findings make it interesting that the PE in this study was related to reduced B-cell populations in the father and the mother and to an increased number of B-cells in the child. The possibility that the paternal factor is contributory is supported by the observation that some women have had normal pregnancies by one man, but had PE during pregnancies by another man.2,3 Our findings of reduced maternal immune responsiveness agree with those of Jenkins et al.16 and Scott et al.17 The increase in B-lymphocyte population in children born to PE mothers has not been reported previously. In an earlier study 12 lymphocyte transformation tests after stimulation with mitogens and antigens showed that the immune response in women was .greater 3-5 months after delivery than that before the onset of pregnancy. In another study14 this increase was statistically significant. This observation, which implies that a completed pregnancy increases the immune response, together with the fact that PE most often occurs in first pregnancies and only seldom in subsequent pregnancies, seems to indicate that PE is due, among other things, to hyporesponsiveness in the mother, and that responsiveness increases after completion of a pregnancy. The PE woman who was followed-up through the whole course of pregnancy showed that important changes in a number of immune responses occurred at the beginning of the second trimester. This is the period during which the fetal immune apparatus becomes fully developed,’8 and therefore it is at this time that fetal immune hyperresponsiveness manifests itself. We are collecting more subjects for the study and additional investigations will include the measurement of T-suppresive cells. This study was supported by grants from Carl and Ellen Hertz’s legacy, Hafnia-Haand-i-Haand-fondet, Ebba Celinder’s legacy, Fonden for Laegevidenskabelig Forskning m.v. ved Sygehusene pa Fyn samt, and Danish Medical Research Council





Requests for reprints should be addressed to S. A. B., Tissue CulLaboratory, Institute of Pathology, Odense University Hospital,


DK-5000, Odense C, Denmark.


1. Chesley LC, Annitto JE, Cosgrove RA. The familial factor in toxemia of pregnancy. Obstet Gynecol 1968; 32: 303. 2. Need JA. Pre-eclampsia in pregnancies by different fathers: immunological studies. Br Med J 1975; i: 548-49. 3. Platt R. The ætiology, incidence, and heredity of pre-eclamptic toxæmia of pregnancy. Lancet 1958; i: 552-56. 4. Stevenson AC, Davidson BCC. Contribution of fetal/maternal incompatibility to ætiology of pre-eclamptic toxæmia. Lancet 1971; ii: 1286-89. 5 Feeney JG, Tovey LAD, Scott JS. Influence of previous blood-transfusion on incidence of pre-eclampsia. Lancet 1977; i: 874-75. 6. Jenkins DM, Need J, Rajah SM. Deficiency of specific HLA antibodies in severe pregnancy pre-eclampsia/eclampsia. Clin Exp Immunol 1977; 27: 485-86. 7. Gordon YB, Ratky SM, Baker LRI, Letchworth AT, Leighton PC, Chard T. Circulation levels of fibrin/fibrinogen degradation fragment E measured by radioimmunoassay in pre-eclampsia. Br J Obstet Gynœcol 1976; 3: 287-91. 8. Scott JR, Beer AA. Immunologic aspects of pre-eclampsia. Am J Obstet Gynecol 1976; 125: 418-27. 9 Birkeland SA. The immunological capacity of peripheral lymphocytes in a blast-transformation system using frozen-stored cells. Cryobiology 1976;

13:433-41. 10. Birkeland SA. The influence of different freezing precedures and different cryoprotective agents on the immunological capacity of frozen-stored lym-

phocytes. Cryobiology 1976; 13: 442-47. 11 Birkeland SA. Rosette formation tests for T and B lymphocytes using frozenstored cells. Acta Path Microbiol Scand, Sect C 1975; 83:298-302.

Reviews of Books Experimental Leukemia and Mammary Cancer Induction, Prevention, and Cure. CHARLES BRENTON HUGGINS

University of Chicago. Chicago and Chicago Press. 1979. Pp. 221. £14;$25.

London :

University of

Charles Brenton Huggins, who with Francis Peyton Rous received the 1966 Nobel prize for physiology and medicine, has spent his career attempting to understand the mechanisms of growth and control of malignant cells. In this book he describes his approaches to these problems by the use of systems developed at the University of Chicago for studying the chemical induction of mammary cancer and leukaemia in rats. This is not the book to read for the latest reviews of the hormonal control of growth of malignant cells or of chemical carcinogenesis; or for the philosophical thoughts of a worldrenowned scientist. Instead there is a personal account of 20 years of a scientist’s life, discoveries of his colleagues being woven into a picture of how research progresses. The description of actual experiments, including details of how to prepare fat emulsions of chemical carcinogens, at first seems unnecessary, but this is how research is carried out, and the underlying theme of Professor Huggins’ book is that progress comes at the bench "and not at the desk. In the midst of his descriptions of experiments one is brought face to face with reality by statements such as "Yes, the thing about cancer is to cure it." These are the ideals Huggins has imparted to his many students and colleagues, and the book should be read by research-workers embarking on cancer research.

Carcinoid Tumors

Clinicopathologic Study.

CHARLES MARKS, Louisiana State School of Medicine. Boston: Massachusetts. G. K. Hall & Co. 1979. Pp. 154:$22.



IN this well-presented monograph Professor Marks, who has 172 cases of carcinoid tumour, describes in detail the many fascinating aspects of this rare and intriguing growth (the total number of cases reported worldwide is less than 4000). The tumour was first described in the appendix by Merling in 1838, but it was not until 1931 that Sir Maurice Cassidy presented the earliest two cases of the carcinoid syndrome at the Royal Society of Medicine, his diagnosis then being metastatic carcinoma. A review of the literature indicates that two-thirds of these lesions occur in the small intestine and appendix and that they are not uncommonly encountered in the rectum. Pofessor Marks’ description of his cases, seen

12. Birkeland SA, Kristoffersen K. Lymphocyte transformation with mitogens and antigens during normal human pregnancy; a longitudinal study. Scand J Immunol (in the press). 13. Birkeland SA, Kristoffersen K. Cellular immunity in pregnancy: blast transformation and rosette formation of maternal T and B lymphocytes. Clin

Exp Immunol 1977; 30: 408-12. 14. Birkeland SA, Kristoffersen K. A longitudinal immunological study of lymphocyte response to Escherichia coli during normal human pregnancy. Br Med J (in the press). 15. Birkeland SA, Kristoffersen K. The fetus as an allograft. A longitudinal study of normal human pregnancies followed by mixed lymphocyte cultures between mother-father and mother-child. Scand J Immunol (in the

press). 16. Jenkins DM, Need JA, Scott JS, Morris H, antigens and mixed lymphocyte reaction in

Pepper severe

M. Human leucocyte pre-eclampsia. Br Med

J 1978; i: 542-44. 17. Scott JS, Jenkins DM, Need JA. Immunology of pre-eclampsia. Lancet 1978; i: 704-06. 18. Asma GEM, Pichler W, Schuit HRE, Knapp W, Hijmans W. The development of lymphocytes with T- or B-membrane determinants in the human fetus. Clin Exp Immunol 1977; 29: 278-85.

724 with his detailed review of the literature, provides a basis upon which the clinician can understand and look at the problem in true perspective. Professor Marks also draws attention to rare manifestations of carcinoid tumours-duodenal carcinoids may, for example, resemble islet-cell tumours of the pancreas since they originate from a common neuroectodermal precursor cell with the capacity for the secretion of many diverse peptides. Unfortunately, the section on treatment is rather brief and that on surgical therapy disappointingly so; one would, for instance, expect a book written by a surgeon to contain more advice on the treatment of liver metastases. Despite this, the book is a very good source of reference.


Manchester Museum Mummy Project

Multidisciplinary Research on Ancient Mummified Remains. Edited by A. R. DAVID, Manchester Museum. Manchester: Manchester University Press. 1979. Pp. 160. [15. THERE must be something of the ghoul in all of us; to explain the perennial success of books, plays, and films about Egyptian mummies would otherwise be difficult. Hammer Films have profited enormously by the judicious use of re-animated mummies whose features are based on the unprepossessing appearance of the poorly embalmed Pharoah Rameses m. The volume reviewed is a detailed technical account for the professional egyptologist and palaeopathologist of work shown in a BBC Chronicle programme and described in a popular book Mysteries of the Mummies. The latter was a bestseller and is probably a better buy than this one for the interested layman. Both these volumes stem from the unwrapping of what proved to be a very poorly preserved Egyptian mummy (no. 1770), whereas far more profitable investigations sponsored by Aiden Cockburn’s group in the United States and Canada have been largely ignored except by the cognoscenti. However, upon this slender foundation Rosalie David and her associates have reported much interesting material nearly seventy years after Margaret Murray from the Manchester Museum unwrapped and described two male mummies, which are now celebrated among egyptologists as the two brothers, Nekht-ankh and Khnum-nakht, and who appear in the present book in a useful catalogue of human and animal mummified remains held in Manchester. Ian Isherwood and his colleagues contribute an impressive paper on radiology (including tomography), and Frank Leek, doyen of palseoodontology, another on dental aspects. The generalist may prefer R. Garner’s page on experimental mummification, E. Tapp’s description of unwrapping mummy 1770, and Richard Neave’s fascinating reconstruction of the heads and faces of the two brothers and mummy 1770 (a technique which may well prove to have forensic value). The non-expert will also appreciate the account of fingerprinting mummy hands and the methodology of ancient textile examination, and one does not have to be an entomologist to admire the beautiful scanning electron micrographs of ancient insects. The medical reader will probably turn first to Tapp’s account of evidence of disease including pneumoconiosis and infestation by Dracunculus and Strongyloides. Throughout the book there are useful bibliographies containing further references to palveopathology. This handsome volume, ably edited and well illustrated, is good value for money.

engineering, then medicine with Pal, Exner, and Nothnagel before spending two years touring the main European medical centres. He combined the post of assistant to Wagner von Jauregg at the Vienna Neuropsychiatric Clinic with the fledgling sport of aviation and qualified as a pilot in 1908. Two years later, when president of the Austrian Aero Club, he spent two hours flying his own aeroplane before arriving at the dintc at 9 A.M. At the outbreak of war Economo served as a pilot in the Austro-Hungarian army and flew on many reconnaissance missions over the Tyrolean front. As early as 1912 he had begun his major study of the cerebral cortex, and when his monumental Cytoarchitectonics of the Cerebral Cortex in the Adult Man (1925) appeared, he was offered several prestigious posts including succession to Wagner vonjauregg, buthe declined them all to give more time to research. Economo studied sleep mechanisms, choreiform movements, and hereditary aspects of the psychoses, but he was particularly interested in brains of the elite. By comparing the structural qualities of brains from extra-talented subjects with those of ordinary people he hoped to throw light on the anatomy of genius. This was part of a wider investigation of "progressive cerebration" in which Economo researched into the evolution of the human brain by using a plaster-cast technique to study the development of the temporo-parietal region. The authors of this fascinating biography (which includes translations of Economo’s original papers, a bibliography, and eighteen illustrations) are well qualified for their task. L. van Bogaert, the distinguished neurologist, worked with Economo, while Jean Theodorides, a biologist and historian of the biological sciences, belongs to the paternal branch of the Economo family. Dickens’ Doctors

DAVID WALDRON SMITHERS, Emeritus Professor, University o London. Oxford and New York: Pergamon Press. 1979. Pp. 111


making a worthwhile contribution to our knowl of Charles Dickens may justifiably hope for at least mention in this journal. After serving under him on a coroner’ jury, the great novelist praised Thomas Wakley warmly, at time when the founder of the Lancet was not without hi critics. Sir David’s book would, however, merit attentio on several grounds, and not least because its author, now retired and better known for his papers on neoplasia, emerge as an undoubted authority on another subject. Indeed, if on had to find fault, it is that his volume is addressed less to thos who enjoy Dickens casually, and as the mood takes them, tha to fellow-aficionados. He is, too, concerned with personalities rather than with the numerous clinical gems in the novels but the syndromes characterised by Miss Havisham, and th Fat Boy, are here. (Sam Weller’s sovereign remedy for gout and "any disease associated with an excess of jollity", is not He advised marrying a widow with a sharp tongue and, it wil be recalled, spoke from experience.) The fact that some of th very best passages cannot be directly attributed to Dickens no way detracts from the appeal of this delightful work-the are the pithy asides of someone who has- clearly profited fro an earnest study of his hero’s observations on human nature ANYBODY


New Editions

Constantin von Economo Modern Medicine.-2nd ed.

The Man and the Scientist. By L. VAN BOGAERT and J. THÉODORIDTS. Vienna: Verlag de Osterreichischen Akademic der Wissenschaften. 1979. Pp. 138. DM 34.

BORN into a patrician Trieste family of Greek origin, Constantin von Economo (1876-1931) achieved eponymous immortality with his description of encephalitis lethargica. Primarily a neurologist, Economo showed the versatility of the grand seigneur and appropriately married an Austrian princess. He was an excellent linguist, who first studied mechanical

By Alan E. Read, D. W. Barritt, a Langton Hewer. Tunbridge Wells, Kent: Pitman Medical. 19Pp. 653. £14.95. Clinical Diagnosis and Management by Laboratory Merhoa —16th ed. Vols. i and n. Philadelphia & London: Saunders. 1 Vols. i & u pp. 2107. By J. B. Henry. £16.25 per volume. The Basis of Clinical Diagnosis.-2nd ed. By R. A. Parkms a G. D. Pegrum. Tunbridge Wells: Pitman Medical. 1979. Pp. 4 5.95. Help Yourselves.-3rd ed. By Peggy E. Jay. Essex: Ian Henry Pu lishers. 1979. Pp. 161. /;2.45. R.

Culture of Legionella pneumophila.

723 findings make it interesting that the PE in this study was related to reduced B-cell populations in the father and the mother and to an increased...
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