problems that face him. In this respect it is iudeed a “primer”. But the graduate physician, wide though his clinical experience may be, very frequently needs a reorientation of his knowledge on a good solid framework of basic understanding. Here also Dr. Burch has fulfilled a very real need.

The second edition uses the same plan of presentation as did the first. Illustrations employed in the latter have been improved and new ones added, and all of them are excellent. There has been an extension of the discussion of congenital heart disease, with emphasis on the current method of clinical study and management, and the treatment section has been expanded (though still relatively brief). Newer developments in other sections have been added also. No bibli- ography has been included since this is not considered as belonging in a primer. Some objection might be raised to the inclusion of so-called arteriosclerotic heart disease under “Heart Disease Produced By the Aging Process” in view of the mounting evidence in recent years relative to vital metabolic factors, but this is a controversial matter, and Dr. Burch has wisely avoided attempting to present both sides of such questions.

This book is heartily recommended to beginners in cardiology and to all other physicians who wish a reorientation of their knowledge based on the newer developments in the field of cardio- vascular physiology. Dr. Burch is to be congratulated for a job very well done.

T. D.

BALISTOCARDIOGRAFIA CLINICA. By D. Sibilia Roma, 1953, Societa Edizioni Mediche, 105 pages and 27 figures.

This monograph collects in a concise and clear presentation the various contributions deal- ing with ballistocardiography, including several by the author himself. Ballistocardiographic techniques are described. Among them, the direct and the indirect methods, and the optical, magnetic, and piezoelectric devices are discussed. Longitudinal, transverse, and sagittal ballisto- cardiograms are described. In general, the ballistocardiogram is studied more from the point of view of changes of the single waves than as a method for determination of output or ejection.

The various physiologic types of tracing are discussed. In particular, clear schemes point out the differences between the tracing of the “vertical” heart and that of the “horizontal” heart. Functional tests and respiratory variations are described. The second part of the book is devoted to clinical abnormalities with special regard to coronary heart disease. In the evaluation of the clinical value of ballistocardiography, the author shows critical sense and moderation. The final paragraph is devoted to the future of the method which is considered as important.

This book represents a useful compendium and may be employed for consultation. The edition is excellent; the illustrations are good.

A. A. L.

FONOCARDIOGRAFIA CLINICA. By A. Caniggia. Torino, 1953, Edizioni Minerva Medica, 290pages and 232 illustrations. Lire 3,000.

This monograph of clinical phonocardiography represents the result of a great effort made with singularly inadequate and obsolete technical means. The author is using an electrical method of recording; the microphone is connected with an ink-writing galvanometer. As a result, the electrocardiogram and phonocardiogram are traced as sections of two superimposed arcs.

While the film speed is inadequate (2.5 mm. per second), any direct-writing instrument has a too low period of vibrations for an accurate sound tracing. Therefore, the various graphs trans- scribed by the author represent only an interesting technical curiosity. Little exception can be taken to most of the statements of the book. However, there are no quotations, and no bibli- ography is given in order not to “overload the book” (see foreward by Prof. Izar). Therefore, it is often difficult to know whether the author actually saw the described phenomena or whether he is quoting from published works.

It is a pity that a gifted person, like the author, should try to accomplish so much with so little.

The edition is good, and the trar.ings are well reproduced A. A. I,.