illustrations are simply appalling. Some are unnecessary (Figs. 9.2,9.5 and Plate 3) and almost all the black and white photographs are so dark as to be meaningless. Indeed it is the very poor quality ofthe illustrations that spoils an otherwise excellent book. It is not confined to the reproduction of X-rays, but to clinical photographs and photographs ofapparatus. All the illustrations are excessively pale, with a washed-out Bume-Jones effect, in striking contrast to the bold type ofthe text. At first, I thought this might have been an isolated printing fault in the review copy, but inspection of other copies in different book shops shows that this is not so. The book is excellent value. Predictably its editors have set a very high standard and future volumes will be judged by the same yardstick. We trust that the publishers will see to it that the illustrations in future volumes will attain the same standard. M. N. TEMPEST Fundamental
Ian A. McGregor. Edinburgh,Churchill
of Plastic Surgery.
7th ed. By
212 x 138 mm. Pp. 346. Livingstone. f8.00.
The 7th edition of this excellent book has maintained the high standards of the previous ones. The first part deals with basic techniques which are easily understood by any surgeon and in no way should it be restricted to the established or training plastic surgeon. The text is clear and the illustrations, whether photographs or drawings, are explicit and easy to understand. For the accident surgeon there is much material that can be used almost daily in the emergency department and in elective procedures. An admirable chapter on hand surgery deals fully with both early techniques as well as with advanced procedures for severe injuries to digits, though the neurovascular techniques under the microscope should only be undertaken by specialists in hand surgery. The big innovation of this volume is to extend the indications and techniques for applying musculocutaneous flaps, which are of great value in securing vascular surfaces over exposed joints and bone so that later split skin grafts can have a better chance of success. It is noteable that the author is reducing the indications for tube pedicle. laying more stress on the application of axial flaps, He has drawn from his wide experience the conclusion that axial pattern flaps are to be regarded as the norm so that tube pedicles can be, as he says ‘relegated to dinosaur status’. This book is of a convenient size for the pocket but should be present in every accident department and hospital library and at f8 is remarkably good value. R. L. BATTEN Handbook of Total Parenteral Nutrition. By J. P. Grant. 262 x 180 mm. PO. 197. I I illustrations. 1980. Philadelphia, Saunders. flO.00. This summary of the current status of the art and science oftotal parenteral nutrition is a combination of the extensive personal experience of the author and a comprehensive review of the literature up to October
1979. The I I chapters supplemented by 24 tables, 83 figures and almost 1000 references cover the history of parenteral nutrition, present guides to the selection of patients likely to benefit from intensive treatment, describe the technical aspects of catheter insertion and care, the choice, preparation and administration of parenteral nutritional solutions and relevant aspects of basic metabolism and the recognition and management ofmetabolic and infectivecomplications. The book is a well written practical manual in which can be found the answers to most ofthe questions posed either by a complex clinical condition for which parenteral nutrition is an appropriate form of therapy; or by the physician or surgeon in charge of the patient and the associated nursing, dietary and pharmaceutical personnel. The advice is firmly based on extensive experience and in most instances has passed from the controversial to the universally accepted. The remaining contentious issues are presented fairly. thus allowing the reader to come to his/her own conclusions. The book is highly recommended for both the novice wishing to learn the ‘tricks of the trade’ and for the expert who wishes to explore further the need for and effectsoftotal parenteral nutrition. J. W. L. DAVIES Medicine. By R. Frey and P. Safar. Pp. xx + 355. 97 illustrations. 1980. Berlin, SpringerVerlag. DM 84. In the autumn of 1977 an international congress on disaster medicine was held in Mainz but the proceedings of a conference at which more than 100 persons have contributed papers are bound to be repetitious, and to that extent tedious; this volume is no exception. Nevertheless, it is surprising to read in the preface that ‘most of the most valuable workshop presentations are not included’. Although the contents are grouped under the headings of: (I) Types and events of disasters. Definition of disasters; (2) Organization in various disasters; (3) Workshops dealing with global disasters, local and regional disasters, and definitive care; this subdivision is not very obvious as one reads the individual sections. Each section contains a mixture of plans and organizations that owe more or less to personal experience, and of accounts of disasters experienced, with casualties ranging from a score or two up to the tens of thousands caused by earthquakes in Central and South America. Disasters of comparable magnitude in Asia go unmentioned, as do the special arrangements needed for the large-scale urban rioting reported from South Africa and the United States, in which communications and supply routes may be cut for days and in which the families of staff as well as the staff themselves may have to be accommodated and fed. This is intended to be the first of a series of volumes on an important topic about which too many persons know too little but a distinction needs to be made between the information that is made available at such large meetings and the information that should be disseminated in order to improve the standards of Disaster