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The Pharmacologic Principles of Medical Practice
762
BOOK REVIEWS
proof-reading incorrectly printed texts in types descending from 18 to 4-point, check ing arithmetic miscalculations, detecting dif ferences between apparently similar designs or photographs, and completing jig-saw pat terns. Another device involves tracing on an overlying transparent sheet the dots of pat terns of increasing complexity and then com pleting the designs. For the amblyopic eye with eccentric fixation, special patterns have been constructed to avoid confusion and eye-ear-hand co-ordination is utilized by in structing the patient to talk aloud while he points to the various letters and characters. As the French have been intensely inter ested in the re-education of the functionally amblyopic eye since the time of Javal, it is odd that no mention is made of The Amblyopia Reader by Margaret Dobson of London, published about 20 years ago, which was printed in various sizes of black and red type and required the clipping of a ruby filter over the lens of the dominant eye. An English adaptation of this book by Sedan would be a very worth-while project. James E. Lebensohn. Edited by Gustav J. Martin, Sc.D. Boston, Massachusetts. Little, Brown and Co., 1958. 241 pages, index. Price: $6.00.
CLINICAL ENZYMOLOGY.
It has become almost trite to state that the study of disease in man is the study of aberrations in enzyme systems. The list of such diseases is lengthened daily: diabetes, sickle-cell anemia, ochronosis, sprue, the vitamin deficiencies, adrenal diseases, and perhaps even cataracts. Another aspect of the study of these or ganic catalysts is the use of enzymes for diagnosis and therapy. This book is con cerned with this area of enzyme activity. The major emphasis is on the enzyme trypsin, with which the author is apparently most familiar. This may derive from his associa
tion with a large drug firm. Those interested in the use of trypsin to modify edema states in and about the eye will find well-docu mented instruction in Chapter 4 on the use of enzymes in medicine. Dr. Martin is a provocative writer and feels compelled to defend the parenteral use of enzymes against detractors. One feels that he dismisses some of the evidence for anaphylactic reactions rather lightly and chastens his critics by referring to "intel lectual atheromatosis and sclerosis." Other enzymes of possible interest to ophthalmol ogists discussed in this monograph are hyaluronidase, ribonuclease, chymotrypsin, and cholinesterase. For those less technically inclined the uninhibited philosophic meanderings of the author make stimulating read ing. David Shoch. T H E PHARMACOLOGIC PRINCIPLES OF MEDI CAL PRACTICE. By J. C. Krantz, Jr., and C. Jelleff Carr. Baltimore, Williams & Wilkins Company, 1958, edition 4. 1,285 pages, 59 illustrations, index. Price: $14.00.
The first edition of this justly popular work appeared in 1949 and went through four reprintings. The second edition ap peared in 1951 with two reprintings; the third in 1954 with two reprintings. A Portuguese edition appeared in 1955, and a Spanish one in 1956. The reason for this popularity is readily understood, for the book is lucidly written and illustrated and eminently practical. Ophthalmologists will find it of much value, although the short chapter on "Drugs in eye, ear, nose, and throat," is disappoint ing and incomplete from our viewpoint. It should be rewritten in the light of modern ophthalmic pharmacology and therapeutics. (For example, the old mercuric oxide oint ment is still on the list and there is a thing called OpH Eye Lotion containing phenylephrine hydrochloride, zinc sulfate, and
BOOK REVIEWS boric acid which is given a good send off by the authors.) Let us hope that those physi cians who are not ophthalmologists do not take this chapter too seriously but refer to recent ophthalmic literature instead. Otherwise, and in spite of this, the book is fine and contains a wealth of readable in formation of much practical use for us in the broad field of pharmacology. Derrick Vail. T H E PSYCHOLOGY OF MEDICAL PRACTICE. By
Marc H. Hollender, M.D. Philadelphia, W. B. Saunders Company, 1958. 276 pages, bibliography and index. Price: $6.50 Perhaps some unfathomed mystic relation between ophthalmology and psychiatry, rather than coincidence, has caused a remark able number of sons and brothers of ophthal mologists to enter psychiatry, while others, such as Schlaegel, have gone from psychiatry to ophthalmology. This volume by the son of A. R. Hollender, editor of The Eye, Ear, Nose and Throat Monthly, is written for the healing profession simply, clearly and with out distracting psychiatric jargon. The au thor, who is chairman of the Department of Psychiatry at the State University of New York, gives a rational formulation of the art of medicine, which in the past was derived only from intuition and experience. The pa
763
tient, who resents subconsciously the attitude of his physician, usually seeks another doctor more attuned to his current needs. When a patient turns to religion to ward off anxiety, depression, or fear, the physician's personal feelings about religion should not distort his evaluation of its significance for the patient. A "check-up" visit cannot always be taken at face value. Asking for information in an open, frank, and casual manner will en courage a similar response. For most patients information about their illness is anxiety-re lieving, but lengthy and complicated explana tions should be avoided. Elective surgery should be discussed a week or more in ad vance so that patients may mobilize their in ner resources for the ordeal. The procedure should be outlined so as to repress fearful fantasies. Co-operation without apprehension should be sought. It is certainly hazardous to tell a cataract patient: "If you make the slightest move during the operation, I cannot be responsible for the outcome." A running account of the technique, spoken in a matterof-fact voice to the assistant provides assur ance that the surgeon is master of the situa tion. Contrariwise, rambling chatter gener ates a sense of uneasiness. Every ophthalmologist, young or old, but especially the young, will find this wise and mature text most helpful. James E. Lebensohn.
BOOK REVIEWS
proof-reading incorrectly printed texts in types descending from 18 to 4-point, check ing arithmetic miscalculations, detecting dif ferences between apparently similar designs or photographs, and completing jig-saw pat terns. Another device involves tracing on an overlying transparent sheet the dots of pat terns of increasing complexity and then com pleting the designs. For the amblyopic eye with eccentric fixation, special patterns have been constructed to avoid confusion and eye-ear-hand co-ordination is utilized by in structing the patient to talk aloud while he points to the various letters and characters. As the French have been intensely inter ested in the re-education of the functionally amblyopic eye since the time of Javal, it is odd that no mention is made of The Amblyopia Reader by Margaret Dobson of London, published about 20 years ago, which was printed in various sizes of black and red type and required the clipping of a ruby filter over the lens of the dominant eye. An English adaptation of this book by Sedan would be a very worth-while project. James E. Lebensohn. Edited by Gustav J. Martin, Sc.D. Boston, Massachusetts. Little, Brown and Co., 1958. 241 pages, index. Price: $6.00.
CLINICAL ENZYMOLOGY.
It has become almost trite to state that the study of disease in man is the study of aberrations in enzyme systems. The list of such diseases is lengthened daily: diabetes, sickle-cell anemia, ochronosis, sprue, the vitamin deficiencies, adrenal diseases, and perhaps even cataracts. Another aspect of the study of these or ganic catalysts is the use of enzymes for diagnosis and therapy. This book is con cerned with this area of enzyme activity. The major emphasis is on the enzyme trypsin, with which the author is apparently most familiar. This may derive from his associa
tion with a large drug firm. Those interested in the use of trypsin to modify edema states in and about the eye will find well-docu mented instruction in Chapter 4 on the use of enzymes in medicine. Dr. Martin is a provocative writer and feels compelled to defend the parenteral use of enzymes against detractors. One feels that he dismisses some of the evidence for anaphylactic reactions rather lightly and chastens his critics by referring to "intel lectual atheromatosis and sclerosis." Other enzymes of possible interest to ophthalmol ogists discussed in this monograph are hyaluronidase, ribonuclease, chymotrypsin, and cholinesterase. For those less technically inclined the uninhibited philosophic meanderings of the author make stimulating read ing. David Shoch. T H E PHARMACOLOGIC PRINCIPLES OF MEDI CAL PRACTICE. By J. C. Krantz, Jr., and C. Jelleff Carr. Baltimore, Williams & Wilkins Company, 1958, edition 4. 1,285 pages, 59 illustrations, index. Price: $14.00.
The first edition of this justly popular work appeared in 1949 and went through four reprintings. The second edition ap peared in 1951 with two reprintings; the third in 1954 with two reprintings. A Portuguese edition appeared in 1955, and a Spanish one in 1956. The reason for this popularity is readily understood, for the book is lucidly written and illustrated and eminently practical. Ophthalmologists will find it of much value, although the short chapter on "Drugs in eye, ear, nose, and throat," is disappoint ing and incomplete from our viewpoint. It should be rewritten in the light of modern ophthalmic pharmacology and therapeutics. (For example, the old mercuric oxide oint ment is still on the list and there is a thing called OpH Eye Lotion containing phenylephrine hydrochloride, zinc sulfate, and
BOOK REVIEWS boric acid which is given a good send off by the authors.) Let us hope that those physi cians who are not ophthalmologists do not take this chapter too seriously but refer to recent ophthalmic literature instead. Otherwise, and in spite of this, the book is fine and contains a wealth of readable in formation of much practical use for us in the broad field of pharmacology. Derrick Vail. T H E PSYCHOLOGY OF MEDICAL PRACTICE. By
Marc H. Hollender, M.D. Philadelphia, W. B. Saunders Company, 1958. 276 pages, bibliography and index. Price: $6.50 Perhaps some unfathomed mystic relation between ophthalmology and psychiatry, rather than coincidence, has caused a remark able number of sons and brothers of ophthal mologists to enter psychiatry, while others, such as Schlaegel, have gone from psychiatry to ophthalmology. This volume by the son of A. R. Hollender, editor of The Eye, Ear, Nose and Throat Monthly, is written for the healing profession simply, clearly and with out distracting psychiatric jargon. The au thor, who is chairman of the Department of Psychiatry at the State University of New York, gives a rational formulation of the art of medicine, which in the past was derived only from intuition and experience. The pa
763
tient, who resents subconsciously the attitude of his physician, usually seeks another doctor more attuned to his current needs. When a patient turns to religion to ward off anxiety, depression, or fear, the physician's personal feelings about religion should not distort his evaluation of its significance for the patient. A "check-up" visit cannot always be taken at face value. Asking for information in an open, frank, and casual manner will en courage a similar response. For most patients information about their illness is anxiety-re lieving, but lengthy and complicated explana tions should be avoided. Elective surgery should be discussed a week or more in ad vance so that patients may mobilize their in ner resources for the ordeal. The procedure should be outlined so as to repress fearful fantasies. Co-operation without apprehension should be sought. It is certainly hazardous to tell a cataract patient: "If you make the slightest move during the operation, I cannot be responsible for the outcome." A running account of the technique, spoken in a matterof-fact voice to the assistant provides assur ance that the surgeon is master of the situa tion. Contrariwise, rambling chatter gener ates a sense of uneasiness. Every ophthalmologist, young or old, but especially the young, will find this wise and mature text most helpful. James E. Lebensohn.