BOOK REVIEWS

Acute Grief and the Funeral by V R. Pine, A H. e l very particular interest are the chapters on Kutsche~, D. PeretZr I~. C Slater, R. De Bellis, R. J. Valk, D, J, Cherico 1976. Springfield, Ilk inois, Charles C. Thomas $16.50.

This volume has seven editor~ and one assist- ant editor. In addition, lhey utilise the services of 47 contributors to produce an informative and practical account of the effects of bereavement. It is divi~ed into three parts, the title of the book being the btle of Part One, the tit{e of Part Two, The Funeral and Those who Sewe, and Part Three is The F~neral and ThOse who Survive. Needles9 to say, with, so many contribul~rs, there is some uneveness and considerable overlap

The volume aims at describing the psychologi- cal and social impact of bereavement during the immediate period after the death of a significant loved individual The list ol contributors includes physicians who care for the terminally ill, psy- chologists, ministers of religion, sociologists, nurses, geriatrieians and philosophers; and a number of funeral parlour directors al~o contri- bute chapters.

The value of the funeral in contemporary society as a form for the therapeutic expression of grief is well documented It is pointed out that wakes, funerals and burials are more clearly for the living than Ior the dead. They allow expressions of sorrow ahd provide something for mourner~ to do that is helpful and a welcome relief from ~erely standing by helpless. It is ~uggested that the funeral serviee is psychologic- ally necessary in order t~ give the opportunity for "grief work". It is stated that the bereaved must be given the capacity to work through his grief if he is to come out of the situation emotional]y sound, and those who serve the grieving are left with comforting memories, During the period of acute grief Lindemann in 1944 pointed te five oharacteristics: 1, The somatic distress i.e. the acute physical symptoma, 2. The pre-occupation with the linage of the d~ceased, 3. Guilt. 4 Hob- tile reaction. 5. A less of pafterns of conduct with aimiessnee~ and restlessness. The funeral makes things easier during t he~ periods. It provides social support and a togetherness for the few days Iol]ow~ng the death Later in the book, the detdmental effect~ of grief for older people is very ~ell documented, The death rate among men ~ithin six months of becoming wid- owers i~ 40 per cent higher than the expected death rate for married men of the same age. It is felt that older people may experience a "ber- eavemeni overload" because of cumulative [os- ~es. These losses continue ta increase while compen~ating or coping mechanisms for dealing with them continues to decrease

explaining death to children, the meaning ol death to a child. The tendency for adults to take children away and avoid their exposure to the grimness, sadness and fear of death is regretted. This forces the child to cope alone. The fantasies a young child experiences when faced with a grieving but uncommunicative family are usually more terrifying than the saddest reality. Ironically, it is pointed out the death of a roved one pro- duces the temporary loss of many of the child's most important and caring members. The adults are mourning the lOSS of cue person with the support of family ~nd friendo, the young child grieves Ibe Ices ol all his f~mily without any sup- pof t Keeping the young child within the suppor- tive, shadng, acknowledging framework of the family, and encouraging him to know the feel, allows him to grow and cope, even as it alloWS bereaved adults, an active t~sk at the time when helplessness is most ove~helming,

This book can be recommended and indeed should be lequired reading for all those whose work brings them into contact with bereavement. It will be Of interest to all medical, and nursing personnel, to clergymen and to members of other disciplines interested in bere&vemenb

THOMAS LYNCH.

The Year Book of Surgery, 1976. Ed by S I Schwartz and others. London. Lloyd-Luke (Medical Books). s

Thi~ book is designed to give us 8 birds-eye view of surgical progres~ in 1976. Seymour I, Schwartz as Editor has as Associate Editors John S. Nai- arian, Erie E. PeaeOCkr Tom Shires, William Silen and Frank C. Spencer. From a team of this calibre a real heavy weight performance is to be expected and this is fully realised on reading ~his book An enormous amount of inforrnQtien is packed into its 494 pages and excellent value is given for the price of s

The Year Book ot Surgery 1978 is worthy of a pla~e in every hospital library and is clearly a mu~t for all teachers and research workers. It is not a book ~or the FelLowship candidate being far too advanced and detailed which on the other hand is the source of its value to the established surgeon.

The reader is first presented with a terse and succinct Annual Overview which surnmari~es re- cent l iteratu~ dealing with fluid~, electrolytes and nutritiom shock, trauma, wound healing, in- fections burns, transplants, ontology, tumour immunology, hand, breast, head and neck, thor- acic and heart surgery, vascular surgery, and the

182 IRISH JOURNAL OF MEDICAL SCIENCE

surgery of gastro-mtesbnM and billowy tracts. "rhecne'$ Bai ter Medical Writing, 2rid Ed. by Step- These subieots are al l deal t wdh in subsequent ben Lock 1977 Tunbr idge Wells, Pdman Medi- sections in great detai l .

Highl ights from the chapler "General Consid orat ions ' include a we l l t imed warning on the starch granulema syndrome and the transcer- v i t a l approach to the thymus in myasthen]a gravis and th]s of course is of great interest to the parathyroid surgeon as well .

In the chapter on oncology an account of the use of streptozotocin is given in cancer chemo- therapy and it is suggested that patients w i th mal ignant caro]noid may benefit from this drug.

In the section on non-cardlac thoracic disease there is a short and somewhat provocat ive s e ~ t i e r on operagve slabil iza~ion of non-penet lat ing chest injudes. Moore and GrilPo fa l lowed in 112 patients "an aggressive pol icy to correct or prevent major paradoxical chest wa l l movement by intramedul lary pinning of ribs, costal cartil- ages and sternum, Whenever possible posi t ive pressure mechanical venblat ion and trachecs- tomy were avoided". Food for controversy here...

Congenital, va lvu lar and coronary cardiac dis- ease have excellent chapters devoted to them as have the arteries and veins,

The gastro-intestina] section f c l l ~ s w i th the highl ight here, in my view, being pre-operative irradiation for colon.rectal cancer and the chemo- therapy of this disease. T i le book concludes w i th va luable sections on the b~liary tract and endo- crine surgery.

At var ious stages in the book the appropriate edi tor gives Ms personal v iew on the recent l i terature and these ' f oo t notes" are most wel- come and valuable, The industry and zeal of the team that produced this Year Book d e s e x e s a very high rating. Only tr ivial crit icisms are justE- fled. One of these is the lack of reference to the role of prevention in surgical disease. One looks forward t o a summary of our knowledge of prevention in surgical coedit iens in the '77 Year Book,

PATRICK B, HIELY.

Clays Handbook of Envi ronmental Health by F. G. Davies and W. H. Basse t t 14th Edition. 1977. Lon-

don, H. K. Lewis and CO. Ltd s

A book that is in its fourteenth edit ion does not need an introduction and the numerous edi t ions indicate the demand for a book of this kind. There are s ix main parts in the book deal ing w i th Administration; Construct ion Technology; Housing and Urban Development; Health and Safety; Pol- lution Control; and F ~ d Safety ~lnd Hygiene. The book relates to legislat ion in England and Wales but despite this there is mush, apart from the legislation, which is re levant

In the field of envi ronmental heal th this book is a necessary tex t and an essentlai re|e[ence.

GEOFFREY J BOURKE.

col Publishing Co. Ltd s

The second edit ion of this del ightful book is by Stephen Lock alone : his originaJ co-author, Tony Sm i th was unable to col laborate this t ime. al- though he is thanked in the Preface for h is help. Those who have at tended the courses on medical wri t ing and speaking run by the B.M,A at var ious centres wilJ have a good idea of the general lenor of {he work. It g ives comprehensive guid- ance to the would-be author, from "when to s t a r t " how to wr i te (and not to wr i te) , whore to send the paper, a~d it discusses style in some detai l .

There is exce l lent advice on hew to present an article, what to de if its is reiected and the author goes on Io give useful ideas for the more exper- ienced w r i l e r Or. Lock puts his own advice ~nlo practice and the entire book is wr i t ten in lucid, stmp]e EngJish which, however, is else humorous wi thout being fl ippant. He could be read wi th profit by t h o s ~ a l a s , so many, who confuse pthy- syl labic dul lness with erudit ion.

This is a valuable book to read and ponder upon, it wou ld make an exeeffenl present for any young doctor and, if bought for the Depart- mental l ibrary might be studied by ~enior staff members t o o The printing and product ion are Erst-rate.

ROBERT P. TOWERS.

Sodium Melabol lsm in Disease by J. D Swa les 19T5 London Lloyd-Luke (Medical Books) L i d s

Professor Swale& of Leicester University, has set out to deal wi th the abnormali t ies of sodium metabol ism which occur in cl inical medicine. The result it a wel l -presented review of 32O pages (about one-third being references).

He begins wi th a most interesting history of the evolut ion of knowledge concerning sodium metabol ism and its effects on the b o d y Current concepts of sodium physiology are covered briefly, though we l l Much physiological referenc* thg a lso occurs throughout the remainder of the book, which deals wi th disease processes,

It is diff icult 1o provide a comprehensive review in the s p ~ e al lot ted for the who le complex field of knowledge on sodium homeostasis. T o o smal l to be a reference work for the academic cl inioial investigator, it is nevertheless probably more extensive than the general phzsioian needs. But for the interested metabol ic physician, nephrol- ogist, or endocrinologist, it provides a most use- ful synopsls Obviously. it is permeated by Prof. Swales' personal bias, but is wel l -documented, and gives ample references to major review a icles from the l i terature where the academic can pin down the finer poinls which Prof. Swales, by providing an ove~ iew, has had to omit,

DAVID POWELL

BOOK REVIEWS 183

Eugene Wolf;'s Anatomy of the Eye and Orbit. 7th Postgraduate Medicine. 3rd Ed by I. d. T Davies Ed. Revised by Roger Warwick 1976. London H. K. Lewis. s

The sevenm edition of this standard reference work fot[0ws the plan of its successful predeces- sors. The new edition contains virtually the same number of pages and figures as the sixth edition, and the text of sev~ out of the 11 chapters which it contains remains virlually unaltered. Nevertheless, there have been a considerable number of Changes. Current anatomical he len clature is used, footnotes have been eliminated and a single bibliography has replaced the bib- liogrephies which appeared at the end of each chapter The work continues to be lavishly and beautdully ~llgstrated, and a number of figures have bee~ replaced by clearer g[ustrations. This ]s particularly ~pparent in 1he ca~ of the elec- tron m[crogtaphs, where the improved quality lends tesllmeny to recenl advances in this tech- nique.

Recent ultrastmctural research ha~ shed new light on the structure o~ the retina and the other layers of the eyeball, and reference to this work has been included, Nevertheless, as Professor W a ~ i c k admits, the functional significance of these details is still largely obscure The chap- ters on the v~sual pathway and the orbital ne~es have also been revised in the liohl of current research However, discussion of 1he functional aspects o~ t hee topica is limited and must re- main so without reference to the electrophysio- logical research which is beyond the scope of the present work. Recourse to mere speciabsed monogranhs and research papers will, therefore, be necessary to obtain a clear understanding of the functional anatomy and histology of the eye.

WoI'~Fs Anatomy of the Eye and Orbit deserves a pla~e in the library of every practising ophthal- mi~ surgeon. The text will undoubtedly remain as a standard "general" reference to the topo- graphical anatomy of the region, but it is doubt- fur if a new edltlon was necessary to achieve this ob i~ t i~e .

GONAL HOOPER.

A~ IntmduCto~] Textbook of Medlc~e by J. J Connon 1977. London Lloyd-Luke s

This paperback sets out to provide "an overa[I picture of the interplay of diseases on the various body systems". It is aimed to help medical students eady ~n their clinical career, nurses, physiotherapists and radiographers. It ]s written in a clear straightfo~ard style, The content of the cha~ters is simply presented and eas[{y grasped. Having said th~s, it is difficuff to see how the book can be recommended ta medical students. It is less comprehensive fhau s~mil~r texts and the need for a more simply presented overview of medicine Ls questionable.

M J WHELTON.

1977 London. Lloyd-Luke Eg.OO

The reviewer has the unusual advantage of having reviewed the first edition of this book some years ago A future was predicted if the pretentious title w~ not taken too literally and {ts presentati(>n was tightened up. Both have been achieved and the book is widely read by candldat~ Ior the MRCP. diploma, The book is really a comprehensive grind for membership It presents facts crisply and concisely. The ap- proach to cataloguing disease is pragmatic. There is no attempt to expand oh any of the areas of controversy in medicine. The diagrams are gen- erally excellent and the lists, dear to candidates in any examination, comprehensive The present edigon has b6en updated satis{actorily although it must be said that there are few references 1o literature later than 1970. The book can be recommended to those studying for the M,R.C.P, provided due allowance is made for its black and white approach.

M. J, WHELTON

Hyperten~on and StrOke in the Community. Geneva W~rld Health Organisafion 1976 362 pages Available (rum Stationery Office, Dublin. $12.00.

This repclt of the Proceedings of the WHO Meeting herd in Tokyo in 1974 provides a com- prehensive review of the epidemiology, natural history and proposals for control of hypertension and ~troke at the community level, As ~h mcs~ countries in the world the vast twin public health problems of hypertension and stroke can be appre~ialed in Ireland, where the Heart Founda- tion can report an inmdence of 15 per cent Of mild hyperlens~on and an incidence of 5 p~r cent of moderate to severe hypertension in the "nor- mat ' mare population. Onty a small minority ot these cases were identified and adequately treated before the Heart Foundation sor~ning procedure. This substantial pool of hyperienslve patients is arl important factor in the high fre- quency of stroke in our population,

The te• is d~vided into five main sectioqs. The epidemiology of hypertension and s~roke in lhe five con~nent~; possible approach tc community control; the pathology and natural history of mild hypertension and transient ischaemic attacks; guidelines for world action and, fina]ly, recom- mendations to be followed within present con- straints of knowledge and facilities.

Thi~ WHO publication should be circulated to politicians and public health administrators as well as to community physicians, cardiologists and physiclans involved ~n preventive medicine. It is an important contdbufion 1o the increasing assault on hypertension and w~U be of particular assislance to those who see the need to face the problem at the widest community level. This

184 IRISH JOURNAL OF

monograph is a further step in preparation for Hypertension Month which the International Soc- iety of Cardiology, in a~oc ia t i on wi th WHO, pro- poses to organise in 1978.

The epidemielogical approach to hypertension and stroke is gathering strength thanks to the international cooperat ion of WHO, the Internat- ional Society for Cardiology, many national heart foundat ions and ether organisations. The re- v iewer envisages an e~rly and perhaps dramat ic fal l in the incidence o1 hypertension and stroke in our country, a further i l lustratiQn of the value of investing our limitecl resources in the preven- t ion of disease

R. MU LCAHY.

Year Book of Ophthalmology, 1976. Ed. Wm. F. Hughes. London. Distr ibuted by Lloyd-Luke. s

The 1976 edit ion of the Year BOok of Ophthal- mology covers oDhthalmio l i terature reviewed up to January 1976 and maintains the high standard associated wi th the se r ies The ski l led condens- at ion of a large number af art icles provides a valuable service for the practi t ioner too busy for systematic reading of al l the j ou rna ls Through the medium of this not=large vo lume he can both st imulate memory as te known developments and broaden the spectrum of his topical awareness. An attractive feature is the Editorial comment, chatty rather than formal, which in i ls candour often manages to give tongue to the readeKs unvoiced thoughts.

The present vo lume te l l s of many ahempts to extend the frontiers of ophthalmology, some cour- ageous r some ingen~ous, some unsuccessful, but all laudable. The p lums to be plucked out of such ~ pie are innumerable. Side by side wi th detai ls of the Rum T Semi41exible Contact Lens. wh ich may avert the need lor operat ion in kera- toconus, one may learn how cryotherapy is fav- oured as t reatment of choice in roden~ ulcers by at feast one front line ophthalmic-plast ic surgeon. He rnaintalns that wh i le it is not less eff icient

MEDICAL SCIENCE

than radiolherapy it is also conslderaply cheaper, wi th fewer complicat ions. The vogue for intra= ocutar lenses in the U.S.A. is reflected in the information 1hat they are there classif ied as new drugs, w~th l imitat ions on doctors as to using them. Another deve lopment er lg]nat ing in Amer- ica is a possible new roJe for cannabis which is being evaluated as an anti-glaucoma agent and whose derivat ives show marked promise in this fieLd,

The quotabil i ty of Ihese spectacular examples must net mask the sol id excel lence of the book. There is a chapter for each depar tment of oph- tha lmology and if one especial ly praises tha t on the retina, th is may xebect a personal r e~ l l ec t i on that the important paper of Lincofl and Kreissig on non-rhegmatogenous detachments, therein abstracted, was del ivered in Dublin in 1975. A review deal ing with opt ical lenses and the oph- tha lmolog is t would also repay the at tent ion ef those interested, The price ul this book is an alarming sign of the t imes, but the discerning buyer is not l ikely to regret his inves tment

G, P CROOKES.

A Synopsis of Fevers and their Treatment, 12th E d By J. H. L a w s o n l g 7 7 London. Lloyd- Luke. s

This is the l~ th edit ion of a just i f iably pop•lar book. New chapters inc lude an excel lent one on lept0spiresls and a t imely one on rabies. The section on bacterial shock has been rewritten in good effect and indeed, is a model of charity. References in al l chapters are key ones and re- markably up to d a l e Viral hepat i t is is web described and the author has captured the essence of recent advances in this field. Not al l would agree however that surgery is highly dan- gerous in pat ients w i th cholestatic hepatit is. Over ad the book cannot be fau l t ed I1 remains in a class of its own, l ight years ahaad of any of its competi tors. This edit ion not only maintains but enhances its reputation.

M. d. W H E L T O N