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Golden's Diagnostic Radiology, 3. Radiology of the Chest
Book Reviews illustrations are carefully chosen, of good quality and in the main help the text along well. On first examination the bibliographies at the end of each chapter and the index would seem too brief. The sections on physiology and pathology are perhaps too terse and prove unsatisfying for the specialist but they are rather densely written for the novice. Better expositions not are available elsewhere, least in Professor Murray’s own book. All that said, who is the textbook aimed at and who is likely to benefit by it? It is difficult to imagine an established physician having the energy and time to digest its contents in full but judicious dipping would be enjoyable and useful. For those already specializing in chest diseases, there would be few major new insights to be gained from this book but most individuals would find the present state of knowledge within their own areas of expertise well summarized, often in enviably clear language. The book is likely to serve best new recruits to chest medicine who need to lay a sound foundation for a future career. For the uncommitted physician in training, there is probably too much detail but again dipping would be painless and fruitful. Those engaged in teaching chest medicine will envy the clarity of explanation and may well base some of their own talks and seminars on the material as presented here. As an introduction to the specialist literature the book is less useful and although its bibliographies provide adequate reference for the general reader, the book lacks the comprehensiveness of its main British rival. The problem with all textbooks is the need to lay out information in a linear sequence. The specialist seeking help with an unsolved clinical problem will not find this volume more helpful than its obvious rivals. The challenge of providing a really good textbook which starts with clinical problems as the present and carries through to successful management has yet to be written; perhaps John Murray could be persuaded to try. All the evidence suggests that he would do it admirably. In these inflationary times the price may be reasonable and certainly this book should be included in every undergraduate and postgraduate library. All candidates for the MRCP would benefit by a browse through its pages at an early stage in their reading but it is not an essential buy for them. JOHN COLLINS
Golden’s Diagnostic of the Chest Coleman Baltimore: edition.
B. Rabin
Radiology, and
Murray
Williams & 1980. Pp. x+764.
3.
Radiology
G. Barron
Wilkins. Price $85
Second
During the past few years the great need for first-class textbooks of pulmonary radiology has been filled almost entirely from the USA. Authorship is often erudite and the standard of pictorial reproduction usually excellent. Even so there is as yet no book which effectively links the clinical state with the radiographic findings at the various stages of disease or emphasizes the fundamental defects inherent in the chest radiograph. Some of these defects may be reduced by computerassisted tomography, especially in relation to the mediastinum, but this recent branch of ‘imaging’ bears its own false-positives in relation to parenchymal disease of the lung and wide gaps of uncertainty still exist. Image enhancement and nuclear magnetic resonance are still in the experimental stages and as yet play no part in every-day pulmonary radiology. Regrettably the second edition of this radiological textbook also follows in the established groove yet, within such confines, has much to commend it. It is divided into three major sections : General considerations, single pathological processes and regional roentgen pathology, and there is a brief, well illustrated appendix on computed tomography. The references are extensive and commendably recent. The reproductions are excellent and are accompanied by informative captions. The lack of correlation between clinical and radiological change inveitably devalues the radiographic assessment of nodular densities, widespread parenchymal opacities and other aspects of diffuse disease. The radiological descriptions are sound enough but without the catalysis of clinical detail there is little to add to the well trodden path of descriptive account. Chest physicians and radiologists on this side of the Atlantic will inevitably find some statements to be at variance with their own experience. Bronchopulmonary aspergillosis is summarily dismissed as a somewhat unusual complication of asthma of very little relevance. The presence and character of calcification in mediastinal tumours is given considerable diagnostic significance in differentiating benign from malignant conditions. Broncholithiasis as a
Book causative factor in pulmonary disease is thought to be of major importance and the total omission of a-1-antitrypsin factor in relation to basal emphysema is somewhat difficult to understand. Nevertheless a large amount of very sound information is crammed into the 760 pages. The format is pleasing and the print is clear. As a quick, non-comprehensive, reference book it will prove more than adequate in the majority of cases. The bibliography is very useful for further reading and the work is recommended to chest physicians and radiologists alike whatever their vintage.
BASIL STRICKLAND
Frimley
: The
Biography
of a Sanatorium
J. R. Bignall London: National Heart and Chest 1980. Pp. viii+ 182. Price L3.75
Hospitals.
Almost all tuberculosis sanatoria came and went in the first half of this century. They thus saw the demise of an epidemic which lasted for at least three hundred years and had its peak in Napoleonic times. Maybe they should have been opened earlier. After all, Laennec greatly facilitated the diagnosis of pulmonary tuberculosis in the years 181Q1830 and Koch demonstrated its infective cause in 1882. Alas, consumptives were rarely admitted to hospital beds which, it was thought, could be more usefully occupied by patients with potentially treatable and clinically more interesting diseases. They were, for the most part, condemned to linger and die at home, often infecting their families. When George Bodington, a general practitioner in Sutton Coldfield, revived the ancient remedy of fresh country air and exercise in 1840 and Brehmer advocated a stay in the mountains of Germany in 1856, at least a definitive form of therapy was discernible but the physicians at Brompton, founded in 1840, were unimpressed; indeed, the windows of the hospital were still firmly shut in 1882, the year in which Bodington died. In the following years the Governors at Brompton were prevailed upon to assume the
Reviews additional financial burden of a country branch, which was eventually opened at Frimley by the Prince of Wales in 1904. As a new venture, Frimley had much in its favour. It had the support of the Brompton physicians who provided patients with reasonable prognoses and instituted a remarkable follow-up system which continued for fifty years. It was fortunate in its medical superintendents, namely Marcus Paterson, W. 0. Meek, R. C. Wingfield and A. F. Foster Carter. Together with King Edward VII Hospital, Midhurst, it set standards which many other sanatoria emulated. Dr Bignall is rather more concerned with the human aspects of individual patients than he is with administration and statistics, and, with half of those admitted in the early years dying within five years, he has many harrowing stories to tell. Yet, granted the terrible social and financial effects of the disease upon themselves and their families, the patients were at least hopeful during their stay, if they could not be entirely happy. They were made to feel that somebody cared for them and looked after their interests. In time, those who graduated to reasonable amounts of exercise built a reservoir and chapel and maintained a large vegetable garden and piggery. The introduction of medical and surgical collapse therapy in the 1920s improved the prognosis, which was transformed by antituberculosis drugs after World War II. By the mid-1950s Frimley was no longer needed for tuberculosis and became the Country Branch of the Brompton, caring for patients with pulmonary and cardiac disease. Dr Bignall describes the realities of life and work in a sanatorium, from the points of view of both staff and patients. Those of us who share his affection for Frimley are greatly indebted to him for recording the ups and downs of a very human institution. His book will certainly be enjoyed by many doctors nurses and social workers; it can also be recommended to anybody interested in tuberculosis or medical history. The book is available from the Administrator, Brompton Hospital, Frimley, Camberley, Surrey. NEVILLE C. OSWALD
Golden’s Diagnostic of the Chest Coleman Baltimore: edition.
B. Rabin
Radiology, and
Murray
Williams & 1980. Pp. x+764.
3.
Radiology
G. Barron
Wilkins. Price $85
Second
During the past few years the great need for first-class textbooks of pulmonary radiology has been filled almost entirely from the USA. Authorship is often erudite and the standard of pictorial reproduction usually excellent. Even so there is as yet no book which effectively links the clinical state with the radiographic findings at the various stages of disease or emphasizes the fundamental defects inherent in the chest radiograph. Some of these defects may be reduced by computerassisted tomography, especially in relation to the mediastinum, but this recent branch of ‘imaging’ bears its own false-positives in relation to parenchymal disease of the lung and wide gaps of uncertainty still exist. Image enhancement and nuclear magnetic resonance are still in the experimental stages and as yet play no part in every-day pulmonary radiology. Regrettably the second edition of this radiological textbook also follows in the established groove yet, within such confines, has much to commend it. It is divided into three major sections : General considerations, single pathological processes and regional roentgen pathology, and there is a brief, well illustrated appendix on computed tomography. The references are extensive and commendably recent. The reproductions are excellent and are accompanied by informative captions. The lack of correlation between clinical and radiological change inveitably devalues the radiographic assessment of nodular densities, widespread parenchymal opacities and other aspects of diffuse disease. The radiological descriptions are sound enough but without the catalysis of clinical detail there is little to add to the well trodden path of descriptive account. Chest physicians and radiologists on this side of the Atlantic will inevitably find some statements to be at variance with their own experience. Bronchopulmonary aspergillosis is summarily dismissed as a somewhat unusual complication of asthma of very little relevance. The presence and character of calcification in mediastinal tumours is given considerable diagnostic significance in differentiating benign from malignant conditions. Broncholithiasis as a
Book causative factor in pulmonary disease is thought to be of major importance and the total omission of a-1-antitrypsin factor in relation to basal emphysema is somewhat difficult to understand. Nevertheless a large amount of very sound information is crammed into the 760 pages. The format is pleasing and the print is clear. As a quick, non-comprehensive, reference book it will prove more than adequate in the majority of cases. The bibliography is very useful for further reading and the work is recommended to chest physicians and radiologists alike whatever their vintage.
BASIL STRICKLAND
Frimley
: The
Biography
of a Sanatorium
J. R. Bignall London: National Heart and Chest 1980. Pp. viii+ 182. Price L3.75
Hospitals.
Almost all tuberculosis sanatoria came and went in the first half of this century. They thus saw the demise of an epidemic which lasted for at least three hundred years and had its peak in Napoleonic times. Maybe they should have been opened earlier. After all, Laennec greatly facilitated the diagnosis of pulmonary tuberculosis in the years 181Q1830 and Koch demonstrated its infective cause in 1882. Alas, consumptives were rarely admitted to hospital beds which, it was thought, could be more usefully occupied by patients with potentially treatable and clinically more interesting diseases. They were, for the most part, condemned to linger and die at home, often infecting their families. When George Bodington, a general practitioner in Sutton Coldfield, revived the ancient remedy of fresh country air and exercise in 1840 and Brehmer advocated a stay in the mountains of Germany in 1856, at least a definitive form of therapy was discernible but the physicians at Brompton, founded in 1840, were unimpressed; indeed, the windows of the hospital were still firmly shut in 1882, the year in which Bodington died. In the following years the Governors at Brompton were prevailed upon to assume the
Reviews additional financial burden of a country branch, which was eventually opened at Frimley by the Prince of Wales in 1904. As a new venture, Frimley had much in its favour. It had the support of the Brompton physicians who provided patients with reasonable prognoses and instituted a remarkable follow-up system which continued for fifty years. It was fortunate in its medical superintendents, namely Marcus Paterson, W. 0. Meek, R. C. Wingfield and A. F. Foster Carter. Together with King Edward VII Hospital, Midhurst, it set standards which many other sanatoria emulated. Dr Bignall is rather more concerned with the human aspects of individual patients than he is with administration and statistics, and, with half of those admitted in the early years dying within five years, he has many harrowing stories to tell. Yet, granted the terrible social and financial effects of the disease upon themselves and their families, the patients were at least hopeful during their stay, if they could not be entirely happy. They were made to feel that somebody cared for them and looked after their interests. In time, those who graduated to reasonable amounts of exercise built a reservoir and chapel and maintained a large vegetable garden and piggery. The introduction of medical and surgical collapse therapy in the 1920s improved the prognosis, which was transformed by antituberculosis drugs after World War II. By the mid-1950s Frimley was no longer needed for tuberculosis and became the Country Branch of the Brompton, caring for patients with pulmonary and cardiac disease. Dr Bignall describes the realities of life and work in a sanatorium, from the points of view of both staff and patients. Those of us who share his affection for Frimley are greatly indebted to him for recording the ups and downs of a very human institution. His book will certainly be enjoyed by many doctors nurses and social workers; it can also be recommended to anybody interested in tuberculosis or medical history. The book is available from the Administrator, Brompton Hospital, Frimley, Camberley, Surrey. NEVILLE C. OSWALD