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Orthotics Etcetera
Mayo Clin Proc, July 1986, Vol 61
those of the best reference texts. As a source for study or review of geriatric medical data, this text would be my choice. The book is a compendium of geriatric knowledge; it presents strong science, very little conjecture, and only a slight amount of editorialization. The subject matter is covered thoroughly and consistently, and the material relies on the data base that has developed during the past 15 to 20 years. Most of the information about general medicine relates directly to the elderly population. Several topics are addressed in more than one chapter, yet the presentations are never boring and seldom overlap. The book is divided into seven parts. The delightful introductory part is entitled "The Biology of Human Aging" and consists of five chapters. The second part (composed of six chapters) is a thought-provoking section called "The Epidemiology of Human Aging." The best sections of the book are the two parts (with a total of 41 chapters) entitled "The Cardinal Manifestations of Aging and Disease" and "Diseases of the Organ Systems." These sections set this book apart from earlier works, in that a sound scientific data base is brought into play in discussing the particular problems and needs of the elderly population. The book, however, has some shortcomings. The last 50 pages lack continuity with the rest of the text. In addition, more space could have been devoted to drug metabolism and specific treatment, as drug and dosing schedules are oftentimes described in vague terms. The chapters on osteoporosis and Alzheimer's disease should have been expanded. Despite these minor deficiencies, this text is well worth the $65. Do not wait for the next edition! Eric G. Tangalos, M.D. Division of Community Internal Medicine
Orthotics Etcetera, 3rd ed (Rehabilitation Medicine Library series), edited by John B. Redford, 836 pp, with illus, $68.50, Baltimore, Williams & Wilkins, 1986 Orthotics Etcetera is one of many books in the Rehabilitation Medical Library series published by Williams & Wilkins. This third edition of the
BOOK REVIEWS
607
text is considerably updated, a reflection of the dramatic technologic changes in the field. The intended audience for this book spans the spectrum of the rehabilitation team. Physiatrists, orthopedists, neurologists, and rheumatologists will find information relevant to prescription orthotics and other devices. Orthotists, physical therapists, and occupational therapists will find helpful material regarding fabrication and functional application. Rehabilitation counselors, administrators, and even insurance company personnel may also find the book a valuable resource. An orthosis, as defined by Sidney Licht, is any device that, when in contact with the body, improves function. The "etcetera" in the book title refers to the many other devices that are in some way associated with orthotics and facilitate optimal function in disabled persons. Orthoses do not, however, include prosthetics (artificial limbs) or surgically implantable devices such as total joint replacements. Judging from the title, one might anticipate this book to be principally a catalog of technical devices for the disabled population; however, I was pleasantly surprised to find much more. The book begins with several foundational chapters on the principles and mechanics of orthotics and the features of many natural and man-made materials used in orthotic fabrication. Subsequent chapters include practical discussions of orthotic options in relationship to clinical problems. Nearly half the chapters are organized according to anatomic regions treated by orthotic adaptation. There are four chapters related to trunk and spine devices, and one each for upper extremities, lower extremities, feet ("Shoes and Modifications"), and lungs ("Respiration and Respiratory Aids"). Several chapters deal with aids for mobility, including "Crutches, Canes, and Walkers," seating devices, wheelchairs, and automobile modifications. In other chapters, adaptations to facilitate independent living are discussed, such as "Self-Help Aids and (Modified) Clothing," special features of various types of beds, accessibility in building and home design, and the rapidly changing area of high technology for disabled persons. I found several features of this book to be particularly useful as reference sources. One such feature is a 70-page dictionary of orthotic eponyms. It is always frustrating to come across a reference to an unfamiliar orthotic without a
608
BOOK REVIEWS
description of its particular features. This book provides a comprehensive, descriptive list of many orthotics and devices. Other chapters provide helpful lists of additional resources for selfhelp aids and clothing for disabled persons, microcomputer applications, and architectural design for barrier-free environments. This updated edition of Orthotics Etcetera should continue to be a valuable reference source for all rehabilitation health professionals. David L. Nash, M.D. Department of Physical Medicine and Rehabilitation
Parental Influences: In Health and Disease, edited by E. James Anthony and George H. Pollock, 531 pp, with illus, $29.95, Boston, Little, Brown and Company, 1985 I had high hopes for this book. In a sense, the book is a sequel to Anthony and Benedek's deservedly renowned Parenthood: Its Psychology and Psychopathology, and the contributors are well known. The topic is at the forefront of developmental research in child psychiatry and in behavioral and developmental pediatrics. Despite these promises, the book is a disappointment. It begins with a consideration of crossgenerational influence, including the maternal behavior of a formerly autistic child and the repetition of child abuse from generation to generation. Three contributions on "the parental experience" follow: chapters on maternal-child empathy, the maternal experience during early infancy, and parenting as a function of the adult self. The next section deals with "the abandoning parent," with chapters on parent-child interactions associated with parental depression, psychosis, and divorce. The final section considers parents of children with psychosomatic illnesses, maternal influences in a case of fetishism, and the role of fathers. Most of these topics are important in a consideration of human development and parent-child interactions. Some of the descriptions of individual dynamics are of interest, and some of the speculations are ingenious. The introduction provides an excellent summary of the contributions of
Mayo Clin Proc, July 1986, Vol 61
Anna Freud and Theresa Benedek to this field. The chapter by Engel and associates is a brilliant review of a single-case study, which has been under way for 33 years. Monica, an infant who was fed by gastric fistula until age 2 years because of congenital esophageal atresia, has been studied intensively since age 15 months. Photographs associated with the study show Monica being fed through the fistula, Monica holding her own babies in the manner in which she was held, and Monica's daughters holding their dolls in the same manner. This long chapter merits careful reading. The chapter on fathers and aggression is interesting. Some of the chapters, such as the one that considers maternal patterns in the childhood of highly creative persons, are also thoughtprovoking. The negative features of this book overwhelm its merits, in my view. Most of the chapters present, at most, a handful of individual cases. Thus, although some important topics are reviewed, they are not covered in a systematic manner. Several of the chapters are irritating or one-sided. Even in the well-written introduction that presents a fine assessment of the contributions of Anna Freud and Theresa Benedek, the discussion of D. W. Winnicott's work is superficial, and there is no discussion of modern theories and studies (and by now there have been many) on parental influences. The chapter on the generational repetition of maltreatment of children presents little that is new. Several of the chapters use imprecise or nearly meaningless language: one author maintains that empathy derives from a "flow of tension" and that trust derives from a "flow of shape." Another contributor urges analysts to develop a "thereness." The chapter on maternal influence in psychosomatic illness blames mothers in a shotgun manner. They are described as domineering, intrusive, demanding, clinging, rejecting, insensitive, or narcissistic. Some are, of course, and so are many mothers of children without psychosomatic disorders. Both asthma and anorexia nervosa are viewed as psychosomatic illnesses, although both fit much better into Engel's biopsychosocial model of illness. Fortunately, the author of this chapter assures us that he is not advocating a "linear causal relationship" but something in accord with a "combinational specificity hypothesis." Thank goodness! I had broader objections to the book as well. There are major problems with drawing broad
those of the best reference texts. As a source for study or review of geriatric medical data, this text would be my choice. The book is a compendium of geriatric knowledge; it presents strong science, very little conjecture, and only a slight amount of editorialization. The subject matter is covered thoroughly and consistently, and the material relies on the data base that has developed during the past 15 to 20 years. Most of the information about general medicine relates directly to the elderly population. Several topics are addressed in more than one chapter, yet the presentations are never boring and seldom overlap. The book is divided into seven parts. The delightful introductory part is entitled "The Biology of Human Aging" and consists of five chapters. The second part (composed of six chapters) is a thought-provoking section called "The Epidemiology of Human Aging." The best sections of the book are the two parts (with a total of 41 chapters) entitled "The Cardinal Manifestations of Aging and Disease" and "Diseases of the Organ Systems." These sections set this book apart from earlier works, in that a sound scientific data base is brought into play in discussing the particular problems and needs of the elderly population. The book, however, has some shortcomings. The last 50 pages lack continuity with the rest of the text. In addition, more space could have been devoted to drug metabolism and specific treatment, as drug and dosing schedules are oftentimes described in vague terms. The chapters on osteoporosis and Alzheimer's disease should have been expanded. Despite these minor deficiencies, this text is well worth the $65. Do not wait for the next edition! Eric G. Tangalos, M.D. Division of Community Internal Medicine
Orthotics Etcetera, 3rd ed (Rehabilitation Medicine Library series), edited by John B. Redford, 836 pp, with illus, $68.50, Baltimore, Williams & Wilkins, 1986 Orthotics Etcetera is one of many books in the Rehabilitation Medical Library series published by Williams & Wilkins. This third edition of the
BOOK REVIEWS
607
text is considerably updated, a reflection of the dramatic technologic changes in the field. The intended audience for this book spans the spectrum of the rehabilitation team. Physiatrists, orthopedists, neurologists, and rheumatologists will find information relevant to prescription orthotics and other devices. Orthotists, physical therapists, and occupational therapists will find helpful material regarding fabrication and functional application. Rehabilitation counselors, administrators, and even insurance company personnel may also find the book a valuable resource. An orthosis, as defined by Sidney Licht, is any device that, when in contact with the body, improves function. The "etcetera" in the book title refers to the many other devices that are in some way associated with orthotics and facilitate optimal function in disabled persons. Orthoses do not, however, include prosthetics (artificial limbs) or surgically implantable devices such as total joint replacements. Judging from the title, one might anticipate this book to be principally a catalog of technical devices for the disabled population; however, I was pleasantly surprised to find much more. The book begins with several foundational chapters on the principles and mechanics of orthotics and the features of many natural and man-made materials used in orthotic fabrication. Subsequent chapters include practical discussions of orthotic options in relationship to clinical problems. Nearly half the chapters are organized according to anatomic regions treated by orthotic adaptation. There are four chapters related to trunk and spine devices, and one each for upper extremities, lower extremities, feet ("Shoes and Modifications"), and lungs ("Respiration and Respiratory Aids"). Several chapters deal with aids for mobility, including "Crutches, Canes, and Walkers," seating devices, wheelchairs, and automobile modifications. In other chapters, adaptations to facilitate independent living are discussed, such as "Self-Help Aids and (Modified) Clothing," special features of various types of beds, accessibility in building and home design, and the rapidly changing area of high technology for disabled persons. I found several features of this book to be particularly useful as reference sources. One such feature is a 70-page dictionary of orthotic eponyms. It is always frustrating to come across a reference to an unfamiliar orthotic without a
608
BOOK REVIEWS
description of its particular features. This book provides a comprehensive, descriptive list of many orthotics and devices. Other chapters provide helpful lists of additional resources for selfhelp aids and clothing for disabled persons, microcomputer applications, and architectural design for barrier-free environments. This updated edition of Orthotics Etcetera should continue to be a valuable reference source for all rehabilitation health professionals. David L. Nash, M.D. Department of Physical Medicine and Rehabilitation
Parental Influences: In Health and Disease, edited by E. James Anthony and George H. Pollock, 531 pp, with illus, $29.95, Boston, Little, Brown and Company, 1985 I had high hopes for this book. In a sense, the book is a sequel to Anthony and Benedek's deservedly renowned Parenthood: Its Psychology and Psychopathology, and the contributors are well known. The topic is at the forefront of developmental research in child psychiatry and in behavioral and developmental pediatrics. Despite these promises, the book is a disappointment. It begins with a consideration of crossgenerational influence, including the maternal behavior of a formerly autistic child and the repetition of child abuse from generation to generation. Three contributions on "the parental experience" follow: chapters on maternal-child empathy, the maternal experience during early infancy, and parenting as a function of the adult self. The next section deals with "the abandoning parent," with chapters on parent-child interactions associated with parental depression, psychosis, and divorce. The final section considers parents of children with psychosomatic illnesses, maternal influences in a case of fetishism, and the role of fathers. Most of these topics are important in a consideration of human development and parent-child interactions. Some of the descriptions of individual dynamics are of interest, and some of the speculations are ingenious. The introduction provides an excellent summary of the contributions of
Mayo Clin Proc, July 1986, Vol 61
Anna Freud and Theresa Benedek to this field. The chapter by Engel and associates is a brilliant review of a single-case study, which has been under way for 33 years. Monica, an infant who was fed by gastric fistula until age 2 years because of congenital esophageal atresia, has been studied intensively since age 15 months. Photographs associated with the study show Monica being fed through the fistula, Monica holding her own babies in the manner in which she was held, and Monica's daughters holding their dolls in the same manner. This long chapter merits careful reading. The chapter on fathers and aggression is interesting. Some of the chapters, such as the one that considers maternal patterns in the childhood of highly creative persons, are also thoughtprovoking. The negative features of this book overwhelm its merits, in my view. Most of the chapters present, at most, a handful of individual cases. Thus, although some important topics are reviewed, they are not covered in a systematic manner. Several of the chapters are irritating or one-sided. Even in the well-written introduction that presents a fine assessment of the contributions of Anna Freud and Theresa Benedek, the discussion of D. W. Winnicott's work is superficial, and there is no discussion of modern theories and studies (and by now there have been many) on parental influences. The chapter on the generational repetition of maltreatment of children presents little that is new. Several of the chapters use imprecise or nearly meaningless language: one author maintains that empathy derives from a "flow of tension" and that trust derives from a "flow of shape." Another contributor urges analysts to develop a "thereness." The chapter on maternal influence in psychosomatic illness blames mothers in a shotgun manner. They are described as domineering, intrusive, demanding, clinging, rejecting, insensitive, or narcissistic. Some are, of course, and so are many mothers of children without psychosomatic disorders. Both asthma and anorexia nervosa are viewed as psychosomatic illnesses, although both fit much better into Engel's biopsychosocial model of illness. Fortunately, the author of this chapter assures us that he is not advocating a "linear causal relationship" but something in accord with a "combinational specificity hypothesis." Thank goodness! I had broader objections to the book as well. There are major problems with drawing broad