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the short bowel syndrome, with an excellent article by Dowling on intestinal adaptation. This is followed by 5 essays on various clinical and epidemiological aspects of cholestasis. There are 4 articles on various aspects of paediatric gastroenterology, and the books end with 2 unrelated essays on the absorption of vitamin B12 and the causative virus of Crohn’s disease.

The book therefore contains something for everyone and a great deal for any general surgeon with a principal interest in the gut and its appendages. The chapters are all relatively short and the book is so beautifully produced that it is a pleasure to dip into it for the odd half hour. It is also a useful reference source. At €20 it is reasonable value and it should certainly, with the rest of the series, be stocked by every good medical library.

A Textbook of Regional Anatomy J . Joseph. 255 mm x 195 mm. Pp. 519 + xviii. Illustrated. 1982. London: MacMillan. f30.00. With the splendid exception of recent editions of Gray’s Anatomy, anatomy text books are not noted for their capacity to evolve. Prefaces to new editions always emphasize changes but they are mostly minor and the scope and emphasis of most textbooks scarcely alters from one edition to the next. Thus, it is inevitable that the introduction in many UK medical schools of shorter (around 200 hours) topographical anatomy courses should be followed by the publication of a new generation of anatomy texts, and this book by Professor Joseph is the latest addition. Most of our students buy Snell’s Clinical Anatomy for Medical Students and it must be the hope of most UK medical publishers that they can produce a similarly successful ‘homegrown’ version. Professor Joseph’s lifetime of experience as a teacher makes him well qualified to produce such a work, but I fear that even he has failed to get the formula quite right.

The book is just over 500 pages long and, true to its title, is a proper regional anatomy book. The writing is clear and in narrative form; lists and tables are eschewed. Facts are presented without fuss and an attractive feature of the book is the inclusion of word derivations and thumbnail sketches of people associated with commonly used eponyms. The treatment of the three ‘1s’-lymphatics, locomotion and the larynx-is a good guide to the quality of an anatomy book, and all three are presented in a balanced fashion. There is also a good deal of attention to functional anatomy which is to be commended. The index is sensibly arranged and I picked up very few mistakes in the text, and even they were relatively trivial. What, then, are my reservations?

The first is the lack of imagination in the organization of the text and in the layout. The clinical implications of structures are mentioned, but because attention is not drawn to them, they tend to get lost within the apparently relentless progression of the text. The student is not involved. There are no problems to solve, no questions to answer. Surface and radiological anatomy are mentioned, but not stressed in the way I think they ought to be.

My second reservation is about the planning, style and content of the illustrations and diagrams. Too often these seem to be poorly inte- grated with the text (e.g. Fig. 190 and p. 299). Many are rather an uncomfortable compromise between an illustration and a diagram (e.g. Fig. 248) and as a result succeed as neither. This is not to say that their reproduction is poor; it is not, the problem is with the conception of what each fgure is designed to do. Some are so poorly conceived (e.g. Fig. 188, right) that students will have to learn the anatomy to understand the diagram! Others are let down by the combination of a poor caption and a poor diagram (e.g. Fig. 253 ( I ) and (2)).

Despite these reservations about presentation and style, the steadiness and reliability of the information within this book will ensure it a following among undergraduate students, and it may prove to be the first really serious threat to the position of Last’s Anatomy as the book of choice for postgraduates. Only time and the ‘cheque book‘ vote of the consumers will tell whether it will prove in the long term a serious rival to Snell. My guess is that it will not.

Computed Body Tomography Edited by Joseph K . T. Lee, Stuart S. Sagel and Robert J. Stanley. 285 mm x 220mm. Pp. 582 +xviii. Illustrated. 1982. New York: Raven. $99.20. The CT body scan produces seductive pictures for the surgeon. Unlike the hieroglyphics of ultrasound, CT has a clarity and immediate recognizability which may persuade the surgeon that he can interpret it; yet few surgeons have received any formal instructions either in cross- section anatomy or in the interprettion of CT scans. For them this book is a worthwhile primer. A comprehensible introduction explains the principles of CT scanning, 16 subsequent chapters then deal with each clinically important anatomical area. Although each chapter has a different author the style is both clear and consistent, the text is well leavened with clearly reproduced CT scans of perhaps unrepresentative clarity. Almost all the chapters include a digestible review of the literature. Unfortunately not all the chapters contrast the virtues of CT

T. KENNEDY

B. WOOD

Book reviews

scanning with that of other investigations. A separate chapter com- paring ultrasound isotope scanning and CT does not make up for this defect. The book is nevertheless satisfactory in so far as it can help the surgeon to see more in CT scans. Its format is such that the surgeon can use it to help decide when to do a CT scan.

CT scans are here to stay; not only those surgeons fortunate enough to have a body scanner in their hospitals but also those with only distant access need a guide and a reference. This book admirably satisfies that need.

Transient Ischemic Attacks Edited by Charles Warlow and Peter J. Morris. 235 mm x 155 mm. Pp. 412+xi. Illustrated in black and white and colour. 1982. New York and Basel: Marcel Dekker. SFr 185. Reports of transient loss of motor function in patients with arterial disease have been available for more than a century but this is the first occasion on which an entire volume has been devoted to this subject. The editors have brought together an authoritative interdisciplinary team, providing an overview of TIAs extending from their epidemi- ology to their medical and surgical management.

A clear summary of the pathophysiology of TIAs, detailing their diffuse origin, is followed by chapters on the blood, its viscosity, cardiac factors, clinical features and the investigation of this problem. Radiological and non-invasive tests are considered fully, although phrases in the latter such as ‘most of the energy parallels the frequency envelope, leaving a distinct systolic window’ are less digestible than the remainder of the text.

The senior editor has provided a detailed account of the properties of aspirin and reviewed the severe limitations of the existing trials on the natural history of the TIA. It is hoped that any tendency of the Oxford aspirin trial group to rush into print with uncontrolled anecdotes from the study will be guarded against, and the data, when available, will fill in some of the wide gaps in the existing literature.

The excellent results of carotid endarterectomy reported from the American and German authors justify their aggressive approach to asymptomatic disease. It is surprising that such figures cannot be routinely reproduced in the United Kingdom. Useful guidelines and a cautious note on the value of extracranial to intracranial bypass surgery are provided by the Ontario school and serve to balance the surgical viewpoint. Although the work throws little new light on the many clouds that shroud the TIA, it does provide a valuable reference for workers in all aspects of this field.

The Management of the Diabetic Foot Irwin Faris. 235 mm x 155 mm. Pp. 131 + viii. Illustrated. 1983. Edinburgh: Churchill Livingstone. €8.50. The disasters which afAict the feet of diabetics tax the skills and depress the spirits of surgeons and physicians and these patients suffer prolonged hospital admissions. Mr Faris has assembled in a small and extremely cheap volume a wealth of information and practical advice on the manabement of this spectrum of ischaemic, neuropathic and affective problems which we encounter. He strikes an admirable balance between objective investigation and clinical commonsense and his statements are supported as far as possible by very adequate bibliography.

He outlines the spectrum of ischaemia due to major vascular disease, vascular calcification and the possible effects of micro-angiopathy, the effects of peripheral neuropathy and of sepsis. Methods of asses- sing the magnitude of these abnormalities are carefully summarized and the main value for the clinician lies in the careful structured outline of the management of a variety of problems. In particular he dwells on the aspect of the care of diabetic feet which is grossly neglected in the prevention of pressure sores and traumatized skin.

I can thoroughly recommend this book to anyone involved in the management of the diabetic. I congratulate Churchill Livingstone on its price and recommend that other publishers examine this volume as representing excellent value for money.

A. YOUNG

I. LUMLEY

C. JAMIESON

Foot and Ankle Pain. 2nd Edition. Rene Cailliet. 22Smm x 150mm. Pp. 2OO+xiii. Illustrated. 1983. Philadelphia: F. A . Davis. $15.00. This relatively short book of only 190 pages forms part of a series by the same author dealing with pain in different anatomical regions. It is easy to read quickly and covers the whole range of disorders of the foot with a background of anatomy and physiology. The chapters on walking and running are particularly succinct. Inevitably, only a bird’s- eye view is provided as the sections are very brief. It will be of use for someone who wishes to have a rapid introduction to the foot and its problems, but is too short to provide an adequate background. The clear line diagrams are useful additions to the text.

L. KLENERMAN