Reviews and notices of books

Pediatric Orthopedic Nursing Nancy E. Hilt and E. William Schmitt, Atlanta, Georgia. 254 x 175 mm. Pp. 248+xuiii, with 301 illustrations. 1975. London: Henry Kimpton. f6-15. THIS is a really splendid book. The entire field of nursing care of the orthopaedic child is covered in a practical manner with- out neglecting the emotional problems which are encountered when a child undergoes prolonged surgical attention. The text is highly informative and the illustrations are clear and concise. It may be read with pleasure from cover to cover or can be used as a reference book. It will be found invaluable for teaching nurses. So often textbooks for nursing and para- medical staff have a patronizing tone, but these authors show that it is possible to be simple and instructive without being condescending. This book will, in my opinion, become the standard reference book on paediatric orthopaedic nursing in the foreseeable future. It cannot be commended too highly.

LIPMANN KESSEL

Abdominal Operations. Volumes 1 and 2 Edited R . Maingot. Sixth edition. 2 5 0 ~ 180 mm. Val. I : pp. 1220 txx ix ; Yol. 2: pp. 2264+xxiii. Illustrated. 1975. Hemel Hempstead, Herts: Prentice-Hall International. f46.75.

THE sixth edition of this famous work is a worthy successor to previous editions and Rodney Maingot is to be congratulated on drawing contributions from so many distinguished auth- orities. Descriptions of most of the operations performed by alimentary surgeons are interlaced with discussions of basic principles, sections on physiological and pathological aspects, methods of investigation, historical notes, etc. As a compre- hensive text, sensibly presented in two volumes, it is well worth having if your work is mainly in the abdomen and you have not already acquired publications that cover essentially the same field. However, it is atrociously expensive even by present day standards and I doubt if the surgical registrar or Fellow- ship candidateshould-or could-buy it; he wouldundoubtedly

Digestive Surgery. Proceedings of the Second World Congress of Collegium Internationale Chirurgiae Digestivae Edited L . F . Hollender and G . D'Onofrio. 2 4 0 ~ 170 mm. P p . 969 ixxx i i . Illustrated. 1974. Padua: Piccin Medical Books. $60. THIS long book of approximately one thousand pages com- prises the Proceedings of the Second World Congress of Collegium Internationale Chirurgiae Digestivae, held in Strasbourg in June 1972. The volume is divided into sections on the physiology and surgery of the oesophagus and hiatal hernia, the stomach and duodenum, the small intestine, the colon, the rectum and anus, the bile ducts, the pancreas, portal hypertension, etc. As might be expected, some of the contri- butions are now rather 'old hat', but it is useful to have so many valuable papers collected into one volume. The quality of the contributions is inevitably rather uneven but the general standard is high. It is perhaps invidious to pick out any parti- cular papers for special mention, but there is the expected rash of communications on selective proximal/highly selective/ parietal cell vagotomy and an interesting account by G. Holle et al. on the changes in the parietal cell mass after selective proximal vagotomy for gastric ulcer. Kronberger contributes a vigorous defence of gastric resection for chronic peptic ulcer, sentiments which echo those of McKeown in this country and Ochsner from the United States. De Miguel has an interesting paper showing how diarrhoea diminishes as the types of vagotomy become more refined. Bruckner and his colleagues from Munich report interesting work on the effect of sympa- thectomy on pepsin secretion in cats with gastric fistulation. The fascinating data on Crohn's disease from Birmingham pre- sented by J. Alexander-Williams et al. will by now be familiar to most British surgeons. There are fine accounts of the treat- ment of chronic pancreatitis and of portal hypertension from experts in these fields. Altogether, this is a stimulating publi- cation which should be present in medical libraries, but which one would hesitate to recommend for purchase by the individual

be glad to find it in his hospital library as a superb source of reference on practical and theoretical matters.

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Having thus recommended it, I cannot refrain from some criticisms which might be considered for a further edition in a few years. Monographs are all the rage, but I think there will continue to be a place for major 'spectaculars' such as this.

Some subjects must be included and others expanded. For example, proximal gastric vagotomy receives scant attention; the trans-sphincteric approach to the rectum deserves a full description; prolapse of the rectum merits a more thorough exposition; as fissure-in-an0 is dealt with, there seems no reason to exclude haemorrhoids; prevention of deep vein thrombosis is worthy of more than three lines.

As a text largely devoted to technique, the avoidance of excessively dogmatic statements is remarkable, and the policy that led to this must be sustained vigorously.

Now to relative trivialities. References are dealt with in different ways in different chapters which is wrong. There seems to be a schizophrenia about whether to use the English or American spelling of such words as haematemesis, colour and anaesthetized, and the common bile duct becomes the choledochus occasionally. To convert inches to centimetres seems reasonable, but it is surely impossibly precise to describe an incision as 7.62 cm from the pyloric sphincter-why not go metric throughout anyway? Some of the illustrations are poor because of excessive shading or detail, and one is frankly silly -we do not need a line drawing to show a surgeon with a hand in an abdomen doing a laparotomy! It also seems out of place to go into such detail as when a patient may get up 'for bedmaking'-particularly when the advice is out-of-date. Despite these blemishes, it is an excellent book-if you can afford i t .

ALAN G . COX

DAVID JOHNSTON

Lessons of Leucotomy Edited Ashley Robin atid Duncan Macdonald. 215 x 137 mm. Pp. 100, with 7 illustrations. 1975. London: Henry Kimpton. $2.25. THE senior editor of this book is noteworthy in that he is one of the few psychiatrists who has paid attention to the need for an adequate control population with which to compare the results of prefrontal leucotomy. He himself, in his study from Runwell Hospital, found that his group of patients derived little benefit. The editors have had an almost impossible task in comparing the results on patients with different diagnoses undergoing different kinds of operation, and there is much evidence, though little of it as yet published, which shows that lesions are by no means always placed in the intended areas. The book contains a considered discussion of the methodology involved in a proper controlled trial and ends with a plea for some adequately controlled trials. It is to be hoped that such trials will indeed be carried out, for the occasional dramatic improvement seems far more than can be due to chance. For examples of this kind of improvement and for the various i l l effects that may follow operation there is still no better study and certainly no more entertaining one than Partridge's Prefrontal Leucotomy (1950, Oxford, Blackwell). The present volume will encourage a more critical attitude in the future by those concerned with this operation. Neurosurgeons have with stereotaxis increased the accuracy of the lesions that they can produce; it is now the psychiatrists who must play their part.

R. T . C. PRATT

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