Methods in Medicine. A Manual of the Medical Service of Dr. George Dock. By GEORGE R. HERRMANN, M.D., Ph.D., Assistant Professor of Medicine, University of Michigan; formerly House Officer, Peter Bent Brigham Hospital, Boston; formerly Assistant in Medicine, Washington University; formerly Resident Physician, Barnes Hospital, St. Louis. 521 pages, 6 x 9, numerous charts and illustrations. C. V. Mosby Co., St. Louis, Missouri. 1924. Price in cloth, $6.00. This manual covers in detail a system which has up to the present volume not been considered in any published work. It is based chiefly upon the methods so successfully carried out by Prof. George Dock at the Barnes Hospital in St. Louis, but also embodies many ideas of the Precedent Book of the Medical Service of Prof. Henry A. Christian at the Peter Bent Brigham Hospital in Boston. It is intended to be a practical ward and bedside guide, presenting an "outline of sound minimal requirements in the complete, systematic diagnostic study; a system of essential emergency, scientific, therapeutic and dietetic management; and directions for the ever important and vital preservation of the valuable data in the record of each patient."

In his foreword Dr. Dock says that this book originated in brief and simple suggestions given to his early House Staff; and that these gradually became more comprehensive as the scope and variety of the work expected of the house staff of a properly equipped hospital increased. All of the resident physicians of the Washington University and Barnes Hospital were asked in turn to revise the manual according to their experience. The material in this way grew rapidly, was progressively improved and made more orderly and concise. Dr. Herrmann, by reason of his natural gifts and his previous training at the Peter Bent Brigham Hospital brought the Manual to

a degree of completion and perfection not previously attained, so that it began to attract the attention of medical visitors, and requests for its publication began to be made. To the original material representing Dr. Dock's Manual for his medical service, Dr. Herrmann has collected additional material from many diverse sources, and the whole has been unified and condensed into the matter of this volume.

The Manual consists of five parts. The first is given up to a consideration of administrative methods and rules to insure the prompt, careful, complete and uniform handling of each case admitted. This part comprises a system of the duties of the staff from the resident physician down to the clinical clerks. Notes and suggestions for history-taking, physical examination and laboratory work, with routine requirements for each type of case, and the steps of the ordinary clinical laboratory procedures are given in very full detail. The object of this section is to assist the members of house staffs to the most efficient and economical use of time and material in the various duties of their positions. Such duties as the details of contact with patients, their relatives, family physicians and consultants, the preparation of histories, reports and letters, the making of all the indicated clinical and laboratory examinations for the purpose of diagnosis, control of treatment, or for the purpose of scientific investigation are considered fully. The relationships of the house staff to the hospital general staff, to the health officers of the community, and to the teaching force are included, as is also the use and care of laboratory equipment and supplies. The second part consists of the special methods of clinical and laboratory investigation that must be applied in a more complete study of any case. The third part outlines acceptable therapeutic methods, emergency measures and subsequent treatment and management. The

fourth part is concerned with approved dietetic methods and practical diet lists; while the fifth and last section illustrates the details of recording and graphic methods with representative charts of data from the usual types of cases.

The fact that this book owes so much of its material to the methods of hospital organization originated or employed by one of the most distinguished internists and teachers of clinical medicine in this country, Dr. Dock, is in itself sufficient guarantee for its worth. Moreover, the volume is a much needed one; the material included in it cannot be obtained elsewhere. It is a book of especial value for the senior medical student, and especially for the recent graduate who is just entering his hospital training. It gives him a most needed and

useful guide to the new form of practical work that meets him on graduation. In it he will find the information he most needs when his independent work in the ward and at the bedside begins. In short, it is a most useful and necessary guide for the interne. The first of its kind in the field, it is also as nearly complete and up to date as any book dealing with such labile material can be. Much of the material given will be modified from year to year as new diagnostic and therapeutic conceptions arise, but the basic ideas and principles contained therein will last long beyond this generation of medical students. The book should serve then as a foundation upon which the hospital man and practitioner can build his own modifications of medical organization and service.