368 BOOK NOTICES

erning factor so that these mentally de­fective children should have been in classes for mental defectives rather than in sight saving classes where it was impossible to provide both.

This book records a most encourag­ing step forward and those who have been the instigators and dynamic forces behind this constructive work merit sin­cere recognition. Lawrence T. Post.

Die Rontgendiagnostik und -Therapie in der Augenheilkunde, volume xix of Radiologische Praktika. By Dr. Wolfgang Hoffmann of the Univer-sitats-Augenklinik in Konigsberg i.Pr. 72 pages, 20 illustrations. Georg Thieme, Leipzig, 1932.

Even a hasty glance through this slender volume leaves an impression with the reader, as he turns the leaves and his eye is arrested by the excellent illustrations, the clearly printed page, the lucid German, that here is a good piece of work. This impression is strengthened as the subject matter is studied more closely. The application of the x-ray for diagnosis of ocular af­fections is treated in twenty-five pages with eleven illustrations, and the im­portant literature on. the subject fairly reviewed. A discussion of the well-es­tablished use of the x-ray for localiz­ing foreign bodies is given the greatest space, but in a few pages the more re­cent employment to which it has been put is outlined, such as to reveal dis­eases of the orbit; for example, bone tumors in which it is necessary to dif­ferentiate between the easily operable exostoses from the orbital wall and the more dangerous osteomata from ac­cessory sinuses. By blending hard and soft rays changes in the soft tissues con­tained in the orbit have been depicted, "hemorrhage, angioma, dermoid, lym-phoma, inflammatory pseudo-tumor, in which the picture shows structure, form, extent, and delimitation of the diseased area with surprising clear­ness." The optic nerve can be shown in relation to the optic canal and its neighboring sphenoid and ethmoid

cells, and the effect of disease upon the size of the optic foramen is convinc­ingly treated. Changes in the lacrimal ducts are also demonstrable.

The section on Roentgenotherapy in ophthalmology is introduced by a frank and full discussion of the injurious ef­fects, both early and late, of the x-ray upon ocular tissues, in inducing cata­ract, glaucoma, and other pathogenic manifestations, and how these may be avoided by employing adequate protec­tion and regulated dosage. The second half of the book is concerned with an enumeration of the various ocular af­fections that have been found to yield to x-ray therapy, together with the proper protection and dosage for each. Tuberculosis of the eye and its adnexa is treated at some length, showing what has been done for tuberculosis of the lacrimal passages, conjunctiva, eyeball, and orbit. Chronic inflammations of the eyeball due to other agents are dis­cussed in the next division, such as Mikulicz's disease, in which x-ray is the therapy of choice; uveitis after injury, sympathetic ophthalmia, in which, however, irradiation does not suffice to prevent manifestations in the second eye and should not delay enucle-ation if rapid improvement after the first dosage does not set in; intraocu­lar hemorrhage after injury, and ulcer­ous processes in the cornea. Chronic in­flammations of the lids and conjunctiva are also shown to be subject to this therapy; for example, blepharitis, granulosis and vernal catarrh. There follows a discussion of the acute in­flammations, dacryocystitis, orbital phlegmon, panophthalmia, and kera-titis parenchymatosa, in some of which the results have been surprisingly good. Hemorrhagic glaucoma and secondary glaucoma will often yield most gratify-ingly if the vascular changes have not progressed too far. New growths of the lids, epibulbar tumors and intraocular tumors both carcinomatous and sar-comatous, cysts of the iris, orbital tu­mors and new growths of the hypophy­sis are mentioned with a view to pre­scribing the utmost that can be done for their relief. E. S. Buss.