66 BOOK NOTICES

This volume has intentionally avoided as much as possible the diag­nostic and other practical questions, and, in contrast with most other works on the subject, merely seeks to set forth the present position of investiga­tion with regard to the fluid and to draw therefrom a series of theoretically important conclusions. For this pur­pose the complete literature of the sub­ject has been surveyed and evaluated; and the magnitude of this undertaking may be understood from the fact that, although the author of this volume has used his own judgment as to selection of significant references, the biblio­graphy which he appends covers eighty-eight large pages.

The author's long acquaintance with this subject thoroughly justifies the em­phasis which he has placed upon his personal views. In spite of its highly technical character, the text is very ele­gantly and readably written.

In the special chapter in which the cerebrospinal fluid is compared with the aqueous humor and also with the laby­rinthine and other fluids, the author remarks that the aqueous resembles the cerebrospinal fluid to the extent that it probably arises from the ciliary processes, the structure of which re­sembles that of the choroidal plexus of the brain ; while the aqueous is perhaps also derived from the choroid, which may possibly be regarded as function­ing like the meninges. But, while the aqueous unquestionably bears a close resemblance to the cerebrospinal fluid, it would be a great mistake to regard the two fluids as identical.

The value of this volume is further enhanced by a careful subject index of twenty-eight pages. W. H. Crisp.

Introduction a l'etude des hyperten­sions oculaires (Introduction to the study of ocular hypertensions). By Georges Bonnefon. 143 pages, with drawings in the text. Stiff paper cover, 45 francs. G. Doin et Cie, Paris, 1931.

This brochure states the author's personal views as to the physiological

basis of normal ocular tension ; and also concerning the value of various medical and surgical procedures employed in the treatment of glaucoma. Bonnefon classifies ocular hypertension under two types: static and -dynamic hyper­tension ; the first occurring without and the second with a departure from the equilibrium between vascular pressure and the pressure of the intraocular fluids. He points out that Graefe's iridectomy does not always cure acute glaucoma, and that Lagrange's sclerec-tomy does not always cure simple glau­coma, and associates these facts with certain exceptions which he establishes as to the treatment of individual cases. He expresses himself against temporiz­ing with the long continued use of drugs in cases which will ultimately re­quire operation and in which the only chance of safety rests in operative inter­vention. IV. H. Crisp.

Das Augenzittem der Bergleute, seine soziale Bedeutung, Ursache, Haufigkeit, und die durch das Zittern bedingten Beschwerden (Miners' nystagmus, its social sig­nificance, cause, frequency, and the difficulties occasioned by the nystagmus). By Professor Dr. M. Bartels and Dr. med. W. Knepper. Octavo, 49 pages, with nineteen illustrations. Paper covers, 6.90 marks. Verlag von Julius Springer, Berlin, 1930. (Issued by the Deutsche Gesellschaft fur Gewer-behygiene in Frankfurt a. M.

The senior author is well known for his writings on various social aspects of ophthalmology. In the preface atten­tion is called to the fact that social legislation and medical science are in­separably related to one another, and that only scientifically trained physi­cians can deal with the questions which arise in relation to the etiology of dis­ease and as to payments to be made under the various schemes of social in­surance. Nystagmus is an interesting example of the conditions in which medicine and social economics are closely related,

BOOK NOTICES 67

The last twenty years have witnessed a wealth of scientific study as to the re­lationship between oculomotor balance and the mechanism of equilibrium, and Knepper has contributed to this investi­gation important researches which are set forth in this volume.

Most recent writers are agreed that deficient illumination in the mine is the principal cause of miners' nystagmus, and this view is strongly supported by the experiments of Bartels and Knep­per. Thus there were twice as many nystagmic'miners in the mine with the poorest illumination as in the best il­luminated mine. The idea that nystag­mus is especially to be blamed upon the necessity for constantly looking up­ward in the mine is here regarded un­favorably.

Treatment calls for constant stay in daylight and cessation of mine work. As a prophylactic measure, all mine workings should be adequately equipped with electric lamps.

Further study of the subject should include exact observation of the condi­tion of miners below and above ground. Industrial compensation plays an im­portant part in the statistics as to the apparent incidence of miners' nystag­mus. W. H. Crisp.

L'Extraction totale de la Cataracte par l'erisiphaque (complete extraction of cataract by the erisiphake). By Gilbert Cadilhac. • 76 pages, illus­trated, paper covers, 15 francs. Masson et Cie, 1927, Paris.

The operation here treated is natur­ally that of Barraquer. The author in­sists that the operation can be learned by any skillful operator, and he quotes the following statement by Professor Fuchs: "I t is true that Professor Barraquer possesses a great personal skill acquired by use of this method; however, the difficulties which it pre­sents do not appear to me to be much greater than those of other procedures, so that a skillful operator will quickly overcome them". The author adds that a purely theoretical study of the tech­nique is not sufficient, but the beginner

must have seen the operation done by an expert.

The operation is particularly recom­mended on account of the extreme simplicity of the postoperative course, iritis especially being so rare that atropin is no longer necessary.

Barraquer's personal statistics, now including one thousand cases, are analyzed in considerable detail. In 893 of these there were no untoward circumstances during operation: the operative accidents include 68 hemor­rhages in the anterior chamber, slipping of the vacuum cup in 43 cases, rupture of the capsule in 60 cases, vitreous pro­lapse in 49 cases, and iris hernia in 18 cases. No postoperative complications were observed in 787 cases: postopera­tive accidents include prolapse or in­carceration of the iris, 28; incarceration of the capsule, 17, hyphema, 91 ; iritis, 19; late iridocyclitis, 12; detachment of the choroid, 19; detachment of the retina, 7; vomiting, 24; and other ocu­lar disturbances in smaller numbers, as well as some general disorders not con­nected with the operation. A clear black pupil was obtained by 947 cases, 767 having a round central pupil. The vitreous was transparent in 918 cases. The tension remained normal in 951 cases (13 cases of increased tension, 31 with diminished tension, and 5 with secondary glaucoma). The record showed 299 cases as having no astig­matism, 524 as having astigmatism be­tween 0.5 and 2 diopters, 165 as having astigmatism from 2 to 6 diopters, and 7 as having astigmatism above 6 diop­ters. The visual acuity obtained was 10/10 in 680 cases, between 10/10 and 7/10 in 145 cases, between 7/10 and 4/10 in 108 cases, between 4/10 and 1/10 in 58 cases, and between 1/10 and nil in 9 cases. These results were obtained in spite of an important number of co­existing lesions which diminished the vision.

If any operative step has been in­accurately performed (cutting the flap, iridectomy, and so on) the procedure of phacoerisis should be given up and the operation completed by ordinary methods.