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BOOK REVIEWS

Rheumatology: New Directions in Therapy. Edited by Ed Rosenbaum. Garden City, New York, Medical Exam- ination Publishing Co., 1979. 291 pages. $14.50.

This book, available in paperback, reflects the approach of a well seasoned rheumatologist who has been in practice for well over 40 years. It is co-authored by relatives who assisted with certain portions, one a rheumatologist and two neurologists.

The book begins with a review of the many med- ications available for the treatment of people with rheu- matic diseases. The brief discussion of each medication is highlighted by Dr. Rosenbaum’s own recommenda- tions of how to use them.

In the second section, various arthritides are de- scribed and recommended therapeutic approaches given. Unfortunately, the author tries to do too much. This is not a textbook and the description of the diseases should be greatly reduced. Since the book deals with therapy, more should have been written about thera- peutic approaches to the various rheumatic disorders. The discussion of rheumatoid arthritis therapy and the response to the questions patients ask is one of the best in the book.

The third section deals with aids to diagnosis and therapy, and the final sections include a review and guidelines to the common medicines and educational literature available.

Some of the nice aspects of the book are the summary sections after each chapter which list the high- lights in paragraph and occasional outline form, and the places where Dr. Rosenbaum has specifically added his own opinion. Unfortunately, there are spelling errors throughout the book which escaped the proofreader, and occasional important omissions. Allopurinol is re- ferred to as a uricosuric agent which it is not, and tophi and tophaceous deposits contain urate and not uric acid deposits. I believe the book would be aided by further tables not only to guide the reader but also to increase its readability. This book is best directed to physicians as a guidebook to therapy.

JOHN A. GOLDMAN, MD Emory University School of Medicine Atlanta GA 30303

Annual Research Reviews: Rheumatoid Arthritis and Related Conditions. Edited by Gabriel S. Panayi. Vol- ume 3. Montreal and Edinburgh, Eden Press, Inc., and Churchill Press, 1979. 197 pages. $22.00.

This is a review, in book form, of approximately 700 articles listed in Index Medicus from July 1977 through June 1978 on the topics of rheumatoid arthritis, ankylosing spondylitis, juvenile rheumatoid arthritis, Reiter’s, Behcet’s, and Whipple’s diseases, bypass ar- thritis, and others. Unlike the Twenty-third Rheumatism Review, Rheumatoid Arthritis and Related Conditions in- cludes languages other than English.

The book is organized by broad chapters on etiology, cellular immunity, juvenile chronic arthritis, experimental models, etc. Immunology is heavily cov- ered but, surprisingly, the only mention of surgery is in the chapter on ankylosing spondylitis, and the only therapy mentioned for rheumatoid arthritis is pharma- cologic.

Topics covered are treated thoroughly, with heavy emphasis given to case reports. The chapter for- mat varies but is largely one article per paragraph. Edi- torial comment, unlike that of the Twenty-third Rheu- matism Review, is not clearly separated from the review. The editorial comment is generally reasonable, but it occasionally lapses into assumptions (attributing poor delayed hypersensitivity skin test responses to “poor quality” skin) or chattiness (describing the intellectual battle of the humoral hypersensitivity specialists against “the advance of the lymphocyte ‘maniacs’ ”).

References are alphabetized, not numbered, making the search for a paper by a prolific author cum- bersome, and non-English journals are occasionally mysteriously identified (Zbl Bakt Hyg, and Harefuah), leaving the American reader in some doubt as to the language of the original. The index is sketchy-for in- stance, a rather nice summary on hematologic features of rheumatoid arthritis can be found by leafing through the chapter on extraarticular manifestations but not by looking for anemia, blood (the only entry under B is Behcet’s disease), femtin, hemorrhage, hemoglobin, or iron.

The book is offset without right-justified margins and contains a number of typographical errors (iron stores repeatedly becomes iron stones). This is certainly

BOOK REVIEWS 875

the acceptable result of aiming for low cost and rapid publication.

In conclusion, Rheumatoid Arthritis and Related Conditions, Vol. 3, is a handy, reasonably current sum- mary of available literature. Its value to subscribers to Arthritis and Rheumatism’s Rheumatism Reviews is its coverage of languages other than English.

MICHAEL D. LOCKSHIN, MD Hospital for Special Surgery New York, New York 10021

Connective Tissue Diseases. Graham R. V. Hughes. Sec- ond Edition. Oxford, London, Edinburgh & Melbourne, Blackwell Scient$c Publication, I 9 79. Illustrated. Price: $31.00.

. . .many shall run to and fro, and knowledge shall be increased.

Daniel, XII, 4 Many have run to and fro in the past 30 years,

and as a result our knowledge of the connective tissue diseases has increased substantially. Intrepid, therefore, is the author who would seek to review this broad sub- ject singlehandedly. Dr. Hughes makes a brave attempt and if the several sections which I read are representa- tive, he has done a remarkably good job. However, in

view of the rapidity of developments in our understand- ing of these fascinating disorders, it is not surprising to find occasional points of argument. Thus, this reviewer cannot endorse the statement (p 152), “visceral in- volvement (other than oesophageal) is absent or mini- mal” in patients with CRST syndrome. Prolonged ob- servation of individuals with this form of progressive systemic sclerosis (PSS) confirms that their survivorship is indeed substantially longer than that of patients with diffuse scleroderma but reveals that many eventually develop distinctive and fateful internal manifestations, including severe pulmonary arterial hypertension and biliary cirrhosis, as well as serious disease of the small intestine.

Nor can he agree with the comment (p 153) that the speckled pattern of nuclear immunofluorescence “may turn out to be more characteristic of mixed con- nective tissue disease [than of progressive systemic scle- rosis].” The identification of anti-Scl 70 and anti-cen- tromere antibody in PSS, both yielding a speckled pattern on ANA testing, lays this notion to rest. There is a useful appendix on immunologic (actually serologic) tests, which does not, however, include the use of Cri- thidia luciliae. Finally, the several sections on manage- ment are generally nourishing and up to date (circa early 1979).

GERALD P. RODNAN, MD University of Pittsburgh Pittsburgh, Pennsylvania 15261

Errata

In the Special Article entitled “Preliminary Criteria for the Classification of Systemic Sclerosis (Scleroderma)” by Alfonse T. Masi for the Subcommittee for Scleroderma Criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee, 2358 1-590, 1980, the fol- lowing corrections on page 585 Table 6 should be noted:

The entries in parentheses for “Bilateral hand edema” should be 143 for SLE patients (in- stead of 243) and 112 for Raynaud’s patients (instead of 143).