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Modern Practical Neurology
sensations and alteration of the body image to deny the abnormality of the walking-skeleton appearance. The prolonged starvation also has a marked effect on the physiology of the brain, with further adverse effects upon psychoiogic functioning. If unchecked, these processes may progress to the point at which self-perpetuating physiologic changes occur, treatment becomes less effective, and death may follow. The first consideration in treatment is correction of abnormal nutrition; if the condition is severe, this should be done in a hospital by an experienced pediatrician or internist, cooperating closely with the psychiatrist. Tube feeding and intravenous fluids are mentioned, but the author tends to favor hyperalimentation. She does not favor behavioral therapy, in which weight loss is punished by tube feedings and gain is rewarded by points or privileges. Since the problem is a child-parent maladjustment, the only effective therapy is that which is directed toward finding and adjusting the causes. The child is separated from the parents in a suitable residential situation. (The author worries that brief admission to a service without special experience in the management of anorexia can create as many problems as it attempts to solve.) Despite the temporary separation of parents and child, the participation of the parents is vital to the treatment program, either in conjoint or family counseling sessions. As for the patient herself, the task of psychotherapy is to help her search for autonomy and selfdirected identity by working on MARCH 1979 • VOL 20' NO 3
awareness of impulses and needs that originate within her, by focusing on self-expression, by exploring her defective concepts for organizing and expressing needs, and by helping to lessen her bewilderment in dealing with others. Though no revolutionary new developments are presented, the book provides excellent coverage of the subject. The information is supported entirely by anecdotal evidence and controls are not used. The author is to be congratulated for her very readable and interesting presentation and for the fascinating array of aliases she uses for her patients. Fred O. Henker III. M.D. University of Arkansas for Medical Sciences
Modem Practical Neurology By Peritz Scheinberg. 247 pp. $21 hard cover. $12 paperback. New York. Raven Press. 1977.
• This small book is based on annual postgraduate courses given by the department of neurology at the University of Miami. These lectures, which have the purpose of teaching neurologic diagnosis and management to general practitioners, internists, and psychiatrists, are well worth attending. Methods of neurologic examination, diagnosis, and management of common neurologic diseases are reviewed in 16 chapters. Some sections use the conventional pathologic classification, some a symptom-based classification. Each section is illustrated and followed by a well-chosen list of references, especially in regard to cerebrovascular diseases and central nervous system tumors. The list of refer-
ences on epilepsy could be enlarged, however. Some chapters are more comprehensive than others. The sections on central nervous system injuries, dizziness, and neuromuscular disorders are rather brief and seem not to give enough detailed information about the clinical problems. Psychogenesis of certain symptoms is usually mentioned and occasionally stressed. Six lines on poliomyelitis-although presently uncommon in this country-is not adequate for teaching purposes. The section on treatment of epilepsy does not mention recent drugs, like carbamazepine; nor is valproic acid discussed, although it has been used overseas for many years. Modern diagnostic methods such as the CAT scan are mentioned briefly, while other tests, such as electroencephalography, are merely listed. Dr. Scheinberg has to be congratulated on his brevity, although it leads occasionally to superficialities in some sections, especially in cases in which management is controversial. The book introduces the non-neurologist to a slightly oversimplified clinical neurology, possibly stimulating the reader to seek more comprehensive literary advice. The presentations are perhaps less rewarding for medical students, because some of them may gain the impression that the complex problems discussed are much simpler than they really are. In the end it is the author's brevity that provides the book's credits as well as its debits. R.E. Schlagenhaulf. M.D. Edward J. Mever Memorial HO!,pital Buffalo. N. Y.
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awareness of impulses and needs that originate within her, by focusing on self-expression, by exploring her defective concepts for organizing and expressing needs, and by helping to lessen her bewilderment in dealing with others. Though no revolutionary new developments are presented, the book provides excellent coverage of the subject. The information is supported entirely by anecdotal evidence and controls are not used. The author is to be congratulated for her very readable and interesting presentation and for the fascinating array of aliases she uses for her patients. Fred O. Henker III. M.D. University of Arkansas for Medical Sciences
Modem Practical Neurology By Peritz Scheinberg. 247 pp. $21 hard cover. $12 paperback. New York. Raven Press. 1977.
• This small book is based on annual postgraduate courses given by the department of neurology at the University of Miami. These lectures, which have the purpose of teaching neurologic diagnosis and management to general practitioners, internists, and psychiatrists, are well worth attending. Methods of neurologic examination, diagnosis, and management of common neurologic diseases are reviewed in 16 chapters. Some sections use the conventional pathologic classification, some a symptom-based classification. Each section is illustrated and followed by a well-chosen list of references, especially in regard to cerebrovascular diseases and central nervous system tumors. The list of refer-
ences on epilepsy could be enlarged, however. Some chapters are more comprehensive than others. The sections on central nervous system injuries, dizziness, and neuromuscular disorders are rather brief and seem not to give enough detailed information about the clinical problems. Psychogenesis of certain symptoms is usually mentioned and occasionally stressed. Six lines on poliomyelitis-although presently uncommon in this country-is not adequate for teaching purposes. The section on treatment of epilepsy does not mention recent drugs, like carbamazepine; nor is valproic acid discussed, although it has been used overseas for many years. Modern diagnostic methods such as the CAT scan are mentioned briefly, while other tests, such as electroencephalography, are merely listed. Dr. Scheinberg has to be congratulated on his brevity, although it leads occasionally to superficialities in some sections, especially in cases in which management is controversial. The book introduces the non-neurologist to a slightly oversimplified clinical neurology, possibly stimulating the reader to seek more comprehensive literary advice. The presentations are perhaps less rewarding for medical students, because some of them may gain the impression that the complex problems discussed are much simpler than they really are. In the end it is the author's brevity that provides the book's credits as well as its debits. R.E. Schlagenhaulf. M.D. Edward J. Mever Memorial HO!,pital Buffalo. N. Y.
215