Notes on Infant Feeding

(Pp. 96; figs. 4; plates 10. 12s. 6d.) London: N.A.P.T., Tavistock House North, Tavistock Square, W.C.1, 1954. IN this small book, which fits the pocket easily, Dr. Neville Irvine has provided a compact, eminently readable and concise guide to the history, principles and practice of B.C.G. vaccination with up-to-date information on the progress of vaccination with Wells' vole vaccine (Myco. tuberculosis, var. muris). The book is divided into eight chapters, with a foreword by Professor F. Heaf. The different vaccines are described, and their safety and effectiveness discussed. The techniques of tuberculin testing and vaccination, the reading of results and the complications of vaccination are detailed and commented on. Perhaps more stress might have been laid on the importance of keeping separate syringes and needles earmarked for different strengths of tuberculin for the Mantoux test. The difficulty of ridding a syringe completely from antitoxic serum is well known, and tuberculin is an even more tenacious fluid. For mass testing at clinics and schools the changing of the needle between each injection, while somewhat laborious, is to be strongly recommended (vide M.R.C. Memorandum, No. 15-'The Sterilization, Use and Care of Syringes'). Spare heads are provided for the multiplepuncture vaccination apparatus, so that a fresh sterile head can be used while the others are being sterilised. It would be an advantage to have the same provision for the Heaf multiple-puncture tuberculin test apparatus. Dr. Irvine discusses the question of the necessity for conversion testing and follow-up, especially in schoolchildren who are likely to be exposed only to casual infection. The experience of many years and trial of many antigens were necessary before the routine use of the post-Schick test was omitted in diphtheria immunization. It is, perhaps, premature to recommend a similar procedure for B.C.G. vaccination till fuller information is available, especially as the vole vaccine is still on trial, but the first step towards omission of the conversion test would, as mentioned by Dr. Irvine, be the carrying out of conversion tests on selected samples of the vaccinated population. The author's style is lucid, and the coloured plates are excellent. The book is well produced and can be strongly recommended to all doctors and nursing personnel engaged in the struggle against tuberculosis. V. D. A.