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Nov 13, 1976 - English is often slipshod, neurapraxia and myasthenia are consistently misspelt, and some of the chapters are too short to be of practical value.
BRITISH MEDICAL JOURNAL

1203

13 NOVEMBER 1976

and sodium cromoglycate, and uncritical acceptance of certain traditional forms of treatment, such as hyposensitisation, which is potentially hazardous and has not been shown to be effective in any large-scale controlled trial. Dr Jones also makes an ex cathedra pronouncement to the effect that "ACTH and steroids are usually best avoided" in one of his subgroups of chronic asthma, and does not even imply that these measures may be worth a trial in such cases. It is rather surprising that he does not advocate, at least in older children, the routine assessment by serial measurements of forced expiratory volume in one second or peak expiratory flow of their response to bronchodilators, corticosteroids, and ACTH. Even the most experienced clinician cannot predict whether or not a patient will respond to a particular drug, and clinical assessment alone may not always be reliable. A simpler and more logical approach to the use of drugs in asthma would be to adopt a broad classification into "episodic" and "chronic" forms of the disease, identify the drugs which should be given a trial in the two types of case, and assess the response to each drug in turn both by clinical observation and by function tests. If there is indeed an art in the treatment of asthma in children, or in adults for that matter, it must be to recognise that every patient requires individual consideration whether in the selection of drugs or in the management of associated social and

psychological problems. I W B GRANT

Functional Pathology of the Endometrium and Cervical Biopsy Specimens H Jellinek and F Toth. (Pp 387; Akademiai Kiad6. Budapest. 1976.

£13.)

The original Hungarian of this book has been translated by Dr Ilona Koch into excellent English. The volume is beautifully produced; of its many histological photomicrographs those in black and white are good, but some of those in colour lack detail. The considerable number of electron microscope pictures are on the whole technically well produced and well chosen to illustrate salient points. They are unfortunately less useful as an atlas of the various stages of the menstrual cycle and could not really be used for diagnostic purposes. Not all the features described in the text are illustrated in the micrograph referred to (for example, fig 29). However, in a book of this size it is commendable that the illustrations are always close to the relevant text. The section on the endometrium of the uterus, which constitutes the bulk of the book, correlates chemical and biological hormone assays with detailed histological studies of the endometrium. This linking of a quantitative measure with what is essentially a subjective and qualitative science is difficult, but the authors have made careful and detailed studies and drawn logical and well-reasoned conclusions. They certainly promote more careful and detailed study of uterine curettings. The section on cervical biopsies is short, and there is nothing like the detailed study here. Colposcopy and Schiller's iodine test are used to locate the site of the abnormal epithelium on the uterine cervix. Exfoliative cytology is barely mentioned except at the beginning of the book (p 13), when abnormal cytological

findings are given as the prime reason for biopsies being performed. References and bibliography take up 100 pages, yet there is no index. For a book of this size and a total of approximately 2300 references this is most surprising and lamentable. This book presents considerable careful and detailed research by the authors and is designed to provide pathologists and gynaecologists with common ground to approach problems of diagnosis and therapy.

effrontery of celibates who, themselves practising the ultimate form of birth control, attempt to ban more practical methods for other people." Although the book is ostensibly aimed at laymen, medical students, and general practitioners, it will prove refreshing reading even for specialists in "sexpertise." In a way it explains how Sir Alan, with a distinguished research career behind him in fundamental aspects of reproductive physiology in laboratory animals, discovered a new fascination in J E MACGREGOR the influence of social factors on human reproduction, and founded the J7ournal of Biosocial Science in the process. Many of the facts so ably summarised in this book are to be found Emergency and Acute Care A J Harding Rains, K W Reynolds, and documented in detail in that journal. Valerie Hunt. (Pp 172; hardback £3 95, softR V SHORT cover £1-95.) Hodder and Stoughton. 1976.

Though appearing under a new title this is really the second edition of Urgencies and Emergencies. It is intended for nursing and medical students as well as young doctors, and it has been revised with the current overlapping of doctors' and nurses' duties in mind. It introduces SI units, which it does not use consistently, nor do the authors make a point of giving priority to the official names for drugs. There are four sections: basic clinical principles, making a diagnosis, and treatment, and then about half the book is made up of examples in practice. It is there that inexperienced readers may begin to feel at home as they read about the treatment of particular conditions. One may hope that they will go back and study the signs and symptoms of emergencies and the meaning to be attached to them. The authors' purpose is admirable and they have packed a great deal of information into the book, but one may have reservations about it for a number of reasons. Much of the text gives the impression of being conventional and even traditional (anti-gas-gangrene serum, tetanus antitoxin, but where are the currently "popular" drugs of addiction ?), but there are perceptive passages from time to time. The English is often slipshod, neurapraxia and myasthenia are consistently misspelt, and some of the chapters are too short to be of practical value. There are also serious omissions in a number of chapters.

The Ocular Fundus A Color Atlas. Hans-Walther Larsen. (Pp 195; D Kr 200.) Munksgaard. 1976.

Since the introduction of the fundus camera some 20 years ago most teaching hospitals have been able to build up libraries of colour photographs of the commoner intraocular abnormalities. As the photographic technique is simple provided the light pathway is clear, the pictures of the optic disc and central retina are generally of excellent quality, though oblique views to include the peripheral fundus present difficulties. A number of books of fundus photographs have appeared in various countries which must be compared by the standard of the illustrations rather than the necessarily brief text which accompanies them, and since all are technically excellent judgment must go in favour of the author who selected from his collection cases which are the most typical of the abnormality represented. The latest book comes from Denmark, and is a condensed edition of the author's larger work. It is not surprising, therefore, that only the most typical cases are reproduced, and these are just what are required in a readily available form for teaching purposes. It is perhaps a little disappointing that the author has decided to leave out photography after intravenous fluorescein injections, which by providing retinal and choroidal angiograms can someP S LONDON times explain the origin of lesions. Colour illustrations are inevitably very expensive to produce, but in this case the price has been kept to a reasonable figure, so that Patterns of Sexuality and the book should find a ready market as a Reproduction concise reference work and as an aid to the Alan S Parkes. (Pp 148; £3 25.) Oxford teaching of ophthalmology both to postUniversity Press. 1976. graduates and undergraduates. reading, Anything that Sir Alan writes is worth HAROLD RIDLEY for it is likely to be intellectually stimulating and spiced with an occasional forthright, provocative statement. This new little book is certainly no exception. Although it represents SELECTED TITLES a summary of previously published information, some of it many years old, this should be Spinal Cord Injuries. 2nd edn. Sir Ludwig taken as a point in its favour rather than a Guttmann. (Pp 731; £21.) Blackwell Scientific. criticism. Subjects like "twins, triplets, and 1976. quadruplets," "the sex ratio," and "social Anaesthetics for Medical Students. 8th effects on sexual function" are forever topical, Gordon Ostlere and Roger Bryce-Smith. and it is good to be reminded by clear diagrams edn. £1-95.) Churchill Livingstone. 1976. 140; (Pp And before. has what gone and simple text of Short Courses. Staff Development Planning the spice is there, too. Speaking of marriage and coital patterns, for example, Sir Alan in the Social Services. (Pp 32; 50p.) Central states that "little need be said about celibacy Council for Education and Training in Social in relation to fertility, except to marvel at the Work. 1976.