86 OBITUARY

this book will be very valuable, and it cannot be ignored in any review of cur­rent literature.

Edward Jackson.

TUBERCULINOTHfiRAPIE DANS LES NfiVRALGIES FACIALES IDIOPATHIQUES ET CER-TAINES AFFECTIONS ESSEN-TIELLES. (Tuberculin therapy in idiopathic, facial neuralgias and certain essential affections.) By Dr. Carlos Charlin C. Talleres de la Editorial Nas-cimento, Santiago de Chile, 1940. Paper covers 336 pages, 33 figures, of which 20 are photographs, 12 charts, and one drawing. Price not stated. The material making up this volume

has been published in part in several com­munications appearing intermittently dur­ing the past few years in the Annales d'Oculistiques. The earlier papers are de­voted to a discussion of ophthalmic dis­ease associated on the one hand with the nasal nerve, and on the other with Meckel's ganglion. The author dis­tinguishes the two affections by anatomi­cal enervation, sympotomatically by the presence of ocular lesions, congestion, su­perficial pain of the external nose, and facial eruption, all characteristic of the disturbances in the nasal nerve. In either case, however, immediate relief is ob­tained by application of powdered co­caine-adrenalin.

The greater part of the monograph, however, is concerned with the tuberculin treatment of both ocular and generalized conditions of assumedly tuberculous or obscure etiology. The tuberculin used in treatment was either Koch's old tuber­culin, or the methyl alcohol extract origi­nally introduced by Negre and Boquet, the choice of the preparation depending upon the tolerance of the patient. The treat­ment is prolonged and consists of intra-

cutaneous injections of infinitely small doses. The reviewer sees little new in the therapy or the administration, and feels that acknowledgment to preceding workers would have been an important and graceful touch.

In any case, 40 patients with a diagno­sis of essential neuralgia of the eye were treated with tuberculin, apparently with benefit to most. In this group tuberculin skin tests gave reactions in 28 cases, doubtful reactions in 5, no reaction in 5, and in 2 skin tests were not done. This forms the basis of the argument for the tuberculous origin of this manifestation.'

This form of treatment was subse­quently carried over to a large variety of clinical conditions in which ocular lesions were also demonstrable. Thus patients with cardiovascular disease, rheumatoid disease, migraine, and others, received equal alleviation from their symptoms. In tuberculous infection of the eye, iritis, iridosclerokeratitis, and myalgia, the au­thor also reports success. Nonocular forms of tuberculosis are also reported as benefited by tuberculin therapy. Indeed, the general results obtained were so en­couraging that the author recommends that "in the presence of lesions, both of unknown etiology and resistant to treat­ment, there is only one method of elimin­ating infection: the experimental, tuber­culin treatment. One sees the presence of the same clinical problem offered by occult syphilis, namely occult tuberculo­sis."

L. A. Julianelle.

O B I T U A R Y

SIR WILFRED THOMASON GRENFELL

1865-1940

The modern ophthalmologist still re­members he is a member of the medical