772 THE AMERICAN HEART JOURNAL

in flow from room temperature to 13” may amount almost to complete stoppage. (2) Repeated application of heat tends to reduce progressively the speed of de- velopment of and ultimate height of the reaction. (3) Many times reactions to heat were slight and occasionally even absent. The circumstances under which these failures occurred were not quite clear to the author. The reaction to cold was ap- parently more constant. (4) Th e increase in flow of blood in response to warmth begins after a latent period of ten to twenty seconds and takes place very abruptly. Decrease in flow with cold begins at once and progresses slowly and steadily.

The author concludes, therefore, that the one reaction cannot be thought of as the reversal of the other and that the mechanisms of inducing the responses must consequently be quite different. He can say nothing about denervated preparations

since he was unable to verify completeness of denervation. The carrying out of this procedure would seem a useful complement to the present work. He concludes tentatively that nervous elements must play a large part in regulating the reactions to local thermal stimuli.

J. M. S.

Miiller, A. : Thrombophlebitis and Its Treatment With Ambulant Compression Bandages. Med. Klin. 33: 793, 1937.

The author discusses the parts played by local inflammation and slowing of the blood stream in thrombosis and appears to believe that slowing of the stream is

more important. After reviewing literature of figures on the outcome of phlebitis, it became apparent that the use of Fischer’s compression bandage gave better results and he therefore began to use it. Out of several hundred patients, 85

were thromboses of the deep veins, and 12 were postoperative. Only 2 deaths oc- curred, both with pulmonary infarcts. The author states that long standing cases with considerable edema and induration often cleared up in a very short time- two to five days-with almost immediate disappearance of pain. He emphasizes the fact that it can be applied over ulcers to great advantage and appears to be es- pecially useful in aborting early painful thromboses.

The rationale is making smaller the venous cross-section and therefore the flow of blood more rapid. He recommends the use of stiff sized cloth for compression bandages wrapped over softer supporting bandages and wads of padding for the bony prominences of foot and tibia. The knee is left free except perhaps for

stockinette and the thigh is bandaged tightly with an elastic bandage. The com- pression bandage must be as tightly wrapped as possible without stopping arterial flow. Unless there are other contraindications the patient is kept up and active.

J. M. 8.