not really begin or end with the four-year period of formal education in dental school. The sociologist may thus be Frustrated in the sense that the authors only really scrape the surface of the rich vein of studies of professionalization and its concomitants. One would like for example to ree far more comparative questioning and greater reference to such parallel endeavours in understanding the socialization and subcultures of medical students as The Student Physician, Boys in White, and, more recently, Interns, from Students to Physicians. Similarly one looks in vain for any indications that dental students evidence similarities with their peers in other professional schools. For example, is the reported decline in professional ethics and rise in cynicism a general product of professional education in California or elsewhere in the 1960’s? Furthermore, we learn very little about the faculty at the schools studied, and in particular about differences between academic values and practice goals. It would also be helpful to know something of the reasons why the students selected the particular schools they did, and of the school’s self-perceptions. In contrast to a number of other countries, particularly Finland and the U.S.S.R., very few dentists in the U.S.A. are female. Why should this be so, and what of the professionalization processes amongst fledgling lady dentists? Despite some reservations one must nonetheless accord a welcome to this book and in particular applaud the introduction of a theoretical approach, however simple this may appear, to what has largely been a descriptive sociology of dentistry.
abortion, which is not infrequently used by married women as a substitute for adequate contraceptive arrangements. These issues are, however, barely broached except in the most rational, factual way-and we know how ineffective this can be. Perhaps the subject is discussed in the extensive reading lists appended at the end of each chapter. The book is, however, of some reference value because it does collect together quite a variety of information on the subject of vasectomy; it has lists of addresses for every state in the U.S.A. where one can go to obtain a vasectomy, which may be of value, and even a rather quaint but very succinct indexing of the attitudes of all the major religions to the subject. The book should be a useful acquisition to medical libraries, family planning clinics, and those who have to counsel prospective clients and might wish to lend them the book before detailed interviews. FRED EHRLICH, F.R.C.S. Surgical Service, Psychiatric Centre, North Ryde, 2113, N.S. W., Accstralia
Uses of Marijuana by SOLOMON H. SNYDER, M.D. Oxford University Press, New York, 1971. 127 pp. Hardback, $5.95; paperback, $1.95.
THLSis a book which actually makes learning something a rather enjoyable and relatively DAVID RICHARDS about marihuana effortless task. It is short (excluding the pictures, there Department of Community Health, are only about 100 pp. of text), well-written (the style is University of Nottingham straightforward and crisp), and, because it addresses itself well to most of the important issues surrounding this controversial drug, quite informative. The author touches Vasectomy, Manhood and Sex by GILBERT KASIRSKY, upon the history of the drug (both ancient and modern) as well as its effects, uses, and dangers, and the questions Springer, New York, 1972. 128 pp. S5.95. of addiction, dependence, and the stepping-stone hypothesis. In addition, he discusses its relation to sex, IT WAS quite a relief to find that the increasing annoyance crime, violence, and its present legal status. None of these and disappointment experienced whilst proceeding issues are treated with much depth, and for this reason through the book was not due to anything really bad it will have limited usefulness as a resource book. This, about it but rather to the disillusionment engendered however, is not to denigrate the work, because I believe by the broken promise of the title. that its greatest value lies in the fact that it covers just As a matter of fact, the book is quite a good collection about everything the intelligent layman will want to know of facts about vasectomy and, in a bookish sort of way, about cannabis. In fact, I believe that if many of the succeeds in covering the field for everyone. Thus the millions of Americans who are so misinformed about this layman can learn what vasectomy is (presumably some drug would take the one or two evenings required to read readers didn’t know), the surgeon can learn how to do it Dr. Snyder’s book, it would make a substantial difference (same comment) and the lawyer how to draw up the in the rate with which a more sensible national policy “consent for operation” form. The only reader who has toward the use of this drug is elaborated. been left unprovided for is the student of social and My only quarrel with the author is that he does not, in behavioural sciences who wants to increase his underpresenting his material on an issue, bring to bear his standing of the complex relationships alluded to in the excellent critical faculties. Thus, for example, he speaks book’s title. The greatest single barrier to the widespread of the observations of C. Grivas, a man known to those adoption of vasectomy is the phantasy of its impact on in the field as having great disdain for users of marihuana, sexuality and the very threatening implication that the as though they were as well documented and as highly vasectomized man is no longer “entire”. This is particuregarded as those of a Nobel Laureate who carries out larly sad in view of the ease, safety, convenience and some well designed research on marihuana. Dr. Snyder cheapness of the procedure, particularly when seen is eminently qualified to speak to the relative soundness against the alternatives of life-long pharmacotherapy of the various studies he reports, but he does so only with the Pill, laparotomy for sterilization of the female, or
BOOKREVIEWS rarely and when he does, as in the case of the Benabud study, he does not go far enough. Inasmuch as the book is directed to an audience which is unsophisticated in the ways of drug research, I should think that this kind of critical evaluation of the sources would have added to the book’s overall worth. One property of cannabis, certainly as interesting as any other, is that an objective account of its psychoactive effects and the consequences of its prolonged use seems to have been impossible to achieve. This was as true in the nineteenth century as it has been more recently. Dr. Snyder, in this book, provides an overview as far above the partisanship and hyper-emotionalism which so frequently permeate discussions of this drug as any I have read, and its freedom from bias extends not only to the drug itself but to those who use it. In fact, the only cause for which he is an advocate is that of providing as truthful andsensibleanaccount of the drug as is presently possible. In my opinion he has admirably succeeded. LESTERGRINSPOON,M.D. Harvard Medical School, Dept. of Psychiatry, Massachusetts Mental Health Center, Boston, Massachusetts
Marihuana Reconsidered by LESTER GRINSPOON, M.D. Harvard University Press, Cambridge, Massachusetts, 1971. 371 pp. $2.45. THESEtimes are full of public reviews and reconsiderations of issues that have been brewing for some time, studied and argued in relatively smaller groups. One is aware of the public attention to pollution, population, tax reform, racism, sexism and corporate abuse of power and not in the least-the Indo-Chinese wars and the marihuana debate. Grinspoon’s book is riding the crest of this wave and it has the advantage of being written by a single author. Unlike the Report of the National Commission on Marihuana and Drug Abuse, and the pompous pronouncements by the AMA on this matter, he can write freely without having to glance to the political right or left, or accommodate anyone in his search for a genuine understanding. It has the disadvantages of single authorship too, that of one author’s orientation to his subject matter-but after too many edited compilations of taped panel discussions, this is a relief. Grinspoon has done a scholarly piece of research on historical data and the literature about marihuana. With piercing arguments he punctures several myths, ranging from the derivation of “assassins”, their activities, the drug habits of French nineteenth century poets, and the myths responsible for the persistent associations between marihuana and crime, heroin addiction, mental illness and unbridled sex. In his writing he inserts self-descriptions of the effects of intoxication by products of cannabis as well as segments of discussions about this plant in congressional and other hearings to enliven his text. The book reads well, and on the whole is truly neutral to such an emotionally overcharged subject.
The book’s mind expanding scope gives thoughtful analysis and critical comments on many problems relating to marihuana use. I am not familiar with a more lucid description of its use both for pleasure and medicinal purposes-the last of which seems forgotton by most physicians including the AMA. There is a solid chapter on chemistry and pharmacology for those that are interested, and a series of lyrical descriptions of the effects of marihuana products on Gautier, Baudelaire, Bayard Taylor and Ludlow. Less lyrical, but for present tastes more palatable, are the descriptions of Ginsberg and another contemporary, a Mr. X, a “professor at one of the top ranking American universities”. A clinical chapter on the acute intoxication balances these literary effusions. For an answer to the question “why do people smoke pot?‘, a series of motivations is reviewed that have been raised in the now profuse writings on this subject. The intriguing question “why pot now, and not earlier or later?’ addresses itself not to the motivation of the individual user so much as to the conditions that made possible that in the non-poor, non-black populations of the young of many countries in the sixties, marihuana and its derivatives became the intoxicant of choice. This question does receive occasional attention. Its full study still awaits the social scientist equally well versed in his field as Dr. Grinspoon is at home in the psychological study of the individual and equally familiar with the complexities around marihuana use. For instance, Grinspoon conceives of marihuana use as a manifestation of a change in the individual’s life style and comes close to a discussion on social factors in his chapter on the campaign against marihuana. The more sensitive minorities: the artists, the young people and the so called marginally adjusted, were the first to show the profound societal changes in mores and values currently taking place. Grinspoon, I believe, misses this dimension, for instance by assuming, as many do, that especially heavy marihuana use is an indicator of pre-existing individual psychopathology (p. 179) and may even cause personality changes (p. 290)-the so called “amotivational syndrome”. Grinspoon’s emphasis is clearly on the individual as he relates to marihuana or on the individual’s experience of its use and much less on what factors in society have been conducive to the quick and widespread popularization of this “new” intoxicant-as well as on the impact of this phenomenon on the groups it occurs in. In the opinion of this reviewer, the book would have gained by an attempt to relate, for instance, the nature of the marihuana intoxication (introspection, sensuous enhancement and fluidity of perceptions, especially time) to current evolutionary changes in our society, the profundity of which may even add to our understanding of the largely irrational societal attitudes towards marihuana use. One can bemoan, as does Grinspoon in the chapter on legislation, the undesirable effects on the adolescent of growing up in a state of social disapprobation-or one can speculate on the power of large groups to effect social changes, groups who have grown up and lived largely outside of society for a long time, at least in this respect, and who have loosened their ties to it. With the author’s emphasis on the psychology of the