718 BOOK REVIEWS Mayo Clin Proc, October 1985, Vol 60

ning, whereas magnetic resonance imaging is discussed somewhat more completely. Likewise, very little mate­rial is presented on allografts of whole or partial joints, a currently noteworthy topic.

Although this book is expensive, it is obviously a comprehensive and detailed reference source, as Dr. Morrey proposed. This volume is the best available book on the elbow; it is a standard with which other orthopedic texts on single joints wi l l be compared. All orthopedic surgeons who are interested in elbow problems should purchase this book.

Donald C. Ferlic, M.D. Denver, Colorado

Thirty-Five Years in the Tower, by Solomon Papper, 155 pp, $19.95, Boston, Little, Brown & Company, 1985

Dr. Papper's tower is the ivory tower of academic medi­cine. His book is composed of 13 chapters: "The Cast of Characters"; "The Faculty in Act ion"; "The Students in Action"; "The House Staff in Act ion"; "Administration, Organization, and the Power Structure"; "Administra-tionese"; "Teaching and Learning"; "Research"; "Pa­tient Care"; "Community Health"; "The Town-Gown Phenomenon"; "The Rewards and Liabilit ies"; and "Humane Scholarship and the Future."

Readers should turn to the last chapter first. In this chapter, Dr. Papper suggests three basic steps to achieve the desired goals in medical education: the articulation of a philosophic base, formulation of a plan to translate the basic philosophy into reality, and subsequent execution of the plan. I happened to read this book while I was teaching one of the first-year medical school courses. I was impressed with how accurately Dr. Papper de­scribed the problems of presenting basic concepts while requiring minimal memorization of isolated facts.

Dr. Papper reflects on his past in the following state­ment: " I am one who some years ago moved 'too much.' If I had it to do over, I might do otherwise...." Did Dr. Papper move repeatedly in an impossible quest for the twin grails of humane scholarship and academic excel­lence? I invite everyone with an interest in academic medicine to spend the short time needed to read this book. Then they can decide whether Dr. Papper's goal of humane scholarship is ultimately attainable.

Carl F. Anderson, M.D. Division of Nephrology

and Internal Medicine

Medical Laboratory Haematology, by Roger Hall and Robert G. Malia, 669 pp, with illus, $89.95, Stone-ham, Massachusetts, Butterworth Publishers, 1984

The practice of laboratory hematology differs between North America and the United Kingdom and, indeed, between laboratories in the United States. Thus, each hematologist has a somewhat different perspective about what this field does or does not embrace. Any criticisms that follow must be understood in this context.

The strengths of Medical Laboratory Haematology are the lucid descriptions of the mechanisms of coagulation and hemostasis, the excellent review of the correspond­ing laboratory techniques, and the superb illustrations that accompany this material. At least 200 pages are devoted to coagulation and hemostasis. The sections on principles of blood cell measurements and automated instruments for this purpose are also outstanding. Throughout the book, illustrations are of excellent quality and well chosen. The attractive oilcloth binding makes this volume practical for use on the laboratory bench. Because of these features, most hematology services wil l find this volume a valuable resource to have readily available within the laboratory, where it wi l l be consult­ed both by laboratory physicians and by technologists.

This well-deserved praise notwithstanding, the book has some deficiencies. Malignant lymphomas are as­signed a single sentence. Despite inclusion of almost 50 illustrations of blood films or bone marrow specimens and considerable discussion of leukemias, one looks in vain for an illustration of the blood picture of chronic lymphocytic or chronic granulocytic leukemia or of any kind of "blast." Inasmuch as malaria is now becoming more widespread around the world, inclusion of only two illustrations of malarial parasites is surprising. The immunoglobulins are concisely discussed in two pages, myeloma is reviewed in three pages, and the heavy-chain diseases are assigned three sentences, but amyloid and amyloidosis are not in the index, nor are they found in the text. Thus, coverage of this important area of hematology is insufficient. Moreover, no material is presented on the principles of blood banking, immunogenetics, or blood transfusion.

The authors erroneously attribute the original descrip­tion of hereditary sideroblastic anemia, being apparently unaware that, in 1945, Thomas Cooley described this X-chromosome-linked disorder in males of five genera­tions of a large kindred in Michigan. The authors' de­scription of the effects of hemoglobin E is mostly erro­neous. The phenotypes associated with hemglobin E are all thalassemic; none is hemolytic. Perhaps the authors have not encountered hemoglobin E, because it is quite