required reading for all junior hospital staff. In the remaining ... leprosy and other tropical problems, particularly ... St George's Hospital Medical School, London.
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Fetal Physiology and Medicine: The Basis of Perinatology. 2nd edn (Reproductive Medicine, vol 6) R W Beard & P W Nathanielsz (ed) pp 823 £70 ISBN 0407-00366-5 New York: Marcel Dekker & London: Butterworths 1984 This is the latest in an impressive series of monographs on reproductive medicine. There are 43 contributors, mostly from England and the United States. Not only are they experts in the particular fields of basic science in which they write, but many are also practising clinicians. This has ensured that the editors have achieved their objective of integrating clinical and basic sciences. Rather surprisingly, the senior editor has not contributed, although he could have done so most ably. The work is concerned mainly with the fetus and fetal development and also continues into descriptions of neonatal responses. Inevitably, as studies on the human fetus are so difficult, there is frequent reference to animal studies, but in the main the temptation to translate these to the human situation has been avoided. There are 24 chapters devoted to subjects ranging from developmental anomalies, immunological interactions, carbohydrate, fat and protein metabolism, respiratory and cardiovascular systems, infection, perinatal loss, hormones, fetal growth, uterine activity, through to adaptations of the newborn to extrauterine life. Most of the chapters have achieved very high standards, indeed, almost to the extent of being too specialized for the ordinary obstetrician or paediatrician. For anyone sub-specializing in perinatal medicine, either as an obstetrician or a neonatologist, this book can certainly be recommended. It should also make very good reading for those going for higher qualifications in obstetrics or paediatrics. IAN MACGILLIVRAY
Regius Professor in Obstetrics & Gynaecology University of Aberdeen Bone Marrow: Structure and Function M Tavassoli & J M Yoffey pp 300 £37 ISBN 0-8451-0226-5 New York: Alan R Liss 1983 Although written as a series of separate essays, this book presents a coherent, comprehensive review of the structure and function of bone marrow. It is a work of great scholarship: Yoffey dealing largely with the marrow circulation and production of red cells, granulocytes, lymphocytes, 'transitional' cells and stem cells, while Tavassoli reviews marrow phylogeny, ontogeny and structure, and platelet production. The theme is the relation of the overall anatomical structure, cell-cell relations and individual cell morphology to the function of the marrow as a whole. There are extensive references to the earlier literature as well as an initial chapter
on historical perspective. Recent studies with clonal assays and with monoclonal antibodies to surface antigens have helped in the understanding of marrow cell development and, in general, this information has proved consistent with the pathways that Yoffey describes based on kinetics and morphology. Long-term cultures, which have attempted to reproduce the complex cell-cell interactions of the bone marrow and have contributed to current knowledge of the extracellular matrix and its role in the egress of cells from the bone marrow, are not dealt with at length. Semantics will cause some readers problems, e.g. 'transitional' is not a term many use to describe any particular marrow cell, and 'stem cells' are defined here as 'showing no obvious signs of differentiation but under appropriate stimulation, undergoing differentiation' - which is rather different from most workers' functional concept of cells capable of both self-renewal and production of a variety of differentiated progeny under appropriate stimuli. As current research reveals more about marrow pluripotent stem cells, it will be interesting to see exactly which of Yoffey's 'transitional' cells they most resemble. This book will be a valuable source of reference to all haematologists and also to cell biologists with a special interest in bone marrow culture. A V HOFFBRAND
Professor of Haematology Royal Free Hospital, London Peripheral Nerve Disorders: A Practical Approach (Butterworths International Medical Reviews, Neurology 4) A K Asbury & R W Gilliatt (ed) pp 339 £25 ISBN 0-407-02297-X London: Butterworths 1984 This book forms one of a series of volumes put together by a combination of British - or European-and American authors who became assimilated on to an editorial board for the purposes of the series. Previous volumes' published under this imprint have varied somewhat in quality but this one is first-rate. Peripheral neuropathies, both generalized and disorders of single nerves, form a frequent and recurring part of neurological and general medical practice. In addition, such disorders are commonly seen by orthopaedic surgeons and rheumatologists. The range of interest is thus rather wide. Despite the frequency of occurrence of peripheral neuropathy it is sad to reflect that about a quarter of cases of progressive polyneuropathy remain undiagnosed, even in the face of the most assiduous investigation in the very best centres. This book should help to clarify the problem. The book begins with a chapter on the clinical approach to neuropathy written jointly by the two editors, whose wide clinical experience shines
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through every word. This chapter alone should be prenatal genetics is followed by one of the best required reading for all junior hospital staff. In chapters in the book; Robert Wall writes an excelthe remaining 12 chapters of the book the major lent account of nutritional problems during pregvarieties of peripheral neuropathy are discussed nancy and follows it with a short critical chapter in an informative, brief, and practically useful on antenatal fetal assessment. The principles of fashion. The literature is referred to appropriately pharmacology, teratology and radiation physics and effectively and the references are sited at the follow, and a brief chapter on clinical chemistry end of each chapter. The book does not attempt a ends this section of the book. After this, conditions are dealt with in a systerole as a textbook of neurology but seeks to throw light on areas of peripheral neuropathy in which matic fashion and in general they cover briefly practical advances have been made in diagnosis, most of the diseases a physician might see in classification and, one hopes, 'in management. a pregnant woman. William Bentley writes a With the increasing recognition of the importance refreshingly original account of neurological disof autoimmune neuropathy associated with circu- orders in obstetrics. However, the accounts of lating paraproteins, and with better understanding other disorders are often very brief and compare of the role of immunosuppressive therapy in the less favourably with the corresponding sections treatment of the neuropathies associated with from 'Medical Disorders in Obstetric Practice', vasculitis, the aim of effective treatment is becom- edited by Michael de Swiet (Blackwells 1984), ing closer. Diabetic neuropathy, a perennial and which is much more thoughtful and logically common problem, mostly managed by general based. The volume is well produced and referenced, physicians and endocrinologists, receives full and thoughtful coverage but, despite this, the under- and not expensive by current textbook prices. It lying metabolic pathogenesis remains obscure. will probably be well received in major libraries of The nerve entrapment syndromes are rightly the Western world. GEOFFREY CHAMBERLAIN emphasized because of their importance in pracProfessor of Obstetrics & Gynaecology tice, and because they may so readily be treated if St George's Hospital Medical School, London recognized early. The book concludes with three fascinating discussions of geographical patterns of neuropathy in India, Japan, and Africa respectively. Not surprisingly, the same disorders are Advanced Medicine 20. Anne Ferguson (ed) recognized in these countries as in the countries pp 362 £20 ISBN 0-272-79773-1 of Europe and North America but, of course, London: Pitman (for The Royal College of leprosy and other tropical problems, particularly Physicians London) 1984 nutritional deficiencies, have to be reckoned with The annualofvolume of papers presented at the in some of these countries. Altogether this is Royal College of Physicians Advanced Medicine an excellent book that deserves a very wide Conference provides many of us with a brief readership. resum& of progress in fields other than our own. MICHAEL SWASH experience is often pleasant and, in the best Editorial Representative The the word, educational. There is no attempt sense Section ofNeurology to be of comprehensive and the topics chosen represent a personal selection by the editor. On this occasion Dr Anne Ferguson has chosen reviews of Medical Care of the Pregnant Patient gastroenterology, immunology, prevention of R S Abrams & P Wexler (ed) pp 402 cardiovascular disease, chronic disease in adoUS$46.75 ISBN 0-316-00470-7 lescence, immunology and cancer, together with Boston: Little, Brown & Co 1983 There is a grave suspicion about books which four papers on 'new diseases'. The latter category cross the Atlantic. The systems of medicine vary so includes (inevitably) AIDS, the bulimic syndrome, much on each side of the barrier that transatlantic Munchausen's syndrome by proxy, and prolacpassage is often not useful in either direction. tinomas. The first name only seems to have been Medical Care of the Pregnant Patient is written with us an unconsciounable time whilst the second by 35 physicians working in the Denver Schools was, as the author points out, first mentioned by of Medicine. It comes, therefore, from a group Ovid but not subject to the same intense publicity of doctors who have worked together and have either at the time or subsequently. Dr Ferguson is to be congratulated on the broad collected a lot of clinical obstetrical material. It is worrying that the first two chapters are on bio- net which she has cast. Not only are we provided ethics and the legal considerations of looking after with a fascinating discussion of the opportunities higher-risk pregnancies - highly improbable chap- and difficulties provided by monoclonal antibodies ters for the British scene. The book proper starts as drug delivery systems, but other papers deal with 7 chapters of basic material. The chapter on with the best methods of caring for cancer patients
