R E V I E W S O F N E W BOOKS I89

In all 457 children were examined: of these 4 ° controls negative to tuberculin all gave negative results on lavage. Of the remaining 417 children positive to tuberculin, 249 were found positive on lavage. In positive cases direct examination of the lavage fluid rarely showed the presence of tubercle bacilli; culture gave 32"7 per cent. positive and guinea-pig inoculation 94"6 per cent.

The clinical material was carefully controlled by X-ray examination, a large number of films being clearly reproduced. This study showed that out of Io8 children whose tuberculosis was apparently inactive, only one gave a positive result on lavage, whereas in active cases bacilli were found in I55 out of 226 cases (69 per cent.).

The cases were then grouped according to the type of lesion present. In I6 cases the glands at the root of the lung appeared to be the only lesion present; 4 of these cases were positive (25 per cent.). In 74 cases the glan- dular enlargement was accompanied by infiltration of the prehilar region; in 41 of these cases tubercle bacilli were present (55 per cent.). The cases in which the lesions were in the lung parenchyma were divided into primary, secondary and tertiary stages (Ranke). In the primary and secondary stages there were.,78 positive cases out of Io 3 (76 per cent.). In 33 children with tertiary stage lesions 32 were positive (97 per cent.).

Thgrapeutique hydro-climatologique de la tuberculose. By L~oN BERNARD and R. EVEN. Pp. I46. I934 . 2o fr. Paris: Masson.

The above booklet forms one of a series by different experts dealing with spa and climatic treatment of various diseases. As might be expected, the first section of the book is brief, as the authors hold that in the treatment of all active forms of pulmonary tuberculosis balneology has no place.

The greater part of the book is taken up with a description of the climate of France, with special reference to the suitability of the various regions for the treatment of tuberculosis. Humidity of the ground is considered more favourable than dampness of the air, and the stimulating influence of high altitudes is looked on as being suitable for the torpid case and contra-indicated in the acute.

The well-known prejudice of French writers against the seaside resort in the treatment of phthisis appears to be well founded, so far as France is concerned, as the northern and western coastal regions are on the whole humid and exposed to rain-bearing winds. The Riviera resorts, once so popular on account of their sheltered situation-and high sunshine record, are subject to sudden variations of temperature, and provide such unsuitable distractions that they cannot be recommended for the majority of patients. For those unsuitable for treatment in the High Alps, suitable climate may be found at a moderate altitude in the hinterland of the Riviera or in the lower valleys of the Pyrenees.

This book will, unfortunately, be the last contribution to medical litera- ture of its senior author, the late Professor Ldon Bernard; it may be confi- dently recommended as a guide to the climatic t reatment of tuberculosis in France.