76 Reviews and notices of books

Applied Surgical Pathology Edited Angus E. Stuart, Adam N. Smith and Eric Samuel. 245 x 195 mm. Pp. 1112+ uiii. Illustrated. 1975. Oxford: Blackwell. €38. THE introduction of the radiologist as an equal partner with the pathologist and surgeon in a textbook of surgical pathology is a new idea. In this book it has been attempted by a large team of authors, mostly Scottish, directed by three editors from the Edinburgh school. On the whole the experiment has succeeded, high class radiology having contributed to the overall under- standing of the subject. This is particularly true of the chapter dealing with the breast, which contains several xerograms of superb quality.

After a number of general chapters covering injury, wound healing, cancer and clotting, there is a useful chapter on transplantation. All organs and disciplines, including neurology, gynaecology and orthopaedics, are then dealt with systemati- cally. Much symptomatology and some operative treatment are included, not really enough to give a complete picture but enough to enlarge an already large volume.

This is indeed a large and extremely expensive book. The cost would be justified if all the illustrations were of superb quality, but regrettably they are not. Throughout the book there are photomicrographs and radiographs of indifferent quality and one wonders why the editors did not weed them out. The reviewer’s copy was poorly bound and received with the contents subluxated from the cover.

A book of this kind should function not only as a reference work but also as a gateway to the literature. Some chapters, however, are not well endowed with references, the liver, gall- bladder and pancreas having only nineteen; this i s scarcely adequate. Bones, joints and soft tissues, on the other hand, are allowed no less than two hundred and fifty. There seems to be a lack of editorial direction in this and in the fact that after some chapters references are given sequentially whilst in others they are given alphabetically.

The book is stated to be written for ‘surgeons and those undergoing surgical training’. It may prove too expensive for the latter, particularly as there are smaller and cheaper alternatives which are adequate for examination purposes. It will undoubtedly have a place in the hospital or departmental library, where it will be consulted as an authoritative and up-to- date reference work. In spite of the criticisms, which could be remedied in a second edition, this is a splendid book and a monument to the industry of the Scots.

TERENCE KENNEDY

Advances in Cancer Surgery Edited John S. Najarian and John P. Delaney. 230 x 160 mm. Pp. 608+xio, with 17 illustrations. 1976. New York: Stratton. $24.75. THE opening chapter in this excellent volume is a superb exposition by Robert Good, Director of the Memorial Sloan- Kettering Institute in New York, entitled ‘Progress toward the conquest of cancer’. This represents the text of his Judd lecture, delivered during a recent course in cancer surgery held in the University of Minnesota.

The book consists of selected papers from the above course, and Good’s opening contribution emphasizes the essential theme of the book, namely the interface of basic sciences with clinical practice. Written with devastating insight and com- mendable clarity, Good’s chapter is a model of economic writing. Ever optimistic in his approach, he nevertheless is completely practical in his evaluation of the current state of cancer therapy and in pointing the way to the future. His castigation of the ‘Jeremiahs’ for their tedious pessimism is fully justified on the evidence presented in his chapter.

The remainder of the book sustains a remarkable high quality of authorship. Much of the text deals with non-surgical matters, and in this context the title of the volume is perhaps generous to the surgical fraternity. However, there is ample evidence throughout that the surgeon’s role in the management of cancer now goes far beyond pure operative technique.

The earlier chapters are concerned with general aspects of therapy, with notable contributions by Emil Frei I11 on chemotherapy and Donald Morton on immunotherapy. The middle section of the book relates to regional oncology, with successive chapters on the lymphomas, head and neck tumours, cutaneous and soft tissue tumours, intrathoracic lesions and mammary cancer. The writing is vigorous, with strong surgical emphasis and sensible comment on the controversial issues of the moment.

The later chapters revert to a more general nature, dealing with miscellaneous topics of particular interest to a surgical audience. In this section Haagensen reminds us forcefully of the correct way of doing an axillary dissection.

This is altogether a thoroughly professiotial book, which despite its title should have equal appeal to all oncologists actively engaged in treating cancer. The price is not excessive and the editors are to be congratulated on producing such a satisfactory volume.

IAN BURN

Immunologic Aspects of Anaesthetic and Surgical Practice Edited Alix Mathieu and Barry D . Kahan. 230 x 150 mm. Pp. 400. Illustrated. 1975. New York: Grune & Stratton. $27.50. THE editors’ intentions in producing this book were, no doubt, to gather together aspects of immunology that are relevant to anaesthetic and surgical practice. The first section is an introduction to immunology but is very uneven in its coverage. For example, one can hardly imagine the need for the practising anaesthetist or surgeon to be familiar with idiotypic determinants of immunoglobulin molecules. On the other hand, the chapter on host defence and the altered host is well done and would be of value to the practising clinician.

The second section deals with specific aspects of immunity that are relevant to anaesthetic and surgical practice and is the better of the two sections. There is a very good chapter on asthma and other allergic disorders, especially in relation to anaesthesia.

Although this book has some good points it is unlikely to prove attractive to the majority of anaesthetists or surgeons who seek a little more information about immunology and its relation to their practice. On the other hand, it does not have much to offer the person well versed in immunology.

PETER J . MORRIS

Intensive Care John Joakim Skillman, with fifteen contributory authors. 235 x 165 mm. Pp. 609Sxiu. Illusrrared. 1975. Boston: Little, Brown. No price giuen. THIS book is divided into three parts. The first deals with aspects of intensive care, and these highlight conceptual differences between the United States and ourselves. The reviewer was surprised, for example, to find that the respiratory intensive care unit is a haven for any patient who has under- gone major surgery and that the unit has a written charter governed by rules and regulations drawn up by the Common- wealth of Massachusetts.

The second part of the book deals in depth with the physio- logical disturbances associated with severe illness. Two chapters in this part are outstanding: the first on the physio- logy and management of acute respiratory failure deals with the principles of assisted ventilation, and the second entitled ‘Physiological Nursing’ contains a fund of useful information on the care of the chest and the complications of tracheostomy.

The third part of the book deals with specific clinical problems such as hypotension, bleeding, fever and coma. I t is, however, interesting to find that in the land of the auto- mobile there is no specific reference or description of the management of the severely injured chest.

The book as a whole is beautifully produced, excellently illustrated and contains after each chapter a comprehensive list of rerences. Such is the mass of information that a reading time of at least sixteen hours is required. The book should be on the shelves of any intensive care un il

P. G. ShUDDY