DIAGNOSIS OF DISEASES OF THE CHEST, VOL. III

The Bookshelf (continued) CURRENT PULMONOLOGY (VOL. 1). Edited by DANIEL H. SIMMONS. Boston, Houghton MifRin, 1979, 278 pp., $28.00 (US). CUf'f'etV Pulmonology, Volume 1 is the initial publication of an annual review of pulmonary medicine. Doctor Simmons, Chief, Division of Pulmonary Disease, UCLA School of Medicine, has collected eight monographs on important pulmonary subjects. These are written by recognized authorities in the particular field and constitute a superb current review of the particular topic. The extensive bibliography accompanying each chapter is one of the outstanding features of this collection. The article on interstitial lung disease has, for instance, 381 references. The expertise of the authors ensures that this extensive bibliography is properly interpreted and incorporated into the reviews. A well organized and carefully developed effort is the result. Interstitial lung disease from the National Institutes of Health, by Fulmer and Crystal, is a detailed 50 page summary of a wide variety of disorders; approximately 130 are described, involving pathologic changes in the alveolar supporting tissues. The seetions dealing with the structure of the pulmonary interstitium, the various forms of collagen, and the pathogenesis of the interstitial disorders are particularly well done. There is detailed tabling and references to the various organic dusts, gases, and drugs etiologically identi6.ed in interstitial disease. Disorders of regulation of ventilation, by Lopata and Lourenco, provides a detailed introductory physiologic review with excellent needed clinical correlation in various states, particularly the hypoventilation syndrome of obesity, sleep apnea, and the sudden infant death syndromes. Respiratory distress syndrome: pathology and pathophysiology, by Gong and Tierney, is a detailed review of the pathology and disordered physiology of this multifactorial disease state. There is no attempt to review the various clinical entities, specific therapies, or management. This will be done in the second volume. This chapter is an excellent summary of clinical and animal data with respect to the pulmonary vasculature, liquid and solute exchange, intravascular coagulation, platelet and neutrophil dysfunction. Chapters on pulmonary embolism and sarcoidosis by Stein and Israel are, as might be anticipated from authors with their experience and clinical expertise, worthwhile practical reviews. Stein discusses the various diagnostic techniques in pulmonary embolism and proposes a diagnostic approach. The section on the prophylaxis and management of pulmonary thromboembolism is well done and should be of considerable interest to all disciplines. Israel's concise review summarizes the immunologic aspects of sarcoidosis, the various clinical varieties, the effective use of the fiberoptic bronchoscope in diagnosis, and touches briefly on the controversy regarding steroid treatment. Tuberculosis, by Sbarbaro, is the first chapter in an annual review of tuberculosis to be published in future editions, an indication of its continuing importance. Sbarbaro discusses newer concepts in hypersensitivity and immunity, the changing pattern of disease, the correct use of the various drugs, and the evaluation of various treatment regimens in this and other countries. A concluding section on public health management addresses the important problem of disease control in the face of dwindling funds and the closure of tuberculosis.sanatoria. Nontubercu1ous infections of the respiratory tract, by Meyer and Finegold, reviews infections of the pleura, mediastinum and bacterial pneumonia. There are excellent sections on Gramnegative pneumonia including Legionnaires' disease, anaerobic infections, viral and fungal pneumonia, infections in the immunosuppressed patient, nosocomial infection, and newer diagnostic procedures. Recommendations for appropriate antibiotic treatment are made. This entire chapter is very worthwhile to the practicing physician. Lung cancer, by Holmes, is a concise summary of this immense problem. It emphasizes the predominant role of smoking along with genetic and environmental factors in the etiology of lung carcinoma and discusses the early success of new screening programs for its early detection, preoperative staging, therapysurgical and palliative, and immunotherapy. The text is in large, easily read print in a two-column per page format. There is an adequate number of related tables and Sgures with a small number of x-ray reproductions and pathology photomicrographs. A complete index is included.

In the face of an increasing number of pulmonary texts and reviews, Current Pulmonology, Volume 1 can be enthusiastically recommended to the pulmonary specialist, fellows in training, as well as the physician interested in and whose practice includes pulmonary problems. Simmons is to be congratulated on his initial choice of topics, the quality of his contributors, and the general format of the text. This is a valuable addition to the pulmonology literature. We look forward to Volume 2.

Franda L. Colpoy" M.D. Bolton EMBRYOLOGY AND TERATOLOGY OF THE HEART AND THE GREAT ARTERIES. By C. H. S. VAN MIEROP, A. OPPBNHEIMER-DEKKEBs, C. L. D. C. BRUINS. The Hague, Martinus Nijhoff, 1978,224 pp, 80 guilders. This book reports the proceedings of the Borehaave Course held in Leiden in May 1977. Despite its somewhat pretentious title, the book deals with only three topics, but these are of considerable interest in the management of congenital heart disease today. Firstly, it discusses the conducting system, describing its normal embryology, anatomy, morphology and internodal conduction pathways, followed by its disposition in congenital complete heart block, AV canal malformation, univentricular heart and congenitally corrected transposition. The second part is on transposition of the great arteries. There has been considerable interest in this subject in Leiden, particularly as a result of Professor Brom's work in re-establishing the Senning operation. This section deals mainly with the pathogenesis and the morphology and confines the clinical aspect of the problem to surgical considerations and the problems of arrhythmias following the Mustard operation. The final section is on ductus arteriosus and deals simply with the recent work describing the effect of prostaglandins and indomethacin on the ductus. This is followed by a chapter on the mechanics of closure of the ductus. The course brought together a number of well bOWD authorities on these topics and they have produced a useful book which is clearly written and well illustrated. It does, however, assume that the reader will already have a good knowledge of the subject, and as a result, will be of value only to a limited number of people. However, for those with a special interest in pediatric cardiology, surgery or morphology, this book will provide an excellent review of the present position in these three subjects. S. C. Lennox, F.R.C.S. London, England DIAGNOSIS OF DISEASES OF THE CHEST, VOL. III. By ROBERT G. FRAsER, and J. A. PETER PARE, Philadelphia, w. B. Saunders ce., 746 pp, 206 Sgs, $34.00 (U.S.); $39.10 (Canada). DIAGNOSIS OF DISEASES OF THE CHEST, VOL. IV, 2nd Ed. By ROBERT G. FRAsER, and J. A. PETER PARE, Philadelphia, w. B. Saunders Co., 1979, 280 pp, $20.00 (U.S.); $24.00 (Canada). With these two volumes, the 2nd edition of Fraser and Pare's classic text is complete. The authors have maintained in Volume III the highly readable quality that characterized the first two volumes of this new edition. Chapters include discussions of airway diseases, the pleura, the mediastinum, diaphragm, chest wall, the pneumoconioses, and diseases with normal chest radiographs. The text is expanded about 30 percent. The chapter on penetrating and nonpenetrating trauma and its effect on the thorax and thoracic contents is so changed and enlarged, it must be regarded as new. The discussion includes iatrogenic trauma

changes due to surgery and radiation and the complications of intubation and monitoring devices. This material is an excellent addition. Those familiar with Volume IV, first edition, will remember the tables of differential diagnosis and the wide use this section of the book received. Volume IV again is a small book designed for quic1c reference. When faced with an abnormal radiograph one can turn to the familiar tables of differential diagnosis or to the complimentary new flow sheets called "Decision Trees of Basic Patterns." Here one may quickly find tables of serologic and skin tests and microscopic and cultural characteristics of various

Continued on page 30

27

The Bookshelf (continued)

BOOK NOTICES

bacterial, ric1cettsial, viral, parasitic, and mycotic infections. Volume IV also contains many other charts and quiclc reference tables as well as a new short section on lung biopsy. I recommend this textbook highly. This material is so well presented that learning is almost ~ortless, and it is certainly enjoyable. Harriet Kar1cut, MD. B08ton,MA

THE LUNG IN THE TRANSITION BETWEEN AND DISEASE, VOL. 12 OF LUNG BIOLOGY IN AND DISEASE. Edited by PETER T. MACKLEM, BERTPERMUTT, Executive editor CLAUDE LENFANT. and Basel, Dekker, 1979,435 pp, $39.75.

HEALTH HEALTH and SOLNew York

For the reader who is inclined to think of disease in its wider terms, the title of this book may be misleading. It does not deal with the chemical or pathologic aspects of a number of lung diseases, but confines itself solely to a consideration of Hmitation of expiratory air flow. Its special emphasis is the middle ground between normal and abnormal function, and its rmsOR cl etre is the proposition that in this gray zone there are functional changes which indicate the earliest stages of chronic obstructive lung disease. If these can be recognized, so the thesis goes, they will provide the best opportunity for delaying its advance to a symptomatic stage. The text provides a critical and comprehensive evaluation of the methods currently available for identifying these changes. The broad areas of natural history, structural alterations, risk factors, reversibility of functional abnormalities, and screening methods are discussed by an experienced and expert faculty representing epidemiology, pathology, engineering, clinical science, and physiology. A praiseworthy contribution is the identiftcation of the major short-comings of our present knowledge and the complexity of the problems involved. It is frustrating but not surprising to learn that few correlates can be established between structural changes in the lung at autopsy and the functional abnormalities present during life. Although the significant role of reducing agents in the London type of air pollution is thoroughly proved with respect to obstructive lung disease, that of the oxidizing variety in Los Angeles smog is not yet certain. On the positive side, cessation of cigarette smoking results in improvement in tests of expiratory air flow and overwhelmingly it is with the validity of individual tests of this kind and their application that this book deals. Having de&ned their concerns early, the editors try to deal with them in a final summation which develops a theme based on what the authors have reviewed. They conclude that in the absence of satisfactory morphologic correlates, the disease process should be redefined as chronic air flow limitation because this functional abnormality is responsible for the disabling symptoms which develop. Since a comfortable familiarity now exists with the grouping of clinical bronchitis and anatomic emphysema under the umbrella of COPD or COLD, it is doubtful that this new addition will find ready acceptance. Perhaps chronic resistive air flow pathophysiology would produce a suitable, if not original, acronym to meet the frustrations of a unitary approach. In any event, it is recognized that the most generally acceptable tests of expiratory air flow, specifically the FEVl' would not detect the sublest changes but if used serially might be valuable in preventing the advance of the disease to its symptomatic phase by plotting its functional progression. For this to be achieved, both epidemiologic studies and the routine employment of spirometry as part of a general examination are recommended. This is far from the simplistic concept it appears and the results sought will require an enormous amount of highly sIdl1ed work to achieve them. If the present review seems to place undue emphasis on the editorial analysis offered the reader, this is simply because it is the attractive frosting on a very appetizing and substantial cake. This book should prove an invaluable resource for many years to come-which may in itself be a condemnation of our anticipated rate of progress in this field-both for its critical evaluation of our current capabilities and for the stimulating thesis which it develops. Matthew B. Diverde, M.D. Rochester, Minnesota

30

WILLIAM HARVEY AND THE CIRCULATION OF THE BLOOD. By GWENETH WHITTERIDGE. New York, American Elsevier Publishing ce.,Inc., 1971,269 pp, $7.95. Basically, Wbitteridge has tried to show "by what steps he [Harvey] came to the realization that the blood circulated throughout the whole body." Her knowledge of the original sources, especially the harveian manuscripts, is unparalleled. What we have in the book is an intellectual consideration of some highly pragmatic events, presented in a way that should convince the most skeptical of the real originality of Harvey's deceptively simple contribution. DISEASE IN AFRICAN HISTORY: AN INTRODUCTORY SURVEY AND CASE STUDIES. Edited by GERALD W. HARTWIG and K. DAVID PATTERSON. Durham, NC, Duke University Press, 1978, 258 pp, $13.75. This field is an especially neglected one in medical history, and the symposium from which this book derives has helped to remedy the lack, In addition to an informal bibliography, Hartwig and Patterson have included two essays each on East Africa and on"Ghana, as well as chapters on Chad, Cameroon, and the Sudan. Diseases discussed include relapsing fever, onchocerciasis, sleeping sickness, smallpox, and plague. THE SPONTANEOUS GENERATION CONTROVERSY, FROM DESCARTES TO OPARIN. By JOHN FARLEY. Baltimore, Johns Hopkins University Press, 1977, 226 pp, $13.50. Farley presents a compelling thesis, to the effect that spontaneous generation, a concept now treated with disdain or derision, had a sound and rational theoretic basis in the 17th through the 19th centuries. Contrary to popular opinion, not all scientists' belief in spontaneous generation vanished when Pasteur's studies appeared; indeed, Farley contends that it was only after Oparin's discoveries that the battle ended, and that was less than a half-century ago. BETHUNE: THE MONTREAL YEARS. By WENDELL MAcLEOD, LmBIE PARK, and STANLEY RYERSON. Toronto, James Lorimer and Co., Ltd., 1978, 167 pp, $12.95. For those who think of Bethune as a brlIliant chest surgeon,

which he was, this book will hold little appeal, but for those who seek to understand this man's response to the enervating effect of depression, injustice, and disease commingled, this informal portrait will help. It is informal, and it is unsatisfyingly incomplete, yet more bricks are laid. The three authors knew Bethune, and they narrate their recollections of him, and Montreal, and the world in the 1930s. THE CARE OF THE SICK: THE EMERGENCE OF MODERN NURSING. By VERN L. BULLOUGH and BONNIE BVLLOUGH. London, Croom Helm, Ltd., 1979,311 pp, $15.00. Much useful information is contained in this book, which will appeal to historically minded readers in all of the health professions; however, two weaknesses are evident. The early chapters seem overly speculative in their effort to show that "nursing" existed in various cultures long ago. More important, the description of the modem era is heavily committed to "American" (18, USA) nursing, with little or no serious attention to other countries, neighboring or distant. AN INTRODUCTION TO THE HISTORY OF VIROLOGY. By A. P. WATERSON and LIsE WILKINSON. London, Cambridge University Press, 1978, 237 pp, 27 illus, $27.50. Human, animal, plant, and insect viruses are all included in this short but detailed history, with the heaviest emphasis on human disease. The concept of the virus, the evolution of laboratory methods for detecting and combatting viruses, and the bacterial virus are among the topics. Students will appreciate the meticulous and lengthy bibliography.