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example was confirmed by histologic or other laboratory techniques. All the illustrations are of superior quality and clearly demonstrate the in dicated findings. Common diseases are appro priately emphasized with longer discussions and more numerous illustrations. The authors devoted special attention to discussing and illustrating disorders of motility in the small intestine. Within the authors' intended limitations, the book has few weaknesses. They stated that their experience with children is small; thus, few pediatric examples are included. Although the discus sion of various diseases of the small bowel and the diversity of radiologic manifestations is lim ited, the coverage is appropriate for an introduc tory text. Overall, this book would be a helpful text for radiologists learning the technique of small bowel enema or for those interested in a quick review of the radiologic manifestations of common small bowel disease. Clinicians outside the field of radi ology should also find this a valuable resource. C. Daniel Johnson, M.D. Department of Diagnostic Radiology Chronic Pain, edited by Randal D. France and K. Ranga Rama Krishnan, 561 pp, with illus, $32, Washington, DC, American Psychiatric Press, 1988 This well-organized, multiauthored volume was designed to assist clinicians—especially psychia trists—in treating patients with chronic pain. The editors contributed to more than half the chapters, and nearly all the authors are from the Duke University Medical Center. The introduction of the text indicates that 50 million people in the United States are disabled to some degree by chronic pain, at a cost of $60 billion per year in addition to the personal angst involved. This statement certainly catches the reader's attention and justifies the interest in the entity of chronic pain during the past 20 years. In terms of financial burden, chronic pain ranks up there with the Russians, the balance of the trade deficit, and acquired immunodeficiency syndrome (AIDS). The book is divided into four sections: Basic Concepts, Clinical Concepts, Assessment, and Management. Every area of chronic pain is ad
dressed, and although some unevenness in cov erage is evident, the effort is generally laudable. The three chapters on the neurochemical aspects of pain provide an excellent summary, including a comprehensive bibliography, of this rapidly changing area. The authors extensively review psychoanalytic aspects of chronic pain, the rela tionship of chronic pain to conversion disorder, the complexity (confusion?) encountered with such an entity as "psychogenic pain," and the relationship between chronic pain and depres sion. I particularly liked the discussion of the difficult topic of malingering. In one section, the authors attempt to discuss the initial manifestations of pain due to a host of disorders involving peripheral organic disease, from angina pectoris to cancer. Unfortunately, this effort at completeness tries to cover too much ground. The book addresses all areas of treatment, but pharmacologic management and the complica tions thereof receive the most attention—nearly 100 pages. The bibliographies of these chapters are indeed extensive. For example, one chapter has 198 references, and the material on the man agement of cancer-related pain consists of five pages of text and four pages of bibliography. What has the computerized library search wrought? I recommend this book to psychiatrists and other medical and paramedical personnel who deal with patients with chronic pain. For psychia trists, it is likely the best source available on the subject. In addition, purchase of this volume provides support for the American Psychiatric Association, which is the publisher. David W. Swanson, M.D. Department of Psychiatry and Psychology Textbook of Psychiatry, edited by John A. Talbott, Robert E. Hales, and Stuart C. Yudofsky, 1,324 pp, with illus, $85, Washington, DC, American Psychiatric Press, 1988 In the introduction of this text, Melvin Sabshin, M.D., president and chairman of the board of the American Psychiatric Press, states: "Psychiatry is in one of the most exciting, creative, and productive phases of its long history. Fueled by
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the rapid acquisition of new scientific knowledge The chapter on psychopharmacology and electroand catalyzed by external pressures requiring convulsive therapy, however, is outstanding. It empirically documented objectification, the field provides the practitioner with clear indications is undergoing a significant transformation." It and guidelines for the use of somatic treatment was, in part, this rapid growth that led to the regimens and discusses the management of po publication of this new textbook of psychiatry. tential complications. This one-volume text has many strengths, but I enthusiastically recommend this textbook as most importantly, it is easy to read, up-to-date, a reference source for medical students, nonand practical. psychiatric clinicians, and mental health profes The book is organized in a format that is sionals, including psychiatric residents and prac similar to that of other psychiatric texts. Divided ticing psychiatrists. Because it does not have the into five sections, it begins with basic theories, depth of a comprehensive textbook nearly twice then discusses assessment, psychiatric disorders, its size, it is not the only reference text needed and treatments, and ends with special topics in by psychiatrists. It is clearly a valuable resource, psychiatry. What sets this book apart, however, however, and it should be a welcome addition to is the inclusion of handy reference data. Appen any psychiatric library. dix I provides a listing of criteria from the revised Joyce A. Tinsley, M.D. third edition of the Diagnostic and Statistical Department of Psychiatry Manual of Mental Disorders (DSM-III-R), and and Psychology appendix II presents selected terms from the 1988 American Psychiatric Glossary. The first chapter, "Neuroscience and Psychia try," written by Joseph T. Coyle, M.D., reflects Sir William Osier: An Annotated Bibliog the rapid expansion of research and its applica raphy With Illustrations, edited by Richard tion to psychiatry. In the conclusion of this chap L. Golden and Charles G. Roland, 214 pp, with ter, Coyle presents a correlation of biologic psy illus, $100, 442 Post Street, San Francisco, CA chiatry and the humanistic traditions of the field 94102-1579, Norman Publishing, 1988 that allows the reader to move easily through the remainder of section I, which contains chap Both the bibliographic titles and annotations of ters on normal development and psychodynamic this book build on predecessor volumes by other theories. In section II, the chapter entitled "Labo authors. To these antecedents, abundant sub ratory and Other Diagnostic Tests in Psychiatry" stance has been added, much of it derived from contains information not typically found in other contemporary oslerian scholarship. The illustrations, numbering more than 100, texts. This chapter provides guidelines for order ing routine screening tests, supplementary tests, have "studiously avoided the standard poses." pretreatment evaluations, determinations of drug Many were provided from collections of oslerian levels, and biologic markers in psychiatric patients. bibliophiles and admirers and are published for Section III, devoted to specific disorders, con the first time in this text. Clarifying legends were stitutes a significant portion of the book. Appeal provided by the current editors. The organization of the book is outlined in a ing to most psychiatrists is its close relationship to DSM-III-R. Chapters 10 through 14 cover the one-page table of contents. Each entry describes major psychiatric disorders well. In particular, a component of Osier's writings in less than one these chapters are enhanced by the use of case line. These contributions range from his first examples and are supplemented by reference publication—accomplished as a schoolboy and tables. As indicated by the editors in the preface, entitled Christmas and the Microscope—through some submitted manuscripts had to be reduced his ensuing scientific, literary, and philosophic by more than half in order to keep the text articles. These entries are followed by an elab concise, a problem that is clearly evident in some orate and annotated examination of his magnum opus, The Principles and Practice of Medicine. of the chapters in this section. Osier was the sole author of the first seven edi As in most psychiatric texts, the section on tions of this historic textbook of medicine. I ad treatment contains a good balance between or vise that readers do not bog down on the details ganic and nonorganic therapeutic modalities.