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Clinical metabolism of body water and electrolytes
848
Am. Hcurt J. December, 1963
Book reviews
side are mentioned; nor is the determination of vanillvl-mandelid acid (V.M.A.) for the detection of pheochromocytoma hescribeh. These are. however, inevitable difficulties with an early deadline of manuscripts. A more important objection is the denial, on the basis of negative animal experiments, of the value of early sympathectomy and rapid rewarming in the treatment of frostbite. Clinical experience is to the contrary. In the foreword, the authors express their hope that an earlier and closer contact between British and American thinkine would result from such an endeavor as this. The reviewer heartily agrees with this trend, and the yearly exchange of residents and registrars between teaching hospitals on the two sides of the Atlantic has already borne fruit. To further advance this concept, it would help if the source of equipment listed in the footnotes not be limited to British sources, since this will frustrate the American reader. Printing, spelling, and illustrations-with a few exceptions-are excellent. David Sutton’s chapter on arteriography is superb. All in all, this is an intellectual treat for anyone closely or remotely involved in peripheral circulation. And who is not? .J
ATLASOFVASCULARSURGERY. ByFallsB.Hershey, M.D., F.A.C.S., Associate Professor of Clinical Surgery, Washington University; and Carl H. Calman, M.D., F.A.C.S., Assistant in Clinical Surgery, Washington University, St. Louis. St. Louis, 1963, The C. V. Mosby Company, 307 pages. Price $18. This atlas is an excellent addition to the library of any department of surgery or to the library of any resident in surgery who contemplates performing vascular surgery. It is well organized, with the material being presented in a logical and easy-to-follow progression of steps in the various operative procedures. It is complete in that almost all vascular procedures, arterial as well as venous, are considered, most of them in more detail than heretofore presented in a surgical atlas. The book is divided into three sections. The first, an introduction to vascular surgery with general principles and a chapter on radiographic techniques, is extremely well done. The second portion deals with the actual surgical procedures: indications for the operations, a general review of the anatomy of the regions, preoperative preparations, a step-by-step outline of the procedure, with special precautions concerning the difficulties which the surgeon may encounter, and the postoperative care, with mention of the common complications and how best to avoid them. An effort is made by the authors to present the manner in which they handle a particular vascular problem. Although this may vary among vascular surgeons throughout the world, the method presented is usually one of sound judgment and technique. Among the differences that might arise would be the indications for endarterectomy versus bypass grafting in occlusive disease, the use of longitudinal arteriotomies in
aortico-iliac endarterectomies, and the use of anticoagulants in aortico-iliac endarterectomies. The third section of the book, on amputations, is the least comprehensive of the three. The authors do not seem to have the same depth of knowledge of the techniques and postoperative care of the patient who needs the amputation as that which they showed in the previous section on the treatment of his arterial disease. Thev fail also to recognize one of the most helpful allies which the surgeon has in this type of patient-the doctor of physical medicine. This book is, however, extremely well organized and written, superbly illustrated, and is outstanding in its clarity and simplicity of descriptions of the various operative procedures. Although of dubious permanent benefit to the vascular surgeon, this atlas will be of major importance in the training of the resident in surgery.
CLINICAL METABOLISM OF BODYWATERAND ELECTROLYTES. By John H. Bland, M.D., Associate Professor matism College Saunders
of Clinical Medicine, and Director, RheuResearch Unit, University of Vermont of Medicine. Philadelphia, 1963, W. B. Company, 623 pages. Price $16.50.
This volume contains within it a large collection of material by various authors relating to the general topic of body water and electrolytes, with the stated aim of bridging the gap between basic and clinical investigation and bedside medicine. Some of the sections relate specifically to problems in the management of patients, whereas others deal more or less exclusively with experimental work designed to provide a deeper insight into the physiology of the turnover of fluid and electrolytes. Unfortunately, the relevance, or even potential relevance, of some of this material to future medical usage is not made explicit. As in all compilations of multiple authorship the quality of the sections varies considerably-at times, with some careless writing. For example, on page 160 it is asserted that the limits of salt tolerance for normal man range between 1 and 10 Gm. daily. This is followed by the statement that “ingestion of 25 to 30 Gm. of salt per day leads to an immediate increase in body weight of 10 to 15 Ibs.” When one checks the reference cited, the statement is found that most of the subjects maintained body weight during salt loading, but lost some weight after load reduction, from which it was inferred that mild retention of fluid may have occurred during salt loading. It seems almost commonplace clinical experience that normal man can tolerate a daily load of salt well in excess of 10 Gm. without significant retention. On pages 93 and 94, the discussion of the behavior of water and electrolytes across a charged membrane leaves much to be desired, since some of the notations used in equations are not defined, their derivations are not made clear, and references are not given. In spite of these shortcomings, this book does represent an extensive compilation of material, with a laudable although very difficult aim in mind.
Am. Hcurt J. December, 1963
Book reviews
side are mentioned; nor is the determination of vanillvl-mandelid acid (V.M.A.) for the detection of pheochromocytoma hescribeh. These are. however, inevitable difficulties with an early deadline of manuscripts. A more important objection is the denial, on the basis of negative animal experiments, of the value of early sympathectomy and rapid rewarming in the treatment of frostbite. Clinical experience is to the contrary. In the foreword, the authors express their hope that an earlier and closer contact between British and American thinkine would result from such an endeavor as this. The reviewer heartily agrees with this trend, and the yearly exchange of residents and registrars between teaching hospitals on the two sides of the Atlantic has already borne fruit. To further advance this concept, it would help if the source of equipment listed in the footnotes not be limited to British sources, since this will frustrate the American reader. Printing, spelling, and illustrations-with a few exceptions-are excellent. David Sutton’s chapter on arteriography is superb. All in all, this is an intellectual treat for anyone closely or remotely involved in peripheral circulation. And who is not? .J
ATLASOFVASCULARSURGERY. ByFallsB.Hershey, M.D., F.A.C.S., Associate Professor of Clinical Surgery, Washington University; and Carl H. Calman, M.D., F.A.C.S., Assistant in Clinical Surgery, Washington University, St. Louis. St. Louis, 1963, The C. V. Mosby Company, 307 pages. Price $18. This atlas is an excellent addition to the library of any department of surgery or to the library of any resident in surgery who contemplates performing vascular surgery. It is well organized, with the material being presented in a logical and easy-to-follow progression of steps in the various operative procedures. It is complete in that almost all vascular procedures, arterial as well as venous, are considered, most of them in more detail than heretofore presented in a surgical atlas. The book is divided into three sections. The first, an introduction to vascular surgery with general principles and a chapter on radiographic techniques, is extremely well done. The second portion deals with the actual surgical procedures: indications for the operations, a general review of the anatomy of the regions, preoperative preparations, a step-by-step outline of the procedure, with special precautions concerning the difficulties which the surgeon may encounter, and the postoperative care, with mention of the common complications and how best to avoid them. An effort is made by the authors to present the manner in which they handle a particular vascular problem. Although this may vary among vascular surgeons throughout the world, the method presented is usually one of sound judgment and technique. Among the differences that might arise would be the indications for endarterectomy versus bypass grafting in occlusive disease, the use of longitudinal arteriotomies in
aortico-iliac endarterectomies, and the use of anticoagulants in aortico-iliac endarterectomies. The third section of the book, on amputations, is the least comprehensive of the three. The authors do not seem to have the same depth of knowledge of the techniques and postoperative care of the patient who needs the amputation as that which they showed in the previous section on the treatment of his arterial disease. Thev fail also to recognize one of the most helpful allies which the surgeon has in this type of patient-the doctor of physical medicine. This book is, however, extremely well organized and written, superbly illustrated, and is outstanding in its clarity and simplicity of descriptions of the various operative procedures. Although of dubious permanent benefit to the vascular surgeon, this atlas will be of major importance in the training of the resident in surgery.
CLINICAL METABOLISM OF BODYWATERAND ELECTROLYTES. By John H. Bland, M.D., Associate Professor matism College Saunders
of Clinical Medicine, and Director, RheuResearch Unit, University of Vermont of Medicine. Philadelphia, 1963, W. B. Company, 623 pages. Price $16.50.
This volume contains within it a large collection of material by various authors relating to the general topic of body water and electrolytes, with the stated aim of bridging the gap between basic and clinical investigation and bedside medicine. Some of the sections relate specifically to problems in the management of patients, whereas others deal more or less exclusively with experimental work designed to provide a deeper insight into the physiology of the turnover of fluid and electrolytes. Unfortunately, the relevance, or even potential relevance, of some of this material to future medical usage is not made explicit. As in all compilations of multiple authorship the quality of the sections varies considerably-at times, with some careless writing. For example, on page 160 it is asserted that the limits of salt tolerance for normal man range between 1 and 10 Gm. daily. This is followed by the statement that “ingestion of 25 to 30 Gm. of salt per day leads to an immediate increase in body weight of 10 to 15 Ibs.” When one checks the reference cited, the statement is found that most of the subjects maintained body weight during salt loading, but lost some weight after load reduction, from which it was inferred that mild retention of fluid may have occurred during salt loading. It seems almost commonplace clinical experience that normal man can tolerate a daily load of salt well in excess of 10 Gm. without significant retention. On pages 93 and 94, the discussion of the behavior of water and electrolytes across a charged membrane leaves much to be desired, since some of the notations used in equations are not defined, their derivations are not made clear, and references are not given. In spite of these shortcomings, this book does represent an extensive compilation of material, with a laudable although very difficult aim in mind.