Oxford Handbook of Clinical Medicine

Oxford Handbook of Clinical Medicine

British Journal of Anaesthesia, 98 (6): 849 –51 (2007) Book Reviews Anaesthesia Science. N. R. Webster and H. F. Galley (editors). Published by Blac...

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British Journal of Anaesthesia, 98 (6): 849 –51 (2007)

Book Reviews

Anaesthesia Science. N. R. Webster and H. F. Galley (editors). Published by Blackwell Publishing/BMJ Books, London, UK. Pp. 466; indexed; illustrated. Price £69.50. ISBN 9780-7279-1773-7.

J. P. Thompson Leicester, UK E-mail: [email protected] doi:10.1093/bja/aem107

Oxford Handbook of Clinical Medicine, 7th Edn. M. Longmore, I. Wilkinson, T. Turmezei and C. K. Cheung (editors). Published by Oxford University Press, Oxford, UK. Pp. 840; indexed; illustrated. Price £22.95. ISBN 0-19-856837-1.

The Oxford Handbook of Clinical Medicine enters its seventh edition, 21 yr after the first edition entered junior doctors’ white-coat pockets. In itself, such ongoing demand is an indication of this book’s appeal. The Oxford Handbook series was originally ground-breaking in its format; bullet-points, a matter-of-fact approach married with a white-coat-pocket size, and splash-proof covers made them a big hit. Their compact dimensions belied their detailed contents. Many readers will be familiar with the enormous amount crammed into the current Oxford Handbook of Anaesthesia. The Oxford Handbook of Clinical Medicine does not disappoint in this regard—its 840 pages of tightly spaced text waste no words on flowery prose or descriptive style, and information is delivered in a direct and unambiguous style, with minimal preamble. Photographs, radiographs, and line illustrations are used generously, and this edition is the first to use colour

# The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: [email protected]

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Anaesthesia Science is a new book that aims to cover in detail areas of science related to the practice of Anaesthesia, Critical Care and Pain Management. The editors state, in their Preface, that they wish to complement rather than replace more comprehensive texts, and concentrate on areas covered less well elsewhere. It is aimed at trainee anaesthetists preparing for their professional examinations. The 30 chapters have been written by 46 authors, mostly European, the vast majority of whom are well-known experts in their respective field. The book contains 466 pages and is very well produced in a medium sized hardback edition, which is more than pocket-sized but small enough to be used in the theatre or clinic environment. It is comprehensively referenced and the text clearly set out, with good use of tables, line diagrams, and clinical images where appropriate. It is to the editors’ credit that the chapters generally conform to a lucid style, and most provide a historical perspective to the subject matter, which is both interesting and informative. Most chapters are referenced through the text with a range of 20– 180 current references, though a small minority refer simply to ‘further reading’. The reasons for failure in professional examinations often reflect poor knowledge of the fundamental principles of basic physiology, pharmacology, and statistics. The outside cover states that Anaesthesia Science is based on the syllabus for the primary FRCA examination and, although it does not profess to be comprehensive, the mixture of topics included is slightly eclectic. The book is broadly divided into Pharmacology, Physiology, and Measurement, but these are rather artificial distinctions. For example, there is a very good chapter on heart failure, which is mostly concerned with advances in pharmacological and other management, but is included under ‘Physiology’, whereas the chapter on cardiovascular assessment contains mostly physiology, but is listed under ‘Measurement’. There is more emphasis on certain topics at the expense of others. Specific, brief chapters on anaphylaxis and antibiotics are included, but no mention of renal or haematological pathophysiology, topics that are changing rapidly and often cause confusion among trainees. However, the first two sections of the book are largely very good, and the chapter on pharmacogenomics is the best resume of this topic I have read. Conversely,

the ‘Measurement’ section was a little thin, with a fairly basic chapter on assessment of respiratory function; chapters on nanotechnology and study design seemed incongruous within the whole book, but there was an excellent chapter on magnetic resonance imaging. So should you buy it? It really depends on what you are looking for. Anaesthesia Science would not replace Scientific Foundations, were it still in print, yet is much more than a collection of vignettes, is very well produced, and reasonably priced. In many respects, this book will enable practitioners to fill gaps in their knowledge and fill a gap in the market. Therefore, it should achieve its stated aims. As the editors recognize, examination candidates will still need to read both more specialized and also more inclusive texts. However, I suspect that examiners will also find it useful, because it provides up-to-date details in several selected areas and so potential candidates may follow suit.

Book Reviews

specialties and our tendency to be first at the scene may well make this book a life-saver. For trainees in intensive care, this book will also be useful and worth carrying to work daily. On the whole, I congratulate the authors and the publishers on improving a book that already holds a prominent place in British medical practice, and commend it to all medical practitioners. J. G. Hardman Nottingham, UK E-mail: [email protected] doi:10.1093/bja/aem108

Anaesthesia and the Practice of Medicine: Historical Perspectives. M. K. Sykes and and J. P. Bunker (editors). Published by The Royal Society of Medicine Press Ltd, London, UK. Pp. 303; Price £15.95. ISBN 978-1-85315674-8.

This concise book of 23 chapters tells the story of advances in anaesthetic knowledge and practice over 150 years since its demonstration in the Ether Dome in Massachusetts in 1846. It is the story of the development of anaesthesia as a speciality in its own right. The book also shows how these developments in anaesthesia have allowed advances to be made in other specialities such as cardiac surgery, intensive care, resuscitation, the treatment of chronic pain, and the provision of pain relief in obstetrics. Of the 23 chapters, 15 are written by M. K. Sykes, formerly Professor of Anaesthesia at Hammersmith and Oxford, and 8 are by J. P. Bunker, formerly Chair of Anaesthesia at Stanford and Visiting Professor at Harvard. The book is written from their European and American perspectives. They took 6 years to write this book, which is based on their professional experience and on their extensive research. They have similar styles of writing and, as in any good book with a tale to tell, one chapter leads easily on to another. The breadth and depth of this book are impressive, and you can read it cover to cover. Four of the chapters (curare, the Copenhagen polio epidemic, anaesthesia for cardiac surgery, and halothane hepatitis) are especially interesting. The book demonstrates that ideas can be born before their time. Humphry Davy had described the narcotic effects of nitrous oxide in 1799, but it was another 47 yr until Morton demonstrated surgical anaesthesia with ether. However, although anaesthesia now permitted patients to undergo surgery painlessly, further developments in major surgery had to wait until Lister demonstrated how to prevent sepsis, in 1867. In cardiac surgery, Souttar had performed a mitral valvotomy in 1925, in a patient who survived, and in


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photographs and illustrations. Images are used to illustrate important points where necessary, and occasionally to provide clinical examples. While radiographs or clinical photographs may measure only 1 – 2 cm in width, they are remarkably clear and comprehensible. A small selection of radiographs is presented in larger format in an appendix towards the end of the book. The text is split intelligently into digestible chunks that are headed clearly and follow in logical progression. Knowledge is presented very much in the style of a guidebook, with advice being offered didactically and with minimal discussion of the alternatives. Clearly, this has strong and weak points; for examination preparation, the reader may be insufficiently informed of the broader perspective around a clinical problem, but for practical, wardbased medicine, the reader will be efficiently prepared. The range and depth of content are breath-taking. The book begins, as it has in previous editions, with a generic and philosophical section regarding the role of the doctor, communication skills, diagnostics, and empathy. Clinical skills follow and, system by system, a large variety of signs and symptoms are described. This rather general, but interesting, section occupies around 80 pages. The largest section of the book follows: ‘internal’ medicine, comprising cardiovascular, chest, gastroenterology, renal, haematology, infectious diseases, neurology, oncology, palliative care, and rheumatology. This section occupies almost 500 pages and is impressively detailed. The next section, which occupies around 190 pages, covers surgery, epidemiology, clinical chemistry, eponymous syndromes, and radiology. This seventh edition is the first to contain a radiology section. This new section is well written, and is comprehensive enough to inform doctors requesting radiological investigations. The next 30-page section contains reference intervals and descriptions of a number of wardbased, physician-orientated practical procedures. These will not be very useful to most surgeons or anaesthetists, but will be greatly appreciated by junior medical trainees. Finally, the book finishes with a nicely written and wellillustrated section on medical emergencies. These are indexed for rapid availability on the inside front cover of the book. Many of these emergencies have pertinence for anaesthetists (e.g. status epilepticus, dysrhythmias, pulmonary oedema, and acute asthma), and most will be of use in intensive care. The style of the book is generally pleasing and invites occasional browsing. As a pocket book, it would certainly be very useful to medical trainees, and its direct, clear, and didactic style suits this purpose well. I doubt its usefulness as a revision text because of its lack of discursiveness, but I am sure that this was not the authors’ aim. The text is well proofed, on the whole, although the occasional error has made it into print (e.g. ‘loosing weight’). With a modest price, this compact book seems to me a sensible investment for many trainees and consultants in anaesthesia. Our occasional brush with other medical