in a population may lead (through a period of polymorphism)to a gradual change of the phenotype of the population. Itrequires the replacement of the old by the new homeoboxgene by selection over very many generations. Furthermore,the conversion of a population into a new species requires theacquisition of appropriate isolating mechanisms. But neitherthe words isolation nor isolating mechanisms can be found inSchwartz’s account (at least not in his index).

What is the reason for Schwartz’s failure in spite of hisextensive reading and his efforts to make use of some of themost recent findings of molecular biology? Perhaps it is dueto an insufficient consideration of some of the basic conceptsof the synthetic theory. For instance, nowhere does headequately emphasize that evolution takes place in popula-tions and consists of the replacement of individuals, genera-tion after generation. Furthermore, in numerous discussionsof mutation in this volume, it is always implied that the gene(mutation) is the target of selection rather than the phenotypeof the individual, and this favors acceptance of a theory of asaltational role of homeobox genes. Nor does Schwartz seemto appreciate that natural selection is a two-step process.Homeobox mutations occur during the first step, the produc-tion of variation. The fate of these mutations, after they havebecome components of new genotypes, however, is decidedat the second step, the actual selection. Therefore, no conflictexists between the occurrence of homeobox mutations andthe classical Darwinian process.

Schwartz has produced a very readable account of thehistory of evolutionary thinking, particularly with reference tohominid evolution. Every reader will benefit from the informa-tion which he presents, some of which is not as easilyaccessible elsewhere. I am afraid I must conclude, however,that he has not succeeded in presenting ‘‘a groundbreakingand radical new theory of evolution.’’

Human disease mappingApproaches to Gene Mapping in Complex Human Diseases(1998). Haines JL and Pericak-Vance MA (Eds). John Wiley &Sons, 434 pp. £45.50 hbk; ISBN 0471171956

Reviewed bySimon Bennett and Jenny TaylorOxagen Limited,91 Milton Park, Abingdon,Oxfordshire OX14 4RY, UK

Genetics is playing an increasingly important role in under-standing the mechanisms of disease. Attention to studydesign will be critical to the success of these studies. Thisbook, edited by Haines and Pericak-Vance, is the first of itskind to provide both a theoretical background to geneticstudies and detailed practical advice on how to embark upongenetic studies of complex human disease. The book drawstogether chapters from seventeen contributors, each cover-ing a discrete facet of the process and together illustrating the

breadth of expertise and multiple disciplines involved. Byreading this book prior to initiating a study, investigators willbe more than adequately warned of the potential pitfallsinvolved, which will ultimately prevent costly mistakes.

Readers should not be put off by the complexity of thissubject as the book is remarkably easy to read and is ideal forstudents and experts alike. In particular statistics dominatesonly three of the chapters and in one of these complicated‘‘brick wall’’ formulae, which might deter some readers, arewisely packaged into a series of appendices. The contents ofeach chapter are clearly highlighted, a prerequisite for such areference text. However, the chapters themselves are notnecessarily arranged in the most logical sequence.

At the start of any genetic study particular attention shouldbe paid to the definition of disease phenotype and theascertainment criteria to be used. This point is stronglyemphasized by Aylsworth in Chapter 3. Additional features ofsuccessful study design, such as the identification of pro-bands and other family members, and the collections andmanagement of their samples, are also well-covered insubsequent chapters. Whilst Cohen and Wolpert, in Chapter6, pay some attention to ethical issues and include theirversion of a standard consent form, the increasing awarenesson ethics in genetic studies is not reflected in this chapter,which provides a very US-orientated overview. Some indica-tion of ICH harmonized tripartite guidelines for good clinicalpractice, at least where applicable to family recruitment forgenetic studies, as requested by most European medicalethics committees, would have been useful.

Vance and Othmane provide a detailed account of meth-ods of genotyping up to the present day as well as comprehen-sive practical advice. However, they only briefly mention morefuturistic approaches that are already in place in somelaboratories and which will become increasingly more widelyused, especially in the light of recent developments in singlenucleotide polymorphism (SNP) technologies. For example,capillary electrophoresis and the use of chips for genotypingcould have warranted detailed descriptions in their own right.At the end of the chapter, the authors highlight the importanceof size standards, particularly between gels, a practical issuethat is essential for quality and consistency of genotype data.

Consistent with the overall style of the volume, Haynesand Blach’s chapter on database design is impressive in itsscope, ranging from the fundamentals involved in construct-ing a database in addition to guidelines on data management.They also provide detailed advice on database maintenanceand management, including tips on unambiguous question-naire design and double entry of data, all of which willfacilitate successful data management.

The remaining contributions focus on the process of genediscovery, including the basics of linkage and other methodsfor statistical analysis, whole genome screening, lod score,

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sib pair and affected relative pair analyses, linkage disequilib-rium, gene identification and complex genetic interactions.Particularly useful is Haines’ chapter on the use of publicdatabases which, amongst other things, provides a compre-hensive array of web site addresses and information. Collec-tively these chapters, together with the initial introductorychapters, succeed in getting across some important mes-sages about the nature of complex, multifactorial diseaseanalysis. The book in general could have benefited, however,from being furnished with a wider variety of examples ofcommon diseases other than the APOE in Alzheimer’sdisease story, as elegant an example as it is. Marchuk’sexpose on approaches in gene identification covers a multi-tude of experimental techniques, developments in many ofwhich are moving apace, especially in methods for mutationdetection and SNP allele calling. Notable omissions from thebook, presumably owing to space constraints, include the useof animal models, the critical issue of using defined patternsof linkage disequilibrium to help pinpoint disease-predispos-ing polymorphisms, as well as the social and ethical responsi-bilities of patenting discoveries in DNA sequence variantsimplicated in human disease.

As for any publication in the dynamic field of complexhuman disease genetics, the content of some chapters islikely to be soon outdated by advances in the field. This veryuseful, inexpensive, easy-to-read volume is a desirable pre-scription for anyone – medic, scientist, nurse, statistician,student – involved or interested in the science of geneticmedicine. Haines and Pericak Vance’s book is a timelyaddition to the genetics literature.

Instant success for Instant PharmacologyInstant Pharmacology (1999). Saeb-Parsy K, Assomull RG,Kahn FZ, Saeb-Parsy K, and Kelly E. John Wiley and Sons349 pp. £19.99 pbk; ISBN 0471976393

Reviewed byIE HughesDept of Biomedical SciencesUniversity of Leeds, LS2 9JT, UK

Instant success for Instant Pharmacology-or at least it couldbe since this book was written for medical students, bymedical students and provides an answer to the traditionalmedical student problem – what do we need to know? InstantPharmacology encapsulates the essential knowledge andpresents it in a concise and compact manner without theobscuring overlay of unnecessary complexity and detailfound in many other pharmacology text-books for medicalstudents. It has also solved another medical student prob-lem – what about chemical structures? There are no chemicalstructures at all in this book and while this initially comes as ashock to the pharmacologist it certainly enables the medicalstudent to concentrate on actions, mechanisms and uses; theessential bread-and-butter of medical drug use.

After an introduction dealing with basic pharmacokineticand pharmacodynamic (including receptor types) conceptsthe book is divided into four parts. The first provides informa-tion on peripheral, central, local and hormonal chemicaltransmission and some of the drugs which modify theseprocesses. Part II is largely systems based and deals with thedrugs which affect the circulatory system, the central nervoussystem and the gastrointestinal tract as well as with inflamma-tion, anaesthesia and analgesia, chemotherapy, disorders ofthe blood and the vasculature, endocrine pharmacology andreproductive pharmacology. This largely systems-based ap-proach is helpful to students on the increasingly commonintegrated and systems-based medical courses, though theinformation in this book is mostly pharmacological.

These two parts total 174 pages of concise and compre-hensive information targeted at a good pass level for amedical pharmacology course. There are some omissions,however. At the macro level practically no mention is made ofthe drug development process, post-marketing surveillanceor the design and interpretation of clinical trials. This will nothelp medical students to make evaluations of drug effective-ness within the context of evidence based medical practice.At the micro level, while adrenaline, noradrenaline andphenylephrine are mentioned as vasoconstrictors for localanaesthetics there is no mention of felypressin. Generally,however, the information is accurate, concise and clearlypresented with many diagrams (unfortunately all black andwhite) and tables where appropriate. Although the bookmentions about 700 drugs those typical of the class areunderlined which helps the student to focus on representativeexamples. Up to date and well chosen references to addi-tional reading are provided at the end of each section.

Part III of the book provides 150 pages of a dictionary ofdrugs where the uses, mechanism of action, pharmacokinet-ics and adverse effects are summarised for drugs typical oftheir class and differences noted for the other drugs in thedictionary. This is a very useful feature and helps to providean overall view of the pharmacology of a drug though theseparate index has to be used to find the more extendedinformation on the drugs which is provided in parts I and II.

Part IV provides a self-assessment section with traditionalstem plus 5 completions multiple choice questions presentedin groups suitable for each chapter. These are at an appropri-ate level for a medical student and deal mainly with main-stream information. Correct answers are provided at the endof each section but there are no explanations. However, sinceeach chapter is divided into sections dealing with particulartypes of drug and there is an effective index as well as theDictionary of Drugs it is not difficult to find an explanation foreach answer. The questions and answers, and indeed thewhole book, have been very carefully proof-read and arecommendably free of any sort of error.

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