Klinische Rheumatologie: Pathogenese, Symnptomatologie, Diagnostik und Therapie der Rheinzaerkrankungen. By Werner Moll. Foreword by Dr. S. de SRze. (Pp. 454+xii; illustrated. Sw. Fr. 79.) Basle, New York: S. Karger. 1957. This book on clinical rheumatology is bigger than it sounds, since approximately balf the text is printed in very small type. Such a device for making a large book seem of reasonable size does not make it more readable. After struggling through the small print one can find a substantial amount of information laid out in a very systematic manner, but it is not especially up to date. For example, in discussing the treatment of gout, "benemid" (probenecid) is dismissed in nine lines as a new American remedy, and the important uricosuric analogues of phenylbutazone are not mentioned; and in the chapter on rheumatoid arthritis the rheumatoid serum factor gets one page of small print. At the back of the book there are 166 illustrations, but nearly half of these consist of photographs and radiographs of the hands of patients with early rheumatoid arthritis, which all look alike, and there is no indication that the author has been selective in the material he presents. For those who read German with ease the most informative chapter is probably the one on disk disorders. J. H. KELLGREN.

Arthritis & RheumatismVolume 9, Issue 5 p. 658-674 ArticleFree to Read Joseph J. Bunim memorial lecture. Epidemiology of rheumatoid arthritis J. H. Kellgren M.B., M.Sc., F.R.C.S., F.R.C.P., J. H. Kellgren M.B., M.Sc., F.R.C.S., F.R.C.P. Professor of Rheumatology Rheumatism Research Centre, University of Manchester, Manchester, England. Physician, Manchester Royal InfirmarySearch for more papers by this author J. H. Kellgren M.B., M.Sc., F.R.C.S., F.R.C.P., J. H. Kellgren M.B., M.Sc., F.R.C.S., F.R.C.P. Professor of Rheumatology Rheumatism Research Centre, University of Manchester, Manchester, England. Physician, Manchester Royal InfirmarySearch for more papers by this author First published: October 1966 https://doi.org/10.1002/art.1780090503Citations: 28AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume9, Issue5October 1966Pages 658-674 RelatedInformation

Bulletin, of which this is the latest, are admirable in conception and form.Undoubtedly they bring great credit to British medicine.In addition to the Editor's introduction, there are fifteen complete chapters, each written by authorities who have themselves contributed important original work to this field.The presentation and content is scientific throughout, although the clinician will find a great deal that will interest and instruct him.Professor Gray's chapter gives a full account of the processes of investigation of the disorders of the adrenal cortex; Drs.Beck and McGarry summarize the physiological importance of cortisol in complete and masterly fashion; and Dr. Saffron provides a fascinating contribution on the mechanisms of adrenocortical control.Everyone interested in the adrenal cortex and its mysterious ways-and this must include every rheu- matologist-should buy or borrow this important publication.

Goin, entitled "Mach Tables for Real Gas Equilibrium Flow of Air in Hypervelocity Test Facilities with Total Temperatures to 10,000° K.".This report tabulates the aerodynamic flow parameters for isentropic expansions and flow through normal shocks in the pressure range 100-4,000 atmospheres.Both the bibliography and the monograph are available, price 0•75 and 2•0 dollars, respectively, from the Office of Technical Services, Department of Commerce, Washington 25, D.C.

Goin, entitled "Mach Tables for Real Gas Equilibrium Flow of Air in Hypervelocity Test Facilities with Total Temperatures to 10,000° K.".This report tabulates the aerodynamic flow parameters for isentropic expansions and flow through normal shocks in the pressure range 100-4,000 atmospheres.Both the bibliography and the monograph are available, price 0•75 and 2•0 dollars, respectively, from the Office of Technical Services, Department of Commerce, Washington 25, D.C.

The history of osteoarthrosis is long, for degenerative joint changes can be seen in fossil skeletons of prehistoric animals and in the joints of ancient Egyptian mummies. Despite this long history our knowledge of the disease is incomplete, perhaps because it is one of those dull commonplace disorders that are hard to study with enthusiasm, but new knowledge of osteoarthrosis must be gained if the later years of our lengthening lives are not to be plagued by increasing pain and disability. Osteoarthrosis can be defined as an expression of a joint's inadequacy to meet the mechanical stress placed upon it, and in certain patients and in certain joints, notably the hip, abnormal mechanical factors do obviously play a dominant part in both causation and treatment. But are such joints representative of the total problem of degenerative joint disease ? May there not be important constitutional factors which predispose to premature degeneration of multiple joints submitted to no more than average mechanical stress ? Detailed laboratory studies of individual patients have been unrewarding in this respect; except in such rare conditions as alkaptonuria, where congenital absence of the singre enzyme homogentisic acid oxidase (La Du, Zannoni, Laster, and Seegmiller, 1958) is associated with premature degeneration of all the intervertebral disks and articular cartilages. This lack of positive laboratory findings, however, may only reflect the inadequacy of our methods, and while we are waiting for the biochemists to devise new methods it may be interesting to review some of the information obtained in recent years from the study of osteoarthrosis in population groups by field-survey techniques.

The Epidemiology of Chronic Rheumatic Diseases Get access J.H. KELLGREN J.H. KELLGREN RHEUMATISM RESEARCH CENTRE, UNIVERSITY OF MANCHESTER Search for other works by this author on: Oxford Academic PubMed Google Scholar Occupational Medicine, Volume 9, Issue 1, April 1959, Pages 32–34, https://doi.org/10.1093/occmed/9.1.32 Published: 01 April 1959

CONNECTIVE TISSUE. A Symposium organised by The Council for International Organisations of Medical Sciences. Established under the joint auspices of UNESCO and WHO. Edited under the direction of R. E. Tunbridge, the University of Leeds; by Madeline Keech, the University of Leeds; J. F. Delafresnaye, C.I.O.M.S., Paris; and G.C. Wood, the University of Leeds. 9x6 in. Pp. xii+371, with many figures. Index. 1957. Oxford: Blackwell Scientific Publications. Price 42s

Pulmonary Complications of Abdominal Surgery. By Anthony R. Anscombe, M.S F.R.C.S. (Pp. 121+x illustrated. 20s.) London: Lfoyd-Luke (Medical Books) Ltd. 1957. This is an excellent physiological and clinical study of a problem which frequently troubles both surgeon and anaesthetist. Though the mortality from pulmonary complications following abdominal operations has undoubtedly diminished, yet the author states, and presents figures which support his statement, that "the incidence of postoperative pulmonary complications has altered but little during the last forty years." The surgeon may be surprised, and he will find little comfort in the further dictum that "the anaesthetic and the method of administration have no significant effect on the incidence of pulmonary complications." After a thorough investigation of the whole problem the decision is reached that "*the chief interference with pulmonary mechanical function is a protective reflex from the anterior abdominal wall." This reflex varies according to the position and size of the incision, and the relative merits of various incisions are usefully discussed. The author sees danger in keeping the patient in the Trendelenburg position for a prolonged period. He is in favour of breathing exercises after operation and assesses the value of post-operative physiotherapy. He sees no harm and some benefit in the giving of small doses of morphine to relieve pain after operation. Finally a challenge is thrown down. " It. is suggested that the investigation of pulmonary mechanical efficiency is as essential as the knowledge of the haemoglobin and blood group of a patient who is to undergo an abdominal operation. The vital spirogram is at present the best test available." What the vital spirogram is the reader must find out for himself by reading the book. It will repay him. ZACHARY COPE.

In recent years we have observed 12 patients with rheumatoid arthritis who developed severe and sometimes fatal bacterial infection in connective-tissue structures.In nine cases this was mainly a suppurative arthritis, which was often polyarticular; in two cases the infection was mainly in the bones; and in the remaining case there were multiple subcutaneous and muscular abscesses.This complication of rheumatoid arthritis is therefore not uncommon, and since it presents some dia- gnostic and therapeutic problems and is a grave threat to life it seemed desirable to report our experience with these patients in some detail, especially as we have been unable to find any previous report of a similar series.Coste et al. (1957), however, reported a case of polyarthritis complicated by two episodes of staphylococcal septicaemia, and Bywaters (1953) mentions the occurrence of staphylococcal arthritis in patients with rheumatoid arthritis in discussing two cases of what he calls fistulous rheumatism.In some of our earlier cases the extent of suppuration was revealed only by a systematic examination of the joints at necropsy; but with increasing experience and awareness of the problem we have been able to make a correct diagnosis at an earlier stage and reducemortality by appropriate treatment.In two patients the infecting organism was a coliform bacillus, but in the other ten it was a staphylococcus, and in all but three of these the staphylococcus was resistant to penicillin.The cases are described in chronological order and their main features are summarized in Tables I andII.Case I A retired business man aged 63 was admitted to the in- firmary in July, 1950, for severe progressive rheumatoid arthritis of five years' duration.During the six months before admission he had been constitutionally ill and had lost 20 lb.(9 kg.) in weight, and during the last two weeks he developed an unproductive cough.On admission he was obviously ill, with a fever up to 1010 F. (38.30C.).He had a severe inflammatory erosive arthritis of all the limb joints, some limitation of spinal movement, numerous subcutaneous nodules, lymphadenopathy, and a large left pleural effusion.E.S.R. 106 mm.(Westergren), Hb 12.0 g./100 ml., W.B.C. 9,000, sheep-cell agglutinating titre (S.C.A.T.) 512, serum albumin 3.6 g. / 100 ml., serum globulin 3.5 g./100 ml.The pleural fluid was blood-stained but sterile on culture; bronchoscopy and BRMSH MEDICAL JouRKL4z.