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A Flawed Masterpiece
Book Reviews E d h d by A . R. Brownlie
ARRACK, BHANG, CATAMITE, DHOTI
Textbook of Medical Jurisprudence & Toxicology 3rd Ed. C. K. Parikh (Medical Publicatio?u,Bombay, 1979, 1071pp., index, $30.00) In 63 chapters and assisted by 18 contributors Dr. Parikh has covered the general ground of medical jurisprudence and toxicology in a remarkably clear and condensed fashion. His original work launched in 1970 has been expanded and illustrated and there is every reason for him to describe the text as 'Lfor classrooms and courtrooms". The quality of his writing is uniform, quite acceptable to western readers, and although he describes a very wide range of forensic pathology, some forensic science and everyday toxicology, he achieves a remarkably sound coverage. Even forensic psychiatry has its chapter as does the forensic science laboratory. The book opens by drawing the distinction between forensic medicine (medical aspects of law) and medical jurisprudence (legal aspects of medicine). This is perhaps a distinction without a difference, but what follows sets out the orthodox groundwork of identity, death, mechanical injuries, trauma, blood, hair, sex, sexual offences, abortion, drugs and poisons. Only in parts does the provenance of the work show unmistakeably through. Disposal of the dead in Parsee Towers of Silence where the body "is attacked by vultures who eat away the soft parts and reduce the body to a skeleton within 15 to 30 minutes"; "an occasional mother-in-law may starve her daughter-in-law to death"; "In India such punishment" (tip of the nose cut off) "is comparatively more common than divorce"; "the hijrahs add to their tribes by recruiting boys and castrating them, the castration being performed by their barbers." The strength of this book however is not in its revelations of Indian law or custom, but in its mainstream character. It can be confidently recommended for use much beyond the shores of the Ganges and in jurisdictions far removed from Delhi.
A FLAWED MASTERPIECE
Alcohol, Drugs and Road Traffic W. E. Cooper, in collaboration with T. G. Schwar and L. S. Smith (Cape Town, Juta @ Co. Ltd., 1979, 383pp., index, ,C;29.80) This reviewer jumped at the opportunity when he was asked to review this book: it seemed to be right up his street. But then the more carefully he perused it, and the more he thought about it, the more difficult it became to decide what ought to be said about it. Of the authors named above, the first is an Advocate of the Supreme Court of South Africa, the second is Professor of Forensic Medicine in the University of Stellenbosch, and the third is Professor
of Forensic Medicine and Toxicology in the University of Cape Town; the second and third are also Chief Pathologists of their respective State Health Departments; J. W. de Graad, formerly Chief of the Health Chemistry Services of the State Health Department in Pretoria, is also listed as a special contributor. That list is so impressive as to be practically awe-inspiring, yet the reviewer, if he is honest with himself, cannot pretend that the book did not leave him with a tinge of disappointment. The first sixth approximately is occupied with drink-and-driving legislation and case law in South Africa and its constituent provinces. These subjects are described in considerable detail, and this reviewer is obviously not competent to criticise this section, beyond saying that it is clearly and interestingly written and appears to contain all of the information necessary for a detailed comparison of South African law in this field with that of this or any other country. South Africa has now also adopted an 80mg/100ml legal limit. (In passing it is of interest that by South African law blood samples may be taken by a qualified nurse as well as by a doctor.) The rest of the book consists of chapters on the absorption, distribution, metabolism, elimination and effects of alcohol; on clinical examination and sampling; on analysis of the sample; on urine and breath alcohol; on the particular problems presented by post-mortem specimens; on the effect of alcohol specifically on driving; and on the effects of drugs and other intoxicants. The mass of information presented in these chapters may fairly be described as overwhelming. But this is where niggling doubts creep in: is it always the right (in the sense of most relevant) information? One cannot question the value of much of it-tabulated and graphical data, to mention only a few examples, about endogenous alcohol levels, the alcoholic strengths of various beverages, the factors influencing the rate of alcohol absorption, the water contents of various organs, the ratios of the alcohol levels in various body fluids, rates of elimination, the correlation of blood-alcohol levels and degrees of intoxication. The table on p. 284 listing the results of 27 separate investigations during the period 1930-74 of the bloodlbreath ratio is of particular interest in the present state of drink-and-driving legislation in Great Britain. O n the other hand, it is hard to imagine circumstances in which a half-page of discussion of the relationship between posture and blood pressure could help anyone in this context. The figures of an inconclusive study of the effects of alcohol on blood-sugar levels, and a rather sketchy diagram of a possible metabolic pathway from ethanol to morphine-like compounds in the brain seem similarly to be hardly worth inclusion. The chapter on analytical methods is curiously selective, and its list of references shows some surprising omissions-one looks in vain for the names (to cite but two) of either Nickolls or Curry. One cannot help wondering, therefore, what important omissions there may be in some of the other chapters, however impressive are their lists of references. The reviewer believes that the slight disappointment which he felt is due mainly to the somewhat uncritical and unselective way in which the authors handle and present their masses of data. As the whole subject is one in which conflicting results are the norm rather than the exception, the reader might not unreasonably have expected of the highly qualified authors some critical guidance through the jungle of published results. T o sum up, the book is good enough to make one feel it a pity that it is not better. I n spite of the criticisms expressed above, some chapters (for example, Chapter 18, dealing with the general effects of alcohol) are first-rate. But lacking more guidance than is given, the lawyer is not likely to make much of the scientific section of the book. The medical or scientific user is likely to find this most useful as a quarry for digging out information, although, as has been suggested, this may not always be as complete as the book by its own high standards makes desirable. I t should finally be said that it is handsomely produced and well indexed. H. J. WALLS
ARRACK, BHANG, CATAMITE, DHOTI
Textbook of Medical Jurisprudence & Toxicology 3rd Ed. C. K. Parikh (Medical Publicatio?u,Bombay, 1979, 1071pp., index, $30.00) In 63 chapters and assisted by 18 contributors Dr. Parikh has covered the general ground of medical jurisprudence and toxicology in a remarkably clear and condensed fashion. His original work launched in 1970 has been expanded and illustrated and there is every reason for him to describe the text as 'Lfor classrooms and courtrooms". The quality of his writing is uniform, quite acceptable to western readers, and although he describes a very wide range of forensic pathology, some forensic science and everyday toxicology, he achieves a remarkably sound coverage. Even forensic psychiatry has its chapter as does the forensic science laboratory. The book opens by drawing the distinction between forensic medicine (medical aspects of law) and medical jurisprudence (legal aspects of medicine). This is perhaps a distinction without a difference, but what follows sets out the orthodox groundwork of identity, death, mechanical injuries, trauma, blood, hair, sex, sexual offences, abortion, drugs and poisons. Only in parts does the provenance of the work show unmistakeably through. Disposal of the dead in Parsee Towers of Silence where the body "is attacked by vultures who eat away the soft parts and reduce the body to a skeleton within 15 to 30 minutes"; "an occasional mother-in-law may starve her daughter-in-law to death"; "In India such punishment" (tip of the nose cut off) "is comparatively more common than divorce"; "the hijrahs add to their tribes by recruiting boys and castrating them, the castration being performed by their barbers." The strength of this book however is not in its revelations of Indian law or custom, but in its mainstream character. It can be confidently recommended for use much beyond the shores of the Ganges and in jurisdictions far removed from Delhi.
A FLAWED MASTERPIECE
Alcohol, Drugs and Road Traffic W. E. Cooper, in collaboration with T. G. Schwar and L. S. Smith (Cape Town, Juta @ Co. Ltd., 1979, 383pp., index, ,C;29.80) This reviewer jumped at the opportunity when he was asked to review this book: it seemed to be right up his street. But then the more carefully he perused it, and the more he thought about it, the more difficult it became to decide what ought to be said about it. Of the authors named above, the first is an Advocate of the Supreme Court of South Africa, the second is Professor of Forensic Medicine in the University of Stellenbosch, and the third is Professor
of Forensic Medicine and Toxicology in the University of Cape Town; the second and third are also Chief Pathologists of their respective State Health Departments; J. W. de Graad, formerly Chief of the Health Chemistry Services of the State Health Department in Pretoria, is also listed as a special contributor. That list is so impressive as to be practically awe-inspiring, yet the reviewer, if he is honest with himself, cannot pretend that the book did not leave him with a tinge of disappointment. The first sixth approximately is occupied with drink-and-driving legislation and case law in South Africa and its constituent provinces. These subjects are described in considerable detail, and this reviewer is obviously not competent to criticise this section, beyond saying that it is clearly and interestingly written and appears to contain all of the information necessary for a detailed comparison of South African law in this field with that of this or any other country. South Africa has now also adopted an 80mg/100ml legal limit. (In passing it is of interest that by South African law blood samples may be taken by a qualified nurse as well as by a doctor.) The rest of the book consists of chapters on the absorption, distribution, metabolism, elimination and effects of alcohol; on clinical examination and sampling; on analysis of the sample; on urine and breath alcohol; on the particular problems presented by post-mortem specimens; on the effect of alcohol specifically on driving; and on the effects of drugs and other intoxicants. The mass of information presented in these chapters may fairly be described as overwhelming. But this is where niggling doubts creep in: is it always the right (in the sense of most relevant) information? One cannot question the value of much of it-tabulated and graphical data, to mention only a few examples, about endogenous alcohol levels, the alcoholic strengths of various beverages, the factors influencing the rate of alcohol absorption, the water contents of various organs, the ratios of the alcohol levels in various body fluids, rates of elimination, the correlation of blood-alcohol levels and degrees of intoxication. The table on p. 284 listing the results of 27 separate investigations during the period 1930-74 of the bloodlbreath ratio is of particular interest in the present state of drink-and-driving legislation in Great Britain. O n the other hand, it is hard to imagine circumstances in which a half-page of discussion of the relationship between posture and blood pressure could help anyone in this context. The figures of an inconclusive study of the effects of alcohol on blood-sugar levels, and a rather sketchy diagram of a possible metabolic pathway from ethanol to morphine-like compounds in the brain seem similarly to be hardly worth inclusion. The chapter on analytical methods is curiously selective, and its list of references shows some surprising omissions-one looks in vain for the names (to cite but two) of either Nickolls or Curry. One cannot help wondering, therefore, what important omissions there may be in some of the other chapters, however impressive are their lists of references. The reviewer believes that the slight disappointment which he felt is due mainly to the somewhat uncritical and unselective way in which the authors handle and present their masses of data. As the whole subject is one in which conflicting results are the norm rather than the exception, the reader might not unreasonably have expected of the highly qualified authors some critical guidance through the jungle of published results. T o sum up, the book is good enough to make one feel it a pity that it is not better. I n spite of the criticisms expressed above, some chapters (for example, Chapter 18, dealing with the general effects of alcohol) are first-rate. But lacking more guidance than is given, the lawyer is not likely to make much of the scientific section of the book. The medical or scientific user is likely to find this most useful as a quarry for digging out information, although, as has been suggested, this may not always be as complete as the book by its own high standards makes desirable. I t should finally be said that it is handsomely produced and well indexed. H. J. WALLS