirmed, he is "convinced that at least from 15 to 20 per cent, of physicians in active practice are victims of morphia and spirit taking." And again: "A general study of the habits of physicians in four of the largest cities of the country showed that from 10 to 15 per cent, were drug and spirit takers. In one city a prominent daily paper made inquiries and concluded that at least 15 per cent

In the Wherry Memorial Lecture, entitled "Res Medica 1956," published in the March-April, 1957, issue of the Transactions of the American Academy of Ophthalmology and Otolaryngology , Arthur Proetz 1 made the following statement: "Unquestionably the greatest single advance in medical therapy in the 15 years since Wherry lived-—indeed in the 60 years since Pasteur lived—is the antibiotic in its various forms." In contrast to this statement, it does seem odd that in the list of more than 250 papers presented at the Sixth International Congress of Otolaryngology in Washington in May, 1957, there was only one paper dealing with antibiotic therapy. After consideration of these two facts, one comes up with two ideas. First, either that the principles of antibiotic therapy are clear-cut, well-defined, and hence not worth talking about, or, second, that otolaryngologists simply aren't interested in discussing or knowing what is the best type of antibiotic

This paper describes a clinical trial of the effect of "'gerioptil " on certain psychological dimensions in a group of senile patients. Gerioptil is the trade name of a preparation which contains Professor Anna Aslan's compound H3 together with a variety of vitamins and vitamin derivatives. It is manufactured by a German drug firm, but is available to hospitals and general practitioners in Britain. H3 is the name given by Professor Aslan, of the Geriatric Institute in Bucharest, to diethylaminoethyl para-aminobenzoate, better known as procaine. This substance has been used for half a century or so as a local anaesthetic, and from time to time for other purposes, including coronary and peripheral vascular disease, allergic states, and rheumatoid arthritis, although for these lesser-known uses it has been super seded by other more efficient or more convenient remedies. During the last few years, however, a number of papers have appeared, many from Professor Aslan and her colleagues (1959) themselves, advocating the use of H3 in a wide group of disorders, including senility and the physical and psychiatric syndromes seen in association with it. However, much criticism has been levelled at the clinical reports of these workers, whose papers fall below the standards of statistical method, scientific control, and trial procedure which the modern clinician is entitled to expect from workers making the extensive therapeutic claims that have been advanced by this group. The evidence which Aslan puts forward cannot rival her therapeutic optimism ; frequently there are impressive clinical reports and anecdotes, but the use of controls and standardized procedures are not apparent. These criticisms have been the subject of a leading article in the British Medical Journal (1959a). Professor Aslan herself delivered a lecture on H3 in November, 1959, and this has also been reported with considerable criticism in the British Medical Journal (1 959b). Accordingly, since with this freely available prepara tion there appeared to be a discrepancy between the therapeutic claims on the one hand and the acceptable evidence of its value on the other, it seemed suitable to make it the subject of a controlled trial.

So numerous and so excellent have been the papers on municipal health administration which have been presented before this Association and the American Public Health Association in the past few years and published in their respective organs, to say nothing of other able papers presented elsewhere, that it is scarcely possible to improve on work already so well done. And hence, in accepting the invitation of our Chairman to discuss this subject before the Section on Preventive Medicine and Public Health, I did so with the distinct understanding that I might depart entirely from the usual method of presentation, the method followed in the splendid papers to which I have just referred, that I would not have circles and squares and connecting lines, or text of the kind which goes with such diagrams. There is, it seems to me, one important phase of municipal health administration which may be profitably

To the Editor.— A hundred years ago, as is apparent in Fig 1, the individual prescription ordered a multiplicity of drugs, and was compounded in a neighborhood drug store. Today, a prescription is often fractionated into two to eight separate drug orders. Fractionation into individual drug orders has resulted in an increased burden of paper work, in that the physician must write his name, the date, and the patient's name many times for one therapeutic regimen. The mushrooming lists of useful available drugs have added further to the number of prescriptions, and to the paper work. To meet medicolegal requirements, the physician must next write all the drugs again into his office records. Because of the responsibility, these are duties he cannot easily delegate. A common cause of drug-induced death over many years has been cardiac arrhythmias in patients given digitalis, resulting from low potassium states secondary to diuretic therapy.

Problems of Psychiatry and Neurology is another in a series of English translations of the Russian scientific literature undertaken by the Pergamon Press with assistance from the National Institutes of Health. This volume concerns itself with the Transactions of the Leningrad Scientific Society of Neurologists and Psychiatrists and consists primarily of papers with clinical orientation. The similarity of clinical problems and interests of our Russian colleagues in the practice of medicine are readily evident in the titles of the various chapters. Hence, one finds papers dealing with treatment of epilepsy; clinical aspects of thrombosis of the basilar artery disease; technique of air encephalography; and state and tasks of soviet child psychiatry. These everyday problems of clinical practice are presented in a manner not too dissimilar to that which we ourselves encounter at local medical meetings and in regional publications. The papers are all brief, cover the essentials of the problem

This book should contribute to a better understanding of scleroderma and other connective tissue diseases. It does, but there are serious faults. Much of the volume is written in French. These contributions are excellent, but for those who do not read French they are of little value. Since the papers were presented at a symposium by many authors, unevenness is present. Some papers are cursory reviews, others exhaustive. For the most part, the nondermatologic symptoms and findings of scleroderma are especially well delineated with several new findings of biologic interest. This volume is recommended to the dermatologist and internist who are interested in the group of connective tissue diseases.

This book offers a compendium of papers presented at the Third European Congress of Perinatal Medicine held in Lausanne, Switzerland in April 1972. It is in three main parts: (1) three introductory lectures offer overviews of perinatology from differing perspectives; (2) roundtables in which a number of original papers are presented on each of four major topics, perinatal pharmacology, cesareian section deliveries, prognosis of the high-risk newborn, and monitoring and intensive care in perinatal medicine; and (3) free communications, which number more than 200 brief abstracts of original research projects. The symposium itself is most commendable in that it represents another bringing together and opening up of further dialogue among those concerned with the welfare of perinatal patients: pediatricians, obstetricians, clinical pharmacologists, and biomedical engineers. The vast majority of contributors are from Europe. Unfortunately, most of the presentations by members of one discipline will be of real interest only to

The Veterans Administration Department of Medicine and Surgery, the three Armed Forces, and several other organizations have engaged in a well-coordinated cooperative study of the chemotherapy of tuberculosis since the close of World War II. The 18th Conference was held in St. Louis, in February, 1959. This paper-bound volume is a complete transcript of fifty papers presented there along with spontaneous discussions and comments—sometimes of more worth than the formal presentations—thirty-one papers read by title, and committee reports which deal largely with future study plans. This conference had world-wide representation and can be expected to continue to exert a major influence in tuberculosis practice. The Transactions are devoted chiefly to drug therapy for tuberculosis—primarily pulmonary, of course—but they touch on several extra-thoracic forms of the disease as well. Other modalities of treatment, especially resectional surgery, receive attention. Several good papers are devoted to laboratory methods and the bacteriology of the

At the meeting of the New York State Medical Association on October 23, 1890, I gave my experience with the use of strophanthus in eight cases of Graves' disease. The paper was printed in The Journal of the American Medical Association in Vol. xv, No. 21, 1890, page 785. Previous to writing that paper only two or three references to the use of strophanthus in this disease had been seen by the writer in current medical literature, and since that time the year books and journal articles recommend other therapeutical measures as a rule—rarely referring to this recent addition to our materia medica. While my own use of the drug in this particular disease antedated by more than a year any reference to it in the medical literature, still it had been recommended before the publication of my cases, so that I have no claim to originality or even priority

Here is an example of the confusion or corruption of physicians who beat the drum in a symposium on treating "stress" with hesperidin. This throw-away item appeared under the aegis of the Wayne County Chapter of The Michigan Academy of General Practice. Much scientific work has indicated that hesperidin is a not inexpensive placebo. Controlled studies reported by Shils and Goodhart indicated that such flavonoids are without therapeutic effect. It is not surprising that they have been used to treat hypothetical states or diseases for which there is no known cure and others for which better methods of therapy are known. Perhaps the best that can be said for the papers is that they represent the testimonial approach—statements unsupported by evidence. The papers reveal ignorance of disease and of the experimental method. The Michigan Academy of General Practice has done itself and medicine conspicuous disservice in supporting the hard sell

This book, the sixth in a series entitled Progress in Respiration Research (the first was published in 1962), comprises papers presented at the 1969 meeting of the European Society for Pathophysiology of Respiration. All papers pertain to chronic bronchitis. Of the 71 contributions, 36 are in German, 20 in English, and 15 in French; consequently, the book will have limited value for physicians who read only English. The dust jacket's statements that the contributions indicate how "research work is having a significant effect on the daily practice of medicine" and that the volume gives an excellent summary of therapy of bronchitis are unwarranted. There are only a few papers on treatment, and one of these concludes that "judgment of results of therapy of chronic nonspecific obstructive lung diseases is a very complicated problem." Although the volume is not one of those logorrheic products of symposia and although the papers are

With 23 papers on unrelated problems of clinical rheumatology, the editor, Dr. Allan St.J. Dixon, has selected his contributors so that all the topics are handled with authority and freshness. His contributors, mostly from England but some from the United States, include some senior clinicians such as Professor Bywaters who, with Dr. J. T. Scott, has contributed an excellent review on systemic diseases of connective tissue. Many of the papers are by younger rheumatologists, however, and often they have brought to their topics new knowledge, enthusiastically presented. It is not possible to comment on all the individual topics, but Dr. D. A. Brewerton described the hand deformities of rheumatoid arthritis with great clarity. A paper on surgical correction of the hand lesions, by Dr. Peter Casagrande, made an excellent sequence on this complicated but important clinical feature of the disease. Dr. Malcolm Thompson's description of the multiple clinical features of

IN A PAPER published in theArchivesin 1964, Conrad et al 1 present the results from a double-blind study of long-term oral anticoagulant therapy for the prevention of recurrences of myocardial infarction. In the introduction to their paper we find the following words: "Unfortunately, past medical trials conducted to test the effectiveness of long-term anticoagulant therapy in preventing recurrences of myocardial infarction have been designed so poorly that they do not qualify as controlled medical trials." We should, ourselves, be hesitant to apply such rigorous critical standards, but their adoption by the authors arouses admiration and gives rise to a keen sense of anticipation as to the quality of their own study. It was, therefore, with some dismay that we found ourselves unable to accept many of the interpretations which the authors put on their own results. Some readers may have accepted the authors' conclusions without a careful scrutiny

One needs but to examine the literature and to see who writes upon the topic, to ascertain beyond question that the subject of insanity receives but little attention from the general practitioner. After looking over the reports of the last five sessions of the Oregon State Medical Society, and calling to mind the work of the Portland Medical Society during the same period, it seems safe to say that not a paper upon this subject has been presented by a physician of this State at any of these meetings during such time. Papers upon almost all medical topics have been presented before these societies by physicians of this State, but the great field of psychiatry has been during this period ignored. The history of medicine in Oregon in this particular is, to a great extent, the history of medicine everywhere, and it teaches us that the general practitioner is leaving

To the Editor .—Dr. Grand's letter states that an error was made in the use of the phrase, "The original description of this clinical entity...." in my paper on "Acute Diarrheal Disorders of Newborn Infants," in the April 1950 issue of theAmerican Journal Of Diseases Of Children. I am fully aware that Barenberg, Levy and Grand published their observations on an "Epidemic of Infectious Diarrhea in the New-Born" in the April 11, 1936 issue of The Journal of the American Medical Association . Table 2, line 4, and the accompanying text in the paper by Rice, Best, Frant and Abramson, in the Aug. 14, 1937 issue of The Journal of the American Medical Association , accord proper recognition to the publication of Barenberg, Levy and Grand in the chronologic summary of the early outbreaks in New York city that were investigated by the department of health. Table 1 in the paper

The seventeenth annual meeting of the American Society of Tropical Medicine will be held in Hot Springs, Arkansas, in the fall of 1921, in conjunction with the meeting of the Southern Medical Association. Members who desire to read papers at the meeting are requested to send the titles of their communications to the President or to the Secretary as early as possible. Physicians who are not members of the Society may be invited to read papers setting forth the results of original observations on subjects connected with Tropical Medicine at the suggestion of a member of the Society and upon approval by the officers. The member suggesting that such an invitation should be extended is requested to have the author submit a summary of the contents of his communication with the request for the issue of the invitation. Papers read at the meeting will be published in the American Journal of Tropical Medicine.

The correspondent regrets the lack of emphasis upon homosexuality and the part it plays in maintaining infectious syphilis in a community. To those interested in syphilis this fact is neither "forgotten, unknown, nor neglected." This topic had a prominent place on the program of the World Forum on Syphilis and Other Treponematoses last September. In a more expanded paper read at the Forum, the author of the communication in question gave attention to this topic, and the reference list was more extended. The contracted paper was to point up the need for an awareness by the practicing physician of his responsibility in epidemiological control. The physician already knowledgeable in this area is well aware of the role of homosexuality. In the implementation of education for the unknowledgeable, the role of homosexuality will, no doubt, not be forgotten by the physician-teacher nor by the health officer. Regarding another item in the

Presented in Section on Practice of Medicine and Materia Medica of American Medical Association, May 8, 1884. Dr. Formad opened the discussion on this subject, but refrained from presenting it for publication, as a similar paper, by himself, and giving his views in full, had just been published in The Journal of theAmerican Medical Association, April 26, 1884. He said, in the remarks which he read before the section, that he was not at liberty to present any additional matters upon the subject, being about to publish, in conjunction with Professor William Pepper, Provost of the University of Pennsylvania, a monograph on tuberculosis, in which the whole of his research and experiments, upon which his views were based, will be related with full details. Dr. Formad's paper elicited the following DISCUSSION. Dr. Austin Flint, Sr., thought that if tuberculosis was an infectious disease, produced by a parasite, its contagiousness

In view of the tact that modern medicine is chiefly occupied in bacteriological investigations of a more or less practical nature, it is perhaps too much for one to expect a subject as old and apparently wellworn as that selected for discussion in the present paper, to attract much attention, or excite a great deal of interest. I am convinced, however, that there are those present who, if they so choose, can express views upon the action of heat and cold, and upon hydrotherapy in general, which will be both interesting and profitable. A desire to hear such expressions of opinion upon a subject in which I am greatly interested, rather than the hope of adding greatly to our general fund of information, must be my apology for presenting this paper. The usefulness of water in its various forms in the prevention and treatment of disease is very great, and

Turn on the radio, casually glance through advertisements in papers and periodicals or read the signs which are scattered everywhere along the highways, and it soon becomes evident how important symptoms of dyspepsia have become to the laity. All these advertising mediums give instructions on how to return to gastronomic happiness by easy and inexpensive means. In this paper we shall outline some of the more frequent causes of chronic dyspepsia and submit evidence pointing to the danger, particularly at certain ages, of the layman's attempting to cure himself by taking advertised therapeutic nostrums. Physicians are in part responsible for this lamentable situation, because a diagnosis of "dyspepsia" is frequently made although, as is well known, this condition is not a disease but only a symptom. In the hope that certain symptoms are transitory and inconsequential, the physician sometimes advises easily available medications which have previously been found to be

The participants of this Symposium were predominantly British psychiatrists with a few representatives from "overseas" such as Himwich and Brodie (USA) and Pletscher (Switzerland). The avowed aim of this book "is to review the present state of knowledge of the clinical and therapeutic effects and the mode of action of the various psychotropic drugs." It is divided into five sessions, namely—Basic Concepts, Major Tranquilizers, Anti-Depressants, Anti-Anxiety Compounds, and General Considerations. In general the subject matter is presented in a lucid and clear-cut style, though the papers by pharmacologists such as Pletscher and Brodie are difficult for the clinician to assimilate. Each major session consists of a few main papers, followed by two formal discussions, and finally a general discussion. In the opening session on general concepts, Hamilton has much to say that is worthwhile both reading and remembering. He stresses the importance of accurately

To the Editor:— I am writing concerning my article "The Family Physician and Heart Disease" inThe Journal, Nov. 7, 1953. I wish to state that some of the material used in the first part of my paper was taken from a paper presented to the Florida State Medical Association in April, 1953, by Dr. Sidney Davidson of Lake Worth, Fla. Dr. Davidson's paper was later published in the January, 1954, issue of the Journal of the Florida Medical Association . It is my wish to give Dr. Davidson due credit for the material that I used from this paper.

Twenty-five investigators, in 16 contributions (in part reprinted) focus on the psychological and sociological aspects of abortion. This collection has pragmatic interest, for it reviews the experiences of patients and physicians in the light of changing laws. An introduction by the editor gives an overview of the problem and puts the papers in a wider perspective. Indeed, among the great values of this collection are the extensive bibliographies. In the first section, on attitudes, Pohlman examines abortion dogmas. Stone et al ask the intriguing question, to whom does the child belong? Polsky reviews other legal aspects. Ayd succinctly states the Catholic viewpoint. Beck looks at abortion from the little-studied perspective of the mental health consequences of unwantedness, while Alvarez and Wingate present the seldom-solicited attitude of the gynecologist. The second section presents reviews and studies, many of which shatter the prejudices and dogmas cited by Pohlman. Simon's paper should silence

IN THE SECTION on Dermatology of the American Medical Association (AMA), we try to have a diversified program. Papers are accepted which deal with new drug evaluations, and it is always hoped that these are controlled studies. New or improved treatment approaches will be given a place on the program. An attempt is made to appeal to clinicians as well as basic science investigators in the field of dermatology. A rather large number of papers are reviewed and it is our purpose to try to judge these on quality as best possible. We also endeavor not to overbalance the program with a single individual or institution. National geographic distribution is taken into consideration with all papers. The section feels that this meeting gives another opportunity for the relatively unknown individual to present his work for review.

This agglomeration of eight papers from two 1967 international congresses—chemotherapy (Vienna) and dermatology (Munich)—falls disappointingly short of providing the up-to-date reference work the title suggests it might. Two thirds of the book covers the antibiotic therapy of syphilis in monotonous and repetitious detail. Additional chapters briefly consider gonorrhea in the male, trichomoniasis, and nonspecific urethritis, but other venereal diseases are entirely ignored. Inevitably, with a heterogeneous group of authors such as this, the scope, style, content, and overall quality of individual papers vary greatly. "Antibiotic Treatment of Syphilis" by Guthe and Idsoe and "Trichomoniasis — Metronidazole" by Durell et al best fulfill the intent of this book, with concise and informative discussions of recent advances and problems encountered in therapy. "Late Syphilis— Prevention and Treatment" by A. Perdrup and "Causes and Treatment of Nonspecific Urethritis in the Male" by J. Meyer-Rohn, on the other hand, contribute little and would better

In 1920, C. Morton Smith, 1 in a paper read before the American Dermatological Association, made the statement that "It seems probable that secondary and tertiary lesions of syphilis will continue to occur less and less frequently." In the discussion on this paper, various observers agreed with him in this and also in the observation that teaching material was becoming more scanty. The belief seems to have been that acute syphilitic eruptions were gradually diminishing in numbers, and that teaching material would eventually become so scarce as to constitute a serious handicap for future students of medicine. At that time it was our impression that a similar state of affairs obtained at the Washington University Medical School. We then began gathering the material for this statistical study. It seemed wiser, however, to wait a little longer and to include the years 1921 and 1922 in order to observe postbellum effects

The first third of the book is a review of the history of psychosomatic medicine from the earliest days of metaphysics down to the more recent days of metaphysics. After criticizing Cartesian mind-body dualism throughout the first chapter, the authors write the following clause in the second chapter, "... Freud, who drew our attention to the mighty influence which the psyche has in the soma." The book is a survey, not a critical analysis. Anecdotes, quotations from philosophers and commentators, unique cases, and carefully done experiments are all assigned equal weight. The second third of the book describes in great detail the literature on psychological and sociological variables in rheumatoid arthritis, asthma, and duodenal ulcer. Part of this is quaint; the only definition of rheumatoid arthritis quoted in the book attributes the disorder to "focal infection." Part induces despair. Paper after paper presenting case studies of rheumatoid arthritis, asthma, and

J. B. Cole and R. W. Gerard, Editors. Proceedings of a Conference on the Evaluation of Pharmacotherapy in Mental Illness, sponsored by the National Institute of Mental Health, the National Academy of Sciences-National Research Council, and the American Psychiatric Association, Washington, D. C., Sept. 18-22, 1956. Publication 583. Price, not given. Pp. 662. National Academy of Sciences-National Research Council, Washington 25, D. C., 1959. This volume summarizes the knowledge of psychopharmacology existing in 1956 under the following headings: I. General Review Papers; II. Preliminary Screening of Drugs; III. Patient Selection and Controls; IV. Test Conditions, and V. Evaluation. Each paper is thoroughly discussed, and at the final session published under the heading VI. Main Conference the overall reports of each of the five sections are discussed. The volume contains a wealth of material and should be carefully read by all persons concerned with any phase of psychopharmacology.

To the Editor:— Although Sister Kenny's concept of treating poliomyelitis in the acute stage had a purely empiric origin, her observations were so acute that they approached truth, as truth is revealed in nature. The rationale of her physical therapeutic methods is finding accruing support as the newer knowledge of the pathologic physiology of this disease unfolds. The five papers inThe Journalwhich were originally read in the Panel Discussion on Poliomyelitis at the Ninety-Third Annual Session of the American Medical Association enable the reader to contrast and weigh the contributions of the science of medicine, and the art of its practice, to the treatment of a single important disease. Having read these papers, one feels that, although physical therapy is a tool admittedly replete with dogma, it is neither just nor fair to blame the technical assistant for the poor results of a treatment prescribed by the doctor.

Dear Sir: —A paper under the above title recently appeared inThe Journalwhich called out some comment to which the author has objected in the last issue (March 19). In this last note he seems to have gone quite as far as the reviewer in refuting his former claims. From the comprehensiveness of the title and from the tenor of his paper one would naturally suppose he had some information to impart about asthma, but he now claims that he was not writing about asthma, but about "a rarer form of the disease." Every laryngologist, and probably nearly every general practitioner, knows that cauterization of the turbinated bodies will cure rare cases of asthma. If the gentleman had entitled his paper "A Case of Asthma Benefited by Treatment," and had confined his subsequent remarks to a statement of facts as pointed out in the review, he would not have

Physicians interested in the treatment of cancer of the head and neck, who were unable to attend this extensive symposium devoted to many aspects of the topic, will welcome this book. By no means a monograph, these papers are from "an outstanding group of specialists who devote their entire life to these problems... encouraged to give their personal opinions on the basis of their experience, hoping that the information would be... provocative." Although not a composite compendium of all methods and techniques, these papers—some old, but most new—interpret truly international concepts and are everything the editor had planned. Several articles are reviews of previously published papers; the majority have a personal touch and a philosophy invariably present in symposia of this type. A few carry the ornate prose of the speakers, which undoubtedly would have been edited in a monograph; most of the articles are extremely full. It must have