Book reviews 219

us rather more help than he did in the management of this condition. It is now more than 5 years since the a pearance of some of his original publications; by now the re& of various forms of treatment should be known, yet we are given only conditional advice such as ‘that anterior rectal mucosal pro- lapse may be treated along conventional lines’ and, further, that ‘if the patient has a complete rectal rola se then either an Ivdon wrap or a Ripstein procedure sgouicf’be peqormed

toms warrant it. Results are usually good . . . . modestly brief almost to the point of being apologetic. His ideas seem to be summarized by the statement that ‘surgery has now sunk to a secondary and supporting role in the manage- ment of this [Crohn’s] disease. . .’. However, there are still very important questions to be answered and surgeons will look to such a book as this for more information and guidance than is p e n .

One of the weak points of the book is the references. The immunological chapter is considered to warrant 109 references, many of which are repetitive; a much smaller number of key references would have sufficed. The chapter on nutrition, in- cluding arenteral nutrition, however, only warrants 5 refer- ences. &e sub-editing of the references is also slipshod; the same author having different initials on different lines and some authors being distinguished by their family name only, rather like Enash public school boys. One has the impression that the volume was not intended as a book of reference; it is stimulating rather than authoritatively comprehensive.

“KT o essor Brooke’s own chapter, ‘Surgical management’, is

J. ALEXANDER-WILLIAMS

medical problems of patients in the perioperative period. Pain control and stoperative positive pressure ventilation are not described-gth are relevant to the thesis of the chapter, that the maintenance of adequate cardiorespiratory function is crucial in the management of many of these patients.

Looking to the future, the Qscourse on immunologic reactivity of patients with colorectal cancer is worthwhileit attempts to make sense of a subject which is quite unclear at resent, but it provides enough data to inform and to stimulate urther interest.

For me, the h i i g h t of the book is the chapter on the management of a vanced colon and rectal cancer (Chapter 8, Horace Whiteley). In this difficult field. a sense of realisq and

ges, with the patient’s indiwdual ;opdfethmy ~ ~ ~ % ~ h ~ d % u n of discusson. Emphasis on definitions of t e different clinical patterns which present and possible treatment methods for each ‘syndrome’ is most helpful to clinicians who are attempting to treat such patients.

The editor (Maus W. Steams jun.) has put together a most useful and inexpensive monograph. The defects of omission and commission in this volume prompt me to suggest that a sequel is required, detailing the controversies in surgical technique that are currently being discussed. The views of the team at MSKCC on these subjects would make interesting reading.

f!

L. P. FIELDING

Croba’s Disuse of the Cmtrohtuthd Tract H . Schachter and J. B. Kirsner. 262 x 182 mm. Pp. 182+xiii. Illustrated. 1980. Chichester: Wiley. €1550. THIS volume in the Clinical Gastroenterology Monograph series is not intended for surgeons, but is directed towards hysicians and family doctors. Thc American text has an

Eistorically inaccurate special introduction-a reprint of Crohn’s account which appeared nearly 20 years after the first series of patients with chronic interstitial enteritis was published b Dalziel in 1913 (I) . The first 50 pages are devoted to a generddiscussion of aetiological theones, all unproved. The authors appear averse to operation, fearing that one limited resection will lead to a rapidly escalating succession of recurrences and further surgical adventures. This type of rogression is rarely Seen in Britain today. It is known that Dr

kirsner has collected a very large series of patients with inflammatory bowel disease in Chicago. Unfortunately, this book provides no facts and figures on that series unlike the delinitwe study on the course and progress of Crohn’s disease recently published by Dr Trevor Cooke and his colleagues in Birmingham (2).

1. DALZIEL T. K.: chronic interstitial enteritis. Br. Med. J . 19 13;

2. coom w. T., MALLAS E., PRIOR P. et al.: Course, treatment and long-term prognosis. Q. J. Med. 1980 4 9 363-84.

J A M S KYLE

2 1068-70.

Ill11.mmatory Discures of the Bowel Editedby B. N . B r o o k e d A . W. Wilkinson. 237 x I50 mm. Pp. 244. Illustrated. 1980. Tunbridge Wells: Pitmon Medical. €2040. THls book must not be dismiss+ as yet another transcript of a jamboree. The week’s meeting in Ence, Sicily, must have been exciting and entertaining as well as having all the other attrachons that go with such a meeting. The authors, who were presumably the principal planners of the meeting, succeeded in collecting an attractive group of particiits with appealing and often exciting ideas. The particular r of the &tors can be Seen in the choice of such subjects as ‘Some molecular properties of organisms which may be involved in Crohn’s disease’. This chapter contains exciting ideas and concepts lucidly explained by Professor Hermon-Taylor.

I found the accounts of the surgical aspects of inflammatory bowel disease less interesting and less stimulatin than I had expected, perhaps because I am a sur I wo& have liked Mr K. R. P. Rutter, who contributef?much to our under- standing of the solitary rectal ulcer syndrome, to have given

Operative Snrgery. Phdples aod Techniques Paul F. Nora. 285 mm x 220 mm. Pp. I181 + xviii. Illustrated. 1980. L.onabn: Kimpton. €57.50. THIS is a large and ex sive book. Written for both the experienced surgeon a n E e surg~al trainee, it comprises 1 1 50 profusely illustrated pages contnbuted by 89 different authors who, except for 2, practise in North America. Such multi- author mammoth tomes almost always show varying standards in the different chapters and this book is no exception. Many chapters are well written with high- quality illustrations but others are less satisfactory. For example, to try to cover heart surgery in 15 ages (of which 5 are taken up by illustrations) is of doubtil value and the chapter on gynaecological surgery describes only abdominal hysterectomy. Oophorectomy, an operation more common1 performed by general .surgeons, is nowhere describtcr Different chapters vary in a haphazard way as to whether alternative o rative techniques are included and end-to-end stapling met&s in oesophageal and colonic surgery are not described.

It would be wrong to be too critical, for many of the chapters are comprehensive and well worth reading. Surgeons of all ages could turn to these a p i n and a n with rofit. Even so, I am doubtful whether it mll be widerbought !y surgeons in Great Britain for their private bookshelves: it seems much more a library reference volume.

BARRY JACKSON

Ibe Injnred CbW. Surgical Management 1. G. Randolph, M. M. Ravitch, K. J . Welch, C . D. Benson and E. A b e r k . 236 x I58mm. Pp. 42O+xiv. Illustrated. 1980. London: Year Book. €29.25. WHEN the third edition of Pediatric Surgery (1978) was being planned, the editors decided that a smaller book, dealing exclusively with the seriously injured child, was needed. They took fourtecn chapters from Pediatric Surgery and added six more to produce this review of the basic principles of the surgical care of injured children. They hoped it would be of value to those who work in accident d ents and junior hospital staff of all kinds, as well as and paediatric ph sicians, general and paediatric surgeons.

h e 25 contributors to this book cover the subject well. There are many good photographs of all kinds of injury, and