The Physiology of Breathing: A Textbook for Medical Students

The Physiology of Breathing: A Textbook for Medical Students

Br.J. Anaesth. (1979), 51, 77 BOOK REVIEWS It is probably not a book by which to be first introduced to the subject and so not, in Britain at any rat...

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Br.J. Anaesth. (1979), 51, 77

BOOK REVIEWS It is probably not a book by which to be first introduced to the subject and so not, in Britain at any rate, a book which medical students are likely to use, except for the few whose interest is particularly captured by the physiology of breathing. For a medical graduate embarking on a respiratory research project or a study of the topic in relation to aspects of anaesthesia or pulmonary dysfunction it would be ideal. Clinical Parenteral Nutrition; The Proceedings of a Paren- The sub-title "A textbook for medical students" is thus teral Nutrition Workshop. April 1977. Edited by D. H. misleading. Although of very manageable size and readability Baxter and G. M. Jackson. it is more in the nature of a scholarly review with extensive Professor R. Shields states in the introduction: "We are references (60, for example, for Pressure—Flow Relations). going to be concerned with operational tactics" and "How One expects Professor Bouhuys, as an expert in the field of could this fact and that theory improve the care of patients mechanics of breathing, to write well on this, but his section who have nutritional problems". The editors emphasize on control, for instance, is at- least as good: there is a these words with bold type. However, the aim is never ful- commendable—and comprehensible—summary concerning filled. The first 51 pages contain, at the most generous the brain-stem "centres", which relates recent functional anatomical studies to the classical and modern models estimate, only two pages dealing directly with parenteral and of the system. Some sections seem more difficult than nutrition, and one questions whether the title "Workshop" others; the reader wishing to understand ventilationis justified. perfusion ratios, for example, would perhaps be discouraged The clinical aspects of prolonged parenteral nutrition by and better advised first to look elsewhere—such as West's Professor A. H. G. Love are of interest, but his account book—to grasp what it is all about; then to come to Bouhuys' lacks detail. It is only in the discussion that a reference is account and appreciate its logicality and completeness. given to trace elements and then only that they were given This is an intellectually satisfying book, but it is not by weekly. Chapters such as those of Balstone and Alberti and of Smith and Wells justify attention. The diagrams any means "academic" in the pejorative sense; there is an and figures are particularly helpful. The contribution by eye open to practical application and to the potential Dr G. C. Wise on "Patenteral Nutrition in Intensive growth of clinical importance, even whilst the author is Therapy Patients" will appeal to those readers whose guiding us over the most stony theoretical ground. The summaries at the end of each chapter are masterduties lie in this field because of its controversial content. Although Dr Paymaster (on the role of parenteral nutri- pieces of precis; they alone could provide a brisk and tion in gastrointestinal surgery) derived the standard error comprehensive revision of the whole field as well as pointers for various values in 14 patients receiving Aminoplex 5, to areas of clinical application and of current research. little benefit accrues to the reader, as the control group Sheila Jennett contained only one patient. The editors must be criticized for several reasons. The Pain Control in Obstetrics. By Ezzat Abouleish. Published (1977) by J. B. Lippincott, Philadelphia and Toronto. most significant is that not all of the figures and tables Pp. 452; illustrated; indexed. Price £22. can be understood without reference to the text. There is also a lack of uniformity of choice of units—in some Although the title does not describe this book as a text of instances two systems appear in one figure. Moreover, the local anaesthetic techniques in obstetrics, this is the subject size of print in the tables varies, suggesting that the pre- in which it excels. Dr Abouleish's interests in obstetrics are sentation is derived directly from a lantern slide. Finally, reflected in the choice of subject matter, and are slightly it was presumably an editorial decision to use bold type unusual. The first of the three sections of the book considers for certain words and statements in the text. These appear maternal anatomy and physiology, with a good account of like statements made by some drug house representatives. placental function and placental drug transfer. The Although it is interesting and informative in part, this pharmacology of local anaesthetic agents is considered in is not a book which this reviewer would recommend for some detail, as is the physiological effect of "vertebral" blocks. An extensive account of vomiting aspiration and his hospital library. regurgitation follows and a lengthy chapter on amniotic J. M. Reid fluid embolism. The section ends with a useful discussion The Physiology of Breathing: A Textbook for Medical of the assessment of fetal wellbeing antenatally and during Students. By Arend Bouhuys. Published (1977, labour. paperback) by Academic Press. Pp. 352; indexed; The second section is directed to a detailed and practical illustrated. Price £8.85. account of the techniques of regional anaesthesia which are Those prepared to work carefully through lucid, tightly employed by anaesthetists in the U.S.A. Each technique is packed prose and clearly annotated graphical presentations considered separately and includes history, anatomy, will find this a very rewarding book. It is a book to refer to physiology, choice of drugs, indication and contraindication. for clarification both of the background and of the current A clear description, amplified by excellent diagrams is state of the art in each subsection of respiratory physiology. given of Dr Abouleish's own method of choice in performing Editors' note.—The review of Anesthesia for Neurological Surgery: International Anesthesiology Clinics, Vol. 15, No. 3, which appeared in the September issue of this Journal (Vol. 50, p. 976) was furnished by Professor D. G. McDowall. We apologize for the fact that Professor McDowall's name was omitted from the published report.

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