things in the course of a year's work. Many of thesewill turn out to be unusual appearances of entitieswhich are all too familiar, such as cancer. Others willbe true curiosities, such as glycogenic acanthosis ofthe esophagus or xanthoma of the stomach. All aredealt with in this book, with one important proviso: ifthe subject is well covered in other texts, it will not becovered here, and vice versa. Polyps of the stomachare given 20 pages, but polyps of the colon are hardlymentioned. Why should they be when they are sothoroughly covered elsewhere? The happy result isthat this volume is comprehensive and yet handy andsells for a good price. Only one with Professor White­head's authority and experience could pull this off.

The book is divided into four sections on esophageal,gastric, small intestinal, and colonic biopsies, respec­tively. Each begins with a chapter on normal appear­ances and then continues in a craftsmanlike way toexplore those conditions that are of concern to theendoscopist and histopathologist. The writing is au­thoritative and very practical but does not neglectetiology and natural history. There are numerous pho­tomicrographs. Those at low magnification are oftenfollowed by a detail at higher magnification, which isvery useful.

Someone who owns the second edition of this bookshould buy the new third edition. The section onesophageal biopsies is newly added. The remainingsections have been extensively rewritten and updated,thus taking advantage of the numerous advances inthe past five years. The book is well printed, wellbound, and of pleasing proportions.

Luther R. Mills, MDVA Medical CenterAugusta, Georgia

Atlas of Therapeutic Proctologyby Emilio de los RiosW. B. Saunders, Philadelphia, 1984, 185 pp., $69.00

Close-up photographs in brilliant color are thestrength of this volume by Dr Emilio de los Rios ofBarcelona. Common anorectal diseases are describedbriE\fly and treatment is discussed in detail, with theauthor's preferred methods illustrated by photographsand sketches at the end of each chapter. Numerousdrawings clarify salient anatomic features and en­hanfe the superb photographs. Typically one or moreexamples of each lesion are shown, the steps in sur­gical treatment are depicted, and in some (but not all)cases a follow-up photograph is included to show theend result. The absence of completion photographsfor some cases is a minor deficiency, particularly whenthe suggested procedure is different from one thereader might prefer. Abscesses and fistulas are excep­tionally well illustrated, and the photographs ofhemorrhoids are excellent also. One drawing that

VOLUME 31, NO. 4, 1985

shows anatomic differences in the anal canal withcontraction and relaxation is particularly fine becausethis point is not often made in texts. Other insightsthat may be new to the reader or that present oldknowledge in a different light are scattered throughoutthe book.

The experienced surgeon will find much to criticizein this volume. There are minor regional peculiaritiessuch as the practice of routinely admitting patients tothe hospital preoperatively in Barcelona. More impor­tantly, however, the author advocates fistulectomyrather than fistulotomy in most cases; he uses rubberband setons, and he attempts to treat the fistula atthe time of drainage of an anorectal abscess wheneverpossible. All of these points are controversial. If theprimary fistula orifice cannot be identified in a patientwith an abscess, electrocoagulation of the crypts inthe vicinity is advocated; the value of this step isunproved. Fissurectomy rather than lateral internalanal sphincterotomy is recommended for anal fissure;this too is a debatable issue. Indeed, nearly everyprocedure selected by the author could provoke argu­ment in this field where there is still a relative absenceof sound scientific data comparing various methods.

This atlas is handsomely produced. Its origin inanother language is apparent from such oddities asthe use of the expression "anus in the eye of a lock"to refer to what we know as a "keyhole deformity."Excellent photographs alone are sufficient reason torecommend purchase of this volume by surgeons andlibraries. Physicians and surgical residents will benefitfrom access to the book, but the steep price and thelimited scope (minimal discussion of symptoms andsigns) make purchase unnecessary. The didactic in­formation should be balanced by reference to a stand­ard textbook that discusses opposing points of viewmore fully.

Theodore R. Schrock, MDUniversity of California

San Francisco, California

Disorders of the Oesophagus: Advances andControversies

edited by A. Watson and L. R. CelestinUrban & Schwarzenberg, Baltimore, 1984, 298 pp., $42.50

With the recent advances in the understanding andmanagement of esophageal disorders, new controver­sies have arisen. A book focusing on these advancesand controversies is a welcome addition to the litera­ture. This publication by an international panel of"esophagologists" contains 24 chapters by 27 authors.The topics are appropriately selected for new andcontroversial information. The grouping in four majorparts-investigations/motor disorders, gastroesopha­geal reflux, carcinoma of the esophagus, and esopha­geal varices/pediatric problems-is an interesting ap-

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