Anatomy: the Reproduction of Man

By W. Stanley Sykes, M.B.E., M.B., B.Chir., D.A. (Pp. 171. 30s.) Edinburgh and London: E. & S. Livingstone, 1960. READERS must not get the impression that this is just another book on the history of anrsthesia. The author retired from an-xsthetic practice when muscle relaxants and techniques were introduced and, in the intervening time, he has accumulated an enormous amount of interesting data on the early days of anasthesia. In his preface he states that he has photographed nearly six thousand pieces of early apparatus and has cross-indexed every reference to anxsthesia in the first hundred years of its history in British journals. From this collection of data he has produced a most fascinating series of essays. He has not attempted to cover the historical aspects of anasthesia in systematic order and the book may be quite unintelligible to those who have not read some of the standard history books on this subject. Its appeal to readers in general might have been increased had he included a very short synopsis of the early history of anesthesia at the beginning. The first of these essays is 'The Effect of Cantharides on the Hedgehog.' In this he shows the futility of pharmacology as it was taught to him as a student and the dangers of applying animal experiments to human subjects. He follows this by the most interesting description of life in the medical profession at the time just prior to the introduction of anxsthesia. The difficult conditions under which medical practitioners worked in those days is almost unbelievable and their financial remuneration was extremely small. It is hard to believe, in these days of state medicine, that just one hundred years ago the physician had to use the tradesman's entrance to homes. The picture which he paints obviously shows that conditions were not conducive to new advances in medicine and surgery except in the large teaching centres and it is not hard to see that the early work of the English pioneers of anasthesia could easily have gone unnoticed and that the final discovery of the anesthetic properties of either would find a more receptive medical profession in the United States than in Britain. In the remaining chapters of the book he gives a series of unrelated instances such as the introduction of chloroform in Scotland, the early work on curare and a review of 'The seven foundation stones; in order of merit.' It is obvious that he held Mr. Wakley, the foundation editor of the Lancet, in very high esteem and this gentleman seems to have dedicated his life to exposirtg rackets in the medical profession. Chapter 6 is entitled 'Stupidities,' and rather than stupidities of anoesthetists, one finds that this actually deals with stupidities of surgeons. This can be illustrated by two references direct from the book. "The stoppage of the heart would have saved his life" . "mistakes made by a surgeon can usually be rectified by a more skilled surgeon at a later date . . . an anesthetist's mistakes, on the other hand, tend to be permanent and final." Dr. Sykes seems to have picked out all the controversial issues in the first hundred years of anxsthesia and he has written these in a most glowing form. He is obviously not a beginner in the field of writing and his penmanship is such that one would expect from a writer of detective fiction. This is not a book which students should expect to obtain information from prior to an examination but rather one which one would sit down in front of a cosy fire and enjoy. Its title may suggest that it should only be read by anxsthetists but, in fact, it would make most fascinating reading for any medical practitioners, particularly surgeons and obstetricians. It is a volume which would be very much appreciated as a present and is a worthwhile addition to Livingstone's list of interesting historical books. J.W. D.