i\m. Hrart J. March. 19hO Slightly more than half the patients operated upon ill 1951 were dead in 1956. SlightI>lehs than one quarter of all patients were dead within less than three years of operation. The reviewer thinks that such a mortality is not justilied unless e\ridencc is presented that nonsurgical treatment in such a group is apt to have at least as high a mortality. Such evidence is not presented. On the a clinical status compatible with man? years of contmr)., dyspnca without (right) heart failure, life, xvas the predominant indication for operation. Furthermore, the authors do an elective cholecystectomy before valvulotomq-, an illogical practice, in the reviewer’s opillion, and one which hardI> suggests a sick cardiac- patient. Incidentally, the reviewer counted 21, not 20, late deaths. The case for prophq-lasis against emboli and infarction is tilted ill fax-or c>f erlrgerk by the simple expedient of omitting those accidents which occur at operation or hoon thereafter. .\c.tuall>.. the natural recurrence rate as a basis for comparison is not discussed. Oni). 32 of 300 roentgenograms were a\-ailable for comparison postoperatively, and of these the majority showed larger silhouettes. Oni! one electrocardiogram is briefly described. that of the first, the results ;\lthough the mortality rate for the second 200 cases is double of the second group are regarded as better than those of the first because improvement occurred in 79.1 per cent of the second as compared to 72 per cent of the first. The statistical significance of these figures is not tested. Actually, the magic figure of 70 per cent improvement is maintained no matter how many die, by the simple expedient of referring only to survivors. The authors conclude that the mortality rate ill the long-term follow-up cannot be predicted from the short-term evaluation or from the inadequacy of the split as estimated by the surgeon at the time of operation. 1.i this not true because their patients were not anatomically homogeneous, because similar cardiac symptoms do not spell similar anatomic. faults, and because rheumatic heart disease is more thau a mechanical problem? Because splits are not always good, the authors anticipate a trend, as do all students of the subject, toward open-heart surgery.
DI ELISCTKOCARDIOGKAFIA. 327 illustrations. Price:
By Vincenzo 4,500 lire.
This monograph is a manual for students of electrocardiography. It is clearly written and based on typical documents. Even though there is no new contribution or new type of presentation, the book ran be recommended to medical students for whom it is clearly intended.
THE SURGEOK Hospital, Chicago,
AKD THE CHILD. and Professor Ill. Philadelphia,
By \lYllis J. Potts, M.D., Surgeon-in-Chief, Children’s Memorial of Pediatric Surgery, Northwestern ITniversity Medical School, 1959, U;. B. Saunders Company, 22.5 pages. Price $7.50.
In view of the number of excellent, comprehensive books on pediatric surgery recently published, only an intrepid and insensitive author would approach the task of a new book on this subject without considerable misgivings. Dr. Potts could have spared himself any qualms that might have beset him in this regard, because his book, in the reviewer’s opinion, serves a valuable purpose and undoubtedly will occupy the place left vacant by the obsolescence of Ladd and Gross’ monograph. The Sz~geon and the Child possesses the priceless ingredients of simplicity and brevity-two disciplines not easily attained when the complexity of some of the subjects, such as that of congenital heart lesions, is considered, and when one appreciates the temptation to expound which must come to a surgeon of Dr. Potts’ wide experience. The monographic proportions of the book have been maintained by reducing the material to essentials, and yet such is the ability of the author as lecturer and teacher that none of the essentials in an). given subject seems to be omitted. This is accomplished, as Dr. Potts freely confesses in the preface, by focusing “often in a somewhat dictatorial fashion.” His sparkling sense of humor, however, makes it a pleasant dictatorship, with no trace of stuffiness or pedagogy. No one with this superb sense of humor can take himself completely seriously, and it is often obvious that the finger that is being paternally wagged is one that has previously been burned in the school of experience.