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Mediastinal Obstruction in Lung Cancer
Tubercle. Land.. (1967), 48, 75
BOOK
REVIEWS
Pulmonary Diseases and Anomalies of Infancy and Childhood. By MILTON I. LEViNi-and ARMOND V. MASCIA. Harper & Row. New York. Pp. 368; illustrated. 812.00. A book which deals solely with lung diseases and anoinalies ofinf^mcy and childhood certainly fulhls an urgent need, for these disorders constitute an important group in paediatrics both in frequency and degree of morbidity. Although the treatment of pulmonary infections has improved, they still present the doctor with many dilhcult problems. This is the first edition. The print is clear and there are over 100 illustrations, most of which are large scale and good quality. The reading matter is therefore considerably less than the number of pages implies. The text is set out in the usual w^ay, with descriptions of the disease followed by signs and symptoms, x-ray findings, dilTerential diagnosis and treatment: the various pulmonary diseases are grouped into chapters, with tlie first on the normal lung and the last on diagnostic procedures. In the latter there is no discussion of the first breath, and in the former only a few words on pulmonary function, tests, rightly emphasizing their importance but without any descriptions or comments of the tests themselves. The section on skin testing is useful and comprehensive. It is often easy in any book io find statements with which one disagrees; but it seems unrealistic to recommend l of a teaspoon for a dose (p. 269), and dangerous to wait until well-marked respiratory difficulty has occurred before giving an injection of adrenaline in the treatment of asthma. It is confusing to the reader to learn that cystic fibrosis may be associated with chemical evidence of the coeliac syndrome (p. 193) although part of this confusion may be due to lack of acceptance by some of our transatlantic colleagues that coeliac disease is a separate disease. These criticisms should not deter anyone from reading this book, and thereby learning a great deal; but for the contents and price, it would be a doubtful first choice purchase for the medical student, radiologist, or paediatrician, for whom the work is expressly written.
Mediastinal Obstruction in Lung Cancer. By NORMAN HOWARD.- 1967. Livingstone, Edinburgh and London. Pp. 100. £1.15s. The theme of this monograph is that treatment of mediastinal obstruction from bronchial carcinoma can be of more value if greater care is taken in planning and carrying out radiotherapy. The aim should not be merely to relieve immediate distress and send the patient away. The conclusions are based on analysis of 253 patients at the Royal Marsden Hospital. Complete regression of the signs of obstruction was more frequent (up to 90%) when larger doses of irradiation were given and recurrence was less frequent (about 10%). Phlebography can be valuable in localizing the site of the obstruction so that the beam can be accurately directed. It is a well-written book with a clearly stated and developed argument. The reproductions of radiographs are of high quality. Mediastinal obstruction is certainly a distressing complication; and anything more that can be done to reduce distress is well vvorth the efifort.
BOOK
REVIEWS
Pulmonary Diseases and Anomalies of Infancy and Childhood. By MILTON I. LEViNi-and ARMOND V. MASCIA. Harper & Row. New York. Pp. 368; illustrated. 812.00. A book which deals solely with lung diseases and anoinalies ofinf^mcy and childhood certainly fulhls an urgent need, for these disorders constitute an important group in paediatrics both in frequency and degree of morbidity. Although the treatment of pulmonary infections has improved, they still present the doctor with many dilhcult problems. This is the first edition. The print is clear and there are over 100 illustrations, most of which are large scale and good quality. The reading matter is therefore considerably less than the number of pages implies. The text is set out in the usual w^ay, with descriptions of the disease followed by signs and symptoms, x-ray findings, dilTerential diagnosis and treatment: the various pulmonary diseases are grouped into chapters, with tlie first on the normal lung and the last on diagnostic procedures. In the latter there is no discussion of the first breath, and in the former only a few words on pulmonary function, tests, rightly emphasizing their importance but without any descriptions or comments of the tests themselves. The section on skin testing is useful and comprehensive. It is often easy in any book io find statements with which one disagrees; but it seems unrealistic to recommend l of a teaspoon for a dose (p. 269), and dangerous to wait until well-marked respiratory difficulty has occurred before giving an injection of adrenaline in the treatment of asthma. It is confusing to the reader to learn that cystic fibrosis may be associated with chemical evidence of the coeliac syndrome (p. 193) although part of this confusion may be due to lack of acceptance by some of our transatlantic colleagues that coeliac disease is a separate disease. These criticisms should not deter anyone from reading this book, and thereby learning a great deal; but for the contents and price, it would be a doubtful first choice purchase for the medical student, radiologist, or paediatrician, for whom the work is expressly written.
Mediastinal Obstruction in Lung Cancer. By NORMAN HOWARD.- 1967. Livingstone, Edinburgh and London. Pp. 100. £1.15s. The theme of this monograph is that treatment of mediastinal obstruction from bronchial carcinoma can be of more value if greater care is taken in planning and carrying out radiotherapy. The aim should not be merely to relieve immediate distress and send the patient away. The conclusions are based on analysis of 253 patients at the Royal Marsden Hospital. Complete regression of the signs of obstruction was more frequent (up to 90%) when larger doses of irradiation were given and recurrence was less frequent (about 10%). Phlebography can be valuable in localizing the site of the obstruction so that the beam can be accurately directed. It is a well-written book with a clearly stated and developed argument. The reproductions of radiographs are of high quality. Mediastinal obstruction is certainly a distressing complication; and anything more that can be done to reduce distress is well vvorth the efifort.