BOOK NOTICES 343

are many cases of blepharitis in which refractive errors are at least not the only causative factor and in which the obstinacy of the condition is mostly comparable with that of the various types of eczema. In these cases medi­cation seems to afford relatively little relief, or such relief as is obtained proves temporary in character.

Luzsa (Klinische Monatsblätter für Augenheilkunde, 1930, volume 84, January, page 76) found ultraviolet radiation ineffective in the treatment of blepharitis, and he attributes this fail­ure to the fact that ultraviolet rays have very little power of penetration. On the other hand, he has had ex­tremely gratifying results from the use of x-rays. Of thirty-one cases so treated, fourteen were completely cured and nine showed a striking improve­ment. Anumberof the remaining eight cases failed to return to the clinic for repetition of the treatment.

The patients chosen for roentgen treatment were those who had proved most resistant to other forms of therapy over a long period of time. During the course of radiation all other treatment was discontinued.

The effective dose of x-ray was found to be that which produced an actual erythema of the lids. Patients who de­veloped an erythema got well or at least improved, while (with one excep­tion, a very recent cast of blepharitis) those who showed no erythema were not helped. For patients in whom a satisfactory erythema was not produced by the first two doses, a cumulative ef­fect was sought, and if necessary the amount of the individual dose was in­creased. The adequate dose varied in different patients. If the first dose was sufficient to cause an erythema, two treatments at an interval of one week were practically always all that was re­quired.

The first experiments were made with from ten to fifteen percent of the standard skin-erythema dose, but this produced no result. In different subjects the adequate dose was found to vary between twenty and thirty per­

cent of the standard erythema dose. On twenty-two patients a three millimeter aluminum filter was used, and on the other nine the aluminum filter em­ployed was two millimeters thick. The discharge is technically stated as pro­duced with a tension of 109 kilovolts at an intensity of four miliamperes and a focal distance of twenty-three centi­meters for an exposure of twenty minutes through the three millimeter filter, or of sixteen minutes through the two millimeter filter. The eyeball was protected by a layer of glass two millimeters thick, containing fifty per­cent of lead. IV. H. Crisp.

BOOK NOTICES

Stereoskopischer Atlas der äusseren Erkrankungen des Auges nach farbigen Photographien (Stereo­scopic atlas of external diseases of the eye from colored photographs). By Karl Wessely, professor in München. Section 1, plates 1-10. In cardboard case, price 12 ijiarks. Published by J. F. Bergmann, Munich, 1930.

This is the first of a projected series of six such atlases, each to contain ten colored plates of external diseases of the eye. Each plate is a three-color reproduction of an AGFA stercophoto­graph and is designed to be observed through an ordinary stereoscope. The use of a high-powered magnifying stereoscope brings out the grain and de­stroys much of the illusion. This first series illustrates pigmented nevus of the lower lid, circumscribed melanosis of the conjunctiva, recent lime burn, congenital coloboma of the iris, Symblepharon of the lower lid, gonor­rheal conjunctivitis, iris bombé, sarco­ma of the orbit, herpes zoster ophthal­micus, and a far advanced lid carcino­ma. Printed on the back of each plate is a description of the case in German, French, and English, the English trans­lations having been made by Dr. Per­kins of New York.

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In the main, the photographs are ex­cellent and show good plasticity, not exaggerated. The details are such that to the trained eye the diagnosis is pos­sible without reference to the text. The one possible exception to this is the pic­ture of iris bombé. In some instances the grain of the photographic plate is

somewhat too manifest, but this de­tracts only slightly from the value. On the whole, this first of the series prom­ises well for the future and, when the entire sixty plates are available, there will be at hand an atlas of inestimable value for teaching purposes.

Harry S. Gradle.