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The metabolic profile test
Br, vet . ,7. (1989). 145, 5 9 6
BOOK REVIEWS BOOK REVIEW EDITOR : J . M . RUTTER
The Metabolic Profile Test
J . M . Payne & S . Payne Oxford : Oxford University Press . 1987 . 179 pp . £22 .50 The senior author was a veterinary scientist of great distinction, latterly Director of IRAD and Editor of this journal ; his recent death came at a distressingly young age, accelerated perhaps by the mayhem inflicted on British agricultural research during the last decade through myopic monetarism . This reviewer, like many colleagues in veterinary research, owes a debt of respect to Jack Payne and his many contemporaries whose last years in research were distorted by such fickle and illfounded priorities . The metabolic profile test in its Compton prototype and subsequent variations has been with us for 20 years . It is perhaps a timely opportunity for the leader of the original team to reflect on the impact and progress of the concept . The book is characteristically modest, not hiding the problems of interpretation, the disappointing results of some applications, yet retaining optimism for its growing importance, even in fish and deer . The three distinguishing features of the concept were : 1 . The use of standard clusters of tests rather than symptom-led specific tests . 2 . The use of selected groups rather than individuals, to represent different production stages in a herd . 3 . The definition of acceptable ranges on a purely statistical basis rather than correlation with onset of adverse effects . Indeed, the central theme of the concept was that it could predict probl . . .,is, or identify mismanagement which wouio predispose to problems in a herd . In later applications it was hoped that it could predict potential for high performance either in breeding stock, e .g. cattle, or in racing animals (dogs and horses) though in the latter application the test reverts to individuals rather than populations . Certainly the potential uses of the test
have increased alongside the growing emphasis on multifactorial causes of disease, beyond `production disease' . The strengths of the book are the scope of the coverage, the lucid and enjoyable style and excellent references, especially to earlier work and to non-English language sources . It is also strong in emphasizing the variety and subtlety of factors influencing normal ranges (hence some of the arguments, outside the book, concerning how wide they should be cast for specific variables) . Among these are poor laboratory technique and the book emphasizes the need for meticulous analytical and sampling techniques . There are, however, problems . There is a tendency to dwell too readily on blood concentrations without reflecting whether these are of primary importance (as with Na+ or Cal+) or whether intracellular levels may be equally important (as with Mg") and not necessarily running parallel (as with K+ ) . There is no discussion of the possible importance of protein binding in interpreting Mg` data . Throughout, the referencing is 100% veterinary and while extrapolation from man is always risky, it is impossible to ignore the insights available from human clinical biochemistry, notably on divalent ion metabolism and on the effects of exertion. The idea that magnesium affects parathyroid responsiveness, for example, is older than it looks . Nor is it any longer possible to accept that plasma magnesium is unregulated or that potassium is exempt from hormonal regulation . The references do not always allow us to pursue our curiosity : the importance of metallothionein in relation to zinc status is acknowledged but unreferenced . These, perhaps, are the objections of a specialist and there will be others. A more general objection is the considerable ambiguity in the text as to whether values relate to blood, plasma or serum (and the emphasis on the latter rather than plasma) . And much as we may lament it, mmol/l have superseded most other units and it is not enough to acknowledge them in an initial table before reverting to cherished antiques .
BOOK REVIEWS
Yet these are really peripheral issues-the main consideration is the test itself and this account of it . There will be those who say that proper analysis of diet and management may yield almost as much insight . Certainly the interpretation of the text is a hybrid between nutritional monitoring and clinical biochemistry. This book, perhaps, inclines more towards the former . Some will say that judicious selection of diagnostic tests is preferable to `clusters' . But we may never learn more about some diseases, especially multifactorial diseases, until we add far more measurements to the pitifully slender database on which most clinical veterinary medicine rests. And once the database is there, we may derive considerable profit from observing subtle differences of pattern, even in seemingly `irrelevant' measurements . They may modify our view of individual cases or, where consistent, lead to research modifying our view of both regulation and disease . With the increasing availability of cost-effective biochemical techniques for the clinical laboratory, set to accelerate rapidly in the next decade, there will be no excuse for measuring less than we need and we may well benefit from measuring more . In retrospect, the importance of the Metabolic Profile Test may be that it comes to be seen as the far-sighted forerunner of such an approach in veterinary medicine. So my feelings are mixed . Perhaps the distinction between the specialist viewpoint and the general reader is all-important ; in the end it is the latter who needs to be satisfied, provided they are not seriously misled . And when the nitpicking is done, did I enjoy the book and did I benefit from reading it? Yes and without doubt in both cases. Read itbut not uncritically. A . R .MICHELL
Colour Atlas for the Pathogens in Animals
Diagnosis
of Bacterial
W . Bisping & G . Amtsberg (with parallel English text by W . Siller & J . Phillips) Berlin and Hamburg : Paul Parey . 1st edn . 1988 . 339 pp. DM358 .00 The title of this book is misleading, suggesting as it does a compilation of colour plates with explanatory legends ; the plates are a very small proportion of the whole, but quite sufficient for their purpose . Some chap-
5 97
ters deal with families, others with groups of organisms sharing similar, and well recognized, properties . This apparently arbitrary division is in fact quite logical and works well . Groups of organisms can be found without difficulty from the contents pages, which are exhaustive, though the otherwise somewhat spare index may be more convenient for locating individual species . The information is clearly set out, economical and reliable, and should permit satisfactory diagnosis except of organisms which vary from the standard patterns ; such organisms will always require specialist determinative bacteriological investigation . The colour plates are of high quality and, with a few minor exceptions, show what they are intended to show . Reproduction of photomicrographs must cause some loss of definition and in a few cases, notably the illustration of Dermatophilus congolensis on p . 105 (Fig . 90), the result is that a very characteristic feature is not clearly illustrated . This is unfortunate but probably unavoidable . The coverage is comprehensive, including almost all bacteria likely to be of veterinary significance and a wide range of others which might be encountered . The wisdom of parallel presentation of the English and German texts may be questioned, especially since tables are printed only in English though it does permit resolution of the few minor anomalies of translation . This book will surely, and deservedly, go into further editions and presentation in separate languages would be satisfactory . Revision for such separation should result in elimination of the rather high proportion of printing errors . The English translation is serviceable but in places rather too much governed by German constructions, and the next edition might usefully aim at a less stilted style . On the other hand, the substitution throughout of `foetus' for the etymologically correct `Fetus' of the German version should be reversed . Further editions would also be improved by substantial expansion of the index, and some internationally agreed usages, e.g. abbreviations of genera, plurals of `mycoplasma' and its relatives ('mycoplasmas' etc .) should be adopted . There are also many instances of obsolete nomenclature which should be corrected . When a textbook on a wide-ranging subject is written by only two authors it is inevitable that scrutiny in small areas of the topic will produce some quibbles . For future
BOOK REVIEWS BOOK REVIEW EDITOR : J . M . RUTTER
The Metabolic Profile Test
J . M . Payne & S . Payne Oxford : Oxford University Press . 1987 . 179 pp . £22 .50 The senior author was a veterinary scientist of great distinction, latterly Director of IRAD and Editor of this journal ; his recent death came at a distressingly young age, accelerated perhaps by the mayhem inflicted on British agricultural research during the last decade through myopic monetarism . This reviewer, like many colleagues in veterinary research, owes a debt of respect to Jack Payne and his many contemporaries whose last years in research were distorted by such fickle and illfounded priorities . The metabolic profile test in its Compton prototype and subsequent variations has been with us for 20 years . It is perhaps a timely opportunity for the leader of the original team to reflect on the impact and progress of the concept . The book is characteristically modest, not hiding the problems of interpretation, the disappointing results of some applications, yet retaining optimism for its growing importance, even in fish and deer . The three distinguishing features of the concept were : 1 . The use of standard clusters of tests rather than symptom-led specific tests . 2 . The use of selected groups rather than individuals, to represent different production stages in a herd . 3 . The definition of acceptable ranges on a purely statistical basis rather than correlation with onset of adverse effects . Indeed, the central theme of the concept was that it could predict probl . . .,is, or identify mismanagement which wouio predispose to problems in a herd . In later applications it was hoped that it could predict potential for high performance either in breeding stock, e .g. cattle, or in racing animals (dogs and horses) though in the latter application the test reverts to individuals rather than populations . Certainly the potential uses of the test
have increased alongside the growing emphasis on multifactorial causes of disease, beyond `production disease' . The strengths of the book are the scope of the coverage, the lucid and enjoyable style and excellent references, especially to earlier work and to non-English language sources . It is also strong in emphasizing the variety and subtlety of factors influencing normal ranges (hence some of the arguments, outside the book, concerning how wide they should be cast for specific variables) . Among these are poor laboratory technique and the book emphasizes the need for meticulous analytical and sampling techniques . There are, however, problems . There is a tendency to dwell too readily on blood concentrations without reflecting whether these are of primary importance (as with Na+ or Cal+) or whether intracellular levels may be equally important (as with Mg") and not necessarily running parallel (as with K+ ) . There is no discussion of the possible importance of protein binding in interpreting Mg` data . Throughout, the referencing is 100% veterinary and while extrapolation from man is always risky, it is impossible to ignore the insights available from human clinical biochemistry, notably on divalent ion metabolism and on the effects of exertion. The idea that magnesium affects parathyroid responsiveness, for example, is older than it looks . Nor is it any longer possible to accept that plasma magnesium is unregulated or that potassium is exempt from hormonal regulation . The references do not always allow us to pursue our curiosity : the importance of metallothionein in relation to zinc status is acknowledged but unreferenced . These, perhaps, are the objections of a specialist and there will be others. A more general objection is the considerable ambiguity in the text as to whether values relate to blood, plasma or serum (and the emphasis on the latter rather than plasma) . And much as we may lament it, mmol/l have superseded most other units and it is not enough to acknowledge them in an initial table before reverting to cherished antiques .
BOOK REVIEWS
Yet these are really peripheral issues-the main consideration is the test itself and this account of it . There will be those who say that proper analysis of diet and management may yield almost as much insight . Certainly the interpretation of the text is a hybrid between nutritional monitoring and clinical biochemistry. This book, perhaps, inclines more towards the former . Some will say that judicious selection of diagnostic tests is preferable to `clusters' . But we may never learn more about some diseases, especially multifactorial diseases, until we add far more measurements to the pitifully slender database on which most clinical veterinary medicine rests. And once the database is there, we may derive considerable profit from observing subtle differences of pattern, even in seemingly `irrelevant' measurements . They may modify our view of individual cases or, where consistent, lead to research modifying our view of both regulation and disease . With the increasing availability of cost-effective biochemical techniques for the clinical laboratory, set to accelerate rapidly in the next decade, there will be no excuse for measuring less than we need and we may well benefit from measuring more . In retrospect, the importance of the Metabolic Profile Test may be that it comes to be seen as the far-sighted forerunner of such an approach in veterinary medicine. So my feelings are mixed . Perhaps the distinction between the specialist viewpoint and the general reader is all-important ; in the end it is the latter who needs to be satisfied, provided they are not seriously misled . And when the nitpicking is done, did I enjoy the book and did I benefit from reading it? Yes and without doubt in both cases. Read itbut not uncritically. A . R .MICHELL
Colour Atlas for the Pathogens in Animals
Diagnosis
of Bacterial
W . Bisping & G . Amtsberg (with parallel English text by W . Siller & J . Phillips) Berlin and Hamburg : Paul Parey . 1st edn . 1988 . 339 pp. DM358 .00 The title of this book is misleading, suggesting as it does a compilation of colour plates with explanatory legends ; the plates are a very small proportion of the whole, but quite sufficient for their purpose . Some chap-
5 97
ters deal with families, others with groups of organisms sharing similar, and well recognized, properties . This apparently arbitrary division is in fact quite logical and works well . Groups of organisms can be found without difficulty from the contents pages, which are exhaustive, though the otherwise somewhat spare index may be more convenient for locating individual species . The information is clearly set out, economical and reliable, and should permit satisfactory diagnosis except of organisms which vary from the standard patterns ; such organisms will always require specialist determinative bacteriological investigation . The colour plates are of high quality and, with a few minor exceptions, show what they are intended to show . Reproduction of photomicrographs must cause some loss of definition and in a few cases, notably the illustration of Dermatophilus congolensis on p . 105 (Fig . 90), the result is that a very characteristic feature is not clearly illustrated . This is unfortunate but probably unavoidable . The coverage is comprehensive, including almost all bacteria likely to be of veterinary significance and a wide range of others which might be encountered . The wisdom of parallel presentation of the English and German texts may be questioned, especially since tables are printed only in English though it does permit resolution of the few minor anomalies of translation . This book will surely, and deservedly, go into further editions and presentation in separate languages would be satisfactory . Revision for such separation should result in elimination of the rather high proportion of printing errors . The English translation is serviceable but in places rather too much governed by German constructions, and the next edition might usefully aim at a less stilted style . On the other hand, the substitution throughout of `foetus' for the etymologically correct `Fetus' of the German version should be reversed . Further editions would also be improved by substantial expansion of the index, and some internationally agreed usages, e.g. abbreviations of genera, plurals of `mycoplasma' and its relatives ('mycoplasmas' etc .) should be adopted . There are also many instances of obsolete nomenclature which should be corrected . When a textbook on a wide-ranging subject is written by only two authors it is inevitable that scrutiny in small areas of the topic will produce some quibbles . For future