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Full text of "Pathogenic Bacteria"

>                    11

"This is in every way an admirable volume, and we are crenuinely pleased to
congratulate Dr. Holt on his work. Its very size led us to expect something of
the nature of a dictionary—a mere book of reference—but we have found it con-
spicuously free of the stock-in-trade of the wholesale compiler. It is a monument
of labour, and labour not of collation, but the ripe fruit of the many-sided
practical experience of the author himself. It is a book that we can confidently
recommend to every practitioner as the best we know in this department of
medicine, and full of interest and useful suggestiveness from cover to cover. And
when to excellence of matter and style are linked good printing, good paper, and
good binding, we have a most acceptable volume. To the pathologist also there
is a special attraction in the large amount of space devoted to the morbid anatomy
of infantile disease, a subject that receives sparse illustration in existing text-
books ; lesions are fully described, and by means of numerous drawings, photo-
graphs, and coloured plates, brought more within the range of those whose duties
withdraw them from the post-mortem room to the bedside. The coloured plate of
acute meningitis is a masterpiece of its kind, and represents most exactly what
we so often see in the deaclhouse.

" Detailed attention is very properly devoted to the question of nutrition,
with its derangements and associated diseases, and great stress laid upon
diet and hygiene, * since in this rather than, in drug-giving lies the secret of
success, certainly in all disorders of digestion and nutrition,3 and there is no
more promising field for therapeutic activity than the prevention of disease,
in children. The experience of our large Children's Hospitals goes far to show
that there are two chief factors in the causation of infantile disease—bad
feeding and squalor. The former we can only hope to remedy by the better in-
struction of ignorant mothers, and this by medical men whose therapeutic range
is not entirely limited to grey powder and circumcision. We notice with pleasure
a praiseworthy absence of the numerous formulae of food-stuffs that make most
text-books unreadable; while the graphic chart method brings the essentials of
composition readily to recognition. We quite agree with Dr. Holt that artificial
feeding, as at present ignorantly practised, is the most fertile cause of infantile
disease, and fully endorse his experience that ' it is exceedingly rare to find a
healthy child who has been reared in a tenement house, and who has been arti-
ficially fed from birth.'

" A most instructive chapter is that on the ' Peculiarities of Disease in
Children,' while another of no less value is devoted to a discussion of Rickets,
with copious illustrations of the incident bony deformities. We should have
said that the antero-posterior curvature of the lower third of the tibia was much
more frequent than the author suggests, and not necessarily associated with
bow legs; indeed, it is the common and usually the only curvature in those
children who, while kept off their legs, have been nursed on their mother's lap,
with the leg supported in such a way as to incur the bending strain of the full
weight of the foot. The carbo-hydrate phantom, too, is relegated to the sub-
servient position it really occupies in the aetiology of the disease. The handling
of the system diseases, one and all, leaves but little to be desired. True to the
intention expressed on the title-page, the author caters at once both for the
student and the practitioner; the general principles of treatment are so explained
as to be most helpful to the uninitiated, while many practical hints of the highest
value are to be found on every page. We miss many old friends—to wit, the
fallacies and misstatements handed from author to author— and we welcome
many new ones that are usually conspicuous by their absence. On the whole, the
chapters on diseases of the lungs attract us most in this portion of the book.
The statistics of pneumonia and broncho-pneumonia point to a much greater fre-
quency of pneumonia in infancy than is generally imagined to be the case. In
the first twelve months of life the highly bronchial texture of the lung favours
the peribronchial variety; but after this period, as the vesicular element becomes
relatively more abundant, we find at first a tendency to a mixed process^and after
the third year a great preponderance of the croupous type. Thus it is that