44 THE BRITISH J O U R N A L OF TUBERCULOSIS

have still to face their primary .infection at the age of 14 years. She believes that a considerable proportion of the casualties from phthisis in the 15-25 age group are a direct result of a late-acquired primary infection, while a very few cases follow reawakening of an incompletely healed h~emic focus dating back to earlier life. Exogenous superinfection is, in her opinion, exceptional.

The practical consequences of this conception of the disease, if it could be proven true, would be far reaching, for its logical sequeI is that adequate healing of the primary complex and B.C.G. vaccination could provide us with the key to the control of phthisis. One would wish that the solution of this problem was

really so near. Unfortunately, the evidence in favour of this theory is scanty and there is obviously much need here for further research.

Apart from this issue, all other criticism of the book concerns minor points. A work of this quality deserves production in larger format; the print is at present too small for comfortable reading and the illustrations of X-rays are not clear. A better diagram of the lymphatic system of the lung could also be substituted. As regards the text, more stress might be laid on the possibility of bronchiectasis following collapse and more detail given about the use of streptomycin in miliary tuberculosis and tuberculous meningitis. Nevertheless, the book is a storehouse of reliable information, and will be of value to all who are interested in the preventive and clinical aspects of tuberculosis. P . F .

0 detske Plicni Tuberkulose (Tuberculosis of the Lungs in Childhood). By VLADIMIR VOJTE~. OLOUMOIC ~ F.P.S. PP" 545" Price not stated.

Dr. Vladimir Vojtek, Medical Director of one of the largest children's sanatoria in Czechoslovakia, gives a very full account of all forms of tuber- culosis affecting the lungs in childhood. The book is, for Central European conditions, extremely well produced, and some 2i 4 excellent X-ray repro- ductions, each accompanied by a diagram, provide the illustrations for each of the five parts. The first of these deals exhaustively with diagnostic methods, clinical, radiological, physiological and bacteriological. The second part gives an account of all pulmonary manifestations of primary infection. The third part deals with what we would call the early post-.pmmary period. The fourth part, perhaps the most important, deals with cavltatmg or destructive processes as they occur at the various stages of tuberculosis in childhood from the cavitating primary to the adult type of the disease. The fifth and last part deals with differential diagnosis and classification of primary tuberculosis in childhood, quoting in the original language the classifications used by the Anglo-Saxon, French and German schools.

The exposition is clear and concise. The views expressed are based to a very great extent on personal experience and show clearly the influence of pre-war German and French and post-war Anglo-Saxon and Scandinavian literature. Much importance is attached to the r61e of superinfection as the cause 0f malignant primary lesions. The evil influence o'f repeated or continuous massive exposure is particularly stressed. The bool~ is the first comprehensive work on the subject in Czech. E . N .

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Brompton Hospital Reports. Vol. XVI, I947- Gate and Polden, Aldershot. Price Ios.

Those papers which are of more general interest in the current volume of the Brompton Hospital Reports include a description of the surgical treatment of twenty cases of constrictive periearditis. The nature of the disease is con-