i98 BRITISH JOURNAL OF PLASTIC SURGERY

That section which discusses the primary management of the injured hand, especially related to the provision of skin cover, is undoubtedly the best. The section on tendon grafting, however, still remains substantially as it was in the first edition. Much has happened in this field since i953, and while no one suggests that the authors should change techniques effective in their hands, the reader of an authoritative work has a right to expect a discussion of well-established alternative views. The Littler incision, for example, with its advantages of exposure throughout the length of the tendon, receives no mention, and one hopes that the Bruner incision, another conspicuous advance, will be included in the fourth edition.

The book is read and deservedly admired throughout the world and one hopes that succeeding editions will include more reference to techniques established elsewhere. Only the hemi-digital neurovascular island flap, for example, is described and there is no mention of the widely used hemi-pulp flap. The Australian contribution to hand surgery speaks for itself and can well afford to acknowledge contributions from the rest of the world. This edition, nevertheless, maintains the pre-eminence of the book on its chosen subject.

I. A. McG.

B o d y F l u i d s i n S u r g e r y . By A. W. WILKINSON. T h i r d edi t ion. Pp. x i + 3 o 7 , wi th 31 tables. ( E d i n b u r g h : E. & S. L iv ings tone L td . , I969. ) 35 s.

This book sets out the behaviour of the body fluids in health and disease, and then, against this background, gives an account of the management of such disturbances of body fluids as occur in surgical patients. It does so succinctly and clearly.

The author draws on his own extensive experience and blends with it the other outstanding contri- butions in this field. Throughout, the clinical approach is emphasised--" the hardest thinking must be done before any blood is withdrawn for chemical examination ". In this, the Third Edition, the chapters on the Effects of Injury and the Disturbances in Infancy and Childhood have been largely rewritten.

Problems set by patients in the field of body fluid disturbance are rarely easily solved. There are " few short-cuts or routine answers ", but a careful study of the wealth of information here contained will provide a sound base on which the clinician can build his own practice.

This is an excellent publication and one would hope that, as further knowledge accumulates, future presentations will be made by the same author and publisher.

A. D. R. B.

Nervous and Nerve Injuries. By SYDNEY SUNDERLAND. Pp. 1161, wi th 197 i l lustrat ions. ( E d i n b u r g h : E. & S. L iv ings tone L td . , 1968.) £12, lOS.

Professor Sunderland holds the Chair of Experimental Neurology in the University of Melbourne. For many years he has been well known for his meticulous and detailed studies of the funicular and fibre pattern of the peripheral nerves and for his contributions to the treatment of nerve injuries. This monumental work is based on the laboratory and clinical investigations on nerves, nerve injuries and nerve repair which he began in 194 ° and is by far the most complete treatise on the subject which has appeared. There are eight parts : anatomical and physiological features of peripheral nerve fibres and nerve trunks ; degeneration ; regeneration ; a classification of nerve injury ; clinico-pathological construction ; bones, joints, muscles and motor function ; peripheral sensory mechanism, peripheral sympathetic mechanism ; diagnosis and treatment ; individual nerves. The parts are subdivided into seventy-three chapters which appear to cover every conceivable aspect of the subject.

This is a book for praise and commendation and the reviewer although he does not claim to have read all, could find little to fault. The high standard of publishing is what we have come to expect from E. & S. Livingstone with clear type and well reproduced illustrations, the English is lucid and the references should satisfy the most scholarly. Advances in neuro-surgery are transforming nerve suture and nerve grafting into a far more precise procedure than it has been in the past and Professor Sunderland's detailed analysis of the pattern of fibrils in the various peripheral nerves may lead to far more accurate repairs than have been possible until now. His book should prove a continual reference source to all who have to deal with these crippling injuries.

T . G .

P r a c t i c a l T o x i c o l o g y o f P l a s t i c s . By RENE LEFAUX. Pp. 580. ( L o n d o n : Iliffe Books L td . , 1968.) I35S.

Although this book has several chapters that are of interest to the general medical reader, it is principally a book for the specialist in toxicology or public health. It contains comprehensive sections on the chemical aspects of the toxicity of plastics as well as much information about the dangers to workers in factories involved in their manufacture. There are also chapters dealing with the possible hazards to health resulting from contamination of food from plastic containers.

Originally published in French in 1964, there is the feeling that the exact meaning of the author may not always have been exactly conveyed in translation. For example, on p. 68, the conclusion that butadiene cannot be a safe general anaesthetic since it does not produce complete muscle relaxation seems unusual since in modern anaesthetic practice general anaesthetic agents are rarely used for this purpose ; further- more, convincing reasons for not using butadiene as an anaesthetic are given earlier in the same paragraph.

BOOK REVIEWS 199

Certain expressions, presumably French in origin, are not used in modern English medical terminology, for example, internal asphyxia, asphyxia cyanosis, cephalo-rachidan fluid, haematosis (it is difficult to understand what the term haematosis means in its context on p. 258).

The section on the uses of plastic materials in medicine and surgery is informative and relevant although it is one of the briefest.

Certain of the tables shown in the text quoting maximum permissible concentrations of atmospheric contaminants in factories in Britain, U.S.A. and U.S.S.R. show, interestingly, that the permissible level of contamination is consistantly lower in the U.S.S.R. than in the other two countries.

The layout of the book is logical, but there are fairly frequent misprints. For example, plastic anaemia for aplastic anaemia (this would indeed have been a plastic toxic effect).

Large appendices give details of legislation pertaining to the manufacture of plastics in Britain, U.S.A., France, Federal Germany and Italy.

T . G .

T h e H u m a n F a c e . By DONALD H. ENLOW. Pp. 3o3, w i t h 133 i l lus t ra t ions . (New Y o r k : H o e b e r M e d i c a l D iv i s ion , H a r p e r & Row, 1968. )

The opening chapters of this beautifully produced monograph discuss comprehensively the complex processes involved in the growth of bone. Subsequent chapters deal with the application of these processes to the growth of the bones comprising the human cranial-facial skeleton, one chapter being devoted to the growth of the mandible. Finally, there is a special chapter on basic cephalometric techniques and procedures.

The author is an established authority in this highly specialised field and his concepts on bone remodelling and growth mechanisms are convincingly discussed and clearly illustrated with black and white photomicrographs and line drawings and fully descriptive legends.

This is an outstanding monograph and one of considerable value for anyone seeking to understand the complexities of bone growth.

S .P .

Clefts o f L i p , A l v e o l u s a n d P a l a t e . Yugos lav S y m p o s i u m w i t h I n t e r n a t i o n a l Par t i c ipa t ion , M a r i b o r , I 6 t h to I 7 t h May , 1968. E d i t e d b y Professor D r FRANC CELESNIK. Pp . 41o w i t h i l lus t ra t ions . ( T h e O r g a n i z i n g C o m m i t t e e o f t h e T h i r d Yugos l av Congress for Plas t ic and Maxi l lo fac ia l Surgery . )

This book contains the papers delivered at the Symposium on Clefts of the Lip, Alveolus and Palate, which formed part of the third Yugoslav Congress for Plastic and Maxillofacial Surgery at Maribor, in May 1968. The contributors are mostly from Yugoslavia, Germany, Hungary, Czechoslovakia and Austria, with one representative from Russia, and one from England. The papers contain nothing new but the selection gives a very good idea of the present trends in treatment of these deformities in Central European countries. The text is in English with the summaries in Serbo-Croat. I t is disappointing to see that while so much work is going on there is no sign of any attempt to measure the results of treatment in any way, so that objective assessments, and valid comparisons between methods of treatment can be made.

I. F. K. M.

Y e a r B o o k o f G e n e r a l S u r g e r y - i 9 6 8 . E d i t e d b y M. E. DE BAKEY. Pp . 618, w i t h 143 i l lus t ra t ions . (Chicago : Year Book M e d i c a l Pub l i she r s , Inc . , 1968.)

This Year Book of General Surgery lives up to its reputation of providing up-to-date reviews of progress in surgery. Basically, it consists of synopses of important publications in the various fields of surgery up to May I968. The reviews are factually reported but at the end of some of them there is a pungent, critical and usually constructive editorial comment. Several sections which are relevant to plastic surgery include those on transplantation and artificial organs, wounds and wound healing, neoplasms, head and neck surgery and surgery of the breast. Plastic surgeons will also find this book a useful survey to keep themselves au fait with the advances in other branches of surgery.

T . G .

N e l s o n a n d h i s S u r g e o n s . E d i t e d b y P. D. GORDON PUGH, O.B.E. Pp . 68, w i t h 47 pla tes . ( E d i n b u r g h : E. & S. L i v i n g s t o n e L td . , 1968. ) 3os.

This beautifully illustrated monograph records an exhibition entitled Nelson Chirurgiique which was mounted on the occasion of the Spring Meeting of the British Orthopaedic Association at the Royal Naval Hospital, Haslar. I t tells of the life and death of Lord Nelson, recording his wounds and illnesses with descriptions of the physicians and surgeons who attended him. The text discloses some popular misconceptions about his injuries which will be of great interest to medical historians. The exhibits were loaned from many sources and it would be difficult for anyone to become acquainted with so much material by private endeavour. Interspersed with reproductions of portraits, letters, and photographs of personal effects are short accounts of the principal battles fought by Lord Nelson. Gordon Pugh is to be congra- tulated on the success of this monograph, the collection of material for which must have needed much hard work.

D . M .