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associated with oestrogen replacement. A summary of the data on the Robert Marcus, David Feldman, Jennifer Kelsey. San Diego: Academic Press. 1996. risks of breast cancer would have Pp 1373 (plus 120 slides). $149.95.ISBN 012-47086@9. been helpful to the practitioner who is Osteoporosis has been recognised as a i increasing trabecular connectivity. frequently asked about this. The pathological entity for over a century Because of its ability to enhance bone i cardiovascular benefits of oestrogen but it was not until 1948 that Albright i architecture, intermittent parathyroid are also not discussed. The section on distinguished menopausal oestrogen hormone therapy may prove to be i bisphosphonates refers to etidronate deficiency and ageing as separate i much more useful than treatment and pamidronate although neither is processes that result in bone loss. with sodiumfluoride. i approved in the USA for the treatSince then, others have expanded this But several major controversies in ment of osteoporosis. And, unfomidea, and have developed a specialty i the field of osteoporosis treatment are i nately, recent studies on alendronate for research into the mechanisms and i not well covered in this text. For that led to its approval by the Food treatment of osteoporosis. No longer i example, the question of whom to i and Drug Administration were not is osteoporosis exclusively in the treat has moved to the forefront as a included in the text since they were purview of endocrinologists and i result of the increased availability of i published after the chapter was writrheumatologists. Family practitioni ten. The chapter on densitometry ers, internists, gynaecologists, geria- i i describes only briefly quantitative tricians, and orthopaedic surgeons are i computed tomography and there is i no mention of other methods of bone among the specialists that are also i called on to manage this condition. Until now there has not been a i comprehensive textbook devoted to osteoporosis. Marcus, Feldman, and i An unusual and welcome addition Kelsev must therefore be commended i B I to this text is a collection of 120 slides g i taken from the illustrations therein for tackling this daunting project. In i i (see figure). I will find these 70 well-organised and readable chapHlgh-power i immensely beneficial when lecturing ters, all relevant topics are covered mlcmgraph intersection of bone from basic science to epidemiology, i trabcuiaeshowing mu~ipie resorption to students, residents, and practitionbiomechanics, clinical syndromes sites : ers. In summary, Osteoporosis, i although it falls short in some areas, is and, finally, treatment. There is, how- i ever, redundancy among some of the bone densitometry. Thus, the practia valuable addition to the library of chapters and variability in the amount i tioner must now decide whether every any physician or scientist interested in of detail. The chapter on the bio80-year-old woman with an average i osteopenic disorders. chemistry of bone is a book unto itself i bone-mineral density for her age at 60 pages and 980 references should be treated since she will tech- i Raphael L Kieva/ whereas the chapter on the role of cal- i niCallY be Within the OSteOpOrotic Boston University School of Medicine, cium in osteoporosis merits only 6 range. Another concern is the risk : 26GlendaleRoad. Sharon MA02067, USA pages with 52 citations. Special topics i such as osteoporosis in men, children, pregnancy, amenorrhoea, transplan- i Interpretingevidence tation, and gastrointestinal disease are Evaluatingforensic science in the courtroom-Bernard Robertson, G A Vignaux. covered individually. I found the i London: John Wiley & Sons. 1995.€24.95.Pp 262. ISBN 0471-96026-8. chapters on osteoblast and osteoclast biology clearly written, informative, Reviewing this book proved murder- i for some fundamental re-evaluation of forensic science”, a field that they and of practical importance since all i ous. It was received just as a 2-week trial for homicide commenced at the i elsewhere declare is “a mess”. This of our current interventions involve i Old Bailey in London. Three defen- desire to establish first principles of these cells in some way. dants were charged with callous, i expert evidence, and especially those Several chapters provide helpful pertaining to logic and probability, tables summarising, for example, the i cold-blooded murder. As a pupilbarrister, who also trained as a med- i relates directly to their frank belief clinical trials of calcium, vitamin D, and thiazides. Critical appraisals of i ical ethicist, I was involved in the that there has been “a sad failure of the strengths and weaknesses of these defence of one of the accused, and so i communication” between lawyers and forensic scientists. studies is also frequently provided. i this book was brought to court every The book has therefore been writAmple illustrations, graphs, and i day, its contents read, re-read, tested ten for both lawyers and forensic tables are found throughout the book. i in order to do justice-to the accused scientists to address the situationNewer therapies such as parathyroid i as well as to the two authors of theoretically, practically, and profeshormone peptides, androgens, oestro- i Interpreting Evidence. sionally. The authors hope that gen agonists, growth hormone, and Robertson and Vignaux have not through their “deep theoretical thinkflavonoids are presented in detail. Of i sought to produce simply a forensic ing” lawyers will gain a greater these, parathyroid hormone holds the i science textbook to assist lawyers. understanding of “far more practical greatest promise as an osteoblast i Actually theirs is a far more imporsolutions to practitioners’ problems tant, and difficult, task. As they state stimulator that can greatly increase than the ad hoc reasoning which has both bone density and strength by i in the preface: “The time has come

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BOOKSHELF been applied to expert evidence in the past”. Forensic science and its practitioners are meant to gain as a “greater sense of unity and professionalism” are promulgated. So much for the academic apologia. Meanwhile, back at the Old Bailey witness after witness provided their “raw data”, with examinationin-chief followed by cross-examination and re-examination, while I contemplated the chapter contents (and their cases studies) like a medieval monk fixated upon his deadly serious meditation. Then came the revelations of expert witnesses—for both prosecution and defence. Placed in this context, the authors’ attention to developing their critical methodology means that this reader learned much about assessing expert evidence and experts themselves. The interpretation of scientific evidence, its strength and weakness, and indeed its placing into the context of a case as a whole, are also explored with especial attention to examining “a brace of lawyers’ fallacies” (chapter six is highly recommended). Blood and DNA evidence, for exam-

ple, so standard to many cases today, are discussed in terms of their relevance to the overall process of valid and invalid inference (pace OJ Simpson). In this regard, readers familiar with classic statistics and database matching will be at an advantage, but Robertson and Vignaux strive to be clear, concise, and understandable. In short, even the humble fingerprint should no longer be viewed the same way, however mathematical, scientific, or legal your background. For all of the strengths of this book, however, the authors have surprisingly neglected one fast-growing aspect of forensic science: facial mapping. Given the fundamental importance of identification for conviction or acquittals, especially through video recordings in shops or in photographs, forensic science plays an increasingly important role in this field, as in the Old Bailey case. Yet as this case revealed, far greater scientific precision is necessary. Certainly much of the authors’ material is applicable, at least in principle, yet it is surprising that nothing of direct bearing was included. Quite frankly,

it caused serious doubts to be raised in my mind about this particular “forensic science”—in need of fundamental evaluation if not re-evaluation. Unquestionably, forensic science has developed far from the days when Bertillon’s anthropometric classification dominated the field and when he argued that you might “Look at his ears!” to adjudge an accused guilty or innocent based on a portrait parlé. Robertson and Vignaux have written an important and readable work, showing that much of forensic science has come of age in this technological age. Medical practitioners who testify in courts will find their work enhanced in detail and in scientific accountability and argument. Legal practitioners will find themselves grateful for not only quality explanations of forensic science but also demonstration of its application to the law. Even when it proves murderous.

Jonathan Sinclair Carey Somerset Chambers, 52 Bedford Row, London WC1R 4LR, UK

Endpiece

Polyarteritis nodosa Changes in interstitial structures can be of diagnostic value when muscle tissue is ex amined. In the ex ample of polyarteritis nodosa above, intense inflammation is seen in and around the walls of the small intramuscular artery (H & E, magnification⫻80). Taken from Oppenheimer’s Diagnostic Neuropathology—a practical manual, second edition, by Margaret M Esiri. (Ox ford: Blackwell Science. 1996. Pp 458. £125. ISBN 0-86542-915-4.)

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