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THURSDAY, DECEMBER 15, 1904. space connected with the middle ear; (6) the air spaces
opening into the cavity of the nose. These six struc
tures are selected because, during the last twenty or HUMAN ANATOMY.
thirty years, they have been the subjects of the keenest (1) A Treatise on Applied Anatomy. By Edward H. inquiry, and surgeons have published their observations
Taylor, M.D., F.R.C.S.I. Pp. xxvii +738; 178 concerning them in thousand upon thousand of treatises figures and plates. (London : Charles Griffin and and articles. One would expect that the basis of their Co., Ltd., 1904.) Price 30s. net.
treatment would rest on an intimate knowledge of the (2) The Human Sternum. By Andrew Melville Pater- normal use of these structures. John Hunter, Everard
son, M.D. Pp. 89; 10 plates. (London : Published Home, and John Hilton would certainly have sought for the University Press of Liverpool by Williams a complete knowledge of the functions of these parts and Norgate, 1904.) Price 1os. net.
to serve as a foundation for a rational treatment. Dr. (3) Der Gang des Menschen. v. Teil. Die Kinematik
Taylor adopts the orthodox view as regards these des Beinschwingens. By Otto Fischer.
structures; he describes their shape, position, and remarks. vi. Teil. Ueber den Einfluss der Schwere lationships, and the routes by which und der Muskeln auf die Schwingbewegung des reached, but not a word is said of their use. Perhaps Beins. By Otto Fischer. Price 4 marks. (Leipzig : it is unfair to blame Dr. Taylor for this omission, B. G. Teubner, 1904.)
because it must be confessed that we know much more To those unfamiliar with the ways of modern of the diseases of these structures than of their normal medicine the continual appearance of new
function. Yet in a text-book written for house works on human anatomy must cause some surprise. and operating surgeons surely it is the duty of the No subject should be better known, for it has been a author to point out essential gaps in our knowmatter of almost universal study for centuries. At the ledge rather than to gloss them over by a multitude best, many will conclude, a new text-book on applied of unessential details. This criticism is the more anatomy—the kind of anatomy the surgeon and pertinent because the author in this case has not taken physician more especially need—can only be a re- a narrow view of applied anatomy; he devotes a very setting of old facts, and an examination of Dr. Taylor's large part of his space to a description of operative work will show that, to a large extent, the conclusion procedures, pathological processes, embryological deis justified. The steady advance of surgery necessi- fects, and introduces here and there points in tates a continual rearrangement of anatomical per- physiology. spective; the areas of the body which were under a A great part of this work consists not of applied, but surgical taboo to the septic surgeons of former days of purely descriptive anatomy. Some years ago are open to the clean operator of modern times. Waldeyer, of Berlin, gave an elaborate description of The brain and spinal cord, the cavities of the ear and some ten or twelve areas he distinguished within the nose, the organs within the thorax and abdomen, and human pelvis—all of which have been adopted in this the great joint cavities of the limbs, have come, one book; yet not a word is said as to what manner of use after the other, within the field of everyday surgical a surgeon can possibly apply them. Again, as regards procedure during the last thirty years. In his treat- a small peritoneal recess, which may occur to the left ment of these parts of the body Dr. Taylor is quite up of the terminal part of the duodenum, all the various to date; his pages reflect accurately the best opinion forms which have been described by hair-splitting that is to be found in modern text-books of anatomy surgeons are reproduced in detail. An elaborate deand surgery. Still, modern advances will not alto- scription of the condition known as knock-knee is supgether explain the rapid appearance of new works on plied, yet no mention is made of how bones react in anatomy or on any other subject; every generation their growth to the forces which are brought to bear demands its books on science or literature wet from on them, nor is there any allusion to the forces which the press.
normally act on the knee joint. The study of this work, containing more than half Surgeon-anatomists have a fondness for the applia million words, furnished with highly finished cation of certain proper names to surgical procedures figures, written with clearness and accuracy, raises the and anatomical structures-such as the “pouch of question : is the modern surgeon, as seen in a text- Prussak,” the “ fossa of Landzert,” “Gosselin's book such as this, a more scientific man than his pre- fracture,” &c. An examination of the index of this decessor of fifty or a hundred years ago? A consider-work shows that more than one hundred such terms ation of a number of subjects in this work, in the treat- are used, yet, in comparison with many works, the ment of which Dr. Taylor is neither better nor worse number is indeed very moderate; but one feels they than other rising surgeons, will show that, as think- are still rather many. Many terms introduced by ing men, they compare unfavourably with surgeons surgeons are not words which may be used easily, such of past periods. The subjects referred to deal with (1) as “ cholecystotomy
“ cholecystotomy" (opening the gall-bladder),
, the appendix vermiformis, the seat of appendicitis; “ cholecystectomy (excision of the gall-bladder), (2) the prostate, which becomes so frequently enlarged “ cholecystenterostomy” (making a communication in old men; (3) the epididymis, a structure connected between gall-bladder and intestine), “ choledochowith the testicle and very liable to disease; (4) the gall | tomy" (opening the bile duct). bladder, interesting in connection with the formation (2) In this monograph, a companion to one on the of gall-stones; (5) the antrum of the mastoid, an air | human sacrum, published in 1893, Prof. Paterson gives the facts gathered and the conclusions reached evolved from the other, there can be no doubt that the during a prolonged research into the development, ribs, the intercostal muscles, and the sternum as we comparative anatomy, and nature of the human know them in higher vertebrates appeared during this sternum. Leaving aside the convenience of having phase of evolution. Their appearance is directly due our scattered knowledge on this subject summarised, to the introduction of a new type of respiration; the and the value of the mass of evidence collected during sternum which serves in the higher forms as an the examination of hundreds of individuals, the main element of the respiratory thorax is totally unlike the importance of the work lies in two conclusions which bone which merely served as part of the shoulder Prof. Paterson draws concerning the nature of the girdle in the more primitive type. With this evidence sternum :-(1) that it is fundamentally part of the clearly in view it is difficult to understand how Prof. shoulder girdle; (2) that it is not a segmental structure. Paterson concludes that even in mammals the sternum Both these inferences are at variance with accepted is still—what it was when it first appeared in verteopinion.
brates-functionally and fundamentally an adjunct or At the present time it is universally taught that the element of the shoulder girdle. We are surprisingly sternum in mammals, birds and reptiles—that is to say, ignorant of the part played by the sternum in the movein all vertebrates which use the body wall for the pur- ments of respiration, even in man, but a cursory exposes of inspiration—is a composite bone derived from amination of its respiratory movements in various a fusion of the ventral ends of the ribs. The sternum groups of birds, and in several orders of mammals, is thus regarded as a structure of costal origin, and quickly serves to show that its form and size depend having only a secondary connection with the shoulder | chiefly not on the movements of the forelimbs, but on girdle. In Amphibia, on the other hand, it is recog- the part it plays in the respiratory movements of the nised that the sternum is developed in continuity with thorax. In our opinion the key to the morphology of the shoulder girdle, of which it forms an intrinsic part; the sternum is an accurate investigation of its function. it is in them a shoulder-girdle sternum. That the
Prof. Paterson is undoubtedly right in regarding the shoulder-girdle sternum represents the more primitive sternum as primarily a continuous unsegmented type, and that from such a type the costal sternum of median bar. The conception of the sternum as a the Reptilia was evolved, are assumptions which com- segmental structure he characterises as “a nebulous parative anatomists will freely grant. At present, transcendental notion." Yet his own evidence shows however, there is a distinct break in our knowledge that the greater part of the mammalian sternum, at of the history of the sternum; no intermediate forms the commencement of the cartilaginous and osseous between those two types are believed to occur, and no stages of development, is laid down as a truly one, with perhaps the exception of the late Prof. T. J. segmental structure, each segment corresponding Parker, has ever formulated a definite theory as to the exactly to a body segment. Much more " nebulous manner in which the costal sternum of Reptilia could and transcendental ” appears to us his explanation of have arisen from the amphibian shoulder-girdle the occurrence of bony segments or sternabræ as “due sternum. Prof. Paterson's investigations help us very to the traction or pressure on the part of the ribs and materially to trace the origin of the costal or, as it costal cartilages." In support of this theory Prof. may more truly be named, the “respiratory” sternum Paterson cites the fact that centres of ossification of the three higher classes of vertebrates from the appear in bones at points of traction and pressure. In simple sternum of Amphibia. He shows that the the case of the sternum, however, the centres of ossifi“respiratory sternum arises developmentally in con- cation appear not opposite such points, but exactly tinuity with the precoracoid element of the shoulder- between them. girdle, and quite independently of the ribs, and that This monograph is well got up; the figures are it is therefore merely a modified form of the amphibian numerous and highly finished. There is evidently a shoulder-girdle sternum. Further, the various forms slight error in Fig. 35, plate v.; the centre of ossifiassumed by the “respiratory” sternum in reptiles, cation for the fourth segment (if the term may still birds, and mammals do not, when rightly interpreted, be used) of the mesosternum is stated to be present in favour Gegenbaur's conception of its evolution by a 71 per cent. of cases, whereas in the text (p. 18) the fusion of the ventral ends of ribs. The sternum of proportion is given as 26 per cent. A curious misprint amphibians is the median ventral element of their occurs on p. 33, where the centre just alluded to is shoulder girdle, and when Prof. Paterson states that said to appear in 59 per cent. of children before birth, no corresponding element is developed elsewhere in and 15 per cent. after death-probably meaning after the median ventral line, he overlooks the cartilage birth. developed as a median ventral element in the pelvic (3) The brothers Weber were of opinion that in the girdle which in every sense exactly corresponds to the forward swing of the leg in walking the lower exsternum.
tremity acted as a pendulum, the chief force in action The origin of the "respiratory " sternum is part of being that of gravity. Duchenne, on the other hand, a wide problem, viz. in what manner and under what as the result of a special investigation, came to a totally conditions did the body wall become modified to serve different conclusion, viz. that the forward swing was as an active inspiratory agent in higher verte- almost wholly due to the direct action of muscle. In brates, thus replacing the “pharyngeal pump ” of the fifth and sixth parts of his research into the amphibians? Whatever may have been the exact mechanics of the human gait, Prof. Fischer concludes, manner in which the one form of respiration was after an elaborate analysis of the force expended during
the movement, that Duchenne comes much nearer the the new seismology means and what it has accomtruth than the brothers Weber, muscular action playing plished. About the old seismology, volumes, papers, a much larger part than the force of gravity. Those and particularly sermons exist in thousands. But if who have watched the passive movements of a para- we except a few, and amongst the few the works of lysed leg during attempts at progression will have no Mallet stand igh above the rest, all they give are difficulty in accepting Prof. Fischer's results.
reiterated narratives of what people saw and heard, The problem of estimating theoretically the force now and then enlivened by some wild hypothesis or necessary to produce the forward swing of the lower pious reflection. extremity in walking is an extremely complicated one. Major Dutton's work belongs to another category, Prof. Fischer regards the lower extremity as a pen- and rather than telling us what earthquakes do, his dulum made up of three segments, each of which main object has been to tell us what they are, and undergoes certain secondary movements during the while doing this he has kept abreast with the work swing of the entire extremity. Further, the hip joint, of others which his own inquiries in the domain of from which the pendulum is suspended, undergoes an seismic and volcanic activities have enabled him to irregular forward movement during the swing of the present in a terse and accurate form. limb. The resistance and elasticity of the muscles and Everything is discussed with a minimum of matheligaments and the friction at the various joints are matics from a strictly scientific standpoint, whilst that factors which can only be approximately estimated. which is sensational has properly been most carefully
By means of photographic records Prof. Fischer was put under taboo. A justification for the exclusion of able to subdivide the forward swing into forty and what is of practical importance, which gives not only forty-one equal phases of time, and by estimating the to the man in the street but to Governments some amount of force in action during each phase he shows inkling as to the use of earthquakes, is not so apparent. that gravity alone can account for only a minor frac- It is extremely likely that a Prime Minister may not tion of the force necessarily expended in the movement. care a twopenny-bit whether the inside of the world Further, the positions assumed by the foot, leg, and on which he lives is red hot or stone cold, while he thigh during a forward swing show distinctly that might be extremely interested to know that seismovarious groups of muscles are then in action. He grams may afford a satisfactory explanation for the recognises four periods in the forward movement of interruption of his cablegrams. The importance of the limb, each of which is characterised by the action earthquake writings to communities who have been of a distinct group of muscles. In the commencing alarmed by accounts of disasters in foreign countries phase the ilio-psoas bends the thigh on the body, the is self-evident, while it would at least be consoling to rectus femoris extends the leg forwards, the tibialis those who were suddenly cut off from the outer world anticus bends the foot upwards; in the second phase by the failure of their cables to learn whether such the gluteus maximus and hamstring muscles draw failures were the result of an operation of war or of the thigh backwards; in the third phase the knee is nature. A knowledge of how to construct so that flexed by the gastrocnemius and short head of the earthquake effects should be minimised means the biceps; in the final phase the muscles in front of the saving of life and property in countries subject to leg are again in action, and remain powerfully con- seismic disturbances. Seismic charts indicate positracted until the sole of the foot is again planted on tions where it is dangerous to lay deep-sea cables, the ground.
whilst they tell the hydrographer where he may expect These results are certainly much more in keeping to find changing depths. In these and in a variety of with clinical and everyday experience than those of the other directions seismology helps to make communities brothers Weber. Many who only occasionally take comfortable, and at the same time acts as incentive long walks must have observed that one of the first to create a popular interest in and to obtain support groups of muscles to give out are those in front of the for a young science. But as Major Dutton defines his leg, and that they feel painful only at the end of the standpoint, and as a volume of 300 pages cannot conforward swing, when the heel reaches the ground- tain everything, our remarks on omissions must only the period at which Prof. Fischer shows these muscles be taken as indications of the hydra-headed nature of come most powerfully into action. Α. KEITH. . seismology.
The first four chapters are chiefly devoted to the
cause of an earthquake, which is defined as anything EARTHQUAKES.
that “calls suddenly into action the elasticity of the Earthquakes. By Clarence Edward Dutton, Major, earth.” Explosions at volcanic foci produce a local
U.S.A. Pp. xxxiii+314; 63 illustrations. (London : trembling, but they are comparatively of rare occurJohn Murray.) Price 6s. net.
rence and seldom disturb large areas. When a long E
seismological investigations made during the last perhaps mountain ranges drops down along its length, twenty-five years are few in number. Two have been instrumental observations have revealed the fact that published in England, a compilation has been “made the world may be shaken as a whole. Subsequent in Germany," and now we have a volume from the adjustments along such a line due to intermittent redistinguished geologist, Major C. E. Dutton, of the covery from overstrain and settlements of disjointed United States. All told, therefore, we have only four materials give rise to numerous after-shocks which books which give the uninitiated some idea of what are only sensible over areas of small size, and it seems