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Corticosteroids in medical practice
Volume Number
88 2
The Borderland of Embryology and Pathology. By R. A. Willis. Second edition, 686 pages, 244 figures, Washington, D. C., 1962, Butter-worth & Company. $18.00. A medical book as informative and scholarly as Willis’, and, at the same time, as interesting and stylistically elegant, is a pleasure to read and to review. As the title implies, this treatise is not just another textbook of developmental pathology or clinically oriented embryology, but a monograph that presents, from an original point of view, a synthesis of much material that is frequently omitted or relegated to fine print in conventional texts. As in the first edition, Professor Willis draws largely upon his own vast experience in pathology, particularly congenital tumors and malformations, adding material from the rapidly advancing fields of chromosomal disorders and anomalies of sexual differentiation. Those fields have advanced so rapidly, in fact, that some of the material in the 1962 edition was already out of date when the volume went to press. A concise, though necessarily sketchy, discussion of “inborn errors of metabolism” has been added to the present text. The book is written with so consistent a point of view that the subdivision into chapters seems almost arbitrary. An outline of normal human development is followed by discussions of malformations, developmental vestiges, teratomas, regeneration, metaplasia, and the transplantation and culture of tissues. Terms are clearly defined and, regardless of whether the reader is accustomed to those particular definitions, used consistently throughout. The author creates the comforting impression in his readers that he understands what he means by such frequently misused terms as, for example, metaplasia, prosoplasia, and embryonic tumor. No clinical specialty has more to gain from the assimiliation of Willis’ text than obstetrics and gynecology. The experienced gynecological pathologist will no doubt find the discussions of endometriosis and embryology of the vagina devoid of the most recent contributions to the study of those subjects, but, more significantly, he will be introduced to a major trend in current investigation. The correlation of structure with function and the immediate application of functional anatomy to clinical problems is eloquently demonstrated. The receptive younger investigator or clinician derives inspiration therefrom,
Book reviews
271
and the senior worker, satisfaction and pride in our specialty. In summary, Willis’ book is to be read, not skimmed. Ralph M. Wynn Congenital
Abnormalities in Infancy. By A. P. Norman. First edition, 389 pages, 78 illustrations, Philadelphia, 1963, F. A. Davis, Company. $12.50.
This compact volume is limited to anomalies which are apparent in the first weeks of life and will be of value to obstetricians and physicians dealing with newborn children. Written by eleven authors, the book is divided into ten chapters, eight dealing with abnormalities of organ systems, one with syndromes, and one with incidence and etiology. The chapters and sections are necessarily condensed to brief summaries in certain areas, but the reader is referred to selected references which permit further study. A satisfactory index permits finding of notes on specific malformations and syndromes. The text is supplemented by 78 illustrations. This book was written as a practical guide to physicians working with infants, with emphasis on diagnosis, essentials of treatment, and genetic counseling. Iosef Warkany Corticosteroids in Medical Practice. By M. L. Brandon. 586 pages, 5 tables, Springfield, 1962, Charles C Thomas, Publisher. $6.75. A wealth of information concerning the use of adrenocorticosteroids and adrenocorticotrophic hormones in clinical medicine is contained in this volume. The literature is extensively reviewed with many of the chapters containing in excess of 200 references. The first several chapters are concerned with the physiological aspects of adrenocorticosteroids and ACTH, their production, transport, and comparative potency. Immunological considerations, effects upon metabolism, the gastrointestinal tract, and the cardiovascular and respiratory systems follow. The role of corticosteroids in infection, rheumatology, and collagen disorders is also reviewed. The text is not specifically related to the field of obstetrics and gynecology, but has application to medical complications encountered during pregnancy, such as asthma, hepatitis, and rheumatic fever. The author cautions against the use of large doses of corticosteroids in pregnancy
272
Book
reviews
because of the potential interference with normal fetal development. C)f considerable interest is the section on influence of corticosteroids in infectious diseases. Employment of these agents in the treatment of infection necessitates a knowledge of their hazards: suppression of the activity of the reticulocndothelial system; impaired movement of colloidal and particulate materials through ground substance; interference with protein synthesis; depressed lymphoid tissue mass, antibody synthesis and fibroplastic proliferation; reduced phagocytic activity of polymorphonuclear leucocytes; and depression of total white blood count. Corticosteroids are recommended for use in endotoxic shock along with effective antimicrobial therapy. The text gives an extensive survey of the multiplicity of uses for these “wonder’* drugs. Edward
E.
Wallach
The
Diagnosis of Early Carcinoma of the Cervix. By S. Way. 100 pages, 91 illustrations, Boston, 1963, Little, Brown & Company. $7.00. This small book is devoted to clarifying some of the problems that face the cytologist, gynecologist, and histologist in the early diagnosis of cancer of the cervix. The author describes the clinical aspects of obtaining the smear, including the laboratory processing. The interpretation of the smear is not described in detail since the author rightly maintains that this knowledge cannot be obtained from books. It is unfortunate that the newer cytologic terminology is not used. Thus, the words, precornified and cornified are used instead of intermediate and superficial. The proper technique of performing cervical biopsy is stressed, as well as the correct method of handling the specimen in the laboratory. The
above is most important if the correct diagnosis is to be made. There should be no objection to the treatment advocated for early carcinoma of the cervix. It is particularly refreshing to have the author advocate, and give his reasons for, a ntodificd radical hysterectomy as the treatment of early carcinoma of the cervix. The illustrations are in general good and the number is adequate. This is a book primarily for students and general practitioners and it is hoped they will follow its teachings, for by so doing many unpleasant pitfalls will be avoided. J. Edward
Hall
Documenta Geigy: Scientific Tables. Edited by Konrad Diem. Sixth edition, 740 pages, Ardsley, New York, 1962, Geigy Pharmaceuticals Division of Geigy Chemical Corporation. Tables and explanatory essays are provided in the fields of mathematics, statistics, physics, chemistry, metabolism, vitamins, hormones, nutrition, body composition, reproduction, growth, medical norms, and infectious diseases. In the section on reproduction, some of the blood chemical changes in human pregnancy are tabulated, and weight changes and uterine sizes during pregnancy and the puerperium are shown, as are the normal pelvic measurements. Weights and lengths of the fetus and newborn are tabulated. Statistical methods are discussed and illustrated in a 50 page portion of the book. Constituents of living matter are reviewed in 62 pages, following which metabolism and metabolic pathways are described in 50 pages. Many sections are written by outstanding authorities. Leon
C. Chesley
Books received for review Birth
Defects. Edited by Morris Fishbein. 335 pages, Philadelphia, 1963, J. B. Lippincott Company. $5.00. Cancer of the Female Reproductive Organs. By A. I. Sherman. 338 pages, 70 figures, St. Louis, 1963, The C. V. Mosby Company. $13.75.
Cancer
of the Uterus. By C. Sirtori and E. Morano. Second edition, 383 pages and 279 figures, Springfield, Illinois, 1963, Charles C Thomas, Publisher. $22.50.
Childbirth
Without Pain. By P. Vellay, A. Vellay, C. Jeanson, A. Bourrel, and M. Bour-
88 2
The Borderland of Embryology and Pathology. By R. A. Willis. Second edition, 686 pages, 244 figures, Washington, D. C., 1962, Butter-worth & Company. $18.00. A medical book as informative and scholarly as Willis’, and, at the same time, as interesting and stylistically elegant, is a pleasure to read and to review. As the title implies, this treatise is not just another textbook of developmental pathology or clinically oriented embryology, but a monograph that presents, from an original point of view, a synthesis of much material that is frequently omitted or relegated to fine print in conventional texts. As in the first edition, Professor Willis draws largely upon his own vast experience in pathology, particularly congenital tumors and malformations, adding material from the rapidly advancing fields of chromosomal disorders and anomalies of sexual differentiation. Those fields have advanced so rapidly, in fact, that some of the material in the 1962 edition was already out of date when the volume went to press. A concise, though necessarily sketchy, discussion of “inborn errors of metabolism” has been added to the present text. The book is written with so consistent a point of view that the subdivision into chapters seems almost arbitrary. An outline of normal human development is followed by discussions of malformations, developmental vestiges, teratomas, regeneration, metaplasia, and the transplantation and culture of tissues. Terms are clearly defined and, regardless of whether the reader is accustomed to those particular definitions, used consistently throughout. The author creates the comforting impression in his readers that he understands what he means by such frequently misused terms as, for example, metaplasia, prosoplasia, and embryonic tumor. No clinical specialty has more to gain from the assimiliation of Willis’ text than obstetrics and gynecology. The experienced gynecological pathologist will no doubt find the discussions of endometriosis and embryology of the vagina devoid of the most recent contributions to the study of those subjects, but, more significantly, he will be introduced to a major trend in current investigation. The correlation of structure with function and the immediate application of functional anatomy to clinical problems is eloquently demonstrated. The receptive younger investigator or clinician derives inspiration therefrom,
Book reviews
271
and the senior worker, satisfaction and pride in our specialty. In summary, Willis’ book is to be read, not skimmed. Ralph M. Wynn Congenital
Abnormalities in Infancy. By A. P. Norman. First edition, 389 pages, 78 illustrations, Philadelphia, 1963, F. A. Davis, Company. $12.50.
This compact volume is limited to anomalies which are apparent in the first weeks of life and will be of value to obstetricians and physicians dealing with newborn children. Written by eleven authors, the book is divided into ten chapters, eight dealing with abnormalities of organ systems, one with syndromes, and one with incidence and etiology. The chapters and sections are necessarily condensed to brief summaries in certain areas, but the reader is referred to selected references which permit further study. A satisfactory index permits finding of notes on specific malformations and syndromes. The text is supplemented by 78 illustrations. This book was written as a practical guide to physicians working with infants, with emphasis on diagnosis, essentials of treatment, and genetic counseling. Iosef Warkany Corticosteroids in Medical Practice. By M. L. Brandon. 586 pages, 5 tables, Springfield, 1962, Charles C Thomas, Publisher. $6.75. A wealth of information concerning the use of adrenocorticosteroids and adrenocorticotrophic hormones in clinical medicine is contained in this volume. The literature is extensively reviewed with many of the chapters containing in excess of 200 references. The first several chapters are concerned with the physiological aspects of adrenocorticosteroids and ACTH, their production, transport, and comparative potency. Immunological considerations, effects upon metabolism, the gastrointestinal tract, and the cardiovascular and respiratory systems follow. The role of corticosteroids in infection, rheumatology, and collagen disorders is also reviewed. The text is not specifically related to the field of obstetrics and gynecology, but has application to medical complications encountered during pregnancy, such as asthma, hepatitis, and rheumatic fever. The author cautions against the use of large doses of corticosteroids in pregnancy
272
Book
reviews
because of the potential interference with normal fetal development. C)f considerable interest is the section on influence of corticosteroids in infectious diseases. Employment of these agents in the treatment of infection necessitates a knowledge of their hazards: suppression of the activity of the reticulocndothelial system; impaired movement of colloidal and particulate materials through ground substance; interference with protein synthesis; depressed lymphoid tissue mass, antibody synthesis and fibroplastic proliferation; reduced phagocytic activity of polymorphonuclear leucocytes; and depression of total white blood count. Corticosteroids are recommended for use in endotoxic shock along with effective antimicrobial therapy. The text gives an extensive survey of the multiplicity of uses for these “wonder’* drugs. Edward
E.
Wallach
The
Diagnosis of Early Carcinoma of the Cervix. By S. Way. 100 pages, 91 illustrations, Boston, 1963, Little, Brown & Company. $7.00. This small book is devoted to clarifying some of the problems that face the cytologist, gynecologist, and histologist in the early diagnosis of cancer of the cervix. The author describes the clinical aspects of obtaining the smear, including the laboratory processing. The interpretation of the smear is not described in detail since the author rightly maintains that this knowledge cannot be obtained from books. It is unfortunate that the newer cytologic terminology is not used. Thus, the words, precornified and cornified are used instead of intermediate and superficial. The proper technique of performing cervical biopsy is stressed, as well as the correct method of handling the specimen in the laboratory. The
above is most important if the correct diagnosis is to be made. There should be no objection to the treatment advocated for early carcinoma of the cervix. It is particularly refreshing to have the author advocate, and give his reasons for, a ntodificd radical hysterectomy as the treatment of early carcinoma of the cervix. The illustrations are in general good and the number is adequate. This is a book primarily for students and general practitioners and it is hoped they will follow its teachings, for by so doing many unpleasant pitfalls will be avoided. J. Edward
Hall
Documenta Geigy: Scientific Tables. Edited by Konrad Diem. Sixth edition, 740 pages, Ardsley, New York, 1962, Geigy Pharmaceuticals Division of Geigy Chemical Corporation. Tables and explanatory essays are provided in the fields of mathematics, statistics, physics, chemistry, metabolism, vitamins, hormones, nutrition, body composition, reproduction, growth, medical norms, and infectious diseases. In the section on reproduction, some of the blood chemical changes in human pregnancy are tabulated, and weight changes and uterine sizes during pregnancy and the puerperium are shown, as are the normal pelvic measurements. Weights and lengths of the fetus and newborn are tabulated. Statistical methods are discussed and illustrated in a 50 page portion of the book. Constituents of living matter are reviewed in 62 pages, following which metabolism and metabolic pathways are described in 50 pages. Many sections are written by outstanding authorities. Leon
C. Chesley
Books received for review Birth
Defects. Edited by Morris Fishbein. 335 pages, Philadelphia, 1963, J. B. Lippincott Company. $5.00. Cancer of the Female Reproductive Organs. By A. I. Sherman. 338 pages, 70 figures, St. Louis, 1963, The C. V. Mosby Company. $13.75.
Cancer
of the Uterus. By C. Sirtori and E. Morano. Second edition, 383 pages and 279 figures, Springfield, Illinois, 1963, Charles C Thomas, Publisher. $22.50.
Childbirth
Without Pain. By P. Vellay, A. Vellay, C. Jeanson, A. Bourrel, and M. Bour-