Book reviews 751

Dawson’s reference to the problem of ‘symptomless stones’ and ‘stoneless symptoms’ in his chapter on gallstones. It is good to see a reasoned discourse on piles and note the burial of the varicose vein theory and its replacement by the idea of anal cushions. The chapter on the use of radiotherapy for gastrointestinal tumours is illuminating: most clinicians regard radiotherapy for anything other than the lymphomas with suspicion, but perha we need to relook at this field. The section on interventionatngiography is particularly topical and must be essential reading for all fellowship candidates.

Did you know that: 1. Symptoms and complications of varicose veins are

related to the speed of refilling after emptying rather than the size of the veins?

2. Soft tissue radiology of the testicle is of value in the diagnosis of testicular tumours?

3. An operative wedge biopsy of the pancreas is safer than a needle biopsy? *

4. Coronary angiography is possibly safer than intravenous cholangiography?

5. Not only is a thrombosed external pile a misnomer, so also is perianal haematoma? The lesion is really thrombosis in the sacculated venous plexus in the lower pole of an anal cushion.

Perhaps you need to read this book. The time spent will be more profitable than an equivalent time with the journals.

G. W. JOHNSTON

and dental and maxillofacial prosthetic considerations, the subject matter is dealt with on a regional basis. Each group of tumours is treated along similar lines: anatomy, aetiology, classification, surgical pathology, clinical features, treatment and end results. The relative roles of surgery, radiotherapy and, where appropriate, chemotherapy are considered and their combined use outlined in a balanced fashion. Preferred surgical techniques are well described although this is by no means an operative surgical textbook.

The contributors are American with few exceptions: Professor Donald Harrison represents the United Kingdom with a fascinating chapter on unusual tumours, carcinoma of the nasopharynx is written, appropriately, by a surgeon from Hong Kong and lymphomas of the head and neck are dealt with by a team from the Instituto Nazionale of Milan. The overall standard is so good that to single out any contribution for individual mention would fail to do credit to the remainder. Who after all can write with reater authority than Strong and Spiro on oral cancer, Conky and Baker on the salivary glands, John S. Lewis on cancer of the ear and Oliver Beahrs and his group from the Mayo Clinic on thyroid cancer? The chapter on reconstructive procedures by Ballantyne is superb, if marred somewhat by over-dark reproductions of some illustrations. One wonders whether the specialist practitioner requires specific chapters on anaesthesia, medical assessment, nutrition or the care of the incurable patient but the editors have after all sought to be comprehensive and these sections are admirably written.

This book is up-to-date in content and references and is reasonably priced. It can be confidently recommended to all interested in the field of head and neck cancer and is likely to become a standard text.

The Esophagus: Reflux and Primary Motor Disorders R. D. Henderson. 262 x 173mm. Pp. 279+xvi. Illustrated. 1980. Baltimore: Williams and Wilkins. $46.75. THIS volume is an up-dated and extended version of the author’s Motor Disorders of the Oesophagus. It is clear and comprehensive and very well illustrated. The usefulness of this book arises out of its essentially clinical nature. Almost all operative options are covered, and it would be difficult indeed for anyone of Dr Henderson’s experience to be more fair in his assessment of, for example, the many operations for reflux. Reports of his own operative techniques are supported, understandably rather anecdotally, by examples from his own

G . WESTBURY

. . laboratory work.

British surgeons may be surprised at his brief dismissal of guided bougienage of Gricturei The Eder-Puestow technique used so successfully in this country is not even mentioned and conservative treatment of strictures-which occur so often in the elderly-is hardly considered. Indeed, endoscopy itself is ‘reserved for patients with major disease’, and I believe the more aggressive endoscopic attitude in the United Kingdom may be more appropriate.

The book is smartly produced, which makes it a pity that one of several spelling mistakes is in the ‘Forword’! Overall, this is both an excellent reference volume and, at the same time, a useful, practical book for the general surgeon.

Surgical Review 2 Edited J . S . P. Lumley and J. L. Craven. 235 x I55mm. Pp. 435 + vii. Illustrated. 1981. London: Pitman Books. €16.95. THIS second volume in the Surgical Review series covers a wide range of subjects by 23 authors. In these days of super- specialization, this type of volume is invaluable, keeping the busy surgeon informed about advances in surgery and allied specialties. There is a good balance between the management of such common complaints as piles, which affect half the population over 50 years of age, and the less common problems of testicular tumours, leg inequality etc. The in- depth section on inflammatory bowel disease and intestinal stoma is comprehensive. Brendan Devlin’s 77-page section covers everything from psychology to surgical technique, and from the prescribing of appliances to their disposal. I like John

J. SPENCER

Introduction of Abdominal Surgery. Fifty Clinical Studies C. J . Schein. 240 x 168mm. Pp. 521 +xiv. Illustrated. 1981. London: Harper and Row. €19.50. FAIRLY or unfairly, there is a tendency on this side of the Atlantic to view American textbooks with suspicion, especially those for undergraduates-traditionally, they are expected to advocate clever investigations above talking to the patient and to cloud the whole issue in a foreign language.

This book is different. The author has succeeded in producing a magnificent book which encourages an approach to diagnosis that none could fault. Moreover, he transmits his enthusiasm for the subject at every opportunity, surely the prerequisite for any good book aimed at students and junior doctors testing the water in any branch of medicine. He does it mainly through the skilled use of 50 thoughtful, varied case presentations, repeatedly advocating careful history-taking followed by symptom-directed examination and judicious investigation; treatment o tions are then !iscussed. It is always easy to picture t!e patients (i.e. an ill-looking, cooperative, almost deferentially polite man in severe pain’) and almost to hear the careful discussion led by a sympathetic teacher. Each case, spread over 10 pages, is introduced by a symptom complex rather than a diagnosis; alternatively the index can be used to find a case relating to a particular diagnosis. An avuncular preface and sound chapters on the history of abdominal surgery and simulated surgical disorders enhance the volume.

If one can ignore the Americanisms (idiopathicity, emetogenesis, Courvoisier gallbladder etc.) there are few quibbles. The pre-SI units will evoke confusion rather than nostalgia, while the poor MCQs at the end will produce a few smiles (is ‘De Fabnca Humani Corporis’ a ‘14th century quack nostrum’ or perhaps ‘Galen’s case studies’?) and many frowns (does Crohn’s disease recur ‘frequently’ or ‘very often’ after resection? What is the ‘least uncommon’ cause of ‘board- like rigidity of the duodenum’?).

Notwithstanding, students, prospective surgeons and aspiring teachers will find this book very readable; most would be grateful for a cheaper paperback edition.

J. NORTHOVER

Magnesium and Man W. E. C . Wacker. 240x 160mm. Pp. 171. Illustrated. 1980. London: Harvard. E10.50. THE author is long experienced in the field of mineral meta- bolism and is widely known as an expert on magnesium