Diseases of the Eye

valvular heart disease from a regard of the clinical findings by themselves, and without any knowledge of the past history of rheumatic fever. We must have confidence in our objective physical signs. What has been described here does not tell of startling discoveries in medicine, but it does invite us to think seriously of the several ways in which our recognition of the sham signs of disease has failed in the past. A sober reflection on the poignant ills associated with feigned heart disease should compel us to care for the proper interpretation of the physical signs which have been mentioned, and which simulate those found in heart disease. While we continue to insist on healing the afflicted, let us desist from afflicting the healthy. We should not turn from this firm resolve. I suggest that adherence to "Ten Commandments" might keep us from committing, within the speciality of cardiology, the blackest of all sins, namely, the sin of subjecting a healthy individual to a life of unwarranted cardiac invalidism. They are: 1. Avoid fanciful diagnosis like "athlete's heart," "tired heart," etc. 2. Do not lightly diagnose cardiac pain in the presence of a normal electro-cardiogram. 3. Know how to read the electrocardiogram before acquiring an electrocardio-graph. 4. Resist a diagnosis of "high blood pressure" in the absence of cardio-vascular hypertrophy. 5. Make certain that a shifted apex beat is not the outcome of simple cardiac displacement, before attributing it to cardiac enlargement. 6. Don't mistake a "thrillette" for a thrill. 7. Don't mistake a healthy splitting of the first heart sound for a pre-systolic murmur. 8. Know the marks of an innocent murmur. 9. Never seek a past history of rheumatic fever before deciding on the diagnosis obtained from the physical signs. 10. Relinquish the term "mitral incompetence" in diagnosis. IT is always a difficult matter to provide a textbook on a special subject for students and general practitioners-to be comprehensive is to be too elaborate-to be concise is to omit essentials. This book, which has long been popular, now brought up to date avoids both pitfalls. It contains all the purely eye diseases which students should know, and which general practitioners may meet, set out in a manner which they can assess the points of diagnosis and treatment and, above all, contains a number of plates and photographs which probably mean more that the written word to students. …