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Reviews of Books Drug Dependence Current Problems and Issues. Edited by M. M. GLATT, PSYCH. Lancaster: M.T.P. 1977. Pp. 332. kl 1. 50.

F.R.C.

THIS volume presents twelve essays and reviews dealing with various aspects of alcoholism and drug addiction. Space accorded to discussion of the fringe topic of acupuncture treatment of addiction exceeds the space allotted to consideration of such an increasingly important matter as behavioural treatment of alcoholism. The book makes no attempt at a comprehensive coverage of "current problems and issues" and neither does it develop a special perspective of its own. But some of the twelve contributions stand out, and anyone concerned with drug or alcohol problems ought to refer to this book. W. K. Van Dijk writes a delightful clinical essay in the old style on "vicious circles" in alcoholism and drug dependence-the circular influences are those of brain damage and of pharmacological, psychological, and social processes. Glatt himself provides an account of a brave attempt to set up a therapeutic community for drug users in Wormwood Scrubs Prison: there are undertones of Don Quixote in this story of a psychiatrist’s blindly optimistic determination to subvert a prison to the role of healing, and the optimism movingly pays off. In quite another and more technical vein R. G. Smart discusses policies for the prevention of drug abuse which derives from the assumption that "abuse" is an extension of the population’s normal drug use, rather than a logically separate phenomenon. V. Marks and D. E. Fry give a comprehensive account of methods for detection and measurement of drugs in biological fluids. These are the four papers which stand out as being particularly interesting. They stand out more sharply because the background provided by the other contributions is sadly flat.

health and intelligence quotient), maternal health, child loss, or behaviour and attitudes in relation to birth control. There is no review of the findings by the five centres after each section, necessitating repeated cross-checkings by the reader. This may be because the book is already 562 pages long, but a review after each section would have been helpful. The W.H.O. is to be congratulated for setting up this study and the centres for the tremendous amount of work undertaken. The book, which is a mine of previously unpublished and little known data, will be a very useful source of reference; it will also be a guide for similar types of study. It is not a book which can be easily read from beginning to end because of the many tables and the need for constant cross-checking. However, it is invaluable for dipping into specific chapters as the need arises since they give an overall (but, as the authors warn, not necessarily a representative) picture of areas in India, Iran, Lebanon, the Philippines and Turkey. It is unfortunate that Africa and South America were not included to provide a representative coverage of the developing countries.

Clinical and Resuscitative Data R. P. H. DUNNILL, F.F.A.R.C.S. and B. E. CRAWLEY, F.F.A.R.C.S., Canterbury Group Hospitals. Oxford: Blackwell. 1977. Pp. 166.

4.75. THIS little book contains a wealth of factual information which will be invaluable for those involved in the day-to-day care of patients under intensive care. The authors have produced a carefully pruned and well-balanced selection of data which is all the more useful because of the lack of irrelevances. Typographical errors are fortunately few and mostly obvious (e.g., in the physics section speed of anaesthetic recovery is described as being proportional to fat solubility-inversely proportional would appear more credible). No doubt a wellthumbed copy of this book will soon be found in the pockets of junior anxsthetists and other medical staff.

Family Formation Patterns and Health Edited by A. R. OMRAN and C. C. STANDLEY. Geneva: W.H.O. 1976. Pp. 562. Sw.fr. 50,$20.

IN 1970, studies aimed at elucidating the relationship between family health and factors affecting fertility were started at the Gandhigram Institute of Rural Health and Family Planning in Tamil Nadu State, India, the School of Public Health, Teheran University, the School of Public Health, American University of Beirut, the Institute of Public Health, University of the Philippines, and the Institute of Community Medicine, Ankara. Each was a comparative study. In India four rural groups were studied; in Teheran and in Beirut, two suburban communities; in the Philippines groups from Metropolitan Manilla and two rural towns; and in Turkey a semi-urban and a rural group. Originally it was intended to subdivide each group into three socioeconomic levels, but this proved impossible owing to the lack of the upper socioeconomic classes. The final studies are thus comparisons of various cultures subdivided into middle and lower socioeconomic groups. Part I, which contains the background to the study and reviews previous evidence, describes the design of the study. Previous studies have been carried out (with one or two notable exceptions) in industralised countries, and this study was meant to determine if their findings could be applied to developing countries-e.g., theJ or U shaped curves for stillbirths by birth-rank or the increased risk of maternal mortality with multiparity. Part 11, which contains reports from each centre, is divided into eight chapters. The first consists of a description of the study areas and population characteristics. This is followed by seven chapters, each relating family formation to either social characteristics, pregnancy outcome, childhood mortality, child development (growth,

Chemotherapy in Psychiatry Ross J. BALDESSARINI. Cambridge, Massachusetts and London: Harvard University press. 1977. Pp. 201 7.

THERE is now a plethora of books on psychopharmacology and its practical applications. The subject is so wide that it is a brave author who attempts to cover both the basic science and the practical therapy. Dr Baldessarini is quite successful and he gives a useful introduction to the subject. However, psychiatric practice in the United States is different from that in Britain, and British clinicians may find their home-produced equivalents more convenient and informative.

Accidental Hypothermia D. MACLEAN and D. EMSLIE-SMITH. Oxford: Blackwell. 1977. Pp. 476. /;18.30.

hypothermia is now recognised as occurring cases being reported even from the tropics. These authors follow a logical sequence, starting with the environment and ending with pathology. Important points are driven home with arresting phrases such as "the midsummer temperature on the summit of Ben Nevis is on average slightly lower than West Greenland", emphasising the dangers of the weather and of wide open spaces, particularly in Scotland. Again, in the chapter on thermal comfort, after stating that "even heavy polar clothing is no substitute for the artificial heating of houses in winter" the authors deal with the problems of heating and insulating buildings. This practical ACCIDENTAL

worldwide, with

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approach to problems continues in the chapters dealing with the groups at risk since Dr Maclean and Dr Emslie-Smith consider not only the factors which may precipitate hypothermia but also possible preventive measures and the problems faced by those attempting to carry out treatment. Many of the chapters reflect the authors’ vast experience particularly in the hospital management of patients. There is an extensive and invaluable list of references for topics ranging from the physiology of shivering to building regulations. There are minor errors and omissions. For example, on p. 38 skin temperature is alleged to rise from 36.81 to 36-52°C while the reference to Ledingham and Mone (1974), cited on several occasions, fails to appear in the list. Unfortunately there is no section dealing with the effects of cold stress, at the stage before the core temperature starts to drop, on the higher functions of the body. This, however, may have been outside the remit chosen by the authors. Some people will disagree with points such as the value of metallised plastic sheeting ("space blanket") in the management of hypothermia. Nevertheless the recommendations in general accord with currently accepted practice. The authors also discuss ideas or methods of treatment for which they feel there is insufficient evidence, or with which they disagree. Accidental hypothermia is superficially a simple subject which, on investigation, turns out to be very complex with wide, and sometimes unexpected, ramifications. There has been a need for many years for a book like this, which brings together from many disciplines the mass of work done on the subject, and which should take its place alongside such classics as Man in a Cold Environment and Survival in Cold War.

Radiologic Diagnosis of Renal Parenchymal Disease ALAN J. DAVIDSON. Pp. 317. 19.50.

Philadelphia

Understanding Human Behaviour in Health and Biness Edited by RICHARD C. SIMONS, M.D. and HERBERT PARDES, M.D. Baltimore: Williams & Wilkins. London: Quest. 1977. Pp. 718.

$21.95;14.50. THE goal implicit in the title is brilliantly achieved. The idea of the book arose from a course for students in "the health professions" that tried to link the behavioural sciences with clinical aspects of human behaviour. The life cycle is described with all its vagaries, stage by stage, from before birth to death, and there are sections on bodily illness, emotional disorder, psychosomatic relationships, and mental illness. Signs, natur-

dealt with more than symptoms. Perhaps because so of the 37 authors have long shared this course of teachmany and perhaps because the editors have seen so clearly what ing they were seeking, the book has a unity of aim, of method, and even of style, altogether exceptional in a work of this size. There are abundant and aptly chosen’illustrations: from history, from physiology, from films recording behaviour, and from themes recorded in the expressionist paintings of Edvard Munch and the paintings, engravings, and lithographs of Kathe Kollwitz. These and the wide range of the references-in the chapter on suicide, for example, the references list Jane Austen and Kipling but not Durkheim or Stengel-make much of the book a pleasure to read. Those who cannot take their Freud in uncritical gulps, however, had best beware. There are a few errors and omissions: doxepin is not a benzodiazepine and there is no mention of the thioxanthines (e.g.,

ally,

flupenthixol). Current Concepts of Infectious Diseases Edited by EDWARD W. HOOK, GERALD L. MANDELL, JACK M. GWALTNEY JR., and MERLE A. SANDE. New York and London: Wiley. 1977. Pp. 277. 16.50,$27.95.

and London: Saunders. 1977.

THIS book, written by the chief of radiology at the Mount Zion Hospital and Medical Center in San Francisco, is the eleventh in the series of Monographs in Clinical Radiology. The first chapter deals with the physiological and technical factors involved in excretion urography, and this is followed by an excellent one on the embryology and anatomy of the kidney. Next, the author sets out a systemic approach to the diagnosis of renal lesions, based on the evaluation of those pathological processes which lead to a loss of renal tissue or to increasing renal bulk, either locally or globally. These processes are correlated with the anatomical features described in the previous chapter and especially with the concept of the "renal lobe", which is described in some detail. This concept is of great help in the interpretation of the changes seen on radiographic examinations. From these general principles the author derives a series of diagnostic "sets" based on the appearance of diseased kidneys, (e.g., small, smooth, unilateral). In this "set", the diagnostic possiblities include ischaemia due to focal arterial disease, chronic renal infarction, and radiation nephritis. There are chapters each devoted to a single "set". Other chapters are devoted to the differential diagnosis of nephrocalcinosis, renal angiography, and radiological techniques used when there is renal failure. In each chapter the pathology of the various lesions, the radiological features, the clinical setting and the differential diagnosis are described. The book is lavishly illustrated, mostly with high-quality reproduction of radiographs; a number of useful line drawings are included. This book is a pleasure to read-the text is clear and concise, and the author’s approach to the diagnostic problem is logical and convincing. It should have wide appeal. Candidates for the second part of the fellowship of the Royal College of Radiologists will find it invaluable, while experienced general radiologists will be glad to have a copy to hand when faced with a difficult excretion urogram. Even the radiologist specialising in urological conditions will want to turn to the appropriate "set" when faced with the differential diagnosis of some of the less common lesions. No other textbook covers the subject so well.

are

THE study of infectious diseases no longer entails merely gaining knowledge of notifiable infections but extends into most areas of medicine. Current Concepts of Infectious Diseases is the proceedings of a course on Recent Advances in Infectious Diseases which is organised every two years by the division of infectious diseases at the University of Virginia

School of Medicine. The book contains seventeen contributions on important aspects of communicable diseases including antimicrobial chemotherapy, infections of the heart and central-nervous system, infection in compromised hosts, tuberculosis, venereal disease, and virus infections. There is also a section on the prevention of infection by immunisation and by non-immunological methods. Of particular importance is the chapter on infection in impaired hosts. The volume, which should interest all clinicians and microbiologists, provides a very useful review of advances in communicable diseases for postgraduate students.

New Editions The Ovary: vol. I., General Aspects—2nd ed. Edited by Lord Zuckerman and Barbara J. Weir. New York and London: Academic. 1977.

Pp. 517. $35; £24.85. Immunogenetics and Rheumatic Disease (Clins rheum. Dis. vol. III, 2)—Edited by Derrick Brewerton. London: Saunders. 1977. Pp. 381. £8.25. Recent Advances in Cardiology. no. 7—Edited by John Hamer. Edinburgh: Churchill Livingstone. 1977. Pp. 511. £17. Human Heredity—2nd ed. By C. O. Carter. Harmondsworth: Penguin. 1977. Pp. 286. £1.25. Operative Surgery: Urology—3rd ed. Edited by Charles Rob and Rodney Smith. London and Boston: Butterworths. 1977. Pp. 468. £35. Contemporary Topics in Molecular Immunology: vol. VI—Edited by R. R. Porter and G. L. Ada. New York and London: Plenum. 1977. Pp. 252. $30; £15.75.

no.

Adverse reaction to lung-scanning agent.

907 Reviews of Books Drug Dependence Current Problems and Issues. Edited by M. M. GLATT, PSYCH. Lancaster: M.T.P. 1977. Pp. 332. kl 1. 50. F.R.C. T...
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