ANAPHYLAXIS AND ANTI-ANAPHYLAXIS. By Dr. A. Besredka. English Edition by S. Roodhouse Gloyne. Heinemann. 6s. net.
Medical research bears so directly on the well-being of every one of us that it is astonishing that more people do not take an interest in it. The existing indifference may be attributed partly to the lack of good popular books describing recent advances in an easily comprehensible way, partly to the nomenclature adopted by the medical profession, which is apt to frighten the layman into imagining that the exotic polysyllables in question can be used only for phenomena of unimaginable complexity and obscurity. Complex they always are, of course, with the complexity of all natural manifestations, but very often the main lines of the problems which have arisen, and the methods of attack, can be stated in plain language. The book before us, which deals with the profoundly interesting subject of anaphylaxis, is not avowedly written for the enlightenment of the public, yet it is in most parts accessible to anybody with a slight knowledge of medicine, and, not being a "popular" book, it has the advantage of being free from the erroneous generalisations so often introduced in presenting a branch of science to the lay reader. The subject is described as one still in the course of development, and is not given that false air of completion so dear to the populariser.
The phenomena of anaphylaxis are among the most striking in medical science, and have only recently been investigated, for although isolated cases of what we should now call anaphylaxis had been previously noted, Richet was the first to show the significance and extent of the subject in his memoir of 1902, in which he established many of the most important points. The essence of anaphylaxis is that the injection into an animal of a small quantity of one of certain substances—which in some cases are, and in others are not, poisons (with a poison the dose must, of course, be less than the fatal one)—puts the animal in a particular sensitive state, so that a very small second injection produces fatal results of a very violent and well-marked character. Some time must elapse after the first injection for the sensitive state to establish itself, and the second injection must be of exactly the same nature as the first, this latter fact constituting the so-called specificity of the anaphylactic effect. This specificity has been applied for identifying blood of a doubtful source, since an animal which has been sensitised with an injection of blood from a given species is sensitive only to blood of the same species. Further, the blood of an animal in the sensitive state can be used to render another animal sensitive, a result known as passive anaphylaxis.
The important bearing of anaphylaxis on clinical practice is obvious. With therapeutic sera accidents have been fairly common in the past, grave effects following a second injection; this is a pure anaphylactic phenomenon. Much research has been done to find out methods of preventing the anaphylactic shock, and the most important advances in the field of anti-anaphylaxis are due to Dr. Besredka. His book naturally devotes much space to this aspect of the study, and gives details of the successful technique which he has developed. He worked mainly on guinea-pigs, having obtained extreme regularity of reaction with these animals. His most important result, both from the theoretical and the practical standpoint, is that vaccination against anaphylaxis can be produced by a system of gradually increasing doses, starting with the injection of a very small amount of the substance in question. This has led to a routine for serum injection by graduated doses, which has been successful in averting serum sickness. Besredka's interpretation of his results is against Richet's theory that the second injection combines with a substance, the toxogenin, present in the serum as a consequence of the first injection, and so produces a poison, the apotoxin. He considers rather that the reaction of the injected substance, the antigen, with the substance already formed (which he calls sensibilisin) itself produces the fatal result by disturbing the equilibrium of certain nerve cells where the combination takes place. By graduating the doses the reaction is watered down into a series of slight shocks, so that the great shock produced by a single injection is spread over a comparatively large time, and becomes innocuous. He finds an analogy between the effect and the mixing of water and sulphuric acid. If the water is poured in quickly there is an explosive action, but if it is added gradually the combination takes place without violence. "In our opinion the anaphylactic poison does not exist."
There are a great number of interesting experiments cited in the book which we cannot mention here. The translator has done his work well, although we do not like some of his importations from the French. It should not be impossible to find expression more English than "titre of toxicity" and "fulminating cases." He has added an excellent chapter on "Recent Work on Anaphylaxis." We are glad to see at last a short work in English on the subject, which is one of the most fascinating fields in modern medicine. Somebody should translate and bring up to date Richet's excellent little book. It is a pity that the nomenclature of the subject cannot be made uniform.
THE NEW TEACHING SERIES OF PRACTICAL TEXT-BOOKS:
APPLIED BOTANY. By G. S. M. Ellis.
FOUNDATIONS OF ENGINEERING. By W. H. Spikes.
CHEMISTRY FROM THE INDUSTRIAL STANDPOINT. By P. C. L. Thorne.
Hodder & Stoughton. 4s. 6d. net each.
This new series is rather pompously announced as striving to build "up the New Humanism on the basis of the student's immediate economic interest and environment" (which implies a considerable modification of the accepted meaning of Humanism). We translate this as meaning that it is intended to give the reader some idea of the various sciences and arts as they find application in industry and commerce. This is a worthy object, and, on the whole, the books are simple and interesting expositions of the utilitarian aspect of the sciences in question. There is, perhaps inevitably, a tendency to hurry over fundamental difficulties which will not, we think, leave an intelligent student satisfied. For instance, to say that a force is whatever changes motion, without further explanation, may well puzzle the reader, who knows that he can push against a heavy stone without producing any apparent motion. However, there is a distinct place for books of this general character, which do good work by showing to a wide audience the peaceful achievements of science and its practical aspects; they act as a counterblast to the deadening tradition of rule of thumb. The industrial chemistry is particularly comprehensive, and has an excellent set of original diagrams of industrial plant. The series is well printed and well illustrated, and, for present times, moderately priced. It deserves wide recognition.
PROJECTIVE VECTOR ALGEBRA. By L. Silberstein. G. Bell & Sons. 7s. 6d. net.
It is not often that a book appears describing an essential advance in pure mathematics which is intelligible to the man of moderate attainments in that science—by moderate attainments we mean such knowledge of mathematics as is picked up in one or two years at a university. Dr. Silberstein, who is well known in this country for his original work, especially in connection with the theory of relativity, has, in his Protective Vector Algebra, developed his latest researches in geometry in a form which is attractive and free from pedantic formalities, and has throughout aimed at simplicity of expression, in contrast to certain modern mathematicians who endeavour to lend importance to minor conventional problems by a bewildering display of definitions and theorems. The essential novelty of the book, from which the whole theme is developed, is the generalised definition of the addition of vectors, which does not need any construction of parallel lines, but depends solely on a straight line construction making use of the points where the vectors cut an arbitrary fixed straight line. Dr. Silberstein's definition is a generalisation of the Euclidean one, to which it reduces if the arbitrary line just mentioned is moved away to infinity, and if the space is Euclidean. The knowledge of geometry which is demanded is little more than the usual postulates of projective geometry and Desargues' theorem. From his definition the author proceeds to prove the associative law, and then, after dealing with the equality of non-coinitial vectors, gives many interesting uses of the generalised vector algebra. The proof of Pascal's theorem gives a striking example of the power and simplicity of the new method, and the whole treatment of conics will delight the student of projective geometry. Altogether the book is a very original and striking contribution to a fascinating branch of mathematics.