fundus oculi diagnostica oftalmoscopica

BOOK NOTICES 1175

ical investigator of senile cataract is thatof preventing hereditary characteristics!

W. H. Crisp.

HEPARIN FOR RETINALTHROMBOSIS

Twenty years ago heparin, a substancefound within the liver and other parts ofthe body, was proved to prevent thecoagulation of blood. It has been em­ployed as an anticoagulant for blood usedfor transfusion. Recently it has been ob­tained in pure form which may be safelyinjected into the blood in the veins. It hasbeen used with advantage in cerebralthrombosis, and in the last year in thetreatment of retinal thrombosis. A casein which this treatment was used hasbeen reported in the Lancet (March 19,1938) by Holmin and Ploman, of Stock­holm, Sweden.

A hospital nurse, of 52 years, noticedsudden dimness of vision in her right eye.The retinal veins were dilated and therewere hemorrhages along them. On thethird day, vision being 0.2, intravenousinjections of 5-percent heparin weremade, every four hours while the patientwas awake. This was continued three orfour times a day for 10 days, when visionhad risen to 0.8. At the end of threemonths the eye had vision of 1.; that is,standard vision. The remedy removed theobstruction from the vein, and alsohastened the absorption of the retinalhemorrhages.

The prognosis for retinal thrombosisis generally better than that for retinalembolism. It usually ends in partial res­toration of vision, whereas retinal em­bolism often leads to complete, perma­nent blindness. However, the course ofthis case seems to indicate that the useof heparin tends to hasten the cure andmake it more complete. In this case theobstruction seemed to be in the central

retinal vein. Frequently, with the ophthal­moscope, the particular branch of theretinal vein that has been occluded can beidentified, and the effect of the heparinon the clot may be watched from day today.

Since heparin in the blood streamfavors the breaking up and removal ofthe clot, it might be found of considerablevalue in retinal embolism. It certainlyshould be tried as quickly as possible afterthe loss of sight has been noticed. Retinalthrombosis is often confused with em­bolism; however, in either case, heparinis indicated. So far as is known it is aremedy free from serious danger. In theeye we would be justified in pushing it,and watching its effects. Heparin wouldcertainly be a safer substance with whichto experiment than some of the otheranticoagulants; for instance, the aso-dyes,such as "Chicago blue 6B," suggested byRous, or "chlorazol pink."

Edward Jackson.

BOOK NOTICESFUNDUS OCULI DIAGNOSTICA

OFTALMOSCOPICA. By Prof. Q.Di Marzio. Clothbound, 212 pages, 212figures in color. Rome, Stab. L. Salo­mone, 1937. Price not stated.This is as beautiful an atlas of the

fundus oculi as has ever been published.In extensiveness and completeness it farexceeds any other atlas of the eye­grounds. There are 212 colored illustra­tions most of which measure five inchessquare.

The subjects are well chosen, colorsvery true to life. The text describes thepictures fully and accurately, in almostall cases giving the clinical history of thepatient from whom the illustration wastaken. In many of the optic-nerve lesionsvisual fields, X rays, and photographs ofthe patient are included.

1176 BOOK NOTICES

It is unfortunate for the Americanophthalmologist that the text is written inItalian. However, it is so simple that areasonable familiarity with Latin andFrench permits one to understand itwithout recourse to the dictionary. Thebook would be a valuable addition to anyophthalmic library.

Lawrence T. Post.

INTRODUCTION TO OPHTHAL­MOLOGY. By Peter C. Kronfeld,M.D. Clothbound, 331 pages, 32 fig­ures, 5 plates, index and ophthalmicdictionary combined. Charles C.Thomas, Publisher, Springfield, Il­linois, 1938. Price $3.50.

On first picking up the book, the readeris impressed by the good appearance, ex­cellent binding" clear printing, and read­able page. Obviously much thought andcare have been given to these extrinsicfactors.

The author states his intention has been"To formulate the principles underlyingthat portion of ophthalmology which is anecessary part of basic medical educa­tion." If this has been accomplished thebook has a very real value for teaching inmedical schools because this is all thatshould be attempted in ophthalmic teach­ing of the undergraduate. Again to quotefrom the author's preface: "The materialpresented pertains principally to thepathogenesis of disease. The details ofdiagnosis, of methods of examination,and of treatment have been omitted."This seems a very logical method, andthe author has carried out this data faith­fully. The book is interestingly writtenand many important points that are oftenoverlooked are stressed.

The first chapter is of necessity de­voted to anatomy, and succeeding chap­ters to diseases of the various elements inthe eyeball. A consideration of injuries,

vascular disease, and the intraocular pres­sure is then taken up. Neoplasms, theoptic nerve, visual pathway, the pupil,and motor anomalies are presented, andfinally a few pages are used for con­sideration of some of the elements of re­fraction. Plates are in black and white.They illustrate very well a dozen com­mon intraocular conditions.

This book should prove of real valueto the teacher of undergraduates. Acourse modeled on it would include theessentials and give an excellent theoreti­cal outline. Any medical student whohad a good knowledge of its contentswould be conversant with the ophthalmicfacts necessary to him as a generalpractitioner. Lawrence T. Post.

ALLERGISCHE AUGENERKRAN­KUNGEN (Allergic diseases of theeye). By Arnold Lowenstein. 72 pages.Basel & Leipsig, S. Karger, 1938.

This monograph comprises a review ofdiseases of the eye associated with ordue to an allergic state. It therefore rep­resents a summary of the literature to­gether with the observations and com­ments of the author, thus affording abrief but competent presentation of thesubject. That the number of allergic dis­eases of the eye discussed does not repre­sent the total is the author's opinion, andaccordingly the future will reveal evenmore manifestations. LOwenstein ad­vises caution in explaining inflammationsof uncertain pathogenesis as allergic, afault it must be admitted becoming moreand more common. The difficulties ofdiagnosis are acknowledged as faulty his­tory, preconceived notions of the patient,unreliability of cutaneous reactions dueboth to the technical difficulties in elicit­ing reactions and to the interpretation ofthese tests. Thus, as contrasting examples,hay fever and vernal catarrh are the