BOOK REVIEWS 479

The whole book has been carefully edited. The standard of figures, diagrams, and x-rays is hi&h. and each chapter has an adcqr q.te bibliography. This volume fills an important gap in the lit:rature on emphysema, in t!rat it provides a readable and up-to-date summary of con- temporary opinions and knowledge. It deserves to be read widely, and it is not too much to sa*, that the knowledge and outlook incorporated within it should be a part of the normal edu- rational background of any physician or surgeon interested in chest disease.

D. V. B.

ATLAS OF CLINICAL ENDOCRINOLOGY. By H. Lisser, M.D., and Roberto F. Escamilla, M.D., St. Louis, 1957, C. V. Mosby Co., 476 pages, 148 plates. Price $18.75.

The authors of the Atlas of Clinical Endocrinology have succeeded in bringing together a vast experience in clinical endocrinology. They have done this by drawing heavily on photographs of patients, on their x-ray investigations, and on the pathologic specimens whenever these were available. In addition, they have reproduced charts depicting the salient laboratory features in the patients and the disease state under discussion. There certainly can be little or no argument about the general divisions of the endocrine disorders discussed, but undoubtedly there will be differences of opinion regarding nomenclature. Such semantic difficulties are not exclusive to clinical or research endocrinology. The appendix which concerns itself with growth and de- velopmental patterns, as well as with behavior manifestations, is invaluable; it is unusual to find these summarized in a short section.

Undoubtedly, this atlas will be of great value to many physicians who have only an occasional opportunity of seeing endocrine problems, as well as to specialists in other fields in which endocrinology may play an ancillary role.

J. C. B.

CORONARY HEART DISEASE. By Milton Plotz, M.D., New York, 1957, Paul B. Hoeber, Inc., 353 pages.

Since coronary heart disease is ubiquitous in Americans, it is entirely fitting that a book should be written concerning it. Dr. Plotz has presented a very complete treatise on the subject. There are 21 chapters, each with an excellent bibliography. It is my belief that Dr. Plotz has been successful in attempting to summarize the present status of coronary heart disease, and that he has done so by writing a carefully organized and easily comprehended book, using nu- merous illustrations and tables.

Although coronary heart disease is extremely common, the symptoms of this disease fre- quently are overlooked or misinterpreted. Accordingly, I believe that this book should be read by medical students, general practitioners, internists, and cardiologists.

J. W. H.

SCHRIFTENREIHE DER ZEITSCHRIFT FUR DIE GESAMTE INNERE MEDIZIN. (Cardiologie IV, Heft 7) Prof. Dr. Theodor Brugsch, Editor, Leipzig, 19.56, Georg Thieme, 192 pages, 43 illustrations.

The volume consists of 5 papers, the first 4 of which are based on a large amount of the experi- mental material of the authors, together with a quite detailed literature review of the various fields. R. Behre studied the important question of objective experimental documentation of subjective cardiovascular symptoms, comparing 102 patients having primarily organic heart disease with 194 patients having primarily functional disorders (pp. 7-84). All methods used were comparatively simple and applicable in a clinical diagnostic laboratory, or even in a phy- sician’s office; they included venous pressure (at rest, during Valsalva, and after mild exercise), vital capacity (rest and exercise), breath holding time, circulation time, Schellong’s functional test (essentially changes of pulse rate and blood pressure in standing and exercise), ECG (rest,

480 13OOK REVIEWS Am. &art J. September, 1957

exercise, standing), and s-ray.. None ot thcic methods gave rr aigniticant differentiation between the 2 groups of patients, perhaps with the exception of the ECG which was abnormal in 50 pet- cent of the patients with organic heart dise;+e a11d in 3.2 per cent of the patients with fiinctional disorders. The author holds that the response of the ECG to exercise (abnorma1 in 66 per cent of patients with organic heart disease, and of 7.8 per cent of patients with functional disorders) and to standing (abnormal in 16.5 and in 37.4 per cent, respectively) is diagnostically superior to the resting ECG, but these figures do not bear out his conclusion for the orthostatic test (which would miss the majority of patients in both groups). As negative as the results essentially are, it is important that such an attempt was made and reported.

W. Blumenthal discusses the clinical significance of the residual air determined from the planimetric measurement of the thorax area in x-ray films (pp. 8.5-113). Particularly valuable was the relative residual air in per cent of the total capacity, calculated from the difference of the thorax area in inspiration and expiration, minus a correction factor of 20 per cent. There was a significant correlation between the relative residual air and maximum voluntary pulmonary ventilation. A value of the relative residual air of 50 per cent seems to be a critical dyspnoe threshold, and a value of 55 per cent, B threshold for prolongation of the lung-ear circulation time. Decrease of the relative residual air up to 50 per cent may have little or no functional consequence.

A. Dittmer found the protein fractions of diagnostic value particularly in acute myocardial infarction (pp. 114-145). There was a significant increase of the alpha 2, alpha 1, and beta globu- lin fractions in the first 2 day-s of infarction, and a later decrease with healing. In fatal infarction, the increase of these fractions was progressive. The investigations of the author, hcwever, also include other types of cardiac pathology. In animal (frog heart) experiments and clinical material, W. Jenke found a synergistic effect of digitalis and nitrates, and an antagonistic effect between nitrates and catecholamines (pp. 146-182). H. Kanitz and F. P. N. Schennetten studied in 6 patients with cardiac decompensation the effect of rectal administration of G-strophanthin (pp. 183-193).

E. S.

Announcements

THE TIIIRD INTERNATIOSAL CONGRESS OF THE INTERNATIONAL SOCIETY OF ANGIOLOGY will be held in the Ambassador Hotel, Atlantic City, N. J., Oct. 18 to 21, 1957. Address: Dr. Henry Haimovici, Secretary-General, 105 East 90th St., New York 28, N. Y.

THE ELEVENTH ANNUAL MEETING OF THE AMERICAN SOCIIXTY FOR THE STUDY OF ARTERIO- SCLEROSIS will be held on Nov. 2, 3, and 4, 1957, in the Grand Ballroom of the Hotel Knicker- bocker, Chicago, Ill. Address: Dr. 0. J. Pollak, Secretary, P. 0. Box 228, Dover, Delaware.

THE MOUNT SINAI HOSPITAL OF CHUXGO offers a one-year approved RESIDENCY IN CAKDIOLCGY. The training is integrated with that of the Division of Cardiology of the Chicago Medical School.

Applicants should have completed a three-year residency in medicine, or a two-year residency in medicine or pediatrics plus one year in cardiology.

Inquiries should be addressed to Dr. Aldo A. Luisada, Director, Division of Cardiology, 2755 West 15th Street, Chicago 8, Illinois.

On Oct. 17 and 18, 1957, a SEMINAR ON HEART SOUNDS AND MURMURS with particular ref- erence to the diagnosis of congenital and rheumatic heart disease will be held in Burlington, Vt. Among the guest speakers will be Drs. A. A. Luisada and A. S. Nadas. This event is sponsored by the Vermont Heart Association and the University of Vermont College of Medicine. Further information may be obtained from Dr. E. Lepeschkin, Burlington, Vt.