the one devoted to a problem not strictly psychiatric- namely, scientific creativity. The speakers were Lord. Adrian, Linus Pauling, and Albert Szent-Gyorgyi, three.
314
AUG. 3, 1963
BOOK REVIEWS
Book Reviews WHAT TO DO IN A CRISIS Compendium of Emergencies. Edited by H. Gardiner-Hill, M.D., F.R.C.P. (Pp. 328 +xi. 55s.) London: Butterworths. 1963.
A qualified doctor is always expected to do something useful when faced with any sort of medical emergency. This may be extremely embarrassing, for a medical degree does not confer on its possessor an invariable expertness in all such crises. Every doctor should therefore possess a concise reference book to enable him in an emergency to cover the critical period before facilities for orthodox treatment become available. A number of such works are available in Great Britain and America, but only one other, so far as I know, is written, as this one is, not by a single author but by a team of specialists. The team gathered together by Dr. Gardiner-Hill is a distinguished one, each member of which has decided with a discriminating judgment what emergencies are most likely to occur in his particular field and what he, the expert, would advise the inexpert to do under the circumstances. The emergency is considered under three headings: its nature and pathology; its recognition; and its management and treatment. The word " emergency" has been liberally interpreted to include such conditions as pneumonia, acute urinary infection, pyloric stenosis, and so forth. Nearly all the common acute conditions are discussed which occur in internal medicine, paediatrics, psychiatry, dermatology, orthopaedics, ophthalmology, obstetrics and gynaecology, anaesthetics, otorhinolaryngology, and dentistry. The index, of great importance in a reference book of this kind, is a good one. On the whole the advice given is informative, concise, and up to date. It may be questioned whether in diabetic coma zinc protamine insulin should ever be given intravenously even if soluble insulin is not available. No mention is made of the use of glucagon in the treatment of hypoglycaemic coma. It is not stressed, as it should be, that thyroxine is preferable to. thyroid extract in hypothyroidism. In the treatment of acute adrenal crisis it is stated that " if the patient is not vomiting 1-3 mg. fluorocortisone should be given by mouth and repeated 12 hours later. If the patient is vomiting, 50 mg. of hydrocortisone hemisuccinate should be injected through the drip tubing and a further 50 mg. added to the reservoir of the first litre of infusion fluid." The vomiting patient would certainly be the more likely to recover. While a work by a number of experts has great advantages over one by a single author, it requires careful editing to ensure uniformity. It is unfortunate in this case that the editor has allowed his contributors to use the proprietary or official names of drugs and the apothecaries or metric system of dosage quite indiscriminately. It is confusing, for example, to have the anticholinesterase drug edrophonium referred to by its official name in the section on anaesthetic emergencies and by its proprietary name, "tensilon," in that on neurological emergencies. DERRICK DUNLOP.
CURRENT PSYCHIATRY Proceedings of Third World Congress of Psychiatry. Volume 1: (Pp. 746+1i; illustrated.) Volume II: (Pp. 749-1420+xii; illustrated.) Two volumes: £14. Montreal: University of Toronto Press and McGill University Press. 1963.
These two volumes reflect the range and variety of the problems which are in the forefront of psychiatric research
BMJNA
MEDICAL JOURNAL
and practice to-day. The review is not truly international because only 1 % of the 400 papers presented came from the Soviet Union. Informative though they are, it would be unfair to conclude that they represent the state of psychiatry in that part of the world. To many of those who attended the congress the most memorable session was the one devoted to a problem not strictly psychiatricnamely, scientific creativity. The speakers were Lord Adrian, Linus Pauling, and Albert Szent-Gyorgyi, three Nobel-laureates. Their brilliant papers are as enjoyable to read as they were to listen to, each of them presenting a different approach and a different personality. The two academic lectures were given by Jean Piaget and H. W. Magoon. Three special lectures were set aside for leading themes of psychiatry. They were the phenomenological and descriptive aspects (H. C. Rumke); the contributions of experimental psychiatry to the art of healing (J. Massermann); and current psychiatric theories (Henri Ey). This congress report will be invaluable for future historians of psychiatry. For those working in the field as practising clinicians or investigators to-day it is a unique source book which ought to be in every medical and psychiatric library. If used properly it should be worth the formidable price, especially as the World Congress of Psychiatry meets only every five years. E. STENGEL.
COMPARING RADIATION AND CHEMICALS Radiation and Radiomimetic Chemicals. Comparative Physiological Effects. By L. A. Elson, D.Sc., Ph.D., D.L.C., F.R.I.C., M.I.Biol. (Pp. 124+vii; illustrated. 25s.) London: Butterworths. 1963.
The Institute of Cancer Research has played a leading role in the development and clinical testing of anti-cancer chemical agents. Dr. L. A. Elson, a prominent member of this group, has done good service in writing this short book giving us the basic facts about them. One particularly welcomes the chemical formulae and the numerous figures and tables, for they allow readers like the reviewer, with the minimum of competence in this field, to follow the story readily. Since the use of these agents is relatively new, there is a strong case for comparing them with the older therapeutic weapon, ionizing radiation-hence the title of the book. At the cellular and subcellular levels, however, the fashion is now to contrast, to find the specific differences in action. Dr. Elson has not been deeply concerned in reporting these finer details of interest to geneticist, cytologist, and microbiologist. Readers with clinical interest from medical student to specialist might, however, find the time-for example, on train journeys-to read this slim volume, which fits readily into the brief-case. It is well written, well indexed, and well produced. J. F. LOUTIT.
CURRENT PROBLEMS OF ATHEROSCLEROSIS Atherosclerosis. Mechanisms as a Guide to Prevention. By Campbell Moses, M.D. (Pp. 239; illustrated. 60s.) London: Henry Kimpton. 1963.
This book is an admirably mature and thoughtful appraisal of many of the current problems of atherosclerosis. Dr. Moses designed it to provide for physicians with an interest in atherosclerosis a survey of present concepts of mechanisms involved in its pathogenesis, thereby enabling them to have a better understanding of present methods aimed at prevention. But he has done more. He has packed a remarkable amount of useful information into a comparatively small book, and the 1,250 references will
BOOK REVIEWS
AUG. 3, 1963
undoubtedly be used by many close to the subject. Further, he has not just written another review but has infused it with some of his own views, often with a stimulating commentary. Naturally, there are criticisms. One might be that very little mention has been made of the relation of platelets to arterial lesions and another that recent work on endothelial cells, and intimal structure and metabolism, is scarcely mentioned. Yet Dr. Moses clearly declares in his introduction that this book emphasizes the lipid aspects of the pathogenesis of atherosclerosis and the control of hyperlipidaemia, because there is so little knowledge at present of any measures which influence coagulation or fibrinolysis or the formation of collagen or elastin. He fulfils this objective commendably and is to be congratulated on a valuable survey of this difficult subject. M. F. OLIVER. LIFE INSURANCE The Medical Aspects of Life Assurance. By R. D. C. Brackenridge, M.D.(Glas.), F.R.F.P.S. (Pp. 480 + viii; illustrated. 70s.) London: Staples Press. 1962.
Though primarily intended to inform medical readers of the principles and intricacies of medical selection for life insurance, this book will be a valuable addition to the reference books in the underwriting rooms in life offices, and will be a very useful guide for lay underwriters to the significance and meaning of medical impairments. The numerical rating system is explained and discussed and some of the difficulties exposed that have militated against its adoption by all offices. Detailed consideration is given to many of the factors that influence mortality-age, occupation, social habits, family history, place of residence, and physical impairments. In the chapters on such impairments-which are grouped under, for example, cardiovascular disorders, gastro-intestinal disorders-there is a great deal of sound clinical sense, and they can be read with profit by medical men for their general interest. The author engages in a certain amount of nearphilosophical speculation about constitutional factors influencing longevity, but his speculations, though sometimes couched in unjustifiably dogmatic language, are always interesting and thought-provoking. The book, with its full and satisfactory index, is well produced, easy to read, and lies comfortably in the hand. J. G. M. HAMILTON.
LABORATORY TECHNIQUE Progress in Medical Laboratory Technique 2. Edited by F. J. Baker, F.I.M.L.T., F.I.S.T., F.R.M.S. (Pp. 191+vii; illustrated. 35s-) London: Butterworths. 1963.
This collection of articles on techniques by technicians is a successor to a volume which I reviewed last year (Brit. med. J., 1, 1462). Of the ten chapters in this one, three are concerned with haematology, two with histology, two with chemical pathology, and one with the diagnosis of mycobacterial infections. A further chapter on virology is in part an essay on chemical inhibitors of virus multiplication and nowhere technically informative, and that on cardiopulmonary bypass, hypothermia, and congenital cardiac defects seems also a little wide of the scope and purpose of the work. With these two exceptions the chapters describe bench methods, mostly in enough detail to enable the reader to use them, and should thus be found very helpful. L. P. GARROD.
BRITIsH
MEDICAL JOURNAL
315
PHYSIOLOGY AND THE CLINICIAN Clinical Physiology. Edited by E. J. Moran Campbell, B.Sc., Ph.D., M.D., M.R.C.P., C. J. Dickinson, B.Sc., M.A., D.M., M.R.C.P., and J. D. H. Slater, M.A., M.B., M.R.C.P. Foreword by Sir Robert Platt, Bt., M.D., M.Sc., LL.D., F.R.C.P. Second edition. (Pp. 605+xiii; illustrated. 57s. 6d.) Oxford: Blackwell Scientific Publications. 1963.
In their introduction to this edition and in their handling of the contributors and contributions the editors have shown full appreciation of clinical advances. Till about 1920 to 1930, the peak period of Sir Thomas Lewis's work, medicine in the widest sense of the word advanced sporadically, these advances depending on individuals with inquiring minds, each observing, thinking, and acting on his own thoughts. -Since then physicians and biologists have been co-operating in laboratory research to gain accurate knowledge of the mechanism of normal function, for it has been realized that pathological distortions of the norm, as seen in the sick patient, could not be properly understood without a good grasp of the principles of physiology. The editors of this book are aware that its circle of readers ranges from the clinician to the experimental physician and through the experimental biologist and physiologist back to the clinician. The physiologist, who is interested in fundamental problems, can also see the clinician's difficulties in preserving the balance between observing his patients and evaluating the physico-chemical and biological changes that their illness brings about. The outstanding feature in this edition is the strength and maturity of the individual contributions. The reviewer sympathizes with the editors and authors in their immense task. They have accomplished it well. A. ST. G. HUGGETT.
LONG-DISTANCE SWIMMING By Gerald Forsberg, Modern Long Distance Swimming. O.B.E. Foreword by F. W. Hogarth. (Pp. 230+xvi; illustrated. 30s.) London: Routledge and Kegan Paul. 1963.
I have read this book with great pleasure. It begins with a sketch of swimming in ancient times and then describes every aspect of long-distance swimming. There are chapters on training and on building up the necessary muscular and cardiac efficiency and lung capacity at first by half-mile efforts and going on to 20-mile swims towards the end of the training period. The need is stressed for one day's rest from swimming every week to prevent staleness. Swims in lakes and rivers are contrasted with sea swims. The various competitive swims organized by the British Long Distance Swimming Association are described, such as those organized at Lake Windermere, Morecambe Bay, Torbay, the Solent, Loch Lomond, and at other stretches of water where races are held by local bodies. Also described are the Irish Channel, Lough Neagh, and the Bristol Channel swims. Their peculiar difficulties are noted, such as air and water temperatures. There is a chapter on meteorology as it affects swimmers, and another on tides and navigation. Channel swimming is fully discussed, and the author emphasizes the necessity of avoiding mental stress and anxiety while waiting for favourable weather. There is a special chapter on remarkable swimming feats by swimmers of all ages all over the world. Finally, there are appendices on long-distance swimming records. Commander Forsberg has written a masterly book, well upholding the traditions of an officer of the Royal Navy. It should be read by all who love the great outdoors. C}. B. BREWSTER.
