PUBLIC HEALTH VOL. 87 NO. 4
In some instances the arrangement of the material differs from previous editions. For example European Standards n o w has RadiologicaI Examination in a separate section, and in International Standard~ all the information on Sampling has been put together in a separate section. In previous editions o f International Standards about two-thirds of the book was taken up with detailed desc,riptions of individual methods o f examination. These have been omitted in this edition and references are given to where detailed descriptions of methods can be found. Both booklets now have indexes, which makes them a great deal easier to use than previous edifi¢~ns.
ENVIRONMENT;RESOURCES,POLLUTIONAND SOCIETY. Edited by William M. Murdoch. Pp. vii +440. Stanford, Conn., U.S.A., Sinauer Associates Inc., 1971. $5.95. THE STUDY Of human ecology involves many disciplines, and no man can hope to be expert in all, Books on the subject by authors who assemble information gleaned by reading works in unfamiliar disciplines are usually well structured and reasoned but prone to errors arising from their authors' unfamiliarity wi*h the limitations and validity of their material. Dr Murdoch has avoided this trap and prevailed upon some 20 associates to contribute from their own expertise. Consequent differences in style, outlook and quality between its chapters give this boek a refreshing vitality, and a degree of accuracy which is rare in books on this theme, but at the expense of continuity. Dr Murdoch's excellent introductory dissertation on the principles of ecology is followed by 7 contributions dealing with population and resources. Apart from the chapters on land resources and water resources which confine themselves largely to consideration of the American scene, these are of high quality and general interest. The second section of the book comprises 7 chapters dealing with aspects of environmental degradation. In the first of these, Dr Hickey presents an interesting but unproven hypothesis that mortality rates from malignant and degenerative diseases may be raised by accumulation of somatic mutations caused by low levels of atmospheric pollutants such as nitrogen peroxide and sulphur dioxide. While it seems inconceivable that such sophisticated statistical techniques would be applied without the elementary precaution of standardizing mortality rates for the age and sex distribution in the populations in question, a statement of the fact and method of standardization would have been reassuring. More discussion of the quality of his data on air pollution and consideration of other explanations for the correlations observed would make this chapter more convincing. Subsequent chapters on pollution of flesh and salt water, of radiation, of pesticides and alternative methods of pest control are of good quality. Chapter 15 on pollution, weather and climate, while interesting is less than convincing. The final 5 chapters deal with the environment and human society. Mr Yannacone's contribution on.U.S, law in relation to the environment is of little interest outside the States and falls below the rest of the book in quality and objectivity, but Dr Murdoch*s final contribution, like his first one, is excellent. This is a book which I strongly commend to all who are interested in the future of man and the quality of life which our children will enjoy. Its lack of exaggeration and sensationalism, and attempts to indicate hopeful trends and solutions makes its total impact the more devastating. Some of the hypotheses put forward may well be wrong, and citations from other works leads to repetition of occasional error: one quotation attributes to citizens of New York knowledge in 1832 that cholera was water-borne--some 24 years before John Snow demonstrated this and removed the handle of the Broad Street pump. Such faults are few, and the book provides much food for thought. BLACK'S MEDICAL DICTIONARY(29th Edition). Revised by W. A. R. Thomson, M.D. Pp. 1006, 24 plates, 356 illustrations. London, A. & C. Black Ltd. £2.75. TH~S is a remarkable production. The first edition appeared in 1906, by Dr J. D. Comrie. In 1944 Dr H. A. Clegg took over, and in 1948 Dr W. A. R. Thomson, who has been responsible for the last eleven editions. In his original preface Dr Clegg made it clear that the work would be in "a position
somewhere between that of a technical Dictionary of Medicine and one intended merely for the domestic treatment of commoner ailments". With the latter object in view Dr Clegg "hoped. therefore, that these articles will be found useful to district nurses, ship captains, dwellers in remote districts, and others who may be called upon to treat the suffering in the absence of trained supervision". It is patently impossible to please such a wide spectrum of readers, and accepting the original author's aims perhaps one should not be too critical. Criticism is indeed easy, probably any doctor browsing through the 1006 pages, will find matters of disagreement. Throughout there is a mixture of medicine of the Edwardian era, with that of th,.' late sixties. For the ship captains and the like there is a two-page insert, in red, giving an indication of where to turn to for what, i.e. accidents, unconsciousness, management of children. For medical mcn bemused by the enormous spate of modern drugs there is alcuronium, poldine and dioctyl sodium sulphosuecinate. Ghosts of 1906 remain in the article on mental illness, with a long discussion on "moral'" trealmerit. Psychoanalysis, however, has obviously had a much more recent and competent, albeit brief presentation; even though "'id" has no entry. The author might welt remember for his next revision that "depression" omitted, is more worthy than "manic-depressive insanity", included. There is a very useful entry under dosage, some 214 drugs being listed for forgetful practitioners and grannies, even though there are some relics there of Dr Thomsort's student days, such as Dover's Powder, Syrup of Figs, Tincture of Squill and Syrup of Tolu. Issue must be taken with the entry under quarantine; incidentally there is no mention of the World Health Organization, only two international conferences, one in 1893 and the other in 1897, being noted. Under infection, the quarantine periods for contacts of serious diseases, and lesser ones, and the advice on destruction or disinfection of clothes and books (a must!! !) will make any self-respecting M.O.H. write a letter to The Times. I started off by stating how easy criticism was, and that it was inevitable in view of the purpose of the dictionary. 1 end by pointing out, nevertheless, that should I wish to know the meaning of Negro-lethargy, napraspathy or horripilation, I might consult Black's Medical Dictionary.
POLYGLOTMEDICALQUESTIONNAIRE(2nd Edition), by S. Chalmers Parry, M.A.(Cantab.), M.R.C.S., L.R.C.P., D.P.H. Pp. 86. London, William Heinemann Medical Books Ltd., 1972. £5.00. THIS MEDICAL QUESTIONNAIRE contains basic questions, answers and directions pertaining to medical and family history, drugs, diet and a general medical vocabulary in 27 different languages. It is fascinating because nationals of the respective countries, by pointing at the questions or answers, convey important information about their health, thus giving the interrogator sufficient and correct information to take appropriate action. Basic and simple language has been used, so that people of lower educational level can both understand and use the questionnaire. It is thus extremely useful for medical and other interrogators who need to know promptly of any illness and the consequent action that will be required.
EFFECTIVENESS AND EFFICIENCY: RANDOM REFLECT~C'~4SON HEALTH SERVICES. By A. L. Cochrane.
Pp. 85. London, Nuffield Provincial Hospitals Trust. 1972, £1.15. Professor Cochrane has achieved a reputation--to use his own word--apt "debunking" ineffective medical and surgical treatments. He believes fervently that all treatments should be subjected to the discipline of randomized controlled trials to demonstrate whether they are effective or not. In preaching this gospel, as he does charmingly and wittily in this book, he is probably doing more than anyone else in the medical profession at present to transform medical care from beipg still largely a traditional art into being a soundly science-based activity. The importance of objective evaluation in modern medicine is underlined by the escalating cost of medical technology° which is now much too expensive to be applied if it can be expected to have no more than a placebo effect.