Daniel B. Stone

Andreas Vesalius of Brussels, 1514-1564.

Historians have two objectives. They talk and write about what went on, and they try to interpret it. My own view is that when history is only factual it is dull, but that as the historian puts his emphasis on why a man or a group did or thought something and how one mans thoughts or acts influenced others, things become brighter. I wondered if the author of this biography could perceive and shed any light on the sequence of events which led Andreas Vesalius to develop his extraordinary abilities, to stand out in what he did and thought in his time, and to show that truth has no special time of its own. Vesalius was born in 1514 and died in 1564, four hundred years before the publication of this book. We know little about his childhood in Brussels or his years as a medical student in Paris from

The Care of the Geriatric Patient.

People are living longer than their forebears. In the 22 years between 1937 and 1959, life expectancy from birth increased by ten years in the United States. The catch is, of course, that we cannot award these extra ten years as a prize squeezed between the ages of twenty and twenty-one or fifty and fifty-one but we have to add them to life as a postscript or addendum after three score years and ten. When would you like to win an extra ten years? I suggest that the best time to receive this prize might be at the age of twenty-two or twenty-three; this would solve all the problems of medical education even if it broke some of our deans. In any event, 16 million Americans were 65 or more years of age in 1960. And old people need more care than young. The care of these old people is

Clinical Diabetes Mellitus.

This book is obviously worth the money, which is more than you can say of many things these days. It brings together 34 articles which were published seriatim during the last couple of years in the New York State Journal of Medicine . McGraw-Hill have produced it in their usual exemplary style. The price is moderate or modest. It must be a challenging and, I suspect, a bitter and thankless task to keep 34 experts going in a similar direction at the same mean speed. Ellenberg and Rifkin seem to have edited this volume with enlightened patience and skill. They have not tried, or have certainly not succeeded in their efforts if they have tried, to smooth different styles, nor have they gone to excessive or pedantic lengths to prevent overlap. I think that their decision receives commendation from the easy flow and extensive sweep of most of the book, although

Diabetes Mellitus in the Tropics.

There are two ways of finding out what happens to people who habitually eat food which differs from that eaten by Americans. Neither way is easy. One is to see what happens to volunteers in North America or Western Europe who eat an experimental diet for many years. Studies of this kind in outpatients may be unreliable, and inpatient studies are difficult and expensive. The second way is to study people in poor or materially poor—the two are not synonymous—countries of the world where the native eats a high-carbohydrate, low-fat, low-cholesterol diet because he cannot afford to eat richer food. Many people whose judgment I respect believe that the epidemiologie evidence obtained by the latter method supports the fact that there is a correlation between elevated serum lipid levels and the incidence of atherosclerosis or the prevalence of illness by atherosclerosis. I am all in favor of trying to establish

Teaching and Learning in Medical School

Samuel Butler, in Erewhon , transposed the concepts of crime and sickness. The Erewhonians attached no guilt to crime. When a man stole a pair of socks, his family and friends offered him their sympathy and hoped that he would soon recover from his unfortunate attack of burglary. Indeed, when Mr. Nosnibor defrauded his clients on the stock exchange, he was treated for the condition not only by his family practitioner, but also by one of the most celebrated straighteners of the kingdom, who was called in consultation. Conversely, the Erewhonians punished illness. If a man became sick, he was charged and might go to jail. Butler described the Erewhonian judge sentencing a man for tuberculosis: Prisoner at the bar, you have been accused of the great crime of laboring under pulmonary consumption, and after an impartial trial before a jury of your countrymen, you have been found guilty.... The sentence

Diabetic Care in Pictures

You may have read about Jeremiah Glum, of East Cupcake, Iowa. He has diabetes. In 1951, he left our hospital superbly regulated and painstakingly instructed. He returned to the Out-Clinic a week later, complaining bitterly of seven subcutaneous abscesses. The abscesses puzzled us, but eventually we discovered their cause. The patient had tested the urine four times daily by boiling 5 ml. of urine with 8 drops of insulin, and had injected 20 units of Benedicts solution subcutaneously half an hour before breakfast daily. This apocryphal story stems, so far as I know, from the 1920s, but it emphasizes my theme, which is that many diabetics appear to have been poorly instructed and that whats past is prologue. Regulation does not connote simply the negative virtues of an orthodox doctrinal theology, but has meaning because a number of studies have suggested that good control favors a longer and healthier life

Alcoholism: The Nutritional Approach

One social drinker in fifty becomes a drunkard. Why? What changes him? How does he differ from his companions? Experts have offered many explanations. Some have asserted that physiologic or somatic changes precede alcoholism, and that chronic alcoholism may result from causes as organic as those of Addisons disease. Williams, the author of the book under review, is a pioneer in this field. For a decade, he has hammered home the concepts of biochemical individuality and genetotrophism. Each person has a distinct biochemical structure, which charts his susceptibility to infections, to mental illness, to drugs, or to alcohol. The genetotrophic concept infers that one may be born with a great need for certain nutritional elements. Williams believes that these two factors—biochemical individuality and the genetotrophic concept—favor alcoholism in man. In this book, he presents his thesis, adduces his evidence, and appeals for action. People write books for many reasons: to

Master Your Tensions and Enjoy Living Again.

Nor or Never: The Promise of the Middle Years. By Smiley Blanton, M.D. Price,

Current Trends in Research and Clinical Management of Diabetes.

4.95. Pp. 273. Prentice-Hall, Inc., Route 9W, Englewood Cliffs, N.J., 1959. I have always regarded the cave, the fire, and the hunk of meat the rock bottom of human existence. Our technological obsession, our machines, and our economic philosophy have produced the highest general standard of living in the history of the world. Whether we like it or not, this is the age of know-how. Nevertheless, our culture may defeat us. If the cold war warms, the exploitation of science may kill us all. We may emphasize a standard of living as an end in itself. We may deceive ourselves that opulence alone can solve personal, technical, and political conundrums: insecurity and boredom; disease; rocketry; population expansion, and international envy. Materialism is reputed to favor a loss of ethical and cultural values, and this may make

Serum Glucose, Insulin, and Growth Hormone in Chronic Hepatic Cirrhosis

Like Lady Chatterleys husband, editors are often forgotten. From time to time the subscriber should try to edit the editor, praise him for the excellent and blame him for the tedious, for if the reader forgets the editor, this gentleman may well forget his customers. The editors of the Annals of the New York Academy of Sciences do a fine job. This book is an example. It comprises forty-three papers given at a meeting in April, 1959, and published five months later. Those responsible have produced a superior book, for which they and consulting editor Forsham deserve thanks and praise. Even the best of editors have not solved the problem of how to work with a sows ear, of course, but most of the participants at this conference brought some silk along. The papers cover a wide field: clinical facts and figures; new work in physiology; the use of oral