fundus oculi diagnostica oftalmoscopica
TRANSCRIPT
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