Jan 17, 1976 - manometric studies, and the effect of drugs. .... Cybernetics is the science of communication ... planes, and space-craft, and it owes much of.
162
BRITISH MEDICAL JOURNAL
17 JANUARY 1976
BOOIK REVIEWS effect on the small and large intestines, partiDiverticular Disease of the Colon Neil S Painter. (Pp 305; £7.) William cularly on bile acids, but, as one participant put it, the only thing we can say for certain Heinemann. 1975. is that fibre increases faecal weight. For those interested in this rapidly expanded field I can wholeheartedly recommend this book. Fiber Deficiency and Colonic Disorders L M BLENDIS Eds Richard W Reilly and Joseph B Kirsner. (Pp 185; $23 40.) Plenum Press. 1975. Diverticular disease of the colon has become commoner in Western civilised countries this century and with an increasingly older population has become one of the commonest gastroenterological problems. The author of the first of these books has been an active researcher in this field for more than a decade. It is not surprising, therefore, that he has written an authoritative and scholarly monograph. In addition to chapters on the anatomy, clinical presentation, complications, and surgery of the disease there are clearly written chapters dealing with aetiology, manometric studies, and the effect of drugs. Clearly our knowledge of the pathogenesis of this condition is still inadequate. It is therefore fascinating to read of the much higher incidence of right-sided colonic diverticulae in South-east Asians than other people. There should be a strong aetiological clue here. His previous writings show that the author is enthusiastic about the highfibre diet and accepts the importance of the low-residue Western type of diet in the aetiology of diverticular disease. But extracting one factor, dietary, from different civilisations to explain differences in incidence of diseases is rather dangerous, since the chances are that the aetiology will be multifactorial. Extrapolating experiments from laboratory animals to man can also be misleading. These small criticisms aside, this is an excellent reference book for anyone interested in diverticular disease of the colon, and I can reconmnend it highly. Denis Burkitt's epidemiological observations on the diseases of civilisation and their relationship to the lack of fibre in the diet sparked off much interest and research, particularly in Britain. This culminated in a symposium on the subject in the USA at which many of the papers were given by workers from our side of the Atlantic. Both the papers and subsequent discussions are reported in Fiber Deficiency and Colonic Disorders. It thus brings the reader up to date with the research in the field, but it also illustrates painfully the deficiencies. For example, not only is the true fibre content of most foods not known, but even the miller's bran used in the majority of human experiments is totally unstandardised. Thus it is impossible to compare one set of results with another or to explain the mysterious way bran slows fast colonic transit times and speeds up slower ones. There is no doubt that high-fibre foods have a distinct
complemented
by didactically excellent diagrams. On the other hand, there are no illustrations to any other part of the text, even if it could have saved many lines of text. There are practically no citations in the text to published work, but a list of some 100 references to important books and articles, arranged by chapter. Despite reservations the book can be recommended to paediatric cardiologists for the stimulating slant on haemodynamic probCongenital Diseases of the Heart lems in congenital heart disease by a leader Abraham M Rudolph. (Pip 646; £13-20.) in the field. The tyro will want to read it alongside a more conventional and less Lloyd-Luke. 1974. selective account. This is a curious book, unusual among GERALD GRAHAM recent publications on congenital heart disease for being written by one pen. The
preface makes it clear that the author did not attempt "to consider in detail all the varieties and nuances of congenital disease of the heart that are encountered, but rather to present a personal philosophic approach to the understanding of the physiologic and clinical manifestations of the complexes encountered most commonly." It is thus a personal and an idiosyncratic account-but not necessarily any the worse for that. The list of contents gives it an appearance of systenatic coverage: fetal and perinatal circulation; cardiac catheterisation and angiography; a chapter each on 13 of the most common cardiac anomalies. Within each of the latter, embryological and anatomical, haemodynamic, and clinical features are briefly considered, followed by differential diagnosis, complications, and principles of treatment. The text has grown out of talks to medical staff in training, but what is acceptable in that context becomes easily self-indulgent in book form. Thus, the section on cardiac catheterisation and angiography-taking up one-fifth of the book-gives personal preferences of technique at length yet without the details of imitative value to the beginner, while the experienced reader will gain little. Moreover, many of the items are repeated in other chapters. There is a similar uncertainty about the level of approach throughout the book. Problems and difficulties are skated over, while hypotheses, theory, and established fact are not clearly distinguished. Yet there is much in this book to provoke thought and admire. Since much of paediatric cardiology (especially in its surgical aspects) is concerned with the minutiae of structural anomalies, Dr Rudolph's emphasis on hae-modynarnic changes and their consequences in the major congenital cardiac defects is to be welcomed, Perhaps the best feature of the book, and one not found in some of the standard reference works on paediatric cardiology, is the emphasis on fetal and perinatal circulatory adjustments to various cardiac defects. The author, having himself made so many important oontributions in this field over the last two decades, writes a highly readable and instructive account
Current Problems in
Neurocybernetics
A B Kogan et al. (Pp 147; £8-35.) John Wiley. 1975. Cybernetics is the science of communication and control in living organis,ms or machines. The zenith of this study must surely lie in the human brain. Science owes much to engineering, to the development of complex control systems for factories, engines, aeroplanes, and space-craft, and it owes much of its recent advancement to computer logic. There is a two-way relationship between cybernetics and knowledge of brain mechanisms, recognition of wdhich has led to the development of the subspecialty of neurocybernetics. This book, translated from the Russian, originated from the Third All-Union (Soviet) Conference on Neurocybernetics, the
date of which is not known to the reviewer. However, since all the references in the volume date from before 1970, it is likely that the conference was held around that date. It must therefore be obvious that any reader seeking up-to-date information on neurocybernetics will not find it. This delay also prevents any attempt to compare the state of the art in neurocybernetics in the USSR and Western countries. The text is well translated and easy to read. There are considerable references to the Russian literature, although quotations from the whole world literature are included. The text is notably free from polemics or bias in the references. The printing is clear, and the figures, w-hich are mainly line drawings, are well reproduced. Half-tones, however, have fared less well. The volume will prove of value to readers specialising in the fields of cybernetics and neural integration who want to review the Russian work on these topics. Parenthetically it is interesting to read the comments in the preface by Professor A B Kogan, chairman of the steering committee of the Third All-Union Conference on Neurocybernetics, in which he bemoans the tendency for modern scientific conferences to
