530 Reviews and notices of books

Applied Physiology of Respiratory Care John Hedley- Whyte, George E. Burgess I l l , Thomas W. Feeley and Malcolm G. Miller. 235 x 160 mm. Pp. 552 +xiii. Illustrated. 1976. Boston: Little, Brown. $22.50. THE preface to this book suggests that it is ‘a guide for physicians who care for critically ill patients’ and a source of information for examination candidates in medical and surgical specialties. It fulfils both of these aims to a considerable extent, but a t the same time it should be stressed that it does not include all that the title suggests, and which British examination candidates will certainly require. It presumes a knowledge of respiratory physiology at a level far higher than that of the British Primary FRCS, there is, for example, no discussion of the physiology of acid-base disturbances, nor of respiratory failure and the principles, as opposed to the practice, of its treatment. More- over, the book is far from being comprehensive: I looked in vain for discussions on ‘shock lung’, on oxygen therapy with a mask, on the respiratory distress syndrome in premature infants and on the indications for-as opposed to the physiological effects of-positive end expiratory pressure ventilation (PEEP). There are over 2000 references, but these are patchy; in some cases a fact is supported by six or more references, but in other cases important facts, such as that carbon monoxide poisoning is accompanied by an increase of cerebral blood flow (p. 316), and that the maximum protein-sparing effect of glucose occurs with a daily intake of 100 g (p. 86). are not supported by references at all.

In short, this is a book for the specialist in intensive care, for whom it should prove of great value. Certain sections, e.g. those on the effects of smoking on lung function, on massive blood transfusion and on parenteral nutrition, are strongly recom- mended to both FRCS and FFARCS candidates.

G. RICHARD KELMAN

Plastic and Reconstructive Surgery: Paris, 24-29 August 1976 Edited Daniel Marchac. 240 X 160 mm. Pp. 736, with 930 illustrations. 1976. Paris: Masson. 390 F. THIS volume records the proceedings of the 4-yearly inter- national congress of the International Confederation of Plastic and Reconstructive Surgery, which was held in Paris in 1975. As such, it represents current thought and practice on all the subjects covered by this specialty.

Some papers bring new ideas, whilst others restate accepted procedures or modifications of them. The number of papers presented was so great that the editor has been unable to include them all in full, and whilst this is regrettable for authors so penalized, it has the advantage of reducing repetition and making a better balanced book. It is beautifully produced and the illustrations are ample and clear. It will serve all who are engaged in this work, whatever their special interest, as a comprehensive reference book.

The subjects which are of particular current interest are rightly given the widest coverage. Microvascular surgery and orbitocraniofacial surgery are good examples; both subjects in all their differing aspects are covered in depth by the papers which have been included. There are also good sections on basic principles and research, reflecting increasing attention, particularly by the younger surgeons, on the need to explore the fundamentals of tissue repair.

Technical ingenuity is also, happily, in evidence, as, for example, in the reanimation of the palsied face by cross-face nerve transplantation, and also in several procedures described in the section on aesthetic surgery. It is perhaps a reflection on the lack of progress in the treatment of burns that this subject only attracted four individual papers, although this is, to some extent, countered by a good symposium covering skin storage, tissue typing and the problems of rejection.

Round table conferences and the televized demonstrations of operations are also recorded.

The volume reflects that plastic and reconstructive surgery is a vigorous and growing specialty that is producing many new ideas whilst at the same time taking a critical look at the old ones.

DAVID MATTHEWS

Surgical Diagnosis Georfe Quist. 246 x 189 mm. Pp. 712, with 867 illustrations. 1977. Lon&n:Lewis. f15. A MAGNIFICENTLY illustrated book by a great teacher and a kindly examiner. Primarily directed at the undergraduate, it is of value to the young surgeon for its emphasis on the clinical approach to surgery. Some will criticize the didactic approach, but students still prefer this in a textbook. It covers the whole field, including a chapter on obstetrics and gynaecology.

This is an important book which is likely to become a standard text for undergraduates.

C. G . CLARK

Myocardial Revascularhation: A Surgical Atlas Quentin R. Stiles et al. 280 x 215 mm. Pp. 165. Illustrated. 1976. Boston: Little Brown. No price giuen. THIS is a profusely illustrated textbook, devoted solely to the surgery of coronary artery disease. It is based on the results in over 2000 patients and contains a great deal of practical information for the guidance of the surgeon studying this work.

The illustrations aremostly good quality original line drawings and for the most part amplify the text in a satisfactory fashion. There are particularly good illustrations, for example, of the means of identifying the hidden left anterior descending artery and the obtuse marginal branch of the circumflex artery, showing how it proves to be quite large when it may appear to be a mere thread. There are detailed descriptions of anastomotic techniques, including such practical points as how to deal with a twisted graft.

The authors employ interrupted suture techniques which are well established but probably not the most commonly used by the majority of surgeons. There is adequate discussion of the place of endarterectomy. The authors’ technique of myocardial preservation is given in detail together with a useful discussion of the place of other methods. There is a useful description of internal mammary artery anastomosis. There is also a brief account of coronary surgery combined with valve replacement and of operation for left ventricular aneurysm.

Unusual for a book of this type is a fairly detailed consider- ation of the postoperative care and a final chapter on the results of surgery.

This volume, though not an all-embracing account of the problems of management of myocardial revascularization, represents a satisfactory practical handbook for those who require guidance in the methods available. It can be recom- mended with confidence.

H. H. BENTALL

Classics of Orthopaedics Edited Edgar M . Bick. 250 x I80 mm. Pp. 541 +xuiii. Illustrated. 1976. Oxford: Blackwell Scientific. f22. DIPPING into various parts of this anthology has been one of the more pleasant of the holiday chores. The book is very well printed and beautifully bound to give a most satisfying leathery feel. Tables, illustrations and diagrams, for the most part, have been purposely omitted to allow the text to follow smoothly and effectively in essay form. The editor, D r Bick, points out that the contents cannot be regarded as freely chosen, but even so there has been an excellent selection of work by American contributors and, reasonably less so, of work from European sources, since most of this historical material has come from the library of the New York Academy of Medicine.

The recording of accurate data and the ability to make original observations and conclusions are a hallmark of many of the earlier orthopaedic classics. This is one of the many reasons why this book should prove most worth while to all modern authors. At the present time too much is written to record data without any attempt a t reaching conclusions or indeed to advance the subject. The past masters had the necessary skills and perhaps more importantly the patience and wisdom to publish only when they had something worth while to say. A jolly good book for all orthopaedic libraries and heartily recommended.

R. B. DUTHIE