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emphasize the fact that the operation is not a minor one, and that its real success depends on painstaking technique rather than on rapid performance. It is well, too, t h a t all surgeons, however €amiliar with the operation, should take stock of their methods from time t o time, and see whether they can be improved. This book may be recommended, therefore, to all surgeons, young or old, for in it they will find a well-balanced review of all the ordinary methods of operation now in use.
Naturally there are a few points on which there may be differences of opinion : two of them may be mentioned here. The author has a predilection for kangarootendon as the best material t o be used for the buried sutures. There is no doubt that kangaroo-tendon makes a good suture, but there is abundant proof that equally good results may be obtained with catgut, silk, or thread. Thousands of operations for hernia must be performed yearly throughout the civilized world, and one fears there would not be a sufficient number of kangaroo tails t o go round if this form of suture were obligatory. The other difference of opinion concerns the best form of radical cure for a femoral hernia. Mr. Hutchinson prefers the older method of approaching the hernia from Scarpa's triangle, whereas the inguinal route appears now t o find greater favour among the newer generation of surgeons. Both methods, however, are well described, and the point is open t o argument.
Mr. Hutchinson is t o be congratulated on a masterly exposit,ion of a n important. subject, and also on the fact that he has expressed himself clearly in a short compass. A Practical Handbook on Diseases of the Ear. I3y SIR WILLIAM ~IILLIGAS, AI.I)., Aurist and Laryngologist to the Royal Infirmary, Manchester ; Consulting Surgeon to the Manchester Ear Hospital ; and WYATT WINGRAVE, Pathologist (lately Physician) to the Central Throat and Ear Hospital, London. Dcmy 8vo. Pp. 191, illustrated. 1923. London : William Heinemann Ltd. 12s. Gd. net.
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